How long does conservative treatment for lumbar disc herniation take?

Written by Guan Yu Hua
Orthopedic Surgery
Updated on February 21, 2025
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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?

Where to apply moxibustion for lumbar disc herniation. The main acupoint is the Hua Tuo Jia Ji acupoint at the affected intervertebral disc, along with the adjacent Jia Ji acupoints above and below. Additional acupoints are chosen based on different conditions. If there is significant lower back pain, add the acupoint at the affected side's Yaoyan. If there is muscle tension and tenderness in the buttocks, add Huan Tiao and Yi Bian. If there is tension in the hamstring muscles, add Cheng Fu, Yin Men, and Wei Zhong. If there is numbness on the outer side of the thigh, add Feng Shi; if there is numbness in the lower leg, add Wei Yang, Cheng Shan, Yang Ling Quan, Zu San Li, and Xuan Zhong. If there is numbness in the foot and weakness in dorsiflexion, add Tai Xi, Jie Xi, and Xia Xi.

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Written by Na Hong Wei
Orthopedics
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What are the methods for diagnosing lumbar disc herniation?

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 Na Hong Wei
Orthopedics
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Can a herniated lumbar disc be massaged?

Lumbar disc herniation can be treated with massage and is a very important conservative treatment method. The first benefit of this massage is that it can relieve muscle spasms in the lower back. Secondly, through massage, it can dilate blood vessels, increase the speed of blood circulation, and then promote the metabolism of surrounding soft tissues. The treatment techniques primarily include rolling and pushing-grinding methods, supplemented by grasping and grinding methods, avoiding violent pressure. The main acupoints used are the Jiaji points, along with other matching points such as the Yaoyangguan, Mingmen, Shenshu, Huantiao, Yinmen, Chengfu, Weizhong, Chengshan, and Yanglingquan points, mainly selected according to the different conditions of the patients. Many patients experience significant relief in symptoms of lumbar disc herniation after massage therapy.

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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.

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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.