Clinical management concept of lumbar disc herniation

Lumbar disc herniation is a common orthopedic disorder and is one of the most common lumbar disorders in clinical practice. For the people, it is roughly equivalent to the category of “lumbago” and “lumbar and leg pain”, but not exactly the same. The corresponding clinical symptoms of nerve root compression after lumbar disc nucleus pulposus herniation are mainly due to ischemia and hypoxia in the compressed nerve root and its blood vessels, severe local edema of the nerve root, adhesion of the nucleus pulposus to the nerve root and its surrounding tissues, corresponding aseptic inflammation of the nerve root, stimulation of the nerve root, and finally clinical symptoms such as back and leg pain, numbness, muscle atrophy and paralysis. Based on the above analysis of the causes of clinical manifestations of lumbar disc herniation, the clinical treatment concept is described as follows. The first priority is to release the compression of the nerve roots and spinal cord by the nucleus pulposus of the degenerated herniated disc, prevent the aggravation of persistent nerve damage, relieve the pressure in the local intervertebral space, and create a basic environment and prerequisite for the recovery of the locally compressed lesion-producing nerve tissue, with specific methods including surgical release of compression, adequate rest, medication to reduce edema, physiotherapy, etc. Reduce the local sterile inflammatory stimulation of the compressed nerve root and reduce the adhesion of the protruding nucleus pulposus to the surrounding nerve connective tissue, specific methods include physiotherapy, adequate rest, drugs (dehydration, nerve nutrition, anti-inflammatory), rehabilitation exercises, etc. During the period of stabilization and remission, the stability of the lumbar spine should be enhanced by various methods, and the prevention of recurrence should be emphasized. While wearing a lumbar girth to stabilize the lumbar spine, the pulling and exercise of the lumbar back muscles and lateral collateral ligaments of the spine should be strengthened, and traction and massage physiotherapy should be appropriately coordinated to accelerate local blood circulation and promote tissue recovery. The patient should pay special attention to life, living and work for a long period of time after the disappearance of pain symptoms, lie on a hard bed, correct the usual incorrect posture of standing, sitting, labor and sleep, avoid prolonged sitting, prolonged bending and excessive, overly strenuous movements of the waist, strengthen the exercise of the lumbar back muscles, enhance physical fitness, prevent muscle atrophy, and improve the stability, flexibility and durability of the lumbar spine. The purpose of the exercise is to prevent the recurrence of lumbar disc herniation.