Low back pain is one of the common reasons for orthopedic patients to visit the doctor. Probably because there are too many media presentations and advertisements, many people immediately associate the appearance of low back pain with orthopedic diseases such as herniated lumbar disc.
In fact, you do not have to blindly treat yourself as soon as the symptoms appear. There are many kinds of diseases that can cause back pain, and the two most confusing ones are lumbar disc herniation and lumbar strain. Today, we invited our orthopedic specialist, Professor Long Yinsheng, to explain in detail from several aspects, hoping that we will not delay treatment due to misdiagnosis.
The difference between lumbar disc herniation and lumbar muscle strain
The lumbar disc herniation is a painful symptom caused by the lumbar intervertebral disc pulp outwardly pressing on the nerves, while lumbar muscle strain is a soft tissue injury to the muscles on both sides of the lumbar spine.
The relationship between lumbar disc herniation and lumbar strain
Lumbar muscle strain is more common than lumbar disc herniation. Lumbar muscle strain is a lesion that targets the muscles and soft tissues around the lumbar region. If it is not effectively treated for a long period of time, then the protective effect of the muscles and soft tissues on the lumbar spine is reduced, thus triggering the lesion of the intervertebral disc.
After the lumbar disc herniation causes lumbar pain, it leads to the change of lumbar posture, which causes lumbar muscle strain or makes it worse. Therefore, lumbar disc herniation and lumbar muscle strain are two diseases, but they may exist at the same time.
The significance of differentiating lumbar disc herniation from lumbar muscle strain
Lumbar strain does not require surgical treatment and is treated conservatively. This is not to say that the treatment of lumbar strain is not important. If you are sure that it is a lumbar strain, you should pay attention to maintenance, rest and hurry up the treatment. This disease, if not treated effectively, will easily cause habitual injury and will result in shorter and shorter frequency of the disease, heavier and heavier disease, more and more difficult to treat and longer and longer disease duration, etc.
The combination of multiple therapies used to treat lumbar strain can only be used as an adjunctive treatment, and its main treatment should be based on self-behavioral treatment. This is something that the majority of patients do not really understand, which is to change the habits that aggravate lumbar strain in work and life.
When a herniated lumbar disc is suspected
1.Lumbar pain
Low back pain is the first symptom to appear in most patients with this condition, with an incidence of about 91%. A few patients have only leg pain without lumbar pain, so it is not certain that lumbar pain will occur in every patient. There are also some patients who have low back pain first and then leg pain after a period of time, while the low back pain reduces or disappears on its own and only complains of leg pain when they come to the clinic.
2.Radiation pain of lower limbs
Low back pain is easy to come on after trauma, exertion and cold, each time for about 2-3 weeks, and can be gradually relieved. Any factors that increase abdominal pressure such as coughing, straining to defecate, laughing, sneezing, lifting heavy objects, chronic coughing, etc. are likely to trigger lumbar leg pain or aggravate the already occurring lumbar leg pain.
Common sites and clinical manifestations of lumbar disc herniation
3.Limited lumbar activities
The forward flexion and backward extension activities of the lumbar spine in patients with lumbar disc herniation are closely related to the degree of disc herniation. If the fibrous ring is not completely ruptured, the lumbar spine takes the forward flexion position and the posterior extension is restricted.
4. Scoliosis
This is a postural compensatory deformity adopted by patients with lumbar disc herniation to reduce pain. The lumbar vertebrae are bent to the left or right, and the spinous process can be distorted by touching the spinous process in the middle of the back, but this is not a unique sign of lumbar disc herniation, as about 50% of normal people also have a distorted spinous process.
5. Limping
The claudication that occurs in lumbar disc herniation is mostly intermittent, i.e., pain and weakness in the lower extremities after walking a certain distance, and the symptoms can be relieved after bending down or squatting to rest, and the person can still continue walking. With the passage of time, the symptoms of lumbar disc herniation will gradually and slowly aggravate.
6.Sensory numbness
Among patients with lumbar disc herniation, some of them do not experience pain in the lower limbs but only numbness in the limbs, which is mostly caused by the compression of the proprioceptive and tactile fibers of the nerves by the disc tissue. The cause of sensory disturbance in the lateral thigh is mostly due to bulging of the annulus fibrosus or joint degeneration,
This is not due to disc herniation.