Back pain is the most common complaint of people’s physical discomfort, especially after autumn, the temperature gradually decreases, the middle-aged and elderly people’s waist and leg joints often “downtime”, pain episodes are more frequent. According to the World Health Organization, “neck, shoulder, waist and leg pain” has become a common disease that plagues 1 billion people around the world, but when people have pain, the first thing that comes to mind is often to smear some safflower oil, eat some painkillers to relieve. Short-lived back and leg pain can be relieved by applying heat to the painful area and sleeping on a hard bed, but if the attack of back and leg pain lasts for more than two weeks, it must be diagnosed in hospital or caused by other diseases. As a symptom, low back and leg pain can be caused by a variety of causes, and it is most common among manual workers, such as porters, underground miners, carpenters and car drivers. If the patient continues to have back and leg pain, it is recommended to go to the hospital for diagnosis to find out the real cause of the disease, do not blindly take medicine or exercise, but lead to the aggravation of the disease. “Generally low back and leg pain is mostly caused by lumbar muscle strain and myofascial inflammation, which can be rehabilitated by anti-inflammatory drugs, physiotherapy and sedation, in addition to which it is also highly likely that hidden orthopedic diseases are behind.” Professor Lin Hongsheng said that osteoporosis is one of the main culprits triggering back and leg pain in middle-aged and elderly people, according to statistics, about 1/3 of the elderly people over 60-70 years old have osteoporosis, and more than half of the elderly people over 80 years old have osteoporosis. Especially postmenopausal women are more prone to osteoporosis, “general bone loss of 12% or more can occur bone pain, mainly generalized pain, especially low back pain is common, the pain is reduced when lying on the back or sitting, the pain increases when standing upright.” Diagnosis and treatment: For patients suspected of suffering from osteoporosis can be diagnosed by measuring the bone density of the lumbar spine and hip, as well as checking the history of previous fragility fractures can go in, once the bone loss is found to be serious drug and non-drug treatment can be used, at present, the clinical treatment of osteoporosis is divided into two types of drugs according to different mechanisms of action, one is the drugs that inhibit bone loss including bisphosphonates, selective estrogen receptor modulators, calcitonin, etc.; the second is drugs that promote new bone synthesis, such as parathyroid hormone. The non-pharmacological treatment mainly includes more exercise, more sunshine and good dietary habits. Among them, scientific diet is crucial. Lumbar disc herniation is easily confused with hip disease Lumbar disc herniation is another cause of back and leg pain in middle-aged and elderly people. More than 90% of the symptoms of lumbar disc herniation first start with lumbar pain, and the pain is often felt from top to bottom, waist → hip → thigh → calf → foot. Mainly because of lumbar disc strain, degeneration, or in the sudden change of position, lumbar overload, resulting in the rupture of the fibrous ring of the lumbar disc, so that the central nucleus pulposus protrudes backward from the fissure, compressing the nerve root, resulting in the patient will feel sluggish numbness or pain. “If a patient feels pain with pressure on the lower back and has radiation to the lower extremities, it is best to go to the hospital for CT and MRI to confirm the diagnosis.” Professor Lin Hong-sheng said that according to the severity of lumbar disc herniation, it is divided into “bulging”, “herniation” and “prolapse”. Most patients clinically belong to the first two, do not need surgery, can be taken to bed rest, with drugs, traction treatment, etc.. In recent years, the use of minimally invasive discoscopy or foraminoscopic spine technology has given patients with lumbar disc herniation more surgical options. The vast majority of people have good results after surgery. Since the painful area of hip disease is also in the thigh, it is easy to confuse with lumbar disc herniation in diagnosis, so patients need to be extra careful. Lie flat on the bed, straighten both legs together, raise the right leg and bend the knee, put the ankle of the right foot to the upper end of the knee of the left leg, then put the knee of the right leg to the bed, if the knee joint can be basically flat, without any pain, it means that there is no problem with the hip joint. If there is pain, it is recommended that you see an orthopedic surgeon to see if there is a problem with the hip or other joints of the pelvis. Lumbar spinal stenosis can also cause back and leg pain It is understood that lumbar spinal stenosis can also cause back and leg pain, but many patients are unfamiliar with this disease, and it is often ignored. “Generally speaking, lumbar spinal stenosis is mostly seen