Lumbar disc herniation is one of the common diseases in orthopedics, and about 1/5 of patients with low back pain are caused by lumbar disc herniation. It has been more than seventy years since the disease was proposed in 1934. From the epidemiologic analysis at home and abroad, the population rate and absolute value of its incidence are on the rise. The age of onset of the disease from a few years to dozens of years have, we once saw 9-year-old lumbar disc prolapse patients. First, the pathology of lumbar intervertebral disc herniation The intervertebral disc organization itself lacks blood supply, the repair ability is extremely poor, coupled with the negative major activities. Generally after the age of 20, the intervertebral disc began to undergo degenerative changes, and the toughness and elasticity of the annulus fibrosus gradually decreased. At this time, if the trauma `especially cumulative strain injury, it becomes the cause of the rupture of the annulus fibrosus. In many cases, there is no history of trauma, but after catching a cold, the tension of muscles and ligaments increases, which increases the internal pressure of the intervertebral disc and promotes the rupture of the atrophied annulus fibrosus. Pathological process 1, herniation pre-nucleus pulposus can become fragmented due to degeneration and injury, or scar-like connective tissue; degeneration of the annulus fibrosus can be thinned and softened due to repeated injuries or produce fissures. These changes can cause back discomfort and pain. Adolescent patients may have rupture of the annulus fibrosus and herniated nucleus pulposus due to strong violence in the absence of degeneration. 2.Disc herniation period When trauma or normal activities increase the pressure within the disc, the nucleus pulposus protrudes from the weak or ruptured annulus fibrosus. The herniated material irritates or presses on the nerve tissue causing low back and leg pain, and in severe cases, urinary and fecal dysfunction. In elderly patients, the entire annulus fibrosus becomes weak and loose, and the intervertebral disc may bulge out to the surrounding area, and the anterior and posterior diameters of the spinal canal become small. 3, late protrusion lumbar disc herniation, the longer course of the disease, its intervertebral disc itself and other neighboring structures can occur a variety of secondary pathological changes. (1) Fibrosis or calcification of the intervertebral disc protrusion. (2) Narrowing of the intervertebral space and vertebral osteophytes. (3) Thickening and ossification of the posterior longitudinal ligament. (4) Hypertrophy, calcification, and even ossification of the ligamentum flavum. (5) Degeneration of vertebral small joints, due to narrowing of the vertebral space and instability, increased load on the vertebral small joints, causing excessive riding of the articular eminence, hypertrophy, hyperplasia, hyperplasia and ossification of the joint capsule ligaments, and osteoarthritis. (6) Secondary spinal stenosis. Second, the mechanism of lumbar and leg pain, the cause of lumbar and leg pain is not completely clear, clinical and basic research that is related to the following factors. 1, the nerve root and dural sac directly by the protruding mechanical compression and stimulation: the nerve root is very sensitive to direct mechanical compression. Mechanical compression is not the only cause of nerve root pain and dysfunction. 2, lumbar disc herniation when the blood supply of nerve tissue is impaired: when the disc herniation, mechanical compression and stimulation of nerve tissue ischemia and hypoxia caused by nerve dysfunction is worse than simple mechanical compression. 3, pain caused by local inflammatory reaction of the nerve root when herniated disc 4, immune response: normal cartilage plate and the inner layer of the annulus fibrosus have no blood vessels and lymphatic vessels, and the nucleus pulposus is closed, and there is no direct traffic with the body’s immune system. When the fibrous ring ruptures and the medulla protrudes, some components of the medulla enter the body and become antigens, causing antibodies to be produced and causing antigen-antibody reactions locally in the nerve root. Third, treatment Almost all adults have experienced low back pain, and one-fifth of the patients with low back pain is lumbar disc herniation. However, there are some misunderstandings in the treatment of lumbar disc herniation, and traction is not always effective. Traction can reduce the pressure on the intervertebral discs, prompt the nucleus pulposus to return to different degrees, promote the inflammation to subside, relieve muscle spasm, and restore the normal relationship between the posterior joints. However, if the herniated disc is in the inner side of the nerve root, it will be more and more painful, and it is not suitable for central type, free type herniation and huge nucleus pulposus herniation. Tui na massage is not suitable for all patients. Massage can inhibit and regulate the nervous system, play an analgesic effect, relieve muscle spasm, improve blood circulation, promote the inflammation around the nerves to subside, relieve the nerve root extrusion, and may make the protruding nucleus pulposus partially return. However, severe pain of central herniation and accompanied by spinal stenosis, generally should not massage. It should not be used reluctantly in complicated conditions with a long course of disease, severe pain, obvious symptoms of nerve compression or rapid deterioration. The choice of minimally invasive surgical and interventional indications is limited. These include chemical dissolution of the nucleus pulposus, percutaneous lumbar discectomy, endoscopic disc surgery, ozone injection, and laser vaporization. The advantages of these methods are small damage, quick results, short recovery time, and fewer after-effects of surgery. However, the disadvantage is that the indications for treatment are very strict, if your condition is not in the scope of treatment, you do not have any effect, and will produce other adverse consequences. Surgery (conventional open surgery) is required in no more than 10% of cases. Surgical treatment of herniated discs has a history of 60 years, but China’s leading orthopedic specialist Professor Yang Hakqin said, “Surgery is mainly to remove the protrusion to achieve the purpose of decompression, but it can bring about instability of the lower lumbar vertebrae and osteophytes and other problems, and it is difficult to predict the extent to which the symptoms can be alleviated after the operation, so don’t be obsessed with the pursuit of surgical treatment.” He added, “It must be clear that no more than 10% of patients with lumbar disc herniation need surgery.” Fourth, which patients need surgery? 