How to treat a lumbar disc herniation?

Written by Na Hong Wei
Orthopedics
Updated on September 08, 2024
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Clinically, the treatment of lumbar disc herniation usually involves the following three aspects. The first is conservative treatment, which is mainly for those patients whose lumbar disc herniation is not very severe and does not cause substantial compression of the nerve roots and spinal cord. The first step includes general treatment, that is, after developing a lumbar disc herniation, one needs to lie flat in bed, rest on a hard bed, and then rest. The second is treatment with Chinese herbal medicine, the third with Western medicine, and the fourth is traditional Chinese medicine rehabilitation treatment, which includes traction, massage, acupuncture, and others. There is also physical therapy, which includes treatments like shockwave thermotherapy and microwave therapy. Often, some patients experience symptom relief after conservative treatment. There are also some patients whose symptoms do not improve during treatment, and even worsen, at which point surgical treatment is needed. Surgical treatment has its strict indications. However, once within the range of these indications, surgical treatment should be considered. Surgical treatment now is divided into minimally invasive therapy and conventional surgical treatment. The third is other treatments, which are also numerous, including ozone therapy, sacral canal treatment, intradiscal injections, and so on. Therefore, the treatment of lumbar disc herniation mainly depends on the degree of protrusion and clinical symptoms, which are analyzed comprehensively to select a suitable treatment method.

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Written by Li Jin
Orthopedics
1min 19sec home-news-image

Is lumbar disc herniation difficult to treat?

Patients with lumbar disc herniation, after standard and regulated treatment, can mostly effectively alleviate symptoms, and even achieve clinical recovery. The treatment for lumbar disc herniation mainly includes non-surgical treatment and surgical treatment. The specific method of treatment to be used should be comprehensively considered based on symptoms, physical examination, imaging studies, and other factors. For non-surgical treatment of lumbar disc herniation, it is recommended that patients protect their lower back in daily life, develop correct habits of using the lower back, and avoid lifting heavy objects partially and other heavy physical activities involving the lower back. During stable periods of the condition, some exercises to strengthen the lower back and spinal functions can be performed. At the same time, when symptoms occur, anti-inflammatory analgesics, neuro-nutritional drugs, and other medications can be used. Treatments can also be combined with hot compresses, physical therapy, massage, and acupuncture. These conservative treatment methods generally can achieve good results. When conservative treatment is ineffective or functional impairment occurs, surgical treatment can also be considered. (Specific medication use should be guided by a doctor.)

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Written by Su Zhen Bo
Orthopedics
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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.

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Written by Guan Yu Hua
Orthopedic Surgery
1min 29sec home-news-image

How many days to administer fluids after minimally invasive surgery for lumbar disc herniation?

With the development of medical technology, currently for the treatment of lumbar disc herniation, such as when conservative treatment is ineffective—including lying on a hard bed, pre-heating the waist, taking blood-activating and pain-relieving medication, or drugs that nourish the nerves—some interventional surgeries are chosen if these do not provide relief. The main ones commonly used include ozone ablation, collagenase nucleolysis, percutaneous disc removal, and foraminoscopic technology, etc., all of which carry very low risk. The most commonly used is ozone ablation, which involves instant oxidation of the degenerated protruded nucleus pulposus. This destroys the proteoglycans, thereby making the proteoglycans lose their function. The cells produce proteoglycans, reducing the osmotic pressure of the nucleus tissue, which cannot maintain normal moisture, leading to shrinkage and loss of tissue. This increases the space, thereby reducing the symptoms of nerve compression caused by disc herniation. Usually, antibiotics are used post-surgery to prevent infection, generally for about three days. After the medication is completed, considering discharge and returning home for recovery is possible, followed by oral medication. (Please use medications under the guidance of a physician.)

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Written by Na Hong Wei
Orthopedics
1min 24sec home-news-image

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.