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Lumbar disc herniation
How to diagnose a lumbar disc herniation?
Lumbar disc herniation often occurs due to degeneration of the lumbar spine, where the nucleus of the disc protrudes through the ruptured annulus fibrosus backward, compressing the spinal cord or nerve roots. This results in pain in the lower back, limited mobility of the lumbar region, and symptoms such as numbness, pain, and weakness in the lower limbs. For lumbar disc herniation, it is recommended to visit the orthopedic or spine surgery clinic of a standard hospital. Diagnosis should be confirmed with a physical examination by a doctor, along with imaging tests such as CT or MRI. These tests help determine the presence and extent of the disc herniation, and the affected segments. The treatment approach should be chosen based on the severity of the herniation.
Lumbar disc herniation nursing measures
Herniated lumbar discs require attention to several aspects during treatment, First, it is important to advise patients to sleep on a hard bed as much as possible, avoiding soft beds to facilitate the exercise of the lower back muscles; Second, try to minimize sitting and actions such as bending over and picking things up, as these can reduce the load on the lumbar spine, thus alleviating the condition caused by the disc herniation; Third, appropriate functional exercises can be performed, such as the small bird flying exercise and lower back muscle training; Fourth, in terms of diet, opt for plain and less stimulating foods, avoiding the consumption of high-protein, highly nutritious foods, which can increase body weight and thus increase the load on the waist, aggravating the herniated disc situation.
Can a lumbar disc herniation heal by itself?
Lumbar disc herniation cannot heal on its own. The protrusion of the disc is due to degeneration of the nucleus pulposus, which herniates through a ruptured annulus fibrosus, compressing the nerves behind it and causing symptoms such as pain, numbness, and weakness when walking. In the early stages or upon the first occurrence of lumbar disc herniation, symptoms can be alleviated through conservative treatment, such as strengthening the muscles in the lower back, appropriately applying traction, and wearing a lumbar support to reduce symptoms and prevent the herniated disc from further compressing the nerves. If the herniation is severe and it is not the first occurrence of this condition, surgical treatment is recommended. Therefore, lumbar disc herniation cannot heal on its own.
Is a grade two lumbar disc herniation serious?
Lumbar disc herniation level II is a moderate condition, primarily characterized by self-perceived pain in the lower back and legs, numbness in the skin of the lower limbs, and weakened muscle strength. Clinically, positive findings include tenderness in the lower back, percussion pain, and a positive straight leg raise test. Some may experience weakened dorsiflexor muscles of the big toe. Diagnosis can be confirmed through electromyography, CT scans, and MRI of the lumbar region. Treatment options include conservative care, lying on a hard bed, wearing lumbar support, using pelvic traction, and applying therapies such as lumbar massage, physiotherapy, diathermy, and acupuncture.
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.
What should I do if I have a lumbar disc herniation flare-up?
Once a herniated disc occurs, the first step should be general treatment, which involves rest and lying on a hard bed. A soft pillow should be placed under the waist and a soft pad behind the knee joints to help with triangular support recovery and reduce spinal pressure. Second, treatment with traditional Chinese medicine and herbs can be considered, which includes both oral and topical medications and usually has good effects. Third, traction and massage therapy can be considered. Traction is notably effective during the acute phase of a herniated disc. It mainly helps by reducing the pressure on the intervertebral discs, adjusting the gaps in the intervertebral foramina, and thus alleviating the irritation and compression on the nerve roots. Fourth, acupuncture and massage can also be considered, as acupuncture is particularly effective in alleviating symptoms of a herniated disc. Other treatments include small-needle scalpel therapy, target disc decompression through radiofrequency, disc intra-injections, or epidural block. If these treatments do not show significant results, or if there is no improvement and symptoms of cauda equina syndrome appear, then surgical treatment may be necessary.
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.
What should be noted about traction for lumbar disc herniation?
The main points are reflected in the following two aspects: First, during traction, it is essential to pay attention to the force and duration of the traction. Second, it is best to undergo traction at the acupuncture and massage department of a formal hospital. Formal hospitals are more professional, have a better grasp of indications, and the effects should be more satisfactory. You must not undergo traction in outside massage parlors. Sometimes, excessive force or prolonged duration can cause lumbar spine injuries in patients. For patients with lumbar disc herniation, besides traction, combining acupuncture, massage, electrical therapy, and cupping can effectively alleviate the clinical symptoms of lumbar disc herniation.
Which department should I visit for a lumbar disc herniation?
Lumbar disc herniation can be treated in five different departments. First, since lumbar disc herniation is a spinal surgical disease, the primary choice is to consult the Department of Spinal Surgery. Second, lumbar disc herniation is also a common orthopedic condition, and almost all orthopedic doctors are familiar with this disease, so you can also consult the Department of Orthopedics. Third, current traditional Chinese medicine has very good conservative treatment effects for lumbar disc herniation, so you can also consult the Department of Traditional Chinese Medicine. Fourth, lumbar disc herniation is a long-term chronic disease, and its treatment process often involves rehabilitation, so the Department of Rehabilitation can also be considered. Finally, since the main symptoms of lumbar disc herniation are pain and limited mobility, many hospitals have established pain clinics or even specialized pain departments to address the pain issues associated with lumbar disc herniation. Therefore, you can also consult the Department of Pain Management. Thus, lumbar disc herniation can be treated in these five departments, with Spinal Surgery being the primary choice.
Can lumbar disc herniation heal itself?
In clinical practice, patients with lumbar disc herniation often cannot heal on their own. It requires early diagnosis and the correct treatment methods. Patients may lie flat on a hard bed, use lumbar traction, and combine this with heat therapy, physiotherapy, acupuncture, and moxibustion. Regularly using orthopedic herbal fumigation to treat the waist area can unblock the muscle meridians, accelerate metabolism within the muscles, enhance the strength of the waist muscles, stabilize the lumbar spine, and reduce irritation to the dural sac and nerve roots, which can alleviate clinical symptoms. After conservative treatment, if the condition recurs, the next step can involve minimally invasive surgery at the lumbar region, using techniques like discoscopy or foraminoscopy to perform simple nucleotomy. Post-surgery, functional exercises for the waist can be performed.