How long does conservative treatment for lumbar disc herniation take?

Written by Guan Yu Hua
Orthopedic Surgery
Updated on February 21, 2025
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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.

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Written by Lv Yao
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
1min 27sec home-news-image

Precautions for Lumbar Disc Herniation

For patients with lumbar disc herniation, self-prevention and self-treatment are very effective methods. What should be paid attention to in daily life? The first point is to maintain a correct sitting posture, sit upright, do not lean back, and avoid sitting for long periods. It is also necessary to keep the waist warm and prevent it from getting cold. The second point is to engage in some exercises, mainly those that strengthen the muscles of the lower back, such as large swallow flight, small swallow flight, single bridge, and double bridge. The third point is that in daily life, it is important to pay attention to maintaining the correct posture when working, avoiding putting too much pressure on the lumbar spine, and not using brute force. The fourth point is that in terms of rest, it is best to sleep on a hard bed and add a small pad at the waist or a soft pillow under the knee joints. This can keep the knee and hip joints at a certain degree of flexion, allowing the muscles of the lower back to fully relax. The fifth point is to wear a waist brace under the guidance of a doctor. This waist brace is a very common orthopedic support, which functions to immobilize and protect the waist. Moreover, for patients with lumbar disc herniation, it can greatly increase the stability of the lumbar spine and consolidate the effects of previous treatments. Therefore, patients with lumbar disc herniation must pay attention to these details in daily life.

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Written by Na Hong Wei
Orthopedics
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What are the methods for diagnosing lumbar disc herniation?

The diagnostic methods for lumbar disc herniation are essentially three-dimensional; that is, clinical symptoms plus physical examination combined with auxiliary examinations. First, let's talk about clinical manifestations, which include pain, functional impairment, and local sensory abnormalities in cases of lumbar disc herniation. Second, in the physical examination of lumbar disc herniation, the intervertebral disc often shows some deformation, and the most common is a reduction or disappearance of the lumbar spine's forward physiological curvature, referred to colloquially as "flatback," where the back appears flat like a board. Other findings may include spinal scoliosis and specific tender points, usually located next to the protruding vertebrae. Percussing these tender points may induce radiating pain to the buttocks or lower limbs. Additional examinations might reveal abnormalities in the strength or sensation of lower limb muscles at different stages, as various muscles and sensory areas are affected differently. Special tests such as the straight leg raise test, femoral nerve stretch test, and neck flexion test are generally positive. The most routine auxiliary examination involves taking x-ray images, followed by CT scans, which can directly visualize the location and extent of the disc herniation. Currently, magnetic resonance imaging (MRI) is also used, which has significant advantages. MRI provides three-dimensional images, showing the sagittal, coronal, and axial planes, which helps in better assessing the condition of herniated discs. Therefore, these are the areas covered in diagnosing lumbar disc herniation.

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Written by Li Jin
Orthopedics
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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 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.