Conservative treatment for patients with lumbar disc herniation

Conservative treatment of lumbar disc herniation, also known as non-surgical treatment, commonly used methods are: medication, braking therapy, traditional manipulation, physical therapy, traction therapy, etc., as follows: 1, braking therapy: mainly bed, especially during acute attacks, bed can make the pressure of the intervertebral disc, dural sac, nerve roots drop sharply, to avoid further irritation of the nerve roots to the maximum extent possible. The bed rest here refers to absolute lying on a hard bed, except for going to the toilet and eating all in bed. 2.Traditional techniques include tui na, massage, knee twisting, pulling, rubbing and percussion, etc. The efficacy depends on the degree of prominence and the practitioner’s technique. The mechanism is to improve microcirculation, relieve local spasm, promote inflammation absorption, change the location of the protrusion, reduce the release of inflammatory substances, improve the nerve pain threshold, and play anti-inflammatory and analgesic effects. 3.Physiotherapy: mainly electrical therapy (low frequency, medium frequency, high frequency), infrared therapy, wax therapy, magnetic therapy and so on. The main role is to eliminate local muscle inflammation, relieve muscle spasm, so as to achieve analgesia and reduce the role of interdisc pressure 4, traction therapy can be divided into mechanical traction (vibration, pulse type, etc.), pelvic traction (continuous or intermittent), generally need to be carried out in the hospital. Suitable for: short duration of disease more <3 months, small protrusions more <8mm, post-operative recurrence patients. However, the efficacy is poor for long duration and large protrusions. Contraindicated for: unclear diagnosis (such as suspected lumbar spine tumor, tuberculosis, etc.) advanced age, poor general condition, severe respiratory and circulatory diseases, osteoporosis, spinal stenosis and aggravation after traction. < p=""> The mechanism lies in: widening the vertebral space, relieving muscle spasm, enlarging the intervertebral foramen, and reducing the compression of nerve roots; in addition, the widened vertebral space can tension the posterior longitudinal ligament, relax the yellow ligament, promote the return of the nucleus pulposus, improve the relationship between the nerve roots and the herniated disc, and reduce the compression of the herniated material on the nerve roots to achieve the purpose of treatment. Home traction for patients with lumbar disc herniation generally uses the pelvic continuous traction method, so patients need to be equipped with pelvic traction belt, traction rope, pulley fixation frame and weights, etc., and can also buy special traction clothes. The pelvic traction belt is easy to make and can be made of appropriate materials. It is better to use waxed rope with less abrasive force for the traction rope. Pulley fixing frame needs to be securely fixed on the bed frame, while traction weights can use various alternatives of suitable weight. Home traction is generally used lighter weight, roughly controlled at about 1/10 to 1/8 of the patient’s body weight. After a period of traction (about a week), if the patient’s symptoms do not improve significantly, then the weight can be increased appropriately. Traction generally 2 to 3 times a day, each time lasting half an hour can be. Home traction should be carried out under the guidance of a doctor. The posture, weight and time of traction should be carried out according to the doctor’s prescription. (2) In principle, a hard bed or other hard bed is needed to maintain the traction. If you lie on a soft bed, you lose the effect of traction and sometimes even aggravate the symptoms. (3) The traction belt used for traction must fit well. The tension of the pelvic traction belt must act on the iliac wing and must protect the bony prominence to prevent pressure sores. (4) After a period of traction, the symptoms may be relieved, at this time should not be prematurely suspended traction, but should continue to bed combined with traction treatment to reduce the possibility of recurrence. (5) Patients with no significant improvement in symptoms after a period of traction should ask the doctor to help identify the cause in a timely manner and take appropriate measures. For symptom aggravation, traction should be stopped immediately and a doctor should be consulted for further treatment.