Lower back pain, leg numbness, how to save your herniated lumbar disc?

This is the 2855th article of Da Yi Xiao Hu

Xiao Wang is a white-collar worker who often sits at his desk all day. Half a year ago, he had pain in his waist and hips, accompanied by numbness and pain in his calves. Xiao Wang didn't pay much attention to it and just found a massage shop for a waist massage. After that, the pain in his waist and hips was somewhat relieved, so Xiao Wang didn't take it seriously. But one month later, the pain in his calves gradually worsened, the numbness lasted longer and longer, and even his ankles felt weak. Xiao Wang came to the outpatient clinic of Professor Dong Jian, director of the Department of Orthopedics at Zhongshan Hospital. Professor Dong asked Xiao Wang about his medical history, gave him a physical examination, took X-rays and MRIs, and finally diagnosed him with lumbar disc herniation (abbreviated as lumbar disc herniation). Many friends feel empathy when they see this!

Indeed, the incidence of lumbar disc herniation is very high. It is a common orthopedic disease. There are more than 40 million patients in my country. It is also well-known among the public. Many white-collar workers in the workplace often joke that "there is nothing protruding except lumbar disc herniation." So what is lumbar disc herniation? Does low back pain mean lumbar disc herniation? How to save your protruding lumbar disc? How to prevent lumbar disc herniation? Today, we invite Professor Dong Jian, Director of the Institute of Medical Popularization of Fudan University, to explain to you one by one.

What is lumbar disc herniation?

The human spine can be seen as a tube with nerves running through it. When the intervertebral disc at the junction of the tube wall degenerates or is damaged, it is easy for the disc to protrude into the tube, damaging the nerves, causing pain, numbness, and even limb movement disorders, causing lumbar disc herniation. Common causes of lumbar disc herniation include:

① Improper posture, such as hunching or bending over for a long time;

② Long-term heavy physical labor, severe waist strain;

③ Trauma, which can aggravate nerve damage, especially related to adolescent intervertebral disc herniation;

④ Factors such as pregnancy, heredity and congenital lumbar sacral abnormalities can also cause lumbar herniation.

Does low back pain mean lumbar disc herniation?

Many people have low back pain in their daily lives. Are these low back pains caused by lumbar disc herniation? The answer is no. There are many causes of low back pain, including lumbar muscle strain, spinal stenosis, but its lameness symptoms are more prominent, and osteoporotic fractures, which are common in the elderly with osteoporosis. In addition, diseases such as lumbar spondylolisthesis, spondylolysis, and tumors can also cause low back pain.

Professor Dong Jian reminds: If the symptoms of low back pain occur repeatedly and last for a long time, you should go to a regular hospital for treatment. The doctor will conduct corresponding physical examinations and auxiliary examinations based on the medical history and symptoms to make an accurate diagnosis. Do not judge it as lumbar disc herniation by yourself, otherwise it will delay the disease.

How to save your herniated lumbar disc?

Not all patients need surgery after being diagnosed with lumbar disc herniation. 80-90% of patients can get better or recover with conservative treatment. Conservative treatment methods mainly include bed rest, traction, physical therapy and Chinese massage, as well as analgesics and anti-inflammatory drugs, neurotrophic drugs and blockade therapy. Treatment needs to be carried out under the guidance of a professional physician. Do not trust the advice of friends, family members, and colleagues who do not have professional knowledge to carry out so-called special and informal treatments! Otherwise, it will delay the treatment and even aggravate the condition.

However, there are also 10-20% of patients who still need surgery when conservative treatment is ineffective or the condition is serious. Among them, minimally invasive surgery has become the first choice, such as microscope-assisted nucleus pulposus removal or endoscopic nucleus pulposus removal, which has the advantages of less trauma, less bleeding and faster recovery. Some patients with severe spinal stenosis or lumbar instability need radical discectomy and intervertebral fusion surgery. But no matter what the procedure is, it has been developed to maturity and there is no need to worry too much. After the diagnosis, the aforementioned case Xiao Wang received regular conservative treatment for six weeks, but he still had pain and numbness in his waist and legs after activities, which obviously affected his work and life. So Professor Dong performed endoscopic lumbar surgery on him under local anesthesia. The symptoms completely disappeared the next day after the operation, and after another six weeks of recuperation, Xiao Wang successfully returned to work.

How to prevent lumbar disc herniation?

01

Avoid prolonged sitting

Many people in the workplace work at desks for a long time and lack exercise, which causes excessive load on the lumbar spine and easily leads to lumbar disc herniation. After sitting quietly for a period of time, you should relax appropriately to relieve the load on the lumbar spine.

02

Maintain proper posture

Excessive flexion or extension will increase the burden on the lumbar spine, so you should keep your sitting and standing posture upright to reduce damage to the lumbar spine.

03

Be careful when lifting heavy objects

Avoid bending over to lift heavy objects while standing! The correct way is to bend your knees, squat, hold the object with both hands, straighten your waist and chest, stand up slowly, and don't twist your waist. This can greatly reduce the probability of waist injury.

04

Warm-up exercises

When doing physical exercise, do some warm-up exercises before exercise and avoid high-intensity, long-term activities to reduce damage to the waist.

05

Actively exercise your waist

The National Science and Technology Progress Award-winning team of Professor Dong Jian from the Department of Orthopedics of Fudan University Zhongshan Hospital and the Institute of Medical Popularization of Fudan University has created a series of lumbar aerobics for young and middle-aged office workers, elderly friends and postoperative rehabilitation of patients with lumbar disc herniation based on the review of relevant literature. This set of aerobics is simple and easy to learn, and all muscle groups can be exercised. Regular exercise during work and study breaks or at home can effectively relieve waist fatigue and prevent lumbar disc herniation and other lumbar diseases. You can watch and learn on the Weibo and WeChat public accounts of the Institute of Medical Popularization of Fudan University.

Author: Chen Zhiyang Lin Hong Supervisor: Dong Jian

Author's unit: Department of Orthopedics, Zhongshan Hospital, Fudan University

Institute of Medical Science Popularization, Fudan University

Shanghai Geriatrics Center

This article was funded by the following project: Shanghai Science and Technology Commission Science Popularization Project

(No.: 20DZ2312000)

Shanghai Municipal Health Commission Outstanding Academic Leader Project

(No.: GWV-10.2-XD11)