Lumbar disc herniation is a common chronic disease in our life, although it does not affect the patient’s life expectancy, but if it is not well controlled and treated it can seriously affect the patient’s life and work, thus leading to a decrease in quality of life. So is there a standard treatment principle for patients with lumbar disc herniation, both in terms of lifestyle habits and treatment interventions? Why does a lumbar disc herniation occur – life does not pay attention to the maintenance of their spine In life there are many people with lumbar pain, especially long-term sitting, many people think it is not too long to do. In fact, most of them are herniated discs in the lumbar spine. Many people would think, why would there be a lumbar disc herniation? Let us understand it specifically below. Why will there be a lumbar disc protrusion cause one: lumbar weight-bearing In ordinary life or work, the waist if long-term overload, or need to engage in bending work for a long time, such as construction workers, need to bend over for a long time to pick up heavy objects, it is easy to lead to rupture of the intervertebral disc fiber ring. At the same time, long-term vibration can also cause the disease, car and tractor drivers in the driving process, long-term sitting and bumpy state, the lumbar intervertebral disc under excessive pressure, can lead to disc degeneration and protrusion. Cause 2: External force If you do not pay attention to the protection of the lumbar spine in ordinary times, the slight damage caused by long-term repeated external forces, the cumulative effect on the lumbar intervertebral disc aggravates the degree of degeneration. Degenerative changes of the lumbar intervertebral disc: degeneration of the nucleus pulposus is mainly manifested as a decrease in water content, and can cause small-scale pathological changes such as destabilization and loosening of the push joints due to water loss; degeneration of the fibrous ring is mainly manifested as a decrease in the degree of toughness. Etiology three: flash back In daily life, if the human body is flashing due to sudden external force or sprain, this can easily form a rupture of the fibrous ring, or improper posture induces herniation of the nucleus pulposus, and trauma to the lumbar area makes the nucleus pulposus that has degenerated protrude. Cause four: cold and damp After clinical trials and observations, it was found that if the human body is cold or damp for a long time can cause small blood vessel constriction, muscle spasm, so that the pressure on the intervertebral disc increases, which may also cause the degenerated intervertebral disc to crack, which in turn induces the disease. Treatment should pay more attention to maintenance? The above summary of the causes of the disease, let us understand that the occurrence of lumbar disc herniation is mainly and bad habits, and do not pay attention to the protection of the spine so that the disease occurs. So in life we should pay more attention to the maintenance of the spine: measure one: avoid lumbar weight in life if you can not avoid to do some heavy work then bending up must not be too hard, to learn to reduce the weight of the waist, slow to give, but here or remind try to avoid doing heavy work. Measure two: avoid lumbar injuries Many patients are likely to be a certain impact or fall or flashback, so everywhere in life to pay attention to the prevention of dangerous occurrences, to prevent lumbar injuries, it is likely that an injury will fall a lifelong pain. Measure three: pay attention to lumbar warmth lumbar warmth for the prevention of disc herniation is a certain role, while for mild patients lumbar heat insulation can relieve local muscle stiffness, thereby improving the symptoms. What are the conventional conservative treatments? Most patients with lumbar disc herniation can be relieved or cured by non-surgical treatment. The treatment principle is not to return the degenerated and herniated disc tissue to its original position, but to change the relative position of the disc tissue and the compressed nerve root or to partially retract it, so as to reduce the pressure on the nerve root, release the adhesion of the nerve root and eliminate the inflammation of the nerve root, thus relieving the symptoms. Non-surgical treatment is mainly suitable for: young people, first attack or short duration of the disease; people with mild symptoms, whose symptoms can be relieved by themselves after rest; and people with no obvious spinal stenosis on imaging. (1) Absolute bed rest For the first attack, bed rest should be strictly applied, emphasizing that neither large nor small bowel movements should be made in bed or sitting up, so as to have better results. After 3 weeks of bed rest, you can get up and move around under the protection of a lumbar girth, and do not bend over and hold things for 3 months. This method is simple and effective, but more difficult to adhere to. After remission, the lumbar back muscle exercise should be strengthened to reduce the chance of recurrence. (2) Traction therapy The use of pelvic traction can increase the width of the intervertebral space, reduce the internal pressure of the intervertebral disc, the protruding part of the disc retracts, and reduce the irritation and compression of the nerve root, which needs to be carried out under the guidance of a professional doctor. (3) Physiotherapy, massage and tui-na can relieve muscle spasm and reduce pressure within the intervertebral disc, but note that violent massage and tui-na can lead to aggravation of the disease and should be done with caution. (4) Corticosteroid epidural injection Corticosteroid is a long-acting anti-inflammatory agent, which can reduce inflammation and adhesions around the nerve root. Generally, long-acting corticosteroid preparation + 2% lidocaine is used for epidural injection once a week, 3 times as a course of treatment, and another course of treatment can be used after 2-4 weeks. (5) Chemical lysis of the nucleus pulposus Using collagenase or papain, injected into the intervertebral disc or between the dura and the herniated nucleus pulposus, selectively dissolve the nucleus pulposus and the fibrous ring without damaging the nerve roots, in order to reduce the pressure in the disc or make the herniated nucleus pulposus smaller so as to relieve the symptoms. However, there is a risk of allergic reaction to this method. Percutaneous myeloablation/laser vaporization of the nucleus pulposus is performed by entering the intervertebral space with special instruments under X-ray surveillance and extracting part of the nucleus pulposus or laser vaporizing it to reduce the pressure in the disc for symptomatic relief, which is suitable for patients with bulging or mild herniation, but not for patients with combined lateral saphenous stenosis or significant herniation and those whose nucleus pulposus has already prolapsed into the spinal canal. Under what circumstances is surgery necessary? (1)Indications for surgery ①Patients who have a history of more than three months, whose strict conservative treatment is ineffective or effective, but who have frequent recurrences and severe pain; ②Patients who have their first episode of severe pain, especially in the lower extremities, who have difficulty moving and sleeping, and who are in a forced position; ③Patients who have a combination of cauda equina compression; ④Patients who have single nerve root palsy with muscle atrophy and decreased muscle strength; ⑤Patients who have a combination of spinal stenosis. (2) Surgical method Partial laminectomy of the lamina and articular eminence through a posterior lumbar back incision, or discectomy through the lamina space. For central disc herniation, after laminectomy, epidural or intradural discectomy is performed. In cases of combined lumbar instability and lumbar spinal stenosis, simultaneous spinal fusion is required. In recent years, minimally invasive surgical techniques such as microdiscectomy, microendoscopic disc removal, and percutaneous foraminoscopic disc removal have reduced surgical damage and achieved good results. The above is a summary of the principles of care and treatment of herniated discs, chronic diseases are easily ignored, especially in the early symptoms do not affect life, so whether you should be diagnosed with lumbar disc herniation or not yet diagnosed friends, pay attention to the protection and care of their spine in life to prevent the occurrence of disease. For patients who have been diagnosed should change their habits and should be able to change their attention to protect the spine, while trying to avoid aggravation of the disease.