1, diagnosed lumbar disc herniation more than six months, after non-surgical treatment is ineffective, and the symptoms worsen. 2. The first severe attack of lumbar disc herniation, patients are forced to bend their hips and knees and lie on their side or even kneel due to the pain, which makes it difficult for them to move and sleep. 3. Single nerve palsy or cauda equina palsy, manifested by muscle paralysis or defecation and urination disorders. 4. Middle-aged patients, who have been sick for a long time, affecting their work and life. 5. Total disc degeneration or herniation is confirmed by reliable examination. 6. Surgery is recommended for patients who have been treated effectively with non-surgical treatment but have recurrent symptoms and severe pain for more than 3 times. 7.Herniated disc and other causes of lumbar spinal stenosis (lumbar spinal stenosis is due to hypertrophy and hyperplasia of ligamentum flavum, hyperplasia and cohesion of small joints, bulging and protruding discs, and bony degeneration resulting in narrowing of the central lumbar spinal canal, neural root canal, or lateral saphenous fossa, causing the contents of the canal – cauda equina, and pressure on the nerve root, and the corresponding neurological dysfunction. Disorders of the lumbar spinal canal. Clinically, lumbar spinal stenosis is one of the most common diseases causing low back pain or low back pain. Its main clinical features are neurogenic intermittent claudication, as well as weakness and discomfort in the buttocks, thighs, and calves, which worsens after walking or backward stretching, and another clinical feature is abnormal sensation in the saddle area (perineum) and abnormal urinary and bowel function). What exactly should I choose? Is there no one method that can be effective? Is it a disease that can’t be treated? No, the disease is easy to treat. Where does the key lie? The grasp of the indications! In other words, the best treatment is the one that suits your condition. Depending on your condition, you should treat it as you see fit, don’t avoid it, don’t take any chances. If your condition requires surgery, you can’t escape. In the above categories of treatment methods, are effective ways to cure lumbar disc herniation, each has its own advantages and disadvantages, and each has its own scope of treatment. You do not know how to choose, you are very confused, the reason is that our country does not have such a specialized hospital, can be all the treatment methods together, with all the purchase of therapeutic equipment and professionals, the formation of a lumbar herniated disc treatment “supermarket”, so that each patient can find a reliable method suitable for them. The lumbar spine rehabilitation. Lumbar spine rehabilitation do 10 sections of exercise At present, due to people’s less exercise, resulting in lumbar back muscle relaxation, easy to cause lumbar disc herniation. 10 sections of lumbar spine rehabilitation exercise for lumbar disc herniation in the acute stage, the late stage and the course of the longer patients are very effective. If the exercises are performed in the acute stage of lumbar disc herniation, adaptive pulling activities and relaxation activities are used to release the spasm of lumbar muscles and improve blood circulation, it can promote the elimination of inflammation and prevent the adhesion of the nerve root; if it is in the late stage, exercises to increase the strength of the lumbar back muscles and improve the function of the waist and legs can be carried out, in order to correct the bad posture in the lumbar region, increase the stability of the lumbar vertebrae, and prevent the recurrence of the disease. For patients with a longer course of disease, muscle atrophy or decreased muscle strength in the lower limbs on the affected side, weakened low back muscle strength or imbalance between the two sides, these 10 exercises can also be used to improve these symptoms. Bed exercises The first section, leg extension exercise. Lie on your back, alternately bend the knees of both lower limbs and lift them up, try to stay close to the lower abdomen, repeat 10-20 times. The second section, lumbar movement. Lie on your back, bend both knees, make a fist with both hands, bend both hands to the side of the body, lift your waist and buttocks up as much as possible, lift your chest, and slowly perform 10-20 times. Section 3, backward stretching exercise. Prone position, both arms and legs naturally straight, the lower limbs alternately upward as far as possible to lift, each repeated 10 to 20 times. The fourth section, boat movement. Prone position, both elbows flexed, hands crossed behind the waist, both lower limbs rhythmically force backward lifting, lowering, at the same time to lift the chest, repeat 10 to 20 times. Section V. Push-ups. Lie down, bend both elbows, put both hands on the chest and press the bed, straighten both legs naturally, straighten both elbows and hold up, at the same time, lift the whole body upward, lift the chest and head up, repeat 10 to 20 times. Upright position exercise Section 1, upside down feet exercise. Upright position, feet together, heels rhythmically lifted off the ground, and then put down, so alternately, for 1 to 2 minutes. The second section, kicking movement. Hands on the waist or a hand to support the object, the two lower limbs rhythmically alternately try to kick forward, back stretch. Each lasts 10 to 20 times. The third section, stretching exercise. Hands on the object, double lower limbs alternately backward stretching, toes on the ground, try to stretch backward waist. Each lasting 10 to 20 times. The fourth section, turning waist movement. Stand naturally, feet apart and shoulder-width apart, elbow joints of both upper limbs flexed and stretched out, and then move your upper limbs rhythmically from side to side, driving the waist to rotate. Continue for 1 to 2 minutes. Section V, hanging movement. Grasp the bar or door frame with both hands, feet hanging in the air, waist relaxation or for abdominal, abdominal movement, try to adhere to, but do not force.