Where to apply moxibustion for lumbar disc herniation

Written by Na Hong Wei
Orthopedics
Updated on August 31, 2024
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After a lumbar disc herniation, if moxibustion treatment is used, there is a concept of main and supplementary acupuncture points. The main point is the Jiaji point at the herniated lumbar disc segment, accompanied by the Jiaji points directly above and below it. For example, for an L4-5 disc herniation, moxibustion would be applied to the Jiaji points of L3-4, L4-5, and L5-S1. Additionally, supplementary points are chosen based on the patient's other symptoms. If there is significant lumbar pain, the Yao Yan (Lumbar Eyes) point on the affected side is used. If there is muscle tension in the buttocks, the Huan Tiao and Yi Bian points are used. If there is tension in the back of the thigh, support would include the Fu Cheng, Yin Men, and Wei Zhong points. If numbness occurs on the outer side of the thigh, the Feng Shi point is used. For numbness in the calf, the Wei Yang, Cheng Shan, Yang Ling Quan, Zu San Li, and Xuan Zhong points are used. For numbness on the dorsum or sole of the foot, the Tai Xi, Jie Xi, and Xia Xi points are included.

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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 Na Hong Wei
Orthopedics
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How to exercise with lumbar disc herniation

How to exercise with lumbar disc herniation. Patients with lumbar disc herniation should pay attention to the following points if they want to exercise. First, ample preparation is necessary; only with sufficient preparatory work before exercising can injury be avoided during the workout. Second, it is advisable to wear a lumbar belt as much as possible. As an important orthopedic support, the lumbar belt helps to brake and protect the waist, and it limits the amount and range of lumbar spine movement to prevent injuries. The third point is that exercises for lumbar disc herniation should primarily focus on strengthening the muscles of the lower back, specifically exercises like the single bridge, double bridge, large and small swallow movements. By strengthening the back muscles, such as the erector spinae and the multifidus muscles, the stability of the lumbar spine can be enhanced, significantly reducing the risk of further aggravation of the lumbar disc herniation.

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Written by Na Hong Wei
Orthopedics
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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 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.

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Written by Na Hong Wei
Orthopedics
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Where to apply moxibustion for lumbar disc herniation

If moxibustion is used to treat a lumbar disc herniation, the main acupoint is the Jiaji acupoint located on both sides of the herniated disc, along with the Jiaji acupoints immediately above and below it. For example, if you have a herniation between the 3rd and 4th lumbar discs, you should moxibust the 2nd, 3rd, and 4th Jiaji acupoints, and so on. In addition to the main acupoint, there are auxiliary acupoints chosen based on the different symptoms of different patients. Generally, if there is significant back pain, the acupoint on the affected side is the Yaoyan. If there is muscle tension and tenderness in the buttocks, match with Huanjiao and Yibian. If there is muscle tension on the back of the thigh, match with Chengfu, Yinmen, and Weizhong. If there is numbness on the outer side of the thigh, match with Fengshi, and for calf numbness, match with Weiyang, Chengshan, and Yanglingquan. If there is numbness on the top of the foot, followed by weakness in the foot or toe region, match with Taixi, Jiexi, and Xiexi.