Intervertebral Disc instructions
Age: The same age as other people, aging earlier than the face
Place of residence: Between two vertebral bodies of the spine
Near neighbor: Spinal nerve
Functions: Absorb the impact of the vertebral body and assist the movement of the spine
Appearance: it is like a nearly round sandwich cake, with a long diameter of 3~5cm and a thickness of 1~2cm. The cervical disc is a little thinner, the thoracic disc is a little larger, and the lumbar disc is the largest and thick
Main components: outer fibrous ring and central jelly – like nucleus
Autopathological changes: partial fiber fracture, nucleus pulposus enters the fissure of annulus of fiber or protrude its outside
Easy to cause problems: Irritation or compression of nearby spinal nerves, leading to “disc herniation”
What is lumbar disc herniation?
Is one of the orthopedic common disease, lumbar disc prolapse is mainly due to lumbar parts (nucleus pulposus, fiber ring and the cartilage), especially the nucleus pulposus, there are different degrees of degenerative changes, intervertebral disc bulgin, from the rupture of the nucleus pulposus (or emergence) in the rear or spinal canal, lead to the adjacent tissue such as spinal nerve root, spinal cord, horsetail chemical stimuli or physical oppression, and show the waist pain and a series of clinical symptoms.
What symptom does lumbar intervertebral disc protrusion have?
(1) Low back pain. Most patients with lumbar disc herniation have a history of low back pain for weeks or months, or have recurrent episodes of low back pain.
(2) Radiation pain in lower extremities (leg pain). Radiating from the lower back or hip to the lower leg or heel, commonly known as sciatica.
(3) Intermittent claudication. That is, after walking for a distance, lower limb pain, weakness, bending or squatting rest symptoms can be relieved, and then walking symptoms appear again.
(4) Feeling numb. Some patients often appear limb numbness, is also caused by nerve compression.
(5) Severe lower limb muscle atrophy, paralysis, incontinence of defecation and urination.
Why can you get lumbar intervertebral disc herniation?
Degeneration of lumbar intervertebral disc is the root cause of lumbar intervertebral disc herniation.
Long-term repetitive strain injury, such as sitting for a long time, fixing a position, bending over to carry a load, etc.
Most patients with intervertebral disc herniation in adolescents have a history of trauma.
Congenital abnormalities of the lumbosacral vertebra (lumbar facet deformity and facet asymmetry).
Genetic factors (family history of lumbago).
Conservative treatment for lumbar disc herniation
It has been reported in relevant literature that conservative treatment is effective in 80-90% of patients with lumbar disc herniation. All but one patients with lumbar disc herniation are eligible for and require conservative treatment. In this particular case, a large herniated disc is pressing on the cauda equina nerve, causing bowel and urine dysfunction, and we recommend surgery within 24 hours if possible. In addition, all patients with lumbar disc herniation undergo regular conservative treatment after onset.
- Stay in bed
Bed rest has long been considered one of the most important conservative treatments for lumbar disc herniation, especially during acute pain, which is aimed at reducing the vertical pressure of the disc.
However, long-term bed rest will lead to atrophy of the lower back muscle, so for patients with severe pain and need bed rest, bed time should be shortened as far as possible, and they should be encouraged to return to moderate normal activities as soon as possible after the remission of symptoms. About the lumbago patient’s correct sleeping position, can stamp text to understand → lumbar disc herniation, correct sleeping position + sleeping leg pad 1 thing, disease can be half!
Neurotrophin: Vitamin B12, that is, you can see in the drugstore Micaobao, mecobalamine and other drugs. It can not only nourish nerves, but also reduce abnormal discharge of damaged nerves, which indirectly relieves pain.
Anti-inflammatory painkillers: non-steroidal anti-inflammatory painkillers, such as Celebrex, Lesong tablets and other drugs. The pain symptoms caused by the lumbar process are closely related to the inflammatory response of nerves. The application of such drugs can not only relieve pain, but also control the sterile inflammation around the nerves. But these drugs generally irritate the stomach, so patients with stomach problems should be careful to use them as advised by their doctors. This medicine, neck, shoulder, waist and leg pain is the most commonly used, but the most misunderstood
Activating blood circulation and removing blood stasis: There are many proprietary Chinese medicines (Chinese herbal medicine products) on the market, which can be used as appropriate to improve nerve and local tissue blood supply and eliminate local inflammation.
Others: For patients with severe pain but less nerve damage, intravenous dehydrating drugs and hormone therapy for 3-5 days, such as 20% mannitol and dexamethasone, can relieve the inflammatory edema of nerve roots and eliminate pain; Antidepressants are effective in treating chronic low back pain and sciatica.
Exercise the back muscles
The main cause of lumbar disc herniation is lumbar back muscle relaxation, leading to the loss of stable spine support, lumbar instability, thus accelerating the degeneration of lumbar and lumbar intervertebral disc. So, strengthen lumbar back muscle strength to appear particularly important. For details, please poke → lumbago exercise exercise, insist to do, away from low back pain!
- Epidural injection
Epidural steroid injections may be used in the diagnosis and treatment of lumbar disc herniation. For patients with lumbar disc herniation with obvious root symptoms, short-term symptoms can be improved, but the long-term effect is not significant.
Lumbar traction is the traditional method for the treatment of lumbar disc herniation, but the current value of traction in the relief of low back pain and sciatica is not supported by high-quality evidence-based medicine. Traction therapy should be conducted under the guidance of a professional rehabilitation physician to avoid heavy weight traction for a long time.
- Manipulation therapy
Manipulation therapy can improve lower back pain and functional status. For patients with mild to moderate lumbosacral neuralgia without surgical indications, the root symptoms caused by lumbar disc herniation can be improved, but it should be noted that manipulation treatment may aggravate the risk of lumbar disc herniation.
Hot compress, acupuncture and moxibustion, massage and Traditional Chinese medicine have certain effects on relieving the symptoms of lumbar disc herniation, but the follow-up time of relevant literature is short, and the experimental design is limited.
Lumbar intervertebral disc protrusion is the operation treated?
For patients with lumbago, we are against both blind surgery and blind conservative treatment. Every patient who is treated conservatively should know the indications of surgery, so as to avoid the serious consequences caused by blind conservative treatment on the one hand, and the excessive treatment caused by ignorance on the other hand.
Surgical indications include: 1. The history of lumbar disc herniation is over 6~12 weeks, and the systematic conservative treatment is ineffective; 2. Or symptoms worsened or recurred during conservative treatment;
2, lumbar disc herniation pain is severe, or the patient is in forced position, affecting work or life;
- Lumbar disc herniation shows single nerve palsy or cauda equina nerve palsy, manifested as muscle paralysis or rectal and bladder symptoms.
Surgical treatment generally improves symptoms faster and to a greater extent than non-surgical treatment. Surgical treatment is safe and the incidence of complications is low. Surgical procedures for lumbar disc herniation include open surgery, minimally invasive surgery, lumbar fusion, and lumbar artificial disc replacement. The spine surgeon will give you a suitable surgical plan based on your condition.
When diagnosed as lumbar disc herniation and do not need surgical treatment, the first thing we should do is to change the bad habit of hurting our lumbar spine, so as to make the treatment twice the result with half the effort, otherwise, good treatment, do not pay attention to these details, will still cause the recurrence of the lumbar process.
What specific bad habits hurt the waist, we have done in detail in the previous article, here is no longer redundant to elaborate, please stamp text to understand → lumbar disc herniation friends, these bad habits must be changed!