Is lumbar disc herniation difficult to treat?

Written by Li Jin
Orthopedics
Updated on February 06, 2025
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Patients with lumbar disc herniation, after standard and regulated treatment, can mostly effectively alleviate symptoms, and even achieve clinical recovery. The treatment for lumbar disc herniation mainly includes non-surgical treatment and surgical treatment. The specific method of treatment to be used should be comprehensively considered based on symptoms, physical examination, imaging studies, and other factors. For non-surgical treatment of lumbar disc herniation, it is recommended that patients protect their lower back in daily life, develop correct habits of using the lower back, and avoid lifting heavy objects partially and other heavy physical activities involving the lower back. During stable periods of the condition, some exercises to strengthen the lower back and spinal functions can be performed. At the same time, when symptoms occur, anti-inflammatory analgesics, neuro-nutritional drugs, and other medications can be used. Treatments can also be combined with hot compresses, physical therapy, massage, and acupuncture. These conservative treatment methods generally can achieve good results. When conservative treatment is ineffective or functional impairment occurs, surgical treatment can also be considered. (Specific medication use should be guided by a doctor.)

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Written by Su Zhen Bo
Orthopedics
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Can a herniated lumbar disc cause leg pain?

Patients with lumbar disc herniation can experience leg pain, which is a typical clinical manifestation. After the nucleus pulposus protrudes, it can stimulate the dura mater and nerve roots, causing pain in the leg areas innervated by the nerves, or localized skin numbness, and decreased muscle strength in the lower limbs. Some patients may also experience difficulties bending over or walking normally. Additionally, some may have abnormal bowel and bladder function, and exhibit changes in reflexes like hyperactive or absent knee and Achilles reflexes. Diagnostic confirmation can be achieved through electromyography, as well as CT scans and MRI of the lumbar spine. For treatment, patients may be advised to lie flat on a hard bed, use lumbar support, and employ pelvic traction. Additionally, treatments such as massage and manipulation may be recommended.

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Written by Guan Jing Tao
Orthopedics
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Lumbar disc herniation L5-S1 symptoms

You may experience abnormal sensations in the buttocks, lower limbs, and soles of the feet, such as numbness, soreness, and even reduced muscle strength. Additionally, mild to moderate lumbar disc herniation can cause soreness and abnormal sensations in the buttocks, and even abnormal sensations in the perineal region. It is recommended that when symptoms of nerve compression in the lower limbs and buttocks occur, strict bed rest should be enforced, especially on a hard bed, and exposure to cold should be avoided. Consider lumbar traction if appropriate, but if symptoms worsen during traction, it should be stopped immediately. Also, if the disc herniation is localized to a single segment, minimally invasive surgery may be considered.

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Written by Na Hong Wei
Orthopedics
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How to treat a lumbar disc herniation?

Clinically, the treatment of lumbar disc herniation usually involves the following three aspects. The first is conservative treatment, which is mainly for those patients whose lumbar disc herniation is not very severe and does not cause substantial compression of the nerve roots and spinal cord. The first step includes general treatment, that is, after developing a lumbar disc herniation, one needs to lie flat in bed, rest on a hard bed, and then rest. The second is treatment with Chinese herbal medicine, the third with Western medicine, and the fourth is traditional Chinese medicine rehabilitation treatment, which includes traction, massage, acupuncture, and others. There is also physical therapy, which includes treatments like shockwave thermotherapy and microwave therapy. Often, some patients experience symptom relief after conservative treatment. There are also some patients whose symptoms do not improve during treatment, and even worsen, at which point surgical treatment is needed. Surgical treatment has its strict indications. However, once within the range of these indications, surgical treatment should be considered. Surgical treatment now is divided into minimally invasive therapy and conventional surgical treatment. The third is other treatments, which are also numerous, including ozone therapy, sacral canal treatment, intradiscal injections, and so on. Therefore, the treatment of lumbar disc herniation mainly depends on the degree of protrusion and clinical symptoms, which are analyzed comprehensively to select a suitable treatment method.

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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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Contraindications of Lumbar Disc Herniation

Patients with lumbar disc herniation mainly exhibit symptoms such as discomfort in the lower back, numbness in the lower limbs, and pain. These are primarily symptoms of sciatica, such as numbness and pain along the back and outer sides of the thighs, calves, and dorsum of the foot. Patients may find it difficult to put on shoes and socks in the morning, and sometimes they may feel as if their tendons are short when walking. It is generally recommended that patients strictly rest on a hard bed and warm up the lumbar region. They can also take some blood-activating and pain-relieving medications. The main precautions include avoiding bending over to lift heavy objects, carrying heavy items, and bearing heavy loads. Patients should avoid sitting or squatting for long periods and should try to lie flat or walk upright instead. If conservative treatment for lumbar disc herniation is ineffective, interventional surgical treatment may be sought.