Question one.
I have just developed back pain and I suspect that I have a herniated disc, but my doctor does not think it is caused by a herniation; what is the situation?
Answer.
Low back pain is not necessarily caused by a herniated disc. In the opinion of orthopedic surgeons, low back pain is mainly divided into traumatic and degenerative low back pain. Traumatic lumbago includes acute lumbar sprain and chronic fatigue injury, of which chronic lumbago is the most common and includes strain of lumbar muscles, fascia and ligaments. Degenerative low back pain is caused by degenerative changes in the lumbar structure, including lumbar joint degeneration and disc herniation.
In addition, diseases such as kidney stones and ureteral stones can also cause acute lumbago, and this pain manifests as strangulation pain.
Question two.
The herniated disc on my MRI is not very severe, why is it very painful in my lower limbs?
Answer.
People used to think that when a lumbar disc herniates, it compresses the nerves and causes pain. In fact, this is only the mechanical compression theory of lumbar disc herniation producing low back pain. There are other theories to explain the cause of pain, such as the chemical radiculitis theory, which refers to the chemical substances in the discs that stimulate the nerve roots to produce inflammation and cause pain, and the autoimmune theory, which refers to the release of some substances in the discs that cause the body to produce specific antibodies that trigger an immune response and then produce low back pain.
Question three.
My doctor told me I have a lumbar disc herniation; but my best friend has leg pain and was diagnosed with sciatica at another hospital, what is the relationship between the two? Is it the same thing as lumbar spinal stenosis?
Answer.
Many patients with lumbar disc herniation have sciatica, which mainly manifests as pain in the lumbosacral region, buttocks, posterior and lateral thighs, and lateral calves to the heel or back of the foot. The coughing, defecation and straight leg raising of patients with lumbar disc herniation can pull and stimulate the sciatic nerve and aggravate the pain. Severe sciatica needs to be relieved by medication. Of course, as you can see from the picture, the sciatic nerve is very long and any abnormality in any other part of the spine except the lumbar area can cause sciatica, which needs to be identified by a professional doctor.
Lumbar spinal stenosis refers to back and leg pain caused by the compression of nerves by the bony structures of the lumbar spinal canal, ligaments and other growths. Of course, lumbar spinal stenosis and lumbar disc herniation can co-exist.
Question four.
My MRI report says that I have a herniated disc, and I have been advised to have surgery, and others have advised me to be conservative. What kind of herniated discs can be treated conservatively? What kind is suitable for surgical treatment?
Answer.
The vast majority of lumbar disc herniations can be cured by non-surgical treatment. For patients with mild herniation and symptoms, conservative treatment can be chosen, including traction, massage, massage and nerve root injection therapy. Whether during conservative treatment or after recovery, care must be taken to avoid sedentary and bent-over weight-bearing postures, two of the most back-injurious positions.
For patients with a history of more than six months, for whom strict conservative treatment has not been effective, and whose symptoms continue to worsen, affecting life and work, or who have developed abnormal urinary and fecal function (cauda equina syndrome), surgery is required to remove the herniated disc and release the nerve compression. Some patients who do not have the severe symptoms described above, but whose MRI or CT shows a large herniated disc, will also require surgery to avoid nerve damage. This is because any herniated disc cannot be restored to its original position and can only be removed artificially.
Question five.
Sometimes when I accidentally twist my back, I get back and leg pain and a “stuck” feeling in my lower back, is this also a herniated disc?
Answer.
If there is a symptom of “stuck”, which is also called “interlocking syndrome” in medical science, it is because there are small joints in the back of the lumbar spine that move with each other, and if one of them is stuck with each other, it will lead to the inability to twist the back and stimulate the nerves, resulting in back and leg pain. Orthopedic surgeons call this “lumbar spine synostosis syndrome”. In this case, you need to go to the hospital to see a doctor, take drugs or orthopedic methods to lift the joint interlock, do not handle it yourself, otherwise it is easy to aggravate the condition.
Question six.
I have lumbar disc herniation, does it really have an effect on sexual function?
Answer.
The impact of lumbar disc herniation on sexual life is mainly in two aspects: 1. The nerves in charge of sexual function are affected by nerve compression after disc herniation, which leads to impotence and premature ejaculation in male patients, while women may experience sexual frigidity. 2. Lumbar disc herniation, which produces back pain and leg pain, can affect lumbar movement and have an impact on sexual life satisfaction.
Question seven.
What if I can’t do the “little swallow fly” when I do lumbar back exercise?
Answer.
In fact, the small swallow fly is more difficult, the average person can not do directly, or the effect is not good. It is recommended to start with the “five points of support” practice, three times a day in the morning and evening, each time to do three groups, each group of 30, the action should be slow, stay in the air for 5 seconds, each time the back does not fall completely on the bed.
When the lumbar back muscle has a certain basis, and then start to follow the same frequency and method of small swallow fly exercise.
Question eight.
A colleague recommended to me a folk remedy that is said to be particularly effective in treating low back pain, can I try it?
Answer.
At present, among the drugs for lumbar disc herniation, there are three types of drugs that are really effective and have no obvious toxic side effects on human body, including painkillers, such as non-steroidal painkillers and non-opioid central painkillers, etc.; muscle relaxation drugs, such as eperisone hydrochloride, which can relieve muscle tension; and neurotrophic drugs, such as methylcobalamin, which can promote nerve repair. In addition, Chinese medicine will have some blood-activating drugs, which can also help the recovery of back and leg pain.
As for the drugs recommended by folk remedies or irregular manufacturers or clinics, they are not recommended because the ingredients are unknown. Some drugs may be mixed with hormonal drugs without the patient’s knowledge, which may have the effect of relieving pain in the short term and may easily lead to serious consequences such as necrosis of the femoral head and bleeding peptic ulcers when taken for a long time.
Therefore, for the medication of lumbar disc herniation, one should go to the orthopedic outpatient clinic of a regular hospital and strictly follow professional medical advice.
Question nine.
My husband brought me a very good imported lumbar brace from abroad and it is very comfortable to wear, can I wear it all the time?
Answer.
The right waist circumference has a good protective effect on the waist and increases the stability of the waist. If the lumbar disc has an acute attack, the waist circumference can be worn to maintain normal activities and help recovery. However, wearing a lumbar girth for a long time can lead to a lack of exercise for the lumbar muscles, which in turn can lead to a decrease in muscle strength and muscle atrophy. Therefore, while wearing a lumbar girth, pay attention to lumbar back muscle exercise, and stop wearing it as soon as the lumbar pain symptoms subside.