What is lumbar disc herniation? It refers to a herniated or prolapsed nucleus pulposus and a ruptured lumbar intervertebral disc fibrous ring. What kind of people are more likely to develop it? Sex: About 3.1% in men and 1.3% in women Age: It is more common in young adults, with a high incidence in the 20-40 age group, because young adults work more intensely. Body type: too obese or too thin. People with poor working posture Occupation: engaged in greater labor intensity; engaged in ambulatory work (office workers, drivers, accountants, etc.) People with congenital lumbar spine malformation or developmental deformity Women before and after childbirth and menopause When the following symptoms occur, you should suspect that you may have lumbar disc herniation and should go to the hospital for consultation. 1.After lumbar trauma, lumbar pain with unilateral or bilateral lower limb pain 2.Significant lumbar pain with the site in the lower lumbar region, mostly to one side. Radiating pain from the buttocks to the distal part of the lower limbs, sometimes accompanied by weakness and numbness. In severe cases, there is difficulty in urinary and faecal function and loss of sensation in the saddle area. 3. Pain or numbness in the unilateral saddle area (the area in contact with the seat of the bicycle) or in the lateral or medial side of the calf, dorsal or medial side of the foot on one side (both sides). 4. The pain is relieved after rest and reappears after getting out of bed and moving around, or even unable to stand up straight and walk, and the pain increases when coughing, sneezing or lifting heavy objects. Causes: Lumbar disc herniation is the main cause of lumbar leg pain, but lumbar leg pain is not equal to lumbar disc herniation. Such as spondylolisthesis, lumbar spine occupancy (tuberculosis, tumor), spinal stenosis, pear-shaped muscle syndrome, pelvic disease, ankylosing spondylitis, hip arthritis, etc. Therefore, some auxiliary examinations are needed when lumbar pain occurs. What tests should be done after suspicion? Relevant examinations include lumbar spine X-ray, lumbar spine CT, MRI. X-ray: observe the physiological curvature of the patient’s lumbar spine and whether it is combined with spinal deformity; whether the lumbar spine is osteoporotic, bone formation and degeneration. CT: observe whether the lumbar intervertebral disc is herniated, whether the nerve roots and dural sac are compressed, whether the diameter of the spinal canal is narrowed, and bone changes. MRI: Observe the soft tissue condition, and it is easier to observe whether the lumbar intervertebral disc is herniated, whether the nerve root and dural sac are compressed than the lumbar spine CT, which can observe a wider range of segments. What should I do if I have a lumbar disc herniation? The purpose of our treatment is to relieve nerve compression or irritation, reduce or eliminate nerve inflammation, and promote recovery of nerve and muscle function. The methods of treatment include: non-surgical treatment, surgical treatment, minimally invasive treatment, etc. The choice of specific methods depends on the individual patient’s symptoms and the degree of herniation revealed by relevant imaging examinations. 80%-90% of patients can be cured or relieved by conservative treatment. Treatment of acute attack of lumbar disc herniation: 1, non-surgical treatment: Chinese and Western medicine, traction, manipulation, physical therapy, acupuncture, closure therapy, nucleus pulposus treatment, etc. 2, surgical treatment: anterior and posterior, the latter most commonly used. Posterior surgery is divided into total laminectomy, hemilartebral laminectomy and open window according to the method of entering the spinal canal. New treatment modalities: (1) Minimally invasive surgery: percutaneous lumbar discectomy and aspiration. (2) Artificial disc replacement: posterior non-fusion (artificial ligament, interspinous bracing device) Conservative treatment: (1) bed rest. (2) Traction therapy: Generally, axial pelvic traction in the prone position is used. (3) Various physiotherapy treatments: recommended to be performed in a regular hospital by a specially trained physician. (4) Medication: mainly anti-inflammatory, pain-relieving and dehydrating drugs. (5) Local closure therapy: including local acupuncture point closure and local regional closure. (6) Epidural injection therapy: the drug reaches the site of the nerve directly. Can we do massage treatment? Manual massage is not effective for all patients, depending on the type of herniated disc pathology, and is related to the appropriateness of the technique. In the case of intermediate disc herniation, massage can make the herniated discs smaller, and with bed rest, the edematous nerve root swelling can be reduced, microcirculation can be improved, and symptoms can be relieved. Which patients can not do massage? 