First, what is lumbar disc herniation human disc due to age, strain and external forces, resulting in the rupture of the annulus fibrosus, the nucleus pulposus protrudes from the rupture or prolapse, compression of the lumbar nerve root or the cauda equina nerve, and a series of neurological symptoms such as lumbar pain, numbness and other neurological symptoms, known as the lumbar herniation of the intervertebral discs. It should be pointed out that “sciatica” this common disease is actually the vast majority of lumbar disc herniation caused by. Second, the character of the lumbar intervertebral disc Adult spine length of about 70 centimeters, with the body and have to increase or decrease. It is the body’s “beam”, or “axis”, by the cervical, thoracic, lumbar, sacral and coccygeal vertebrae. The disc-shaped structure between the vertebrae is called the intervertebral disc. The disc consists of the annulus fibrosus, the nucleus pulposus, and the hyaline cartilage plate, and is shaped like a pie. Pie” is about 8 to 10 millimeters thick, the upper and lower sides of the cartilage surface of the vertebral body; the central “filling” is the gelatinous nucleus pulposus, surrounded by the “crust” is a dense annulus fibrosus. Third, the role of the lumbar intervertebral disc The role of the intervertebral disc is mainly to connect the vertebrae, reinforce the stability of the spinal column, absorb the role of shock and make the spine elastic. Lumbar intervertebral discs and cervical and thoracic intervertebral discs are basically similar to the function of the intervertebral discs in the intervention of the spine to bear the weight of the torso, contact with the limbs, to maintain the normal physiological posture of the whole body, to carry out a variety of movements of the torso, lumbar intervertebral discs play a special role in the specific functions are as follows: 1, to maintain the spinal column, maintain the height, the development of vertebrae with the discs to grow, which increases the length of the spinal column. 2.Connect the two vertebrae above and below the intervertebral disc, and make the intervertebral body has a certain degree of mobility. 3, so that the surface of the vertebral body to withstand the same force, even though there is still a certain degree of inclination between the vertebrae, but through the nucleus pulposus semi-liquid components of the whole disc to withstand the same stress. 4. Cushioning effect. Due to the elastic structure, especially the nucleus pulposus has plasticity, and can be flattened under pressure, so that the force applied on it can be transferred to the annulus fibrosus and cartilage plate in all directions on an average; it is the main structure of the spine to absorb shock, and plays the role of elastic cushion to make it play the role of cushioning for the force conduction when it falls from a high place or when it is loaded by the shoulder, back and lumbar area suddenly, and play the role of cushioning for protecting the spinal cord and the important nerves in the brain. 5.Maintaining a certain distance and height of the lateral articular eminence. 6, to maintain the size of the intervertebral foramen, under normal circumstances the size of the intervertebral foramen is 3 to 10 times the diameter of the nerve root. 7, to maintain the curvature of the spine, different parts of the intervertebral disc thickness varies, in the same lumbar intervertebral disc in the anterior thick, the posterior thin, so that the lumbar spine appeared physiological foreshortening curve. Fourth, the common causes of lumbar disc herniation 1, sudden weight bearing or flash waist: sudden increase in lumbar load, especially rapid bending, lateral flexion or rotation, is the main reason for the formation of fibrous ring rupture. 2, lumbar trauma: in the violence is strong, did not cause fracture dislocation, it is possible to make the degenerated nucleus pulposus protruding. 3, improper posture: get up, stand up and other daily life and some work, if the waist is in a flexed position, suddenly give an additional rotational movements, it is easy to induce herniation of the nucleus pulposus. 4, increased abdominal pressure: abdominal pressure and disc herniation has a certain relationship, sometimes even in violent coughing, sneezing, constipation, forceful breath holding can also occur when the herniated nucleus pulposus. 