Lumbar disc herniation has what manifestations?

Written by Na Hong Wei
Orthopedics
Updated on September 19, 2024
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Lumbar disc herniation has the following clinical manifestations. First, lower back pain accompanied by unilateral radiating pain in the lower limbs. Second, numbness in the localized area. Third, weakness in the toes. Fourth, decreased temperature in the affected limb. Upon examination, the first finding is a reduced natural anterior curve of the lumbar spine, which we refer to as a flat or board-like back. Second, it can also cause the lumbar spine to bend to one side, possibly toward the affected side or the healthy side, depending on the location of the herniation. Third, there is a fixed tender point beside the lumbar spine, which plays an active role in diagnosis and treatment. Fourth, due to pain, there is a limitation in the movement of the lower back; normally, the lumbar spine can flex 45 degrees forward, extend 20 degrees backward, and bend 30 degrees to each side. If these ranges of motion are not achievable, it indicates a significant limitation in lumbar activity. Fifth is the neurological localization examination, which primarily involves different sensory disturbances, motor disturbances, or muscle atrophy depending on the site of compression. There are also some special tests, like the straight leg raise test, reinforcement test, healthy side leg raise test, as well as the neck flexion test and femoral nerve stretch test. Lastly, additional diagnostic tests like CT or MRI can provide specific information on the location and stage of the lumbar disc herniation.

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Written by Na Hong Wei
Orthopedics
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Symptoms of lumbar disc herniation

The symptoms of a herniated lumbar disc are 1. back pain 2. leg pain 3. both back and leg pain. The essence of a herniated lumbar disc is that, after the disc protrudes, it compresses the surrounding nerve roots or the spine, leading to a series of clinical symptoms. Depending on the area of compression, different symptoms may occur; some people experience back pain, others leg pain, and in more severe cases, both back and leg pain. Therefore, pain is the primary symptom of a herniated lumbar disc. However, following the pain, there often occurs a restriction of movement. If a certain posture is not correct, it triggers pain. In severe cases, it may cause numbness or weakness in both legs, or result in urinary or bowel dysfunction.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Wang Fei
Orthopedics
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How to relieve stiffness in the lower back caused by lumbar disc herniation?

Lumbar disc herniation is very common in clinical settings. The peak incidence age is around forty, typically in middle-aged adults, though some cases occur in the elderly due to degenerative lumbar changes, bone proliferation, or osteoporosis-induced herniation. Patients with lumbar disc herniation usually experience discomfort in the lower back, muscle spasms, and sometimes numbness and soreness in the legs. If such stiffness and discomfort occur, one approach is to rest in bed. Additionally, applying heat, gentle massage, and treatments to relieve muscle spasms can be beneficial. Treatments such as acupuncture and physiotherapy can also help alleviate muscle spasms in the lumbar region, thus easing the stiffness.

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Written by Guan Yu Hua
Orthopedic Surgery
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How long does conservative treatment for lumbar disc herniation take?

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.