Lumbar disc herniation


Lumbar disc herniation symptom diagram
The herniation of the lumbar disc occurs due to degeneration of the disc, causing the nucleus pulposus to protrude backwards from the ruptured annulus fibrosus, compressing the spinal cord and nerve roots, thus leading to a series of symptoms. There will be pain in the lumbar region, and restricted flexion and extension movements of the waist. Symptoms may include numbness in the lateral calf and dorsum of the foot, weakness in walking, decreased muscle strength in the dorsiflexion of the big toe and ankle. In severe cases, there may be loss of control over urination and defecation. Therefore, when a disc herniation occurs, it is important to diagnose and treat it early to avoid worsening of symptoms.


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.


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.


What sleeping position should be used for lumbar disc herniation?
If the patient simply presents primarily with symptoms of back pain, it is advisable to lie on the back and sleep on a firm mattress. It is best to wear a lumbar support belt to protect the lumbar spine. If the patient's lumbar disc herniation is quite severe, causing sciatic nerve pain, it is better to sleep in a lateral position during sleep. When lying on the side, actively flexing the knees and hips can reduce the traction on the sciatic nerve, thereby effectively alleviating the patient's leg pain symptoms. Additionally, for patients with disc herniation, it is necessary to avoid prolonged sitting or standing, avoid excessive bending to lift heavy objects, and avoid lifting heavy items. Actively cooperating with acupuncture, electric therapy, cupping, traction, massage, and other physical therapy methods can further improve the patient’s clinical symptoms.


Is there a cure for lumbar disc herniation?
Lumbar disc herniation is treatable, and the results after treatment are very good. The treatment methods for lumbar disc herniation mainly depend on the direction and degree of the herniation as well as the symptoms it causes. Generally, it is divided into conservative treatment and surgical treatment. Conservative treatment is the first approach, which initially includes general treatment. That is to say, after experiencing symptoms of a lumbar disc herniation, you must first rest in bed and then make sure to sleep on a flat bed and appropriately strengthen the muscles of the lower back. The second approach is traditional Chinese medicine, the third is traction and massage therapy, the fourth is physical therapy, and the fifth is rehabilitation therapy. If the treatment is not effective, or other surgical indications appear, such as urinary and fecal incontinence or spinal cord type nerve damage combined with spinal stenosis, then surgical treatment is needed. Surgical treatments generally include conventional surgery and minimally invasive surgery, with the latter being more commonly used nowadays. Other treatments include disc sealing, sacral therapy, small needle knife therapy, and nucleus pulposus injection with ozone, among others. Overall, not only is lumbar disc herniation treatable, but there are also many treatment methods. However, as to which treatment method is suitable for you, you must go to the hospital and consult a doctor to decide.


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.


How to exercise with lumbar disc herniation
For patients with lumbar disc herniation, self-exercise is a very important and effective treatment method. First, it is important to maintain the correct sitting posture, sit up straight without leaning sideways, and avoid sitting for extended periods. It is also necessary to keep the waist warm to prevent catching cold. Second, it is necessary to strengthen the exercise of the back muscles, especially the erector spinae and multifidus, with exercises such as single-leg bridges, double-leg bridges, and the "little swallow" exercise. Third, maintain the correct posture in daily life, such as when lifting or holding objects, to avoid increasing tension in the waist and causing unnecessary damage. Fourth, regarding rest, it is crucial to lie on a firm bed and possibly add a thin pad under the waist to keep the hips and knees in a certain alignment, ensuring the waist muscles can fully relax. Fifth, always wear a waist belt during exercise. The waist belt is one of the most important orthopedic supports, serving to immobilize and protect the waist, limiting movement during activity to solidify the effects of earlier treatments. Therefore, patients with lumbar disc herniation must develop a complete and reasonable treatment plan at a regular medical institution and normal physiotherapy institution.


Lumbar disc herniation symptoms
Patients with lumbar disc herniation can exhibit a variety of clinical symptoms which may differ according to age, gender, duration of illness, and the location of the herniation. Among these, back pain is a symptom that occurs in over 90% of the patients. The pain is primarily located in the lower back and the sacral area, most commonly presenting as persistent dull pain. Another common symptom is radiating pain in the lower limbs, which may extend from the lower back and buttocks to the back of the thigh, front or back of the calf, all the way to the heel. The nature of the pain is primarily radiating and piercing. Additionally, there may be reduced sensory and motor functions in the lower limbs as well as cauda equina syndrome symptoms.


Lumbar disc herniation is where?
Where does lumbar disc herniation occur? Let's first discuss what a lumbar disc is. A lumbar disc is a fibrous pad located between the upper and lower vertebrae, which can be understood as a joint between the two vertebrae. Its outer layer is made up of a dense fibrous ring, formed in different combinations and arrangements, with a nucleus pulposus in the middle, which primarily functions to bear pressure from various directions and disperse it. Lumbar disc herniation occurs when, for various reasons such as aging, trauma, or pathological changes, the lumbar disc protrudes. If the protrusion does not break through the fibrous ring, it is called bulging. If it compresses and causes the fibrous ring to rupture, it is called herniation. Thus, the herniation can protrude backward, upward, or forward; however, it is mostly the backward protrusion that can cause symptoms by compressing nearby tissues, such as the spinal cord, blood vessels, and nerve roots.


Where to apply moxibustion for lumbar disc herniation
If moxibustion is used to treat a lumbar disc herniation, the main acupoint is the Jiaji acupoint located on both sides of the herniated disc, along with the Jiaji acupoints immediately above and below it. For example, if you have a herniation between the 3rd and 4th lumbar discs, you should moxibust the 2nd, 3rd, and 4th Jiaji acupoints, and so on. In addition to the main acupoint, there are auxiliary acupoints chosen based on the different symptoms of different patients. Generally, if there is significant back pain, the acupoint on the affected side is the Yaoyan. If there is muscle tension and tenderness in the buttocks, match with Huanjiao and Yibian. If there is muscle tension on the back of the thigh, match with Chengfu, Yinmen, and Weizhong. If there is numbness on the outer side of the thigh, match with Fengshi, and for calf numbness, match with Weiyang, Chengshan, and Yanglingquan. If there is numbness on the top of the foot, followed by weakness in the foot or toe region, match with Taixi, Jiexi, and Xiexi.