What are the methods for diagnosing lumbar disc herniation?

Written by Na Hong Wei
Orthopedics
Updated on January 06, 2025
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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.

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Written by Lv Yao
Orthopedics
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How to diagnose a lumbar disc herniation?

Lumbar disc herniation often occurs due to degeneration of the lumbar spine, where the nucleus of the disc protrudes through the ruptured annulus fibrosus backward, compressing the spinal cord or nerve roots. This results in pain in the lower back, limited mobility of the lumbar region, and symptoms such as numbness, pain, and weakness in the lower limbs. For lumbar disc herniation, it is recommended to visit the orthopedic or spine surgery clinic of a standard hospital. Diagnosis should be confirmed with a physical examination by a doctor, along with imaging tests such as CT or MRI. These tests help determine the presence and extent of the disc herniation, and the affected segments. The treatment approach should be chosen based on the severity of the herniation.

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Written by Lv Yao
Orthopedics
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Is running good for lumbar disc herniation?

Lumbar disc herniation is due to the degeneration of the lumbar spine. It results in symptoms from the herniation pressing down on the nerve roots, or the spinal cord, through a rupture in the fibrous ring. The disc mainly serves to cushion and absorb shock in the lumbar region. During running, the load on the lumbar spine and the compression are significantly greater compared to normal walking. Running might exacerbate the condition of herniated discs. Therefore, it is not recommended to engage in running, jumping or similar activities if suffering from a disc herniation. Swimming can be a preferable form of exercise that lessens the load on the lumbar spine.

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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 Wang Cheng Lin
Orthopedics
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Non-surgical treatment methods for lumbar disc herniation

Methods for non-surgical treatment of lumbar disc herniation currently include the following in clinical practice: The first is traction therapy, which can relieve pain and numbness in the lower back, though the effectiveness in alleviating numbness may not be very significant; The second is massage, which can also relieve symptoms of pain in the lower back; The third involves the use of topical plasters, such as non-steroidal anti-inflammatory and analgesic plasters, as well as plasters that activate blood circulation and dissipate blood stasis, to relieve localized pain; The fourth can be achieved through electrotherapy or magnetotherapy; The fifth is acupuncture. Currently, the application of acupuncture to relieve symptoms of lumbar disc herniation in clinical practice is quite evident; it has a better effect than traction. Additionally, oral medications that nourish the nerves are required because patients with lumbar disc herniation might have a protruded disc compressing the nerve roots, possibly causing nerve root damage. Therefore, it is also necessary to take certain nerve-nourishing medications orally to alleviate these symptoms.

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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.