Popular Science | Rehabilitation for Acute Lumbar Disc Herniation

Acute lumbar disc herniation rehabilitation

In clinic, we often see patients limping or sitting in a wheelchair to the rehabilitation department. After detailed questioning and clinical examination, they were diagnosed with acute lumbar disc herniation and nerve root compression symptoms.

For patients with acute lumbar disc herniation, the first problem is to solve the pain and numbness of the patients. The prognosis of lumbar disc herniation is good, and most of them can achieve clinical symptom relief and functional improvement through rehabilitation treatment, but recurrence is possible. Disabling lumbar disc herniation is rare, and only 10%-20% of patients require surgical treatment.

1. If I have acute lumbar disc herniation and the pain makes it difficult for me to stand, do I need to stay in bed and rest?

For decades, bed rest has been considered the standard treatment for patients with acute low back pain. However, in recent years, a number of randomized controlled studies have confirmed that not resting in bed does not affect the speed and degree of recovery of patients' pain.

However, patients who require bed rest for severe symptoms should be encouraged to return to moderate normal activities as soon as their symptoms improve.

Common bed postures: A comfortable bed posture is supine , with a pillow placed under the knee joint and head, and the shoulders raised. Or side-lying , with the upper knee bent and a pillow placed between the knee joints on both sides.

After bed rest and drug treatment, if the patient still has severe symptoms, he or she needs to receive systematic rehabilitation treatment in time to avoid worsening of symptoms.

2. What are the systemic rehabilitation treatments?

(1) Acupuncture treatment

Research shows that acupuncture can provide moderate pain relief and improve function in patients with low back pain.

(2) Physical factor therapy

(a) Viagra: Viagra has a deep effect, which can accelerate local blood circulation, effectively degrade metabolites, and improve the nutrition of local tissues. At the same time, it can improve the pain caused by local inflammation in patients, thereby relieving pain, improving function, and improving the quality of life.

(b) Laser magnetism: It can relieve symptoms such as local muscle tension and spasm, and promote deep blood circulation. Thus, it can relieve local muscle spasm and pain in patients with acute lumbar disc herniation.

(c) Heat therapy: Various heat therapies can improve low back pain by improving local blood circulation and relieving muscle spasms.

(3) Manual therapy

Appropriate stretching and relaxation of local tense muscles and moderate exercise training can relieve local pain. This technique requires systematic evaluation to develop a personalized rehabilitation treatment plan.

3. Is this the end of the treatment?

(1) Balanced nutrition

Supplement calcium, high-quality protein and vitamin D to strengthen the nutrition of intervertebral discs and slow down the degeneration of intervertebral discs.

(2) Correct bad posture

Avoid sitting for long periods of time during work and study, correct bad sitting posture, use ergonomic chairs, and use lumbar support to maintain a good sitting posture.

3. Moderate exercise

Appropriate exercise can intermittently change the pressure within the intervertebral disc, promote nutritional metabolism within the intervertebral disc, and slow down the degeneration of the intervertebral disc.

Everyone is the first person responsible for their own health. Active prevention and proactive intervention can effectively avoid the recurrence of lumbar disc herniation.

References:

1. Zhou Mouwang, Yue Shouwei, He Chengqi, et al. Chinese expert consensus on “Rehabilitation treatment of lumbar disc herniation”[J]. Chinese Journal of Rehabilitation Medicine, 2017, 32(02): 129-135.
2. Wang Xueqiang, Chen Peijie, Jiao Wei, et al. Expert consensus on exercise therapy for low back pain[J]. Sports Science, 2019, 39(03): 19-29.
3. Coulter ID,Crawford C,Hurwitz EL,et al.Manipulation and mobilization for treating chronic low back pain:a systematic review and meta-analysis[J].Spine J,2018,18(5):866-879.
4. Aleksiev AR.Ten-year follow-up of strengthening versus flexibility exercises with or without abdominal bracing in recurrent low back pain[J].Spine,2014,39:997.
5. Dahm KT, Brurberg KG, Jamtvedt G, et al. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica[J]. Cochrane Database Syst Rev, 2010,: CD007612.

Author: Ding Jingbin (Chief Technician)

Unit: Xi'an No. 9 Hospital

Review expert: Liu Jiafeng, associate chief physician, associate professor, director of the Rehabilitation Department of the Ninth Hospital of Xi'an, member of the Science Popularization Committee of the Chinese Rehabilitation Medicine Association