How to choose the right treatment method for patients with lumbar disc herniation

Lumbar disc herniation refers to a group of syndromes in which the nucleus pulposus protrudes due to the rupture of the lumbar intervertebral disc fibrous annulus, which protrudes into the spinal canal and compresses the dural sac or spinal nerve roots, causing lumbar pain, femoral nerve or sciatica as the main syndrome, which is a common clinical disease and a frequent disease, and seriously affects the life and work of patients. There are many treatment methods for lumbar disc herniation, how should patients choose the right one for themselves? At present, the treatment methods for lumbar disc herniation are broadly divided into two categories, one is non-surgical therapy, that is, conservative therapy, including acupuncture, analgesic drugs, traction, massage, nerve block, internal and external application of Chinese medicine; the other is surgical treatment, including minimally invasive and open surgery. Among them, conservative therapy is preferred, mostly using acupuncture-led Chinese medicine integrated therapy, with non-steroidal analgesic drugs and physical therapy when necessary, 80%-90% of patients can be cured by conservative therapy, and has the advantages of fewer complications, safety, no pain, and low cost. For those with recurrent attacks and ineffective conservative treatment for more than half a year, or those with central herniation causing compression of the cauda equina and urinary and fecal dysfunction, surgery should be performed, which accounts for only 10-20% of patients. Lumbar disc herniation is mostly induced by wind and cold, trauma and accumulative strain on the basis of lumbar disc degeneration, so the recurrence rate is high. As the saying goes: three points of treatment, seven points of nourishment. For patients with lumbar disc herniation, post-rehabilitation protection is especially important. So, how to protect? 1, strengthen the hard bed rest, avoid sitting. When sitting, the disc pressure is the highest, about three times the weight of the torso, while the activity to add the dynamic load, so that the disc load up to two times the static position, standing disc pressure is reduced by 30%, 50% lower in the lying position. The increased pressure within the disc will further aggravate its degeneration and strain, increasing the bulging or protruding occupancy, thus increasing the pressure irritation on the dural sac or nerve roots and aggravating pain or numbness. Therefore, in order to reduce the internal pressure of the intervertebral disc, it is necessary to strengthen the rest in a hard bed and avoid sitting as much as possible. 2.Reduce the factors of increased abdominal pressure. Coughing, sneezing, bowel movements are common factors that lead to increased abdominal pressure. Increased abdominal pressure can aggravate the disc protrusion. Therefore, it is advisable to avoid feeling wind and cold, quit smoking and alcohol, eat a light diet and ensure smooth bowel movements. 3, reasonable wearing waist circumference. Patients with lumbar disc herniation are often accompanied by lumbar scoliosis and lumbar myofascial pain, and the lumbar myofascial is an important auxiliary device to maintain the balance of the lumbar three-joint complex. Wearing a lumbar girth helps correct lumbar scoliosis deformity and relieve lumbar myofascial pain. 4.Functional exercise at the right time. Selecting functional exercise methods that patients can easily grasp can help to separate the sciatic nerve roots and strengthen the function of the lumbar back muscles. Such as straight leg elevation exercise: straight leg elevation to 30 degrees, sciatic nerve tension, and can pull the L5, S1 nerve down and forward 0.2-0.8cm, thus causing pain, but more than 70 degrees is no longer involved. Passive or active straight leg elevation within the patient’s tolerance can help separate the sciatic nerve roots; five-point supine jerk exercise: with the head, bilateral elbow tips, bilateral heel as the fulcrum, slowly make supine jerk, can relieve lumbar myofascial tension, and can enhance the function of the lumbar back muscles, improve the lumbar spine curvature flat state.