Do you have waist and leg pain? Do you have pain or numbness in your buttocks and lower limbs? Has anyone been diagnosed with lumbar disc herniation by radiograph? Have you been worried about why the treatment is not effective?
If you are such a person, it is strongly recommended that you read this popular science article carefully. Maybe you can find out what you have been confused about for many years. I hope it is useful to you. It is Dr. Kong’s diagnosis and treatment experience shared over the years.
The pain at the position shown in the picture above should be the most common pain at present. Most people will describe when they are in pain, stinging, burning pain, tearing pain at this position ; there may be traction on the back of the thigh and above the knee. Pulling pain.
In the acute stage, the pain is more severe, and it often presents with limited bending and difficulty in sitting up. Especially when you want to stand up from a sitting position, you must hold on to other people or objects to stand up slowly.
This kind of pain is often deep in location and is mainly limited to the back of the buttocks. There is no obvious distribution boundary. It is difficult for patients to pinpoint the specific location of the pain. However, during examination by professionals, it can be found that the iliac crest is in the middle of the iliac crest. There is obvious cording and tenderness 2-3 cm below the point.
2. Pain in the inner buttocks
The pain at the location shown in the picture above is mainly manifested near the inner side of the buttocks, next to the sacrum area, , and may even be reflected to the back of the thigh to the knee joint.
It is often difficult to detect in images. Only professionals can detect obvious cords or tenderness at the midpoint of the line connecting posterior superior iliac spine and the lateral corner of the sacrum during manual inspection.
3. Pain under the buttocks
As shown in the picture above, the pain at the position shown above is mainly concentrated in the ischial tuberosity area . Many people will describe that after sitting for a long time, the position where the buttocks are in contact with the stool feels like a fire.
When touched with bare hands, the tenderness was obvious at a position 1 cm inside the midpoint of the line connecting the ischial tubercle and the greater trochanter of the thigh.
Why do these parts of the buttocks hurt?
In fact, the above three common pain areas have different nerves innervating ; maybe everyone is only familiar with the sciatic nerve , but is familiar with the gluteal epithelial nerve which controls the posterior hip area, and the middle gluteal nerve in the medial hip area. The cutaneous nerve, the subgluteal cutaneous nerve under the buttocks, is relatively unfamiliar.
These nerves come from the lumbar vertebrae and sacral vertebrae. They pass through the layers of fascia structures and bone fiber tunnel openings of the lumbar back. They control the buttocks area and exert their own functions. Function.
Therefore, to a large extent, problems with these nerves are difficult to detect through imaging examinations such as films, because the paths they follow are relatively unfamiliar to everyone and can even be easily ignored.
Since the nerves come from the spinal cord, they are divided into anterior branches, posterior branches, meningeal branches, etc. The herniated disc often compresses the anterior branches (sciatic nerve, posterolateral femoral cutaneous nerve, etc.), and the posterior branches are the superior and middle gluteal cutaneous nerves. etc., mainly passes through between the articular process of and the transverse process of .
Therefore, if you have scoliosis of the spine and asymmetry in the left and right height of the pelvis, it is very easy for the superior, middle and inferior gluteal cutaneous nerves introduced above to be compressed. Even if you take an MRI or CT, you cannot see these structural changes, so you will ignore them and misdiagnose them.
Why is it said that waist and hip pain is not caused by lumbar disc herniation?
Everyone will have this experience. As long as there is pain or numbness in the waist, buttocks, or lower limbs, a label will be attached to the sciatic nerve. Most people even simply take an MRI or CT of the waist, and the result report will show a herniated lumbar disc.
Then he thought that his problem was caused by lumbar disc herniation. Such an idea was wrong. You should reflect carefully. Is there a causal relationship between the lumbar disc herniation shown on the film and your pain and other symptoms?
Furthermore, in the current medical industry, doctors between majors are also uneven in ability. Not everyone wearing a white coat is a specialist. It is a very common phenomenon that for patients with low back pain, when receiving medical treatment, In the process, can replace . allows you to take a picture. What is the report? What do you think it is? Even the most basic detailed medical history and manual physical examination are omitted. Can you still believe such a hasty diagnosis?
@Toutiao Refuting Rumors @Toutiao Health Information Bureau @Toutiao Health