5, cold and damp: cold or damp can cause small blood vessel contraction, muscle spasm, so that the pressure of the intervertebral disc increases, may also cause degeneration of the intervertebral disc rupture. Avoid the above factors can largely play a preventive purpose. V. Common types of lumbar disc herniation 1. Symptoms: (1) Blood stasis type: lumbar and leg pain like stabbing, pain in a fixed place, light day and heavy night, inconvenience in leaning over and turning sideways, aggravated by coughing, with stool knot and drowning, irritability and dryness of the mouth. The tongue is purplish or with petechiae, and the pulse is dull and astringent. (2) Paralysis type Cold-damp type Cold pain in the lumbar spine, coldness and weakness of the limbs, sometimes numbness of the lower limbs, severe pain in the cold, pain decreases in the presence of heat, urination and drowning are clear and long. The tongue is pale, the moss is thin and white or greasy, and the pulse is dull and tight. Rheumatic type: pain in the lumbar spine, pain in the lower limbs, numbness of the skin, pain in an indefinite place, uncertainty of movement, associated with changes in the weather, accompanied by a slight aversion to wind-cold. The tongue is pale, the moss is thinly white or thinly yellow, and the pulse is weak and fine. (3) Kidney deficiency Kidney yang deficiency, lumbago, limb coldness, numbness and weakness, not cured for a long time, like to press, like to rub, especially in the case of labor. It is often accompanied by constriction in the abdomen, white color, fear of cold, and lack of energy. The tongue is pale, the moss is thin and moist, and the pulse is weak. Kidney Yin Deficiency Lumbar pain is continuous, aching and weak, not cured for a long time, and worse in case of labor. It is often accompanied by restlessness and insomnia, dry mouth and throat, flushed face, hot hands and feet. The tongue is red with little moss, and the pulse is fine. 2, pathological typing: bulging type, rupture type, free type 3, the American Academy of Orthopaedic Surgery suggests that according to the morphology of the classification: type I: degeneration; type II: bulging; type III: protruding; Ⅳ: out of; type V: ossification. Six, from what to determine whether the lumbar disc herniation lumbar disc herniation is in the intervertebral disc degenerative changes on the basis of the development of. Therefore, before the occurrence of lumbar disc herniation, it is possible because of the degenerative changes in the intervertebral disc to produce a series of precursor symptoms, these symptoms are not specific, so it is not unique to the lumbar intervertebral disc. Acute lumbago: The lumbago referred to here is different from the lumbago that occurs when engaging in sports or heavy labor and accidentally sprains the lumbar region. It is mostly triggered by some slight movements, so it is often mistaken by patients as “flashing waist” and not taken seriously. 2, recurrent lumbar pain: in the lumbar disc degeneration and intervertebral joint instability or the posterior joint over-extension, the patient can have recurrent lumbar pain. The interval between each attack varies from several days to several months. This kind of patients, due to its degeneration of the intervertebral space so that the posterior joints have been in a state of hyperextension, so the spine, if the hyperextension movement is prone to joint capsule injuries, which induced the lumbar intervertebral disc herniation. 3, chronic low back pain: some patients after several acute low back pain episodes of pain, gradually formed a persistent chronic low back pain. This kind of low back pain is often aggravated after coughing and straining. All of the above symptoms indicate the potential of lumbar disc herniation, but they are not specific, so patients with such symptoms are expected to treat them correctly. Lumbar disc herniation is common in young adults, especially in manual laborers or long-time sitting and standing workers. Patients suffering from lumbar disc herniation can show a variety of clinical symptoms depending on their age, gender, duration of illness and the location of the herniated material, and the common clinical manifestations are as follows: 1. Lumbar back pain: this kind of pain occurs before the leg pain, and can also occur at the same time. The pain is mainly in the lower lumbar or lumbosacral area, and the cause of the pain is mainly due to the stimulation of the outer layer of the annulus fibrosus and the posterior longitudinal ligament in the sinusoidal nerve fibers after the herniation of the intervertebral disc. The pain site is mostly around the lumbar vertebrae in the herniated stage. 2, lower extremity radiating pain: due to the lumbar intervertebral disc herniation occurs in the lumbar 4, 5 and lumbar 5 sacral 1 intervertebral space, and the sciatic nerve is precisely from the lumbar 4, 5 and sacral 1-3 nerve roots, so the lumbar intervertebral disc herniation patients have sciatica or the buttocks to start, and then gradually radiate to the back of the thighs, calves, dorsal feet and soles of the outer side of the feet and toes. The central type of herniation often causes bilateral sciatica. The radiating pain in the lower extremities is aggravated by increased intra-abdominal pressure such as coughing, sneezing and defecation. Leg pain is heavier than low back pain is one of the main signs of disc herniation. 