Rehabilitation exercises for lumbar disc herniation

Lumbar disc herniation is a syndrome caused by degeneration of the intervertebral disc, rupture of the fibrous annulus, and protrusion of the sacral nucleus tissue to irritate and compress the nerve roots. The main manifestations are lumbago and sciatica, which may be accompanied by limitation of lumbar activities and changes in sensation, movement and reflexes in the area innervated by the affected nerve roots. Functional exercise program starting from the first day after surgery Phase I: (3-5 days in total) ①Straight leg raising exercise in supine position and lower limb flexion and extension exercise: prevent nerve root adhesions, initially starting from 30°, holding time gradually increasing from 15 seconds, 10 times/group, 2-3 groups/day. Ankle dorsiflexion and dorsiflexion exercises: hold each movement for 10 seconds, repeat 20 times/group, 3-4 groups/day. Phase 2: (Mainly do lumbar back exercises) ① 5-point support method: (5-7 days after surgery) Lie flat on a hard bed, use head, feet and elbows to support at 5 points, lift the hips, and raise the hips as high as possible. Hold for 10 seconds, repeat 20 times/group, 2-3 groups/day. ② 3-point support method: (7-9 days postoperative) Lie flat on a hard bed, support with head and feet at 3 points, hold the hips up and lift the hips as high as possible. Hold for 10 seconds, repeat 20 times/group, 2-3 groups/day. ③ 4-point support method: i.e. arch bridge support method (9-10 days after surgery) Lie flat on a hard board bed and use both hands and feet to support the body all the way up in the shape of an arch bridge. Hold for 10 seconds, repeat 20 times/group, 2-3 groups/day. ④Flying swallow point water method: (10-15 days after surgery) lying prone with the hard board bed, head, both upper limbs, both lower limbs posterior extension, abdomen touching the bed as small as possible, in the shape of flying swallow. Hold for 10 seconds, repeat 20 times/group, 2-3 groups/day. (Note: Severe lumbar fractures are unstable fractures, and appropriate lumbar back muscle exercises should be performed so that the fracture can obtain a certain degree of repositioning and finally get out of bed with a support such as a lumbar girth.) Phase 3: (Starting 30 days after surgery) Instruct the patient to use the lumbar girth correctly to avoid twisting the spine when moving. The lumbar girth should be chosen to correspond to the patient’s body type, generally up to the upper rib arch and down to the lower iliac crest, and should not be too tight. Practice getting out of bed with the lumbar girth on, i.e. standing with feet shoulder-width apart, hands crossed at the waist, chest up and abdomen out, so that the lumbar back muscles contract. When walking with correct posture, head up, chest up and abdomen in, sitting position must be upright, do not bend over. Discharge health education: ① Continue the exercise content learned in the hospital after discharge, selective implementation, the number of times time depends on the specific situation, the amount of exercise gradually, a certain interval in the exercise, to avoid excessive strain on the waist. ② Do not use waist brace continuously for more than 3 months to avoid costly muscle atrophy. ③ Avoid strenuous activities and lifting heavy objects within 3-6 months, avoid sedentary, running and jumping as much as possible, avoid sleeping on soft beds, take bending knees and squatting posture when lifting heavy objects from the ground to extract, establish a good life style, change sitting posture frequently, strengthen lumbar back muscle exercise for more than half a year to enhance lumbar muscles and spinal stability. Reduce the onset of chronic low back pain, prevent lumbar injury and review of lumbar disc herniation. ④Strengthen nutrition and maintain a good state of mind. ⑤ Pay attention to keep warm and avoid cold stimulation. ⑥For simple lumbar compression fracture, get out of bed 8-12 weeks after injury and do not bend, practice bending after 3 months, and participate in labor appropriately after 4-6 months.