Low back pain is one of the painful diseases. It may be because there are too many media presentations and advertisements, and many people immediately associate it with an orthopedic disease like lumbar disc herniation as soon as they have low back pain. In fact, you do not have to blindly treat yourself as soon as the symptoms appear. There are many kinds of diseases that can cause back pain, and the two most confusing ones are lumbar disc herniation and lumbar strain. Here I will explain in detail from several aspects, and I hope that you will not delay treatment due to misdiagnosis.
The difference between lumbar disc herniation and lumbar strain.
The lumbar intervertebral disc herniation is the lumbar intervertebral disc pulp outwardly pressing the nerve causing painful symptoms, and lumbar muscle strain is the muscle soft tissue injury on both sides of the lumbar spine.
The relationship between lumbar disc herniation and lumbar muscle strain.
Lumbar muscle strain is more common than lumbar disc herniation. Lumbar muscle strain is a lesion for the muscles and soft tissues around the lumbar area. If it is not effectively treated for a long time, then it will reduce the protective effect of the muscles and soft tissues on the lumbar spine, thus triggering the lesion of the intervertebral disc. After the lumbar disc herniation causes lumbar pain, it leads to the change of lumbar posture, which causes lumbar muscle strain or makes it worse. Therefore, lumbar disc herniation and lumbar muscle strain are two diseases, but they may exist at the same time.
The significance of differentiating lumbar disc herniation and lumbar muscle strain.
Lumbar strain does not require surgical treatment and is treated conservatively. This is not to say that the treatment of lumbar strain is not important. If you are sure that it is a lumbar strain, you should pay attention to maintenance, rest and catch up on treatment. This disease, if not effectively treated, will easily cause habitual damage and will result in shorter and shorter disease frequency, heavier and heavier disease, more and more difficult treatment, longer and longer disease duration, etc. The combination of multiple therapies used to treat lumbar strain can only be used as an adjunctive treatment, and its main treatment should be based on self-behavioral treatment. This is something that the majority of patients do not really understand, which is to change the habits of work and life that aggravate lumbar strain. In the case of lumbar disc herniation, although conservative treatment is also used when the first occurrence and symptoms are mild, surgery is required when conservative treatment is ineffective, when symptoms are severe, when there is spinal stenosis, and when the nucleus pulposus prolapses.
When a herniated lumbar disc is suspected
1.Lumbar pain
Low back pain is the first symptom to appear in most patients with this condition, with an incidence of about 91%. A small number of patients have only leg pain without lumbar pain, so it is not certain that lumbar pain will occur in every patient. There are also some patients who have low back pain first and then leg pain after a period of time, while the low back pain reduces or disappears on its own and only complains of leg pain when they come to the clinic.
2.Radiation pain of lower limbs
Low back pain is easy to come on after trauma, exertion and cold, each time for about 2-3 weeks, and can be gradually relieved. Any factors that increase abdominal pressure, such as coughing, straining to defecate, laughing, sneezing, lifting heavy objects, chronic coughing, etc., can easily trigger lumbar pain or aggravate the already occurring lumbar pain.
3.Limitation of lumbar activities
The forward flexion and back extension activities of the lumbar spine in patients with lumbar disc herniation are closely related to the degree of disc herniation. If the annulus fibrosus is not completely ruptured, the lumbar spine takes the forward flexion position and the posterior extension is restricted.
4. Scoliosis
This is a postural compensatory deformity adopted by patients with lumbar disc herniation to reduce pain. The lumbar vertebrae are bent to the left or right, and the spinous process can be distorted by touching the spinous process in the middle of the back, but this is not a unique sign of lumbar disc herniation, as about 50% of normal people also have a distorted spinous process.
5. Limping
The claudication that occurs in lumbar disc herniation is mostly intermittent, i.e., pain and weakness in the lower extremities after walking a certain distance, and the symptoms can be relieved after bending down or squatting to rest, and the person can still continue walking. With the passage of time, the symptoms of lumbar disc herniation will gradually and slowly aggravate.
6.Sensory numbness
In patients with lumbar disc herniation, some of them will not experience pain in the lower limbs, but only numbness in the limbs, which is mostly caused by the compression of the proprioceptive and tactile fibers of the nerves by the intervertebral disc tissue. In contrast, most of the lateral thigh sensory disturbances are due to bulging of the annulus fibrosus or joint degeneration.
This is not due to a herniated disc.