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 Na Hong Wei
Orthopedics
1min 40sec home-news-image

Lumbar disc herniation has what manifestations?

Lumbar disc herniation has the following clinical manifestations. First, lower back pain accompanied by unilateral radiating pain in the lower limbs. Second, numbness in the localized area. Third, weakness in the toes. Fourth, decreased temperature in the affected limb. Upon examination, the first finding is a reduced natural anterior curve of the lumbar spine, which we refer to as a flat or board-like back. Second, it can also cause the lumbar spine to bend to one side, possibly toward the affected side or the healthy side, depending on the location of the herniation. Third, there is a fixed tender point beside the lumbar spine, which plays an active role in diagnosis and treatment. Fourth, due to pain, there is a limitation in the movement of the lower back; normally, the lumbar spine can flex 45 degrees forward, extend 20 degrees backward, and bend 30 degrees to each side. If these ranges of motion are not achievable, it indicates a significant limitation in lumbar activity. Fifth is the neurological localization examination, which primarily involves different sensory disturbances, motor disturbances, or muscle atrophy depending on the site of compression. There are also some special tests, like the straight leg raise test, reinforcement test, healthy side leg raise test, as well as the neck flexion test and femoral nerve stretch test. Lastly, additional diagnostic tests like CT or MRI can provide specific information on the location and stage of the lumbar disc herniation.

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Written by Na Hong Wei
Orthopedics
1min 15sec home-news-image

What should I do if I have a lumbar disc herniation flare-up?

Once a herniated disc occurs, the first step should be general treatment, which involves rest and lying on a hard bed. A soft pillow should be placed under the waist and a soft pad behind the knee joints to help with triangular support recovery and reduce spinal pressure. Second, treatment with traditional Chinese medicine and herbs can be considered, which includes both oral and topical medications and usually has good effects. Third, traction and massage therapy can be considered. Traction is notably effective during the acute phase of a herniated disc. It mainly helps by reducing the pressure on the intervertebral discs, adjusting the gaps in the intervertebral foramina, and thus alleviating the irritation and compression on the nerve roots. Fourth, acupuncture and massage can also be considered, as acupuncture is particularly effective in alleviating symptoms of a herniated disc. Other treatments include small-needle scalpel therapy, target disc decompression through radiofrequency, disc intra-injections, or epidural block. If these treatments do not show significant results, or if there is no improvement and symptoms of cauda equina syndrome appear, then surgical treatment may be necessary.

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Written by Na Hong Wei
Orthopedics
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Which department should I visit for a lumbar disc herniation?

Lumbar disc herniation can be treated in five different departments. First, since lumbar disc herniation is a spinal surgical disease, the primary choice is to consult the Department of Spinal Surgery. Second, lumbar disc herniation is also a common orthopedic condition, and almost all orthopedic doctors are familiar with this disease, so you can also consult the Department of Orthopedics. Third, current traditional Chinese medicine has very good conservative treatment effects for lumbar disc herniation, so you can also consult the Department of Traditional Chinese Medicine. Fourth, lumbar disc herniation is a long-term chronic disease, and its treatment process often involves rehabilitation, so the Department of Rehabilitation can also be considered. Finally, since the main symptoms of lumbar disc herniation are pain and limited mobility, many hospitals have established pain clinics or even specialized pain departments to address the pain issues associated with lumbar disc herniation. Therefore, you can also consult the Department of Pain Management. Thus, lumbar disc herniation can be treated in these five departments, with Spinal Surgery being the primary choice.

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Written by Wang Cheng Lin
Orthopedics
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How is a herniated lumbar disc treated?

The treatment methods for lumbar disc herniation currently fall into two categories in clinical practice. The first is conservative treatment, which primarily involves methods like massage, acupuncture, electrotherapy, magnetic therapy, and traction to alleviate symptoms of pain and restricted movement in the lower back. If conservative treatment proves ineffective and the patient's condition worsens, accompanied by radiating pain and numbness in both legs, it indicates that the herniated disc has severely compressed the nerve roots. At this point, the effectiveness of conservative treatment becomes very poor, and the only option may be to undergo surgical treatment. The primary goal of surgery is to remove the herniated disc, and if the patient has spinal instability, it also involves the use of screws and plates to restore spinal stability.

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Written by Cheng Bin
Orthopedics
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Can a second surgery be performed for lumbar disc herniation?

Firstly, it should be clarified that for patients with lumbar disc herniation, if the condition recurs after surgery, a second operation is completely feasible. This is because there are many intervertebral discs involved, including L3-L4, L4-L5, and L5-S1, all of which can lead to lumbar disc herniation and subsequently cause symptoms of back and leg pain. Even if the patient has already undergone surgery for L4-L5, it cannot be guaranteed that L3-L4 or L5-S1 will not develop disc herniation. Therefore, it is possible for patients with lumbar disc herniation to undergo a second surgical treatment.