Non-surgical treatment of lumbar disc herniation

Lumbar intervertebral disc herniation is a common disease in young and middle-aged people, and in recent years, with the aggravation of aging in society, the onset of the disease is aging again, and there is a trend of further expansion of the victim group. The pathological mechanism of the disease is complex, and the clinical symptoms are variable, and it is recognized as one of the difficult-to-treat diseases. At present, there are various treatment methods for the disease, which can be broadly divided into surgical and non-surgical treatments. It is reported that 85% to 90% of patients with various acute and chronic lumbar disc herniation, including those with post-operative lumbar disc herniation, can satisfactorily eliminate pain symptoms with active, systematic, regular and timely non-operative treatment, and the clinical efficiency can reach 80% to 90%. In addition, because non-operative treatment preserves the integrity of the normal anatomical structure of the lumbar region to the maximum extent, it preserves the necessary histomorphological basis for patients to perform functional exercises, resume normal activities and prevent recurrence as early as possible. Therefore, non-surgical treatment can spare patients the pain of surgery and has the advantages of effectiveness of clinical treatment, wide applicability of cases and diversity of methods, plus safety of use, few complications and stable long-term efficacy, thus becoming the treatment of choice for many patients with lumbar intervertebral disc herniation. The common non-surgical treatments for lumbar disc herniation mainly include traction therapy, acupressure, acupuncture, Chinese herbal medicine and sacral drip therapy. Their scope of application and technical requirements are different, but their mechanisms of action are to relieve the pressure on the affected nerve roots and related tissues, improve blood supply, eliminate local inflammatory edema and spasm of the lumbar back muscles. Various non-surgical therapies can be effective when used alone, but if multiple mature non-surgical therapies are used in combination, the advantages of each can be enhanced, thus further improving the efficacy and shortening the treatment period. In recent years, with the accumulation of clinical experience and the rapid development of basic medicine, various new methods and doctrinal ideas have emerged, thus promoting the development of the entire level of clinical medicine. Among them, the traditional Chinese medicine approach emphasizes the holistic concept and dialectical treatment, thus occupying a very prominent position in the treatment of lumbar disc protrusion. The biggest problem of patients with lumbar disc herniation is the varying degrees of leg pain or lumbar leg pain, and the continuous or severe pain not only causes physiological trauma to the patient, but also brings a certain amount of psychological pressure. Therefore, rapid relief of pain symptoms becomes the main purpose of many non-surgical treatments. In this regard, all places have accumulated rich clinical experience and have their own more mature and unique methods. Based on the clinical experience of various schools, we summarized the “triple therapy” of Chinese herbal medicine plus electroacupuncture and manipulation. This method has certain advantages in eliminating pain and improving the function of the lumbar spine. First, we explored the appropriate technical parameters for electroacupuncture treatment of lumbar disc herniation with reference to the results of relevant basic research, aiming to improve the analgesic effect and achieve the purpose of “treating the symptoms when it is urgent”. Clinical research has confirmed that this method not only has the obvious “immediate analgesic” effect during acupuncture, but also has the “after-effect” that lasts for a period of time after the end of treatment. The immediate effect of intermittent treatment and the continuous after-effect can be added up, so that the number of treatments and the treatment period can be further reduced. Secondly, based on the theory and practice of “Shi’s Injuries” on low back and leg pain, we adopt the method of internal administration of Chinese herbal formulae to tonify the kidneys and activate the blood, in order to obtain the effects of diuresis, swelling, activation of blood to relieve pain, tonifying the kidneys and strengthening the waist and knees. In addition, according to the functional status of the lumbar spine of patients at different stages of pathology, we also use various kinds of manipulative treatment, focusing on adjusting the coordination of the patient’s lumbar and back muscles, promoting blood circulation in the lumbar and leg area, and speeding up the recovery of the disease. The combined use of these three methods reflects the characteristics of traditional Chinese medicine of “treating both inside and outside and taking into account both the symptoms and the root causes”, which is in line with the pathological mechanism and clinical manifestations of lumbar disc herniation and has the effect of both controlling the development of the disease and preventing recurrence.