What happens to a herniated disc after electroacupuncture for pain management?

  Acupuncture is one of the special methods of traditional Chinese medicine for pain management, and it has been commonly used in various clinical departments. The main feature of lumbar disc herniation is “pain”, the main purpose of patients seeking medical treatment is also “pain”, and the main goal of clinicians treating this disease is still “pain”. The main goal of clinicians in treating the disease is still “pain”. Therefore, “pain is the main contradiction or the main aspect of the disease”.  At present, acupuncture is still very common and practical in treating lumbar disc herniation: 1. Although the understanding, experience and specific methods of various medical practitioners are diverse, the efficacy is satisfactory in most cases. The clinical symptoms such as low back and leg pain, which is called “asymptomatic lumbar disc herniation” 2, after non-surgical treatment within a short period of time, the pain disappears and the patient is cured (including electroacupuncture), the morphology of the herniated disc and the space occupation in the spinal canal and the adjacent relationship between it and the related affected tissue may not change much.  Some patients who have undergone nucleus pulposus removal without painful symptoms can also be seen clinically (the so-called “failed surgery syndrome”). In addition, at present, the main means of understanding the morphology and spatial occupation of herniated discs are imaging methods such as CT or MRI. Although they are very advanced, they have many shortcomings and cannot truly reproduce the objective situation of the herniated disc and its spatial occupation with adjacent tissues inside the human body.  After clinical observation and literature research, the prognosis and regression of disc nucleus pulposus herniation after the disappearance of clinical symptoms such as pain by non-surgical treatment are as follows: 1. Those discs whose annulus fibrosus has ruptured, especially the prolapsed free nucleus pulposus herniation, can be self-digested and absorbed under the action of their own inflammation and immune response, which has been confirmed by relevant animal experiments and clinical trial studies; 2. Some Unruptured bulging or herniated disc herniations (mostly without penetrating the posterior longitudinal ligament), especially in young patients with small herniations, short duration of disease, good elasticity of the annulus fibrosus, can in some cases be retracted or reduced in size. Although there are different or even opposing views in the academic community, we do have typical clinical cases to support the recognition of retraction, and clinical studies with large samples are underway. According to clinical studies, the onset of both of these significantly lags behind the improvement of clinical symptoms such as pain, so the mechanism of action that is effective via non-surgical treatment cannot simply be interpreted as a change in the size and shape of the nucleus pulposus protrusion.  3. For those nucleus pulposus herniations that cannot retract and do not digest and absorb themselves, after non-surgical treatment and are effective, it is possible that the relative spatial occupation between the herniation and the affected nerve root and other related tissues is changed, so that the herniated disc can produce no pain and other hazards as long as there is no direct contact and no frontal conflict, thus leaving the herniation and the pain-causing tissues of the related nerves and/or blood vessels in The “compensatory phase” of “peace and quiet”. Nevertheless, the common understanding of the clinically effective mechanism of non-surgical treatment of disc herniation such as electro-acupuncture still lies mainly in blood activation, anti-inflammation, and improvement of the local chemical environment between the herniated disc and the involved nerve roots and other related tissues.  In conclusion, the goal and effective mechanism of non-surgical treatment such as electro-acupuncture is to promote the return to the “pathological compensatory stage” without symptoms despite herniation as far as possible. “Even if it is “cured”, the patient can be confirmed as a free and healthy person.  In a sense, the target of non-surgical methods such as electroacupuncture is “lumbar disc herniation”, not “lumbar disc herniation”, and the emphasis is on “symptomatic treatment”, which can The emphasis is on “symptomatic treatment”, which can of course also “improve or eliminate symptoms”. The main implication of this is that a herniated disc is in most cases a natural degeneration of the body related to age, genetics, occupation and many other factors, and only when the herniated disc causes clinical symptoms such as pain, i.e., when it causes harm, does it need to be treated, otherwise an asymptomatic disc herniation does not require intervention! This of course includes patients who have clinical symptoms such as pain but are cured by aggressive regression of non-surgical treatment. Of course, further studies have found that patients who are effectively treated non-operatively first experience a disappearance or reduction of clinical symptoms such as pain, while the disc herniation itself lags behind, thus presumably the disc herniation is to some extent, or for a certain period of time, as harmless as a bone spur in a human joint, a scar on the skin, or bacteria in the body “In many cases, it is possible to “get along” with its owner, and it is not necessary to remove it beforehand!