Principles of lumbar disc herniation

One of the main symptoms of lumbar disc herniation is pain in the lower back and lower extremities. The mechanism of pain is mainly due to the degeneration of the lumbar disc and the strong chemical irritation of the nerve roots by the glycoproteins and β-proteins released from the nucleus pulposus fluid after the rupture of the fibrous ring. The pH value of the nucleus pulposus and the herniated disc tissue was proved to be acidic, and the pH value in the tissue was also measured by microelectrodes, and the painful area was found to be acidic as well, so the cause of the soreness in the lower extremity may be caused by the overflow of acidic products to the nerve root after the tiny rupture of the fibrous ring. In addition to the nerve root symptoms caused by the irritation of acidic products from the nucleus pulposus, the accumulation of chemicals released by the sterile inflammatory reaction generated by fatty connective tissue and ligamentous strain in the spinal canal can also be caused. And it is believed that mechanical compression alone can only produce sensory abnormalities of numbness in the affected limb. Therefore, timely release of nerve root compression, or elimination of nonspecific inflammation and reduction of local acidosis are required to relieve this radicular pain from the etiological aspect. In conservative treatment, analgesia is an important adjunct in the application of manipulation and traction, and is gradually becoming an important treatment tool. Epidural cavity injection of anesthetic drugs and a small amount of hormones can inhibit the excitability of nerve endings, while improving local blood circulation, so that local metabolites can be easily taken away from the blood circulation, reducing local acidosis and blocking the vicious cycle of pain, thus achieving the purpose of anti-inflammatory and pain relief.