What should I do if I have a lumbar disc herniation?

Written by Na Hong Wei
Orthopedics
Updated on September 12, 2024
00:00
00:00

After a lumbar disc herniation, it is essential to first determine the type of herniation you have. Clinically, lumbar disc herniations can be categorized into protrusion, prolapse, extrusion, and sequestration, with protrusion being the most common. Once the type of herniation is identified, treatment can begin. Currently, the treatment methods are diverse and can be broadly classified into six categories. The first is internal treatment with traditional Chinese medicine. Traditional Chinese medicine classifies lumbar disc herniation into four types, each treated with different medications. The second is external treatment with traditional Chinese medicine, such as herbal fumigation and plaster application. The third is traction, which includes bed traction and manual massage. The fourth is acupuncture. The fifth category includes other therapies, starting with resting on a hard board bed for approximately a week, followed by techniques like small needle knife therapy, intradiscal injection, sacral canal injection, and ozone therapy. If conservative treatments prove ineffective, or if symptoms worsen during treatment, surgical intervention may be necessary. Surgical treatment is generally indicated in the following four situations: patients with spinal stenosis, patients who do not respond to conservative treatment or who experience recurrent symptoms after recovery, patients with worsening neurological symptoms, and patients with central lumbar disc herniation causing incontinence. These are the conditions mentioned above.

Other Voices

doctor image
home-news-image
Written by Na Hong Wei
Orthopedics
1min 32sec home-news-image

Is a herniated lumbar disc serious?

Lumbar disc herniation is primarily due to degeneration of the lumbar disc or secondary pathological changes caused by this degeneration, which then stimulate blood vessels, nerve roots, and the spinal cord, leading to a series of clinical symptoms. Lumbar disc herniation is categorized into four types. The mildest type is the bulging type, followed by the protruding type, the more severe extrusion type, and finally the most severe, the sequestration type. Generally, lumbar disc bulging is relatively mild and conservative treatment is usually effective. Depending on the site and degree of compression, lumbar disc herniation may be treated conservatively, but some cases require surgical intervention. Most cases of disc extrusion require surgery because the extrusion leads to spinal stenosis, compressing all or part of the blood vessels, and it can also compress the spine and nerve roots, causing irreversible damage, and medications or massages can't reverse the condition. The fourth point concerns lumbar disc prolapse, meaning the nucleus pulposus falls into the spinal canal through the tear. This is one of the few emergencies seen in spinal surgery. If this occurs, immediate surgical treatment is necessary. Therefore, the severity of lumbar disc herniation mainly depends on the type and degree of the herniation, as well as the location and direction of the herniation, and which treatment method needs to be used.

doctor image
home-news-image
Written by Na Hong Wei
Orthopedics
1min 53sec home-news-image

What are the methods for diagnosing lumbar disc herniation?

The diagnostic methods for lumbar disc herniation are essentially three-dimensional; that is, clinical symptoms plus physical examination combined with auxiliary examinations. First, let's talk about clinical manifestations, which include pain, functional impairment, and local sensory abnormalities in cases of lumbar disc herniation. Second, in the physical examination of lumbar disc herniation, the intervertebral disc often shows some deformation, and the most common is a reduction or disappearance of the lumbar spine's forward physiological curvature, referred to colloquially as "flatback," where the back appears flat like a board. Other findings may include spinal scoliosis and specific tender points, usually located next to the protruding vertebrae. Percussing these tender points may induce radiating pain to the buttocks or lower limbs. Additional examinations might reveal abnormalities in the strength or sensation of lower limb muscles at different stages, as various muscles and sensory areas are affected differently. Special tests such as the straight leg raise test, femoral nerve stretch test, and neck flexion test are generally positive. The most routine auxiliary examination involves taking x-ray images, followed by CT scans, which can directly visualize the location and extent of the disc herniation. Currently, magnetic resonance imaging (MRI) is also used, which has significant advantages. MRI provides three-dimensional images, showing the sagittal, coronal, and axial planes, which helps in better assessing the condition of herniated discs. Therefore, these are the areas covered in diagnosing lumbar disc herniation.

doctor image
home-news-image
Written by Na Hong Wei
Orthopedics
1min 10sec home-news-image

Is moxibustion effective for lumbar disc herniation?

As an important treatment method in traditional Chinese medicine, moxibustion has very good therapeutic effects for treating lumbar disc herniation. As long as the acupuncture points are correctly selected, the treatment effect is very good. Specifically, if you choose to use moxibustion for treatment, the main point would be the Jiaji points, and this should include the two adjacent vertebrae. For example, for a L4-L5 disc herniation, you should select points L1 to L5. Auxiliary points should be chosen based on different symptoms of the patient, in combination with different acupoints. For example, if the waist pain is significant, combine with the affected side's Yaoyan point. If the buttock muscles are tense, combine with Huanjiao and Yibian points. If the posterior thigh muscles are tense, combine with Chengfu, Yinmen, and Weizhong points. If there is numbness on the lateral thigh, combine with Fengshi. For numbness in the calf, combine with Weiyang, Chengshan, Yanglingquan, Zusanli, and Xuanzhong points. If the dorsum of the foot is numb, combine with Taixi, Jiexi, and Xiexi.

doctor image
home-news-image
Written by Na Hong Wei
Orthopedics
55sec home-news-image

Can a herniated lumbar disc be massaged?

Lumbar disc herniation can be treated with massage and is a very important conservative treatment method. The first benefit of this massage is that it can relieve muscle spasms in the lower back. Secondly, through massage, it can dilate blood vessels, increase the speed of blood circulation, and then promote the metabolism of surrounding soft tissues. The treatment techniques primarily include rolling and pushing-grinding methods, supplemented by grasping and grinding methods, avoiding violent pressure. The main acupoints used are the Jiaji points, along with other matching points such as the Yaoyangguan, Mingmen, Shenshu, Huantiao, Yinmen, Chengfu, Weizhong, Chengshan, and Yanglingquan points, mainly selected according to the different conditions of the patients. Many patients experience significant relief in symptoms of lumbar disc herniation after massage therapy.

doctor image
home-news-image
Written by Cheng Bin
Orthopedics
55sec home-news-image

Lumbar disc herniation symptom exercise

There are many exercises for lumbar disc herniation, such as the "little swallow" exercise, practicing lifting the buttocks while lying in bed, performing the bridge pose, supporting your body with three and a half points, and actively engaging in swimming. These exercises can strengthen the patient's lower back muscles, thereby better protecting the lumbar spine and alleviating symptoms of lumbar disc herniation. Additionally, for patients with lumbar disc herniation, besides exercise, it is important to keep warm. Avoid prolonged sitting or standing, avoid excessive bending to pick up heavy objects or lifting heavy weights. It is best to use a lumbar support belt, protect the lumbar spine, sleep on a firm bed. Also, locally apply heat actively, combined with acupuncture, electric heating, cupping, massage, traction, and other physical therapies.