What department should I see for a lumbar disc herniation?

Written by Na Hong Wei
Orthopedics
Updated on September 09, 2024
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For herniated lumbar discs, you should visit either the Department of Spine Surgery or Orthopedics. The specific department depends on the hospital you choose to visit. If the hospital is a high-level institution, grade three or above, it will certainly have a Department of Spine Surgery, so this would be the first choice. However, if the hospital is a community clinic or a second-tier hospital, it might not have a Spine Surgery department, so you would need to visit the general Orthopedics department. Although herniated lumbar discs are a common orthopedic condition and can be treated in Orthopedics, visiting a specialist in Spine Surgery can often provide more expert care as these doctors may have higher levels of experience and expertise in treatment.

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Written by Su Zhen Bo
Orthopedics
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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.

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Written by Wang Cheng Lin
Orthopedics
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How is a herniated lumbar disc treated?

The treatment methods for lumbar disc herniation currently fall into two categories in clinical practice. The first is conservative treatment, which primarily involves methods like massage, acupuncture, electrotherapy, magnetic therapy, and traction to alleviate symptoms of pain and restricted movement in the lower back. If conservative treatment proves ineffective and the patient's condition worsens, accompanied by radiating pain and numbness in both legs, it indicates that the herniated disc has severely compressed the nerve roots. At this point, the effectiveness of conservative treatment becomes very poor, and the only option may be to undergo surgical treatment. The primary goal of surgery is to remove the herniated disc, and if the patient has spinal instability, it also involves the use of screws and plates to restore spinal stability.

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Written by Su Zhen Bo
Orthopedics
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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.

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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.