As we all know, when we experience waist and leg pain , the first thing that comes to mind is sciatica , which is probably caused by lumbar disc herniation . This is indeed the case. Many friends who suffer from lumbar herniation will experience unbearable pain, or even want to live in pain.
Just yesterday, I met a doctor from the cardiology department of our hospital who came to see me for treatment. He told me that on the 29th day of the year, he suddenly developed low back pain, radiating pain in the left lower limb, and numbness. He could hardly walk upright and could only walk well. Lying at home; while still wearing the waistband until the sixth day of the Lunar New Year, the value reached 24, and the symptoms worsened.
I thought that in the acute stage, I should rest, so I stayed at home for a few days and waited for the pain symptoms to subside before seeing a doctor. No, yesterday they found me with and MRI of my waist. It was still very painful to walk and I was limping.
After physical examination and evaluation, combined with her symptoms and MRI comprehensive analysis, it was indeed acute lumbar disc herniation.
Of course, in clinical practice, we will find that many people suffer from low back and leg pain. Although MRI shows lumbar disc herniation, the symptoms of low back and leg pain are not caused by lumbar disc herniation.
For example, patients who sit for long periods of time may have sacroiliac joint disorders or compression of some hip cutaneous nerves, and may also experience waist and leg pain, numbness, and difficulty walking.
It seems that the symptoms are caused by intervertebral disc entrapment sciatic nerve . In fact, after treatment of the sacroiliac joint or cutaneous nerve, the symptoms improved, but their films also have disc herniation, and lumbar disc herniation like is not It is lumbar disc herniation .
More often than not, people with lumbar disc herniation are fine and still engaged in physical activities.
For example, most of our sub-healthy people will not have symptoms of waist and leg pain at all, but physical examination will show bulging or herniation of the lumbar intervertebral disc.
In fact, generally people over 25 years old will have more or less lumbar disc degeneration after taking X-rays, but they may not necessarily have symptoms.
So, what I want to tell you is that abnormal MRI of the lumbar spine does not mean that your pain symptoms are caused by the interstitial disc. In order not to let everyone be deceived and waste time or more experience on this issue, I must popularize this content with everyone.
is also a "lumbar disc herniation", why are the symptoms different? What's the difference in severity?
. The location of disc herniation is different
Although it is shown as lumbar disc herniation on your MRI report, it will rarely tell you where the herniation is. Of course, a very few serious imaging doctors will report the location. What does
mean? In other words, our lumbar disc herniation is different for everyone. Generally, the location of the protrusion is different. Some people may have extremely lateral type herniation, some may have central type herniation, and some may have central type herniation. Some people may have intervertebral foraminal type herniation, and others may have paracentral type herniation. As shown in the figure below:
For example, central protrusion is more likely to have bowel problems or bilateral lower limb symptoms; paracentral protrusion is more likely to induce side leg pain and weakness, with a wider range; intervertebral Protruding hole type is more likely to cause abnormal sensation and leg numbness; extremely lateral protruding type is relatively rare.
. The degree of intervertebral disc herniation is different.
We all know that a normal intervertebral disc is composed of 3 parts, namely the surrounding annulus fibros, the nucleus pulposus wrapped by the annulus fibrosus, and the annulus fibrosus and The surface of the nucleus pulposus is covered by the cartilage endplate of .
Lumbar intervertebral disc herniation is actually the structural degeneration of the above three parts. For example, it may be the degeneration and damage of the cartilage end plate covering the surface of , which often manifests as low back pain;
It may also be the degeneration of the nucleus pulposus in the middle, which under stress stimulation , causing damage to the inner layer of the surrounding annulus fibrosus, the most common form of which is bulging or protruding, causing symptoms such as low back pain or lower limb pain; Nuclear overflow, that is, prolapse, is the most obvious symptom of low back pain;
and the most serious nucleus pulposus fragments break through the outer annulus fibrosus and posterior longitudinal ligament, directly invade the spinal canal, compress and stimulate the nerve root, causing severe leg injuries. Pain symptoms; is accompanied by the release of pressure in the lumbar intervertebral disc, and the low back pain is improved.
. The causes of pain are different.
The causes of pain after disc herniation are different. It may be caused by the direct compression of the nerve by the protrusion. lead to.
What is the method to judge whether the lumbar disc herniation is serious or not?
This may be the biggest concern for all patients with low back pain, and it is also a reflection of a doctor’s due diligence. When you have pain symptoms, what you are most concerned about is how to quickly relieve the pain. However, before choosing treatment, it is impossible to choose treatment methods and methods casually. The cause of the disease should be clarified first.
Therefore, when identifying problems, the doctor’s judgment is the most critical. It does not rely on films, but more importantly, detailed consultation and accurate physical examination and evaluation.
This is closely related to the professional knowledge and skills that each doctor has. If the doctor you meet does not even conduct a minimum physical examination, do you think she can make an accurate diagnosis?
Therefore, when you have low back pain, you should go to the hospital for a check-up and observe the professionalism of the doctor, otherwise it will be a hassle for you.
summarizes
the diagnosis of lumbar disc herniation. The current medical circle is really a mixed bag of good and bad . It is impossible for me to change the doctor's diagnosis and treatment standards, but I can do my best to write more popular science knowledge that is beneficial to the general public. , let you know more about and don’t be kept in the dark.
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