Overview:What is lumbar disc herniation Lumbar disc herniation is one of the more common clinical lumbar disorders and is a common disease in orthopedics and traumatology. It is mainly due to the degenerative changes of various parts of the lumbar disc (nucleus pulposus, fibrous ring and cartilage plate), especially the nucleus pulposus, which ruptures the fibrous ring of the disc under the action of external factors. The lumbar disc herniation is a diagnosis in Western medicine, and Chinese medicine does not have the name of this disease, but classifies it under the name of “lumbago”. Lumbar disc herniation is common among people: ( ) From age: lumbar disc herniation is common among young adults ( ) From gender: lumbar disc herniation is more common in men, and the incidence rate of men is higher than that of women, and it is generally believed that the ratio of men to women is ~ : ( ) From body type: people who are generally too obese or too thin are prone to lumbar disc herniation ( ) From occupation In terms of occupation: industrial workers with high labor intensity are more common, but at present the incidence rate of mental workers is not very low ( ) In terms of posture: poor work posture, poor row of workers and often standing salesmen, textile workers, etc. are more common ( ) In terms of living and working environment: often in a cold or humid environment are to a certain extent the conditions that induce lumbar disc herniation ( ) In terms of different periods of women. ( ) From the different periods of women: prenatal, postnatal and menopause are the risk periods for lumbar disc herniation in women ( ) People with congenital lumbar spine dysplasia or deformity and even those who are too nervous are prone to lumbar pain Smokers may be related to the fact that coughing can cause an increase in the internal pressure of the intervertebral disc and the pressure in the spinal canal, making it easy for degenerative changes to occur Etiology: causes of lumbar disc herniation ( ) Degenerative changes of the lumbar disc: degeneration of the nucleus pulposus is mainly manifested as a decrease in water content and can be caused by the loss of water. The degeneration of the nucleus pulposus is mainly characterized by a decrease in water content and can cause small-scale pathological changes such as destabilization and loosening of the pushed joints due to water loss; the degeneration of the annulus fibrosus is mainly characterized by a decrease in the degree of toughness (） The action of external forces: the minor damage caused by repeated external forces over a long period of time acts on the lumbar intervertebral disc over time to aggravate the degree of degeneration (） The weakness of the disc’s own anatomical factors: ① The disc gradually lacks blood circulation after adulthood and has poor repair ability. On the basis of these factors, a trigger factor that causes a sudden increase in pressure on the disc may cause the less elastic nucleus pulposus to pass through the less tough annulus fibrosus, resulting in herniation of the nucleus pulposus. The triggering factors for lumbar disc herniation may include: ① sudden weight bearing or flashback is the main cause of rupture of the annulus fibrosus; ② trauma to the lumbar region causes protrusion of the degenerated nucleus pulposus; ③ improper posture induces protrusion of the nucleus pulposus; ④ increased abdominal pressure can also cause protrusion of the nucleus pulposus ⑤ Cold and humidity can cause small blood vessel constriction and muscle spasm to increase the pressure on the disc, which may also cause the degenerated disc to rupture External factors are excessive weight bearing or rapid bending, lateral flexion and rotation to form a ruptured annulus fibrosus or lumbar trauma Improper posture in daily life and work can also lead to lumbar disc herniation Symptoms: Clinical manifestations of lumbar disc herniation are mainly lower back pain and sciatica Before the onset of the disease, there is often a history of lumbar sprain, lumbar strain or lumbar cold. This lumbar pain is aggravated by walking, standing, sitting and other activities, and can be temporarily relieved after bed rest. In patients with high lumbar disc herniation, the symptoms are mostly in the inguinal region of the lower abdomen or in the anterior medial thigh pain Patients with large central disc herniation may have abnormal bowel movements or incontinence Numbness in the saddle area Severe foot drop may occur Some patients with lumbar disc herniation show chills in the lower extremities due to sympathetic nerve stimulation in the lumbar region Some may also have unilateral or bilateral lower extremity edema What should be done for lumbar disc herniation The X-ray signs cannot be used as a basis for the diagnosis of lumbar disc herniation, but they can be used to exclude some diseases such as lumbar tuberculosis, osteoarthritis, fracture, tumor and spinal slippage, etc. In severe cases or atypical cases, spinal iodography, CT scan and MRI can be considered when the diagnosis is difficult. Most patients with lumbar disc herniation can be correctly diagnosed based on clinical symptoms or signs. The main symptoms and signs are: (1) low back pain combined with “sciatica” radiation to the calf or foot, positive straight leg elevation test, and (2) low back pain combined with “sciatica”. (2) there are obvious pressure points lateral to the lumbar – or lumbosacral – interspinous ligaments and radiating pain to the calf or foot; (3) there is decreased skin sensation in the anterior and lateral calves, decreased toe strength, and decreased or absent Achilles tendon reflex on the affected side.