Is a herniated lumbar disc serious?

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

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Written by Su Zhen Bo
Orthopedics
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Can lumbar disc herniation heal itself?

In clinical practice, patients with lumbar disc herniation often cannot heal on their own. It requires early diagnosis and the correct treatment methods. Patients may lie flat on a hard bed, use lumbar traction, and combine this with heat therapy, physiotherapy, acupuncture, and moxibustion. Regularly using orthopedic herbal fumigation to treat the waist area can unblock the muscle meridians, accelerate metabolism within the muscles, enhance the strength of the waist muscles, stabilize the lumbar spine, and reduce irritation to the dural sac and nerve roots, which can alleviate clinical symptoms. After conservative treatment, if the condition recurs, the next step can involve minimally invasive surgery at the lumbar region, using techniques like discoscopy or foraminoscopy to perform simple nucleotomy. Post-surgery, functional exercises for the waist can be performed.

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Written by Cheng Bin
Orthopedics
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Treatment of Chronic Low Back Pain Due to Lumbar Disc Herniation

For the treatment of chronic lower back pain caused by lumbar disc herniation, the following methods need to be applied: 1. It is necessary to strengthen the patient's lower back muscle strength through exercise, which can better protect the lumbar spine and effectively relieve the patient's lower back pain symptoms. For example, exercises like the "small swallow fly", swimming, and lifting the buttocks while lying on the bed can be performed; 2. Avoid sitting or standing for long periods, avoid bending over to lift heavy objects excessively, and it is best to wear a lumbar support belt to protect the lumbar spine, and sleep on a hard bed; 3. Actively perform local hot compresses, and combine them with therapeutic methods such as acupuncture, electrotherapy, cupping, and massage; 4. Apply topical ointments that activate blood circulation and remove blood stasis, and take oral non-steroidal drugs like pain relievers and drugs that improve blood circulation and remove blood stasis for treatment, which can be very effective.

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Written by Lv Yao
Orthopedics
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Lumbar disc herniation symptom diagram

The herniation of the lumbar disc occurs due to degeneration of the disc, causing the nucleus pulposus to protrude backwards from the ruptured annulus fibrosus, compressing the spinal cord and nerve roots, thus leading to a series of symptoms. There will be pain in the lumbar region, and restricted flexion and extension movements of the waist. Symptoms may include numbness in the lateral calf and dorsum of the foot, weakness in walking, decreased muscle strength in the dorsiflexion of the big toe and ankle. In severe cases, there may be loss of control over urination and defecation. Therefore, when a disc herniation occurs, it is important to diagnose and treat it early to avoid worsening of symptoms.

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Written by Cheng Bin
Orthopedics
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What should be noted about traction for lumbar disc herniation?

The main points are reflected in the following two aspects: First, during traction, it is essential to pay attention to the force and duration of the traction. Second, it is best to undergo traction at the acupuncture and massage department of a formal hospital. Formal hospitals are more professional, have a better grasp of indications, and the effects should be more satisfactory. You must not undergo traction in outside massage parlors. Sometimes, excessive force or prolonged duration can cause lumbar spine injuries in patients. For patients with lumbar disc herniation, besides traction, combining acupuncture, massage, electrical therapy, and cupping can effectively alleviate the clinical symptoms of lumbar disc herniation.

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Written by Guan Yu Hua
Orthopedic Surgery
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How long does conservative treatment for lumbar disc herniation take?

The main issue in lumbar disc herniation is that the nucleus pulposus ruptures through the annulus fibrosus, causing compression of the nerve roots. These nerve roots at lumbar 4 and sacral 3 form the sciatic nerve, leading to numbness and pain on the posterolateral side of the thigh and the dorsum of the foot. This is a distinctive manifestation of lumbar disc herniation, most commonly seen at the L4-5 and L5-S1 intervertebral spaces, accounting for over 95% of cases in outpatient settings. Conservative treatment primarily involves strict bed rest, local application of heat, sleeping on a firm mattress, pre-warming the lower back, and taking medications to promote blood circulation, relieve pain, and nourish nerves. Generally, symptoms will gradually abate and disappear within approximately 10 to 14 days, with noticeable symptom reduction after about 7 days. For cases where conservative treatment is ineffective and symptoms recur, interventional surgery such as ozone nucleolysis can be sought. Ozone therapy can help reduce the pressure on the intervertebral discs, increase their volume, and relieve nerve compression. Surgical trauma is relatively minor, the procedure is currently well-practiced, and the side effects are relatively low. It may be worthwhile to consult a local hospital for more information.