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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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 Lv Yao
Orthopedics
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What is lumbar disc herniation?

Lumbar disc herniation is a condition caused by the rupture of the fibrous ring of the intervertebral disc, protrusion of the central nucleus pulposus, which compresses the nerve roots or the spinal cord, resulting in a series of symptoms. For example, it can cause pain in the lower limbs and instability in the lumbar spine, leading to pain in the waist, as well as pain in the waist when walking or standing, and even sensations of numbness and tingling in the lower limbs. In severe cases, it can cause symptoms affecting urination and defecation.

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Written by Guan Yu Hua
Orthopedic Surgery
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How many days to administer fluids after minimally invasive surgery for lumbar disc herniation?

With the development of medical technology, currently for the treatment of lumbar disc herniation, such as when conservative treatment is ineffective—including lying on a hard bed, pre-heating the waist, taking blood-activating and pain-relieving medication, or drugs that nourish the nerves—some interventional surgeries are chosen if these do not provide relief. The main ones commonly used include ozone ablation, collagenase nucleolysis, percutaneous disc removal, and foraminoscopic technology, etc., all of which carry very low risk. The most commonly used is ozone ablation, which involves instant oxidation of the degenerated protruded nucleus pulposus. This destroys the proteoglycans, thereby making the proteoglycans lose their function. The cells produce proteoglycans, reducing the osmotic pressure of the nucleus tissue, which cannot maintain normal moisture, leading to shrinkage and loss of tissue. This increases the space, thereby reducing the symptoms of nerve compression caused by disc herniation. Usually, antibiotics are used post-surgery to prevent infection, generally for about three days. After the medication is completed, considering discharge and returning home for recovery is possible, followed by oral medication. (Please use medications under the guidance of a physician.)

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Written by Guan Jing Tao
Orthopedics
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Can lumbar disc herniation sleep on a latex mattress?

Generally speaking, for lumbar disc herniation, it is recommended to use a firm bed and avoid exposure to cold conditions, which helps alleviate symptoms and prevents further aggravation. Latex mattresses, as advertised and if of good quality, can also be used. Firstly, a quality latex mattress can conform well to the natural physiological curvature of the entire spine. This means that the latex mattress can accommodate the normal curvature of the waist without exacerbating issues, unlike overly soft mattresses which can lead to increased back pain and other symptoms. However, it is still necessary to use qualified products and assess them carefully.

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Written by Na Hong Wei
Orthopedics
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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.