The merits and demerits of the waistline

  The lumbar girth is one of the commonly used supports in orthopedic surgery, and many patients with back and leg pain have used it, some under the guidance of a doctor, while others have purchased it to wear on their own, so not all users are well aware of the role of the lumbar girth and how to wear it.  It is generally believed that the main role of the lumbar girth is to brake and protect.  It can partially limit the amount and range of activities of the lumbar spine, especially the forward flexion of the lumbar spine has a significant limiting effect, so that the local damaged tissue can rest, creating a favorable environment for the recovery of blood flow and repair of damaged tissue. In addition, the lumbar circumference as an external support still has the role of strengthening the stability of the lumbar spine, it can partially compensate for the lumbar spine instability due to the degeneration and protrusion of the intervertebral disc tissue.  Therefore, clinicians often instruct patients with acute lumbar disc herniation to wear a lumbar girth to enhance protection when they begin to move around after a period of bed rest or traction therapy.  To prevent re-injury to the affected lumbar spine and to play a role in further consolidation of the previous treatment effect. However, there is a duality in everything in the world. In the past, users have only focused on the support and protection of the lumbar spine by the lumbar girth, but neglected the effect of wearing the girth on the intra-abdominal pressure, which can have a very different effect on spinal load and disc pressure. The increase in intra-abdominal pressure is considered to be another element other than the spine that maintains its own vertical pressure load, and it partially shares the load on the spine and also improves the stability of the lumbar spine, and in this respect alone, the increase in spinal load sharing capacity due to the increase in intra-abdominal pressure after wearing a lumbar brace is clinically significant.  However, the increase in intra-abdominal pressure may be followed by an increase in intradiscal pressure, and the increased intra-abdominal pressure may also create a downward and backward synergy, which is a risk factor for further aggravating the degree of disc herniation and clinical symptoms. This is why the vast majority of patients with lumbar disc herniation experience increased back and leg pain due to coughing, sneezing or yelling. The reality is that if we use the method of wearing a lumbar brace to raise the intra-abdominal pressure “pressure pillar” gravity partition to reduce the external pressure of our own gravity and external load on the disc, but inadvertently increase the internal pressure of the diseased disc, this is not only detrimental to the repair of the herniated disc, but even increases the risk of the degree of disc herniation. This approach of losing one side and losing the other gives us reason to reflect on the over-emphasis on the role of the lumbar circumference and the over-reliance of patients on it.  In addition, theoretically, no lumbar girth can completely restrict lumbar spine movement or lumbosacral joint rotational movement, and even increase lumbosacral joint rotational movement for most subjects due to the immobilization of the lumbar region.  Therefore, there are conditions for the fixation and protection of lumbar girth, and the correct selection of the appropriate girth, mastering its correct wearing method and strictly controlling its use time are the main links to play its auxiliary therapeutic role and reduce its adverse effects as much as possible. Commercially available waistbands come in a variety of sizes, generally made of leather or canvas lined with steel or bamboo, and those in need should choose one that is the right size, width and flexibility.  In addition, the current market can be purchased Chinese medicine waist circumference, electric waist circumference, magnetic therapy waist circumference and other so-called multi-functional waist circumference, the developer believes that still has the role of Chinese medicine ion introduction, magnetic therapy, etc., those who have the conditions also choose to buy.  After purchasing the waist circumference, whether to wear it should be based on the principle of whether the waist and leg pain is obvious, when the symptoms of acute waist and leg pain patients are serious, bed rest is emphasized as the main, can not wear the waist circumference to replace bed rest, but in the downstairs toilets, out in the car and other links should wear the waist circumference to protect, use if the discomfort should be carefully adjusted its size, elasticity. After the acute period, the patient should gradually move to the ground when the symptoms of lumbar and leg pain are relieved, and the waist brace should be used at this time.  It is worth noting that some patients wear it all day long, even bed rest also do not take it off, this practice is inappropriate.  This is because the long-term wearing of the waist circumference will also make the waist muscles to varying degrees of disuse atrophy, thus reducing the role of the waist muscle group “soft pillar”, and over time can make the patient a sense of dependence, once the waist circumference will appear to aggravate the symptoms, which is undoubtedly harmful to the patient’s recovery, so the use of time should be controlled. Therefore, wearing a waist girth is only a temporary, excessive auxiliary treatment measures, it is recommended to use a “decreasing” method of use, that is, in the choice of waist girth can first wide and then narrow, first hard and then soft, in the use of time can be shortened day by day, in the wearing method can be tight and then loose, if this can gradually get rid of the dependence on the waist girth, and only Only by gradually restoring the functional exercise of the lumbar back muscles at the right time and giving full play to the soft support role of the self-muscle “muscular lumbar girth” can one’s waist be truly hardened and gradually achieve the purpose of complete rehabilitation.