How is a herniated lumbar disc treated?

Written by Wang Cheng Lin
Orthopedics
Updated on November 30, 2024
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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 Cheng Bin
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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Can a herniated lumbar disc be massaged?

Lumbar disc herniation can be treated with massage, and as a part of conservative treatment, massage is a very important method with generally good effects. Its role is to relieve muscle spasms, expand blood vessels, increase local blood circulation, and promote cellular metabolism of soft tissues. The techniques primarily include rolling and rubbing, supplemented by grasping and grinding methods. The main acupuncture point targeted is the Jiaji point, centered on the lesion between the two vertebral bodies. Other auxiliary acupuncture points include Yaoyangguan, Mingmen, Shenshu, Bahui, Huanjiao, Yinmen, Fucheng, Weizhong, Chengshan, and Yanglingquan.

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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.

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Written by Na Hong Wei
Orthopedics
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How to exercise with lumbar disc herniation

How to exercise with lumbar disc herniation. Patients with lumbar disc herniation should pay attention to the following points if they want to exercise. First, ample preparation is necessary; only with sufficient preparatory work before exercising can injury be avoided during the workout. Second, it is advisable to wear a lumbar belt as much as possible. As an important orthopedic support, the lumbar belt helps to brake and protect the waist, and it limits the amount and range of lumbar spine movement to prevent injuries. The third point is that exercises for lumbar disc herniation should primarily focus on strengthening the muscles of the lower back, specifically exercises like the single bridge, double bridge, large and small swallow movements. By strengthening the back muscles, such as the erector spinae and the multifidus muscles, the stability of the lumbar spine can be enhanced, significantly reducing the risk of further aggravation of the lumbar disc herniation.

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Written by Na Hong Wei
Orthopedics
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Is a herniated lumbar disc serious?

Lumbar disc herniation is primarily due to degeneration of the lumbar disc or secondary pathological changes caused by this degeneration, which then stimulate blood vessels, nerve roots, and the spinal cord, leading to a series of clinical symptoms. Lumbar disc herniation is categorized into four types. The mildest type is the bulging type, followed by the protruding type, the more severe extrusion type, and finally the most severe, the sequestration type. Generally, lumbar disc bulging is relatively mild and conservative treatment is usually effective. Depending on the site and degree of compression, lumbar disc herniation may be treated conservatively, but some cases require surgical intervention. Most cases of disc extrusion require surgery because the extrusion leads to spinal stenosis, compressing all or part of the blood vessels, and it can also compress the spine and nerve roots, causing irreversible damage, and medications or massages can't reverse the condition. The fourth point concerns lumbar disc prolapse, meaning the nucleus pulposus falls into the spinal canal through the tear. This is one of the few emergencies seen in spinal surgery. If this occurs, immediate surgical treatment is necessary. Therefore, the severity of lumbar disc herniation mainly depends on the type and degree of the herniation, as well as the location and direction of the herniation, and which treatment method needs to be used.