in middle-aged and elderly people, with a slow onset, unlike the often sudden onset of central disc herniation.” Professor Lin Hong-sheng explained that there is mainly long-term recurrent lumbar pain, sometimes the pain can be radiated to the lower limbs, usually with lumbar pain first, gradually with heavy legs and leg pain, and some patients will have serious symptoms such as numbness, chills, weakness, and even muscle atrophy, urinary and faecal and sexual dysfunction in the lower limbs. The typical manifestation of patients with lumbar spinal stenosis is intermittent claudication. The so-called intermittent claudication is that after walking for a period of time (usually hundreds of meters, or tens of meters in severe cases), the patient will experience lumbago, lumbago, numbness and weakness of the lower limbs on one or both sides, and even claudication, but after squatting or sitting down and resting for a few minutes, the above symptoms can be relieved or disappear, and then the patient can continue walking again, and after walking for a period of time, the above symptoms will appear again, and as a last resort, it is necessary to squat or sit down again to rest for After walking for a while, the above symptoms appear again, and as a last resort, the patient needs to squat or sit down again to rest for a few moments. Because the limp occurs intermittently during this process, it is called intermittent claudication. The performance of intermittent claudication can gradually worsen, that is, the distance that can be adhered to walking is getting shorter and shorter, and the time needed to rest is getting longer and longer. It is worth mentioning that the most distinctive feature of this type of claudication is that the symptoms are aggravated when the lumbar spine is in an extended position and relieved when it is bent. “A CT and MRI examination will reveal whether there is stenosis in the lumbar spine and spinal canal.” Non-surgical treatment can be tried for early cases with mild symptoms. Non-surgical treatment only relieves symptoms to a certain extent, and surgery should be considered when the pain progresses to the point where it continues to affect the patient’s normal life and work. Do the right health care, early prevention of low back pain Low back pain brings a lot of trouble to people’s quality of life, many middle-aged and elderly people even think that this is an “old age disease”, unable to do a good job of prevention, is this the case? In ordinary life is actually some small way to protect our waist and legs. 1, sleep and rest with a hard texture bed After the age of 25, sleep and rest with a hard texture bed, can be a wooden bed on the pad quilt, or with a brown bed. Texture too soft bed in the body lying down due to the weight of the compression, resulting in the middle low, four high shape, thus easily affecting the normal physiological curvature of the lumbar spine, resulting in lumbar muscle fatigue, easy to induce disc degeneration. 2, waist straight up, to have three 90 degrees When sitting, waist straight up, to have three 90 degrees, that is, flexing the hip, bending the knee and flexing the elbow each 90 degrees on the position. All parts of the body are in a functional position, relatively relaxed state, which is less likely to strain. Maintain the correct sitting posture to avoid increasing the pressure within the lumbar intervertebral disc. 3, squat down to move things, get up by leg force When moving and lifting heavy objects, the feet should be separated from shoulder width, bend the knees, and then move the object. At this time, the muscles of the thighs and calves at the same time, through the leg force to grasp the object. If the knee joint is straight, lifting heavy objects from the ground, the pressure on the waist can increase by 40%, and it is easy to damage the ligaments, muscles and intervertebral discs of the waist. Therefore, when carrying objects can not bend, but should bend the knee, to maintain the normal upright position of the waist when the curvature, to avoid concentrating the power in the waist. If the object is too heavy, do not force force. 4, sitting time try not to exceed two hours watching TV to maintain good posture, sitting time try not to exceed two hours, an hour to stand up and relax, stretching waist, stand up and take a walk. Particular attention to the working class: driving can be equipped with lumbar cushion. 5, pay attention to the waist muscle exercise can do “small swallow fly” Many people complain that they usually have to do sit-ups why they still have back pain? Professor Lin Hong-sheng said, sit-ups are mainly exercised by the abdominal muscles, the exercise of the psoas muscle is small, it is recommended to try “small swallow fly”, on a hard bed or clean hard floor, take the prone position, face down, arms behind the back, slowly lift the head and chest, the whole torso is anti-bow shape, as if “small swallow fly “. Doing it often can play a role in strengthening the lumbar muscles and slowing down the process of spinal degeneration.