Lumbar spine "minor problem"

Many people have this problem: when they bend down to pick up something, their waist suddenly hurts so much that they can’t stand up. This may be lumbar facet joint disorder.

The posterior joint of the human lumbar spine is composed of the inferior articular process of the upper vertebra and the superior articular process of the lower joint. The facet joint surface is covered with cartilage and has a small joint cavity surrounded by a joint capsule. Its inner layer is synovial membrane, which can secrete synovial fluid to facilitate joint movement. The articular surface of the lumbar vertebrae is arranged in semi-frontal and semi-sagittal positions, and its cross-section is approximately arc-shaped. It is more flexible in flexion, extension, lateral flexion and rotation. Because the lumbar sacral region has a large range of motion, the posterior facet joint of the lumbar sacral region is also relatively loose.

When the waist is suddenly twisted, bent, flexed, or rotated, the small joint gap opens, the negative pressure in the joint increases, and the synovium can enter the joint gap. If the synovium of the joint is caught in the joint gap during flexion and extension, it will cause synovial incarceration or dislocation of the small joint. The synovium is severely damaged by the compression of the joint. The synovium and joint capsule have rich sensory and motor nerve fibers, which cause severe pain and reflex spasms. If the incarceration is not relieved in time, chronic severe low back pain and arthritis will occur.

Therefore, when this happens, you can generally do the following:

1. Straight waist rotation method: The patient sits, the operator clamps the patient's lower limbs with his legs, one hand presses against the back of the patient's shoulder, and the other hand reaches from the other side of the patient's armpit to press against the front of the shoulder, and both hands simultaneously exert force to pull in opposite directions.

2. Oblique lumbar pulling method: The patient lies on his side with the lower leg straight and the upper leg hip and knee flexed. The operator pushes and presses the front of the patient's shoulder with one hand and the other hand on the patient's buttocks. After rotating the patient's waist to the maximum, both hands apply force at the same time to pull in opposite directions.

3. Lumbar extension and pulling method: The patient lies prone, bends his elbows, places his hands under his jaw or in front of his head, and stretches his lower limbs naturally. The operator presses the painful part of the waist with one hand, and slowly lifts the lower limbs with the other hand to stretch the waist. When the waist is stretched to the maximum, both hands are used to pull in opposite directions at the same time to stretch the waist.

It is important to note that before performing the manual pulling, the waist muscles should be massaged and relaxed to avoid muscle strain. The movements should be quick and decisive. The waist muscles should also be massaged and relaxed after pulling.