Nowadays, there are more and more low back pains caused by living and working habits, and the large amount of information received from various media makes people’s first reaction to associate lumbar disc herniation as a multifactorial disease. In fact, there are many kinds of diseases that can cause low back pain, the most common of which are lumbar disc herniation and lumbar muscle strain. The incidence of lumbar muscle strain is even higher than lumbar disc herniation, which can account for 60% of lumbar pain diseases. Many people also often confuse these two diseases. What is lumbar strain injury? Lumbar muscle strain is a general term for all lumbar muscle strain diseases caused by the lumbar muscles maintaining a certain state for a long time or repeatedly stretching and flexing the lumbar area, with lumbar pain and swelling as the main manifestation, including lumbar 3 transverse synovial syndrome, lumbar back fascia pain syndrome, lumbosacral ligament injury and other diseases. What is the relationship between lumbar muscle strain and lumbar disc herniation? Lumbar muscle strain is a lesion for the muscles and soft tissues around the lumbar region. If it is not effectively treated for a long time, it will reduce the protective effect of the muscles and soft tissues on the lumbar spine, which will lead to the lesion of the intervertebral disc and lumbar disc herniation. Another possibility is that after the lumbar disc herniation causes lumbar leg pain in the first place, it leads to abnormal lumbar posture, which induces lumbar muscle strain or promotes its aggravation. Therefore, although lumbar disc herniation and lumbar muscle strain are two diseases, they are closely related to each other. The following is a specific analysis of the difference between lumbar muscle strain and lumbar disc herniation: 1. About the pathogenesis Lumbar disc herniation is a degenerative disease that causes disc degeneration due to ageing, repeated shear force and load on the lumbar region, and further protrudes to compress nerves or nerve roots to produce symptoms. Lumbar strain is a sports injury disease, which is a muscle or tendon injury in the low back due to a single huge external force or repeated strain on the low back, etc. It can also be an injury to the ligaments connecting the vertebrae. Localized tissue fluid exudation and microvascular rupture form scar tissue in the intermuscular space, leading to local adhesions, degeneration, muscle atrophy, and the formation of myofasciitis. The nerve fibers in the muscle tissue are compressed and irritated by the diseased tissue, producing pain. Lumbar soft tissue injury is not treated correctly and in a timely manner, or repeatedly and repeatedly, so that the damaged tissues cannot be fully repaired, local sterile inflammation is formed, microcirculation is impaired, and metabolites such as lactic acid accumulate, which can also stimulate or compress nerve endings and produce chronic lumbar pain. 2, about the nature of pain Lumbar disc herniation pain is sharp pain in the lumbar and leg. Many cases are accompanied by unilateral or bilateral radiating pain in the buttocks, legs, feet and even toes. In addition to the electric shock-like sharp pain, it may be accompanied by numbness and weakness of the lower limbs. Patients may have a particular posture, such as significant pain relief when turning sideways to a particular side. Lumbar strain pain is usually a limited soreness-like dull pain in the lumbar region, and rarely the case will be hip pain. It is not accompanied by numbness and weakness of the lower extremities. The pain is recurrent and can be relieved after rest, but it can be relieved after prolonged bed rest, then relieved after getting up and moving around, and then increased again after prolonged activity. The most typical manifestation is the obvious low back pain and tightness of the lumbar plate in the morning, which is relieved by a little activity. 3, about physical examination When examining the body for lumbar disc herniation, the pressure points in the lumbar region are mostly in the middle of the spine or immediately adjacent to the sides. Unilateral or bilateral weakening of the lower limb muscles with hypoesthesia may occur. The straight leg raise test is positive. When the lumbar muscle strain is examined, the pressure pain points in the lumbar region are mostly on both sides of the spine. The pressure pain points cannot be precisely located, but they are usually located in the transverse process of the lumbar vertebrae, the sacrospinous muscle and the posterior edge of the iliac crest, etc. The lumbar muscles can be palpated with obvious tension, or with hard knots and hypertrophy, and the shape of the lumbar region is mostly abnormal. The pain can be relieved by pressing at the pressure point. The muscle strength of both lower limbs feels normal, and the straight leg raise test is generally negative. 4.About imaging examination Lumbar disc herniation can be well diagnosed in imaging examination. Through imaging examination, the degree of disc protrusion, nerve root compression and other visual manifestations can be observed. MRI is a more accurate test to diagnose lumbar strain due to its non-specific nature. Lumbar muscle strain leads to myofasciitis, which can occur with intra-tissue exudation, adhesions and fluid accumulation. The signs of deformation and fluid accumulation in the interosseous space, edema and fluid accumulation in the paraspinal space, edema and fluid accumulation in the transverse and articular fossa, and edema and fluid accumulation in the external iliacus-bone space are useful in the diagnosis of lumbar strain. Among them, the paraspinal space edema accumulation has the most important diagnostic value. For example, the MRI in the figure below shows: joint synovial fossa effusion (long arrow on the left) and bilateral interosseous effusion (short arrow). 5. About treatment The treatment of lumbar disc herniation is generally divided into conservative treatment and surgical treatment. Conservative treatment generally includes medication such as non-steroidal anti-inflammatory drugs, local injection of hormones and some Chinese medical treatments. Surgery is required in the following cases: history of more than three months, ineffective after strict conservative treatment; severe pain with symptoms mainly in the lower extremities; severe sensory muscle loss in the lower extremities; and manifestations of cauda equina compression such as abnormal urination and defecation. Lumbar muscle strain mainly adopts conservative treatment. First of all, bad posture and bad lumbar habits should be changed, and when the pain in the lumbar area is obvious, physical therapy can be carried out, or appropriate anti-inflammatory and pain-relieving drugs can be taken to activate blood circulation and remove blood stasis. Targeted lumbar back muscle exercise. Especially the long-term sedentary population, the weakness of the core muscle group, lack of exercise. Strengthen the core muscle group exercise can effectively prevent and control the occurrence of lumbar muscle strain, improve the stability of the spine. Here are a few ways to exercise the core muscles and prevent lumbar muscle strain. 1, flat support exercise Take a prone position, double forearm support in front of the body, keep the body straight, try to keep the longest time. 2 times a day, do 3 sets each time. 2.Bridge exercise 2-3 times a day, do 3 sets of 10-15 each time, maintain 5 seconds after lifting the hips off the plane. 3.Flying swallow exercise 2 times a day, do 3 sets of 15 or so each time, keep your shoulders and hips lifted off the plane for 5 seconds.