Lumbar disc herniation is a common disease characterized by low back pain and radiating pain in the lower extremities, which causes great inconvenience to the patient’s daily life. Orthopedic surgeons often use surgical methods, which are not easily accepted by patients. Conservative treatment is the preferred method of treating lumbar disc herniation. Comprehensive treatment such as massage, acupuncture, physiotherapy, traction, bed rest, hot compresses and Chinese and Western medicines can have unexpected effects. If the patient pays attention to self-maintenance and proper functional exercise while treating, it can achieve twice the effect with half the effort.
First, maintenance
1, bedding: hard board bed can give solid support to the waist, very hard Simmons (spring mattress that can provide solid support), can also play a similar role. Bed is also a treatment, supine position is best, but for those with severe pain, it is appropriate to use the most comfortable position; hard bed can be padded with a thickness of about 5 cm bedding, but should not be padded with inelastic soft sponge.
2. Keep warm: cold stimulation causes muscle spasm and induces or aggravates pain. The dwelling should avoid damp and cold; it is not advisable to wash the feet with cold water; shoes should be soft-soled and flat-heeled, and you should get used to wearing socks often; you should pay more attention to keeping warm in the hot season, and air conditioning, bamboo mats and bare feet may induce the disease.
3, waist circumference: in the acute period, waist circumference can reduce the burden on the waist and relieve pain; in the remission period and usual, waist circumference can prevent lumbar injury. Waist circumference must have a certain width, about 30 cm is appropriate, the internal curved tough steel or hard plastic plate support; its breathability should be good, canvas or cowhide is better, followed by nylon surface. Waist circumference should not be used for a long time, so as not to affect the recovery of lumbar muscle strength. When lying in bed, it is not appropriate to use lumbar girth.
4, posture: bending forward will prompt the disc to protrude backward, and if combined with the twisting of the waist, it will cause damage to the fibrous ring. In daily life and work should try to maintain a straight posture at the waist, such as: should avoid bending over to sweep, wipe the floor, wash dishes, brush teeth or wash clothes in the bathtub; pick up items from the ground or low, should first squat, hold the items, put the items as close to the body as possible, and then slowly stand up with the strength of the legs; similarly, should not lean on the head of the bed (half lying half sitting position) to read or watch TV, should not sit for a long time on the sofa, low stool ( If you have to, you can put a cushion on your waist; you should sit in a bus or van with a slightly forward seat to avoid vibration; when you get up, you should not use the sit-up method, but lie on your side first (right side for example), move your bent legs under the bed, use your right elbow and left palm to support the force and sit up slowly. Although many patients have no problem riding a bicycle, they should not ride for too long and should put the seat cushion as low as possible.
5, rest: rest can promote the repair of the intervertebral disc. The pressure in the intervertebral disc is minimal when lying down, so if you have the conditions to lie down for a while at noon, there are great benefits, but you should pay attention to keeping warm; long-distance driving, standing or sitting is not good, and long-distance travel is not advisable, so pay attention to posture change and lumbar protection. Posture change can reduce strain, sedentary office should regularly spend a few minutes to get up and walk. Sexual life should be properly restrained. Clinical studies have found that the initial attack of lumbar disc herniation is more related to injury, while recurrence is most closely related to strain, which leads to a decrease in lumbar muscle strength, resulting in a decrease in the ability to protect the stability of the lumbar spine, thus causing recurrence.
6, diet: there is generally nothing contraindicated in diet, follow a good diet on it. Some people are inclined to allergies, and consuming foods with high levels of dissimilar proteins such as hairy crabs and turtle can trigger or aggravate lumbar pain due to allergic reactions, which should be duly noted. Traditionally, you should eat warm food and avoid fishy and cold food, but you don’t have to stick to it if you don’t feel sick. Some people are addicted to spicy food, but they should also pay attention to moderation. Some people can also induce pain or cause difficulty in passing stool or hemorrhoid attacks, which can also indirectly aggravate lumbar prolapse. Keep your bowels open from time to time to avoid aggravating the symptoms because of forceful bowel movements.
Second, exercise
Exercise should follow some principles, such as: the intensity is appropriate, avoid strain; action should not be strenuous, not too much bending, twisting and jumping movements; should gradually start exercising after the symptoms are relieved, should be gradual, persistent; most importantly, should be under the guidance of a doctor to exercise, choose the appropriate posture and action as well as the intensity and progress. The following are a few commonly used methods to exercise the low back and abdominal muscles.
1, prone position
Face down, whole body relaxed, lying flat, hands on both sides of the body, both lower limbs straight.
Single-leg extension: one lower limb straight, slowly lift upward, to the front of the thigh to leave the bed, and then slowly put down, relaxed, in the second leg lift. Do not lift the leg too high, and the speed should not be too fast. After lifting one lower limb 5-10 times, then lift the other lower limb. This action is a small exercise intensity.
Double leg extension: hands on the waist, double lower limbs straight slowly upwards to the front of the thighs to leave the bed, and then slowly put down, relax, and then do the second leg lift. After 5-10 times, rest for 4-5 minutes and then do 1-2 sets. This group of movements exercise intensity medium.
Swallow double fly: hands straight back, the two lower limbs and upper chest at the same time lift off the bed, maintain a few seconds and then put down, repeat several times, this action exercise intensity. Because this action is similar to the flying swallow, known as the flying swallow or swallow double fly.
2.Supine position
Five-point support: with the head, elbows and heels, lift the body off the bed, maintain a few seconds and then put it down, the movement is less intense, suitable for patients with severe pain in the acute stage.
Three-point support: with the head and both heels, hands on the chest, forcefully lift the body off the bed, maintain a few seconds and then put it down, not suitable for patients with cervical spondylosis.
Bridge or bow exercise: with the palms of both hands and the heels of both feet, forcefully lift the body away from the bed in the shape of a bow or bridge, maintain a few seconds and then put down, this action is strong, difficult, to be measured.
3.Supine position
Abdominal muscle training: double lower limbs straight and slowly lift, lift to the lower limbs and the angle of 30-45 degrees can be maintained for a few seconds and then slowly put down, repeat several times. Can increase the strength of the abdominal muscles, applicable to most patients with low back pain, more effective for lumbar spondylolisthesis. Note that sit-ups should not be done, there is damage to the lumbar spine.
Pedal bike: both lower limbs bend knees and hips, lower legs hanging, for alternate pedaling action, similar to the action of riding a bicycle, can be made for several minutes, is also one of the methods to exercise the abdominal muscles and iliopsoas muscle.
4.Walk backwards
Legs alternately backward stride to walk backward at an even speed, can exercise the muscles of the waist and back and buttocks, the intensity is small, generally applicable to the elderly, can be made for about half an hour. But pay attention to safety, to avoid accidents, generally do not recommend patients to do backward walking exercise.
Note: the above exercise methods are generally applicable to lumbar disc herniation, lumbar muscle strain and lumbar degenerative osteoarthritis, etc., not necessarily applicable to lumbar spondylolisthesis, please consult your physician before exercise.