Lumbar disc herniation: from cause to treatment

Lumbar disc herniation : from cause to treatment

What is lumbar disc herniation?

If the spine is the pillar of the human body, the lumbar spine is the foundation of the spine. The lumbar intervertebral disc, as a "soft cushion" in the middle of the lumbar spine, supports, connects and buffers shocks to the lumbar spine.

The definition of lumbar disc herniation is that when the fiber ring of the intervertebral disc ruptures and the nucleus pulposus protrudes, compressing the surrounding nerve roots or spinal cord, it will cause symptoms of lumbar disc herniation. According to the degree and location of the protrusion, lumbar disc herniation can be divided into bulging type, protrusion type, extrusion type and free type.

Common predisposing factors

Office workers are prone to lumbar disc herniation due to the nature of their work and lifestyle. The following are several main reasons:

• Sitting for long periods of time: Sitting for long periods of time causes continuous pressure on the lumbar spine;

• Improper posture: Especially when sitting in a bad posture, it will increase the burden on the lumbar spine. Bad sitting postures such as leaning forward, hunching, and excessive bending of the waist will cause the intervertebral disc to bear uneven pressure and increase the risk of lumbar disc herniation;

• Degeneration: As we age, the water content of the intervertebral disc decreases and it loses its elasticity;

• Lack of exercise: Insufficient exercise of the core muscles (abdominal muscles, back muscles and gluteal muscles) leads to lumbar spine instability;

• Trauma: A sudden impact or twist may cause a ruptured disc.

Symptoms of lumbar disc herniation

The symptoms of a herniated disc vary, depending on the extent and location of the herniated nucleus pulposus. Here are some common symptoms:

(1) Low back pain: Early symptoms usually manifest as dull pain and discomfort in the lower back. This pain is often intermittent and can be relieved after rest. Lower limb soreness and fatigue are also early symptoms. This is because the protruding nucleus pulposus compresses the nerve roots, affecting the conduction function of the nerves.

(2) Sciatica: It usually develops gradually, and the pain radiates from the buttocks, the posterior and lateral thighs, the lateral calf to the heel or dorsum of the foot. When the high intervertebral disc herniates (L2-L3, L3-L4), it may compress the corresponding upper lumbar nerve roots, resulting in pain in the anterior medial thigh or groin area.

(3) Intermittent claudication: As the walking distance increases, the patient will gradually feel increased pain or discomfort in the lower back and back, and may also experience increased pain and numbness in the affected limb.

(4) Cauda equina syndrome: Central lumbar disc herniation can compress the cauda equina nerve, causing urinary and bowel problems and abnormal sensation in the saddle area. When the disease is acute, it should be used as an indication for emergency surgery.

Testing

X-ray

The frontal view can show lumbar scoliosis; the intervertebral space becomes narrower or unequal, with the space on the affected side being wider. The lateral view shows that the physiological flexion of the lumbar spine is reduced or disappears;

CT and MRI examinations

The impact of the intervertebral disc can be clearly shown;

Electromyography

The distribution range of abnormal EMG can determine the damaged nerve root and the extent of its impact on the muscle.

Treatment

Conservative treatment

During the acute attack period, patients need to rest in bed appropriately to relieve symptoms, but it is not recommended to stay in bed for a long time. Patients are encouraged to carry out moderate and regular daily activities. When doing activities, they can consider wearing a waist belt to provide additional support and protection and reduce waist pressure.

Physical therapy is suitable for patients with various types of lumbar disc herniation. Its main purpose is to reduce inflammation and relieve pain, stimulate nerves and muscles, loosen adhesions, and promote the recovery of waist and affected limb functions. The more effective physical therapies include: ultrashort wave, magnetic heat, interference electricity, low frequency, ultra laser, acupuncture, etc.

3D printing technology can be used to make lumbar pillows that conform to the patient's physiological curvature, improve symptoms from a mechanical perspective, and achieve the purpose of treatment;

Surgery

For cases that are ineffective with conservative treatment or have severe symptoms, minimally invasive treatment is an option. Percutaneous discectomy and laser disc decompression are common minimally invasive treatments.

If you have any questions about spinal health, postoperative rehabilitation, etc., you are welcome to consult us! ! !