3, numbness and abnormal sensation: after lumbar intervertebral disc herniation, it can cause localized compression and pulling compression in the nerve root contact area, so that the fibers and blood vessels of the nerves in the body are compressed and lead to ischemia and hypoxia, so pain, numbness and other abnormal sensations appear in the innervation area of the affected nerve root. Lumbar 4 and 5 intervertebral disc herniation can involve the lumbar 5 nerve root and abnormal sensation of numbness at the back of the thigh, the outside of the calf, the outside of the dorsum of the foot, and the dorsal side of the toe. Lumbar 5 sacral 1 disc herniation can involve 4, 5 toes dorsal skin sensory abnormalities. If the intervertebral disc herniation compresses or stimulates the paraspinal sympathetic nerve fiber, it can reflexively cause the lower limb blood vessel wall contraction and the phenomenon of lower limb coldness, coldness, and weakening of dorsalis pedis artery. 4, muscle paralysis: lumbar intervertebral disc herniation compression of nerve roots for a long time, can cause nerve root ischemia and hypoxia degeneration and nerve paralysis, muscle paralysis. Lumbar 4, 5 intervertebral disc herniation, can cause lumbar 5 nerve root paralysis caused by anterior tibial muscle, fibularis longus shortus, extensor digitorum longus and extensor digitorum paralyzed. After lumbar 5 sacral 1 intervertebral disc herniation, sacral 1 nerve root involvement paralysis and calf triceps paralysis. 5, intermittent claudication: due to the compression of the nerve root by the herniated intervertebral disc, resulting in congestion, edema and other inflammatory reactions of the nerve root and ischemia, when walking, the blocked vertebral venous plexus in the vertebral canal is congested, which aggravates the degree of congestion of the nerve root and the dilatation of the spinal cord blood vessels, and at the same time, aggravates the compression of the nerve root and the emergence of intermittent claudication and pain. 6, spinal posture changes: about 90% of patients after lumbar disc herniation have different degrees of functional scoliosis, most convex to the affected side, a small number of convex to the healthy side, mainly depending on the relationship between the protrusion and the nerve root. Scoliosis relaxes the nerve root and reduces pain. If the herniation is on the anterolateral side of the nerve root, the spine will project to the affected side; if the herniation is on the medial side of the nerve root, the spine will project to the healthy side. Side bending is a protective measure to reduce the pressure of the herniation on the nerve root. The final diagnosis of whether the lumbar disc herniation, to determine the location and degree of herniation, must be selected for lumbar spine CT, MRI (magnetic resonance imaging) or lumbar spine angiography for further examination. Seven, what to do after suffering from lumbar disc herniation 1, bed rest: in the first few days of the acute attack of lumbar disc herniation, the patient’s self-conscious symptoms are very serious, at this time should be bed rest. Using bed rest to treat lumbar disc herniation is relatively simple, and patients can do it at home without too much specialized knowledge. However, there are still many problems that should be noted in bed rest, and if they are not solved well, the therapeutic effect cannot be guaranteed. (1) Bed rest requires a hard bed. Specifically, a wooden bed with a thin mattress or cushion, or a harder brown bed is also acceptable. (2) When the patient is lying on his back, a thin pad can be added to the waist or the knees and hips can be kept in a certain degree of flexion, so that the muscles can be fully relaxed. When lying prone, the mattress should be flat to avoid excessive lumbar extension. (3) Bed rest should be strictly adhered to. Even after the symptoms have been relieved for a period of time and the waist cuff is worn to get out of bed, it is not possible to do any lumbar flexion. If the patient is unable to insist on bed rest due to the inconvenience of living, the efficacy of the treatment will be affected. (4) The most difficult thing to insist on in bed rest is to urinate and defecate in bed. If the patient can not accept the flat lying position to urinate and defecate, you can help the crutches or be assisted to go down to the toilet. Do not sit up in bed to defecate, because then the lumbar excessively flexed forward, the disc is more likely to protrude back. Of course, after a period of time in bed, such as with massage, acupuncture, physiotherapy and other methods of integrated treatment, will achieve better results. 2, family lumbar traction, pelvic continuous traction method is a relatively simple and safe treatment method of spinal traction. Patients lying on a hard bed, with pelvic traction belt around the waist fixed, the left and right sides of the belt each connected to a traction rope to the foot end of the bed, or with the lower extremities of the skin traction rope, traction rope through the pulleys on each side of the suspension of 5 ~ 10kg weight, the foot of the bed elevated 10 ~ 15cm in order to produce anti-traction force. Traction can be 24 hours uninterrupted, traction weight can be gradually increased. Generally bedridden for 3 to 4 weeks, with the improvement of symptoms can be allowed to get up every day a small amount of activity, slowly increase the amount of activity, and then consolidate the effect of treatment for 2 to 3 months. If the foot of the bed is not elevated, the upper body must be immobilized to counteract the traction of the lower limbs.