1, the fiber ring has ruptured or the nucleus pulposus has broken through the posterior longitudinal ligament of the mature type protrusion. If the clinical diagnosis of central lumbar disc herniation, and the symptoms are more serious, should be early surgery, should not massage. 2, some special types of lumbar disc herniation: such as lumbar disc herniation combined with ossification, lumbar disc herniation combined with bone protrusion at the lower posterior edge of the vertebral body or protrusion in the neural tube. 3, combined with fractures, bone and joint tuberculosis, osteomyelitis, tumors, severe senile osteoporosis, etc., or with hypertension, heart disease, diabetes and other systemic diseases, contraindicated push-up. 4, adult intervertebral disc tissue that began to degenerate, showing low elasticity of the fibrous ring, less water in the nucleus pulposus, if the pressure increases in the intervertebral disc, when the disc has degenerated or protruded, by the violent effect of massage, can suddenly make the intervertebral disc extrusion, its pressure rises, forcing the disc protrusion increased or fibrous ring broken, breaking through the longitudinal ligament into the spinal canal, compression of the cauda equina nerve, causing damage to the cauda equina nerve . Excessive violence can directly damage the cauda equina nerve, and even make the cauda equina nerve rupture. 5, domestic people engaged in massage and massage, the level varies, should be carried out in the regular medical institutions. Minimally invasive treatment: chemical nucleolysis, percutaneous discectomy, laser disc decompression, intravertebral disc electrothermal therapy, pulpal nucleoplasty. The first two are more popular and have the advantages of easy operation, primary and secondary treatment, less trauma, less pain, faster recovery and fewer complications. Advantages: 1. Good efficacy: compared with traditional open surgery, the efficacy is comparable as long as the surgical indications are properly selected. 2, small trauma: the incision is only 0.6-1.6cm, no stripping of muscle tissue, maximum protection of soft tissue, less postoperative muscular pain. 3.Small impact on the stability of the spine: the surgical lamina and other bony tissues are removed less, the surgery goes directly to the lesion, and only the degenerated and herniated disc nucleus pulposus is removed, which has minimal impact on the stability of the spine. 4.Low risk: less interference with nerves and blood vessels in the spinal canal, greatly reducing the risk of intraoperative damage to blood vessels and nerves. 5, low requirements for anesthesia: can be performed under local anesthesia, reducing the possible effects of anesthesia on the patient. 6.Fast recovery: you can walk on the ground on the 1st day after surgery, and the number of hospitalization days is significantly shortened. 7.Low cost: short hospitalization time, less material cost, local anesthesia saves more cost. How to prevent: The lumbar disc herniation is mainly resting, and bed rest is suitable. Therefore, yoga, gymnastics, badminton, table tennis and other ball sports are not suitable for patients with lumbar disc herniation. But swimming can. Swimming can effectively reduce the compression and wear and tear on the disc caused by prolonged standing and sitting while strengthening the muscles of the human back. Walk backwards! Sleep: the bed is too soft and too hard are not suitable, it is best to sleep in the softness of the palm or other plant-filled mattress. Pillows should be harder, generally choose to use buckwheat bark, bushel, cotton, silkworm poop, mung bean shells as filler. Quit smoking and drinking, smoking and drinking will affect the blood circulation of the nucleus pulposus and delay the healing of the injury. Low back muscle exercise: 1, five-point support method 2, upper body “small swallow fly” 3, straight leg raise method 4, leg press method 5, sit-up method Relapse prevention: in daily life and work to develop the correct posture and habits, pay attention to the usual standing, sitting, labor posture and sleep posture and so on the rationality of correcting bad posture and habits In addition, strengthen exercise, enhance physical fitness, especially strengthen the functional exercise of the lumbar and back muscles.