I believe that most people have experienced waist or lower back pain. Whether it is sudden severe pain in the waist while carrying heavy objects, tightness in the waist after doing exercise or work, or even just waking up after sleeping. I feel soreness and numbness from waist to lower limbs. These may be symptoms of a herniated disc.
Intervertebral disc herniation is one of the results of lumbar spine degeneration.
The symptoms of discomfort caused by lumbar spine degeneration are variable. In addition to lower back pain , the most common symptoms may be limited lumbar spine mobility, and even soreness and numbness in the thighs, calves or feet. However, lumbar degeneration is often asymptomatic. In fact, up to 1/3 of young people with no symptoms may have obvious abnormalities if they undergo MRI examinations. Long-term pain stimulation can even affect the central and peripheral nerves, making pain more sensitive, causing chronic pain syndrome. However, 85 percent of patients with low back pain cannot be attributed to a single diagnosis, and these patients are also known as nonspecific low back pain.
It is not easy to confirm that symptoms are caused by lumbar degeneration or disc herniation. X-rays of the lumbar spine can be used to see whether the height of the lumbar vertebrae has decreased, which indirectly infers the degeneration of the discs. X-rays can also be used to see whether there is lumbar spondylolisthesis. , bone spurs, vertebral dissociation, scoliosis, facet joint disease, etc. may cause low back pain. If you want to learn more about other possible causes, you can consider examinations such as MRI or computed tomography, or electromyography (Electrodiagnosis) to see if there is damage to the nerve root .
Intervertebral discs can be distinguished: intravertebral disc rupture, intervertebral disc degeneration and intervertebral disc herniation
Intervertebral disc problems can be further divided into internal disc disruption (Internal disc disruption), intervertebral disc degeneration (Disc degeneration) and intervertebral disc herniation. Patients with intravertebral disc rupture will cause pain due to the rupture to the nerve fibers in the outer ring of the intervertebral disc; and intervertebral disc herniation can be divided into herniation and bulging according to the proportion of the protrusion range to the surrounding intervertebral disc, but in clinical practice they are generally referred to as Herniated disc.
Intervertebral disc herniation is most likely to occur between the fourth lumbar vertebra and the fifth lumbar vertebra and between the fifth lumbar vertebra and the first sagittal vertebra. Due to the strength of the anatomical structure, intervertebral disc herniation is most likely to occur on the posterolateral side of the intervertebral disc, which may compress the corresponding intervertebral disc. The corresponding nerve root causes nerve root symptoms such as soreness, numbness and pain in the lower limbs. However, if the herniated point occurs in other parts of the intervertebral disc, such as the middle or both sides, different neurological symptoms may occur.
Treatment of intervertebral disc herniation
Like other causes of low back pain, most of the time it is impossible to achieve satisfactory results with a single treatment. Therefore, multiple treatments are often used in clinical practice at the same time in order to effectively improve symptoms and prevent recurrence of symptoms. Commonly used The treatment methods are as follows
Exercise therapy: Patients often dare not move because of fear of pain. However, exercise can improve function and reduce pain. In addition to other physiological benefits of exercise and extremely low possibility of side effects, it is a very important part of treatment. , especially for chronic patients. Currently, there is no specific type of exercise that is the most effective. Generally speaking, muscle strength training will be given to the parts with insufficient muscle strength, usually core muscle group training such as back muscles , abdominal muscles and hip muscles, to help share the pressure on the spine.
In addition, stretching exercises will be provided for parts that lack flexibility; aerobic exercise is also an indispensable part. Try to achieve more than 30 minutes of moderate aerobic exercise at least five days a week each time; finally, the movement pattern should also be analyzed , correct inappropriate muscle contractions, posture and posture. Exercise should be gradual, with individualized exercise training given to each patient, progressing from training of a single muscle group or direction to functional and dynamic movements.
Others include McKenzie exercise, which is used to treat nerve root symptoms caused by the spine, such as numbness and pain in the lower limbs, or water therapy and other exercises that can be tried for patients who are afraid of activities. The most important thing is to make exercise a habit. If patients have any questions about the exercise plan, they are welcome to discuss it with a rehabilitation physician or physical therapist.
Drug treatment: Patients can also try to control symptoms with drugs. Commonly used drugs include: nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. If the symptoms are severe or long-term pain, or combined with symptoms such as depression The doctor may use other medications such as opioid analgesics, antidepressants, and antispasmodics, as well as topical medications such as anti-inflammatory patches and ointments. However, various drugs have indications and side effects, and you should fully communicate with your doctor before using them.
Local injection: including dry needling, anesthesia, steroid trigger point injection and acupuncture, and even the newer Botulinum toxin and prolotherapy (Prolotherapy) are all methods that have been used in the past. Low back pain caused by intervertebral discs can be treated with epidural steroid injections.
Physical therapy: Common treatment methods such as lumbar traction, electrotherapy, massage, etc. These treatments have their own indications and contraindications and need to be discussed with a doctor and therapist before proceeding.
Others: such as yoga, Pilates, etc.
Surgery: If conservative treatment fails, surgery may be considered as a last resort. The most common is discectomy (Discectomy). If there is spinal instability, spinal fusion (Spinal fusion) can also be performed. There are also options for artificial intervertebral disc (Prosthetic disc). These are all performed after detailed evaluation by the surgeon.
Through the above introduction, I hope everyone has a basic understanding of intervertebral disc herniation and low back pain. In addition to developing good exercise habits, movement patterns, and force application methods, if symptoms really occur, you should also actively seek medical treatment and contact the doctor. Discuss the most appropriate and immediate treatment to reduce the occurrence of chronic pain and keep back pain away from us.
