Can a herniated lumbar disc cause leg pain?

Written by Su Zhen Bo
Orthopedics
Updated on October 24, 2024
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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 Na Hong Wei
Orthopedics
1min 53sec home-news-image

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 Guan Yu Hua
Orthopedic Surgery
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Can lumbar disc herniation be treated with an injection block?

Lumbar disc herniation can be treated with an injection, which mainly uses caudal epidural steroid injections. This approach has a certain therapeutic effect but is limited. For example, it may relieve the patient's pain for about a week, after which symptoms may gradually reappear. I believe that this treatment method is more about addressing the symptoms rather than the root cause. For ineffective conservative treatments, such as resting on a hard bed, applying local heat, minimizing prolonged sitting, and lying down as much as possible except for going to the toilet or eating, symptoms will generally gradually alleviate over about 10-14 days. This can be combined with drugs that promote blood circulation and relieve pain, and drugs that nourish the nerves, as well as some diuretic drugs to relieve the pressure on the intervertebral discs. This can alleviate the stimulation of the nerve roots by the nucleus pulposus of the intervertebral discs, affecting nerves from L4 to S3, which may cause numbness and pain in the back of the thighs, the dorsum of the calves, or feet. The symptoms vary depending on the stage of compression but the difference isn't significantly large. For cases where conservative treatment or injections are ineffective, we can consider interventional surgeries like ozone nucleolysis, which are currently performed skillfully with minimal damage and quick recovery. You can consult a 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

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 Cheng Bin
Orthopedics
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Lumbar disc herniation symptom exercise

There are many exercises for lumbar disc herniation, such as the "little swallow" exercise, practicing lifting the buttocks while lying in bed, performing the bridge pose, supporting your body with three and a half points, and actively engaging in swimming. These exercises can strengthen the patient's lower back muscles, thereby better protecting the lumbar spine and alleviating symptoms of lumbar disc herniation. Additionally, for patients with lumbar disc herniation, besides exercise, it is important to keep warm. Avoid prolonged sitting or standing, avoid excessive bending to pick up heavy objects or lifting heavy weights. It is best to use a lumbar support belt, protect the lumbar spine, sleep on a firm bed. Also, locally apply heat actively, combined with acupuncture, electric heating, cupping, massage, traction, and other physical therapies.

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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.