Do you need less exercise for lumbar disc herniation? Not suitable for running and walking? Doctor: Correct exercise and fast recovery

There are many patients with lumbar intervertebral disc herniation , who are afraid of exercise, not only because of pain, but also afraid that exercise will make the disease worse. Even if it is simple, easy and safe walking and running, some patients are afraid to try and feel extremely insecure in the face of exercise. Can patients with lumbar protrusion walk or run vigorously? We will answer this question today, and tell everyone about : should exercise, when should exercise, which exercise should not be done, how to choose for walking and running.

How should patients with lumbar protrusion choose between bed rest and exercise?

Rest is one of the treatment methods for lumbar protrusion. In the acute stage of the disease, patients should take more rest and less exercise. The rest is mainly bed rest, but as the symptoms are relieved, the amount of exercise should be gradually increased. Many patients have two consecutive weeks Even if I stayed in bed for two months, I continued to stay in bed even if the symptoms were relieved, but I didn't know that long-term bed rest would be detrimental to the condition.

The hazards of excessive bed rest to patients with lumbar protrusion include:

• affects the nutrient absorption of the intervertebral disc ——The intervertebral disc absorbs and discharges water under changes in pressure to complete the absorption and metabolism of nutrients The excretion of waste, if lack of exercise, is not conducive to the metabolism of the intervertebral disc and slows down the recovery process.
• Muscle atrophy, decreased muscle strength and endurance ——Long time in bed without exercise, muscles do not contract, muscle strength will decline rapidly, and muscle atrophy will also occur.
• Soft tissue and joint contractures -long-term bed rest,The range of motion of lumbar joints, muscles, ligaments and tendons will gradually decrease.
• leads to osteoporosis -bones bear a certain amount of pressure, which helps bone formation. If you stay in bed for a long time, the bones will not bear pressure for a long time, and the bone density will also decrease, which is easy to cause osteoporosis.
• causes bedsores ——Long-term bed rest will cause long-term pressure on the skin of the back, lumbosacrum and other parts, causing damage to the capillaries and lymph under the skin to form ischemic lesions, resulting in bedsores (pressure ulcers) .
• venous thrombosis and pneumonia -long-term bed immobilization is likely to form deep venous thrombosis . Studies have pointed out that staying in bed for more than 72 hours will increase this risk. Long-term bed rest will lead to decreased lung function, and decreased lung capacity is prone to falling pneumonia .
• Malnutrition and constipation ——Long-term bed rest can cause the intestinal mucosa and glands to shrink, thereby reducing the absorption rate of nutrients. In addition, the intestinal peristalsis is reduced, and the strength of the abdominal and pelvic floor muscles is weakened, which may cause constipation.
• increases the psychological burden -People who are bedridden for a long time are prone to random thoughts, and the anxiety that was originally caused by the disease will be further aggravated, which is not conducive to the recovery of the disease.

learned about the hazards of long-term bed rest,We know the necessity of exercise therapy, but before exercise, patients need to know when to start exercising.

First of all, it's not that the longer you stay in bed, the better the rehabilitation effect! Studies have pointed out that for patients with bed rest for 3 days and 7 days, the improvement in low back pain symptoms and physical function is equivalent . Therefore, it is generally recommended that patients in the acute phase of lumbar protrusion should stay in bed for no more than 1 week .

Secondly, even during bed rest, the patient cannot be completely immobile . Low back pain is difficult to move the waist, but we can still move our legs and stretch out our hands within the tolerable pain range. As the pain is relieved, we can actively or passively turn over, get up, go to the bathroom by ourselves, and walk around indoors. And so on, try to avoid the adverse reactions of bed rest.

Finally, judging the timing of exercise is actually very simple. In one sentence, moves or exercises within the range of the pain , so exercise should be gradual, according to the strength, stop in moderation, and restore itself little by little. It is important to note here that the patient’s ability to move is that the patient cannot release himself while the painkiller is working, especially after rapid analgesic treatment such as closure, if the amount of exercise is increased rashly, it is likely to cause unnecessary damage.

Patients with lumbar protrusion should avoid repeated and rapid bending or turning of the waist!

We have already talked about whether you should exercise and when you should exercise. The next step is how to exercise. In this part, we mainly talk about what exercises should not be done by patients with lumbar protrusion.

After a lumbar disc herniation occurs, the patient’s range of motion of the lumbar spine will be reduced to a certain extent. When engaging in the exercise of bending and turning the waist,It is more likely to cause disease attacks and cause pain and other symptoms, so be careful to engage in these two sports!

But this does not mean that the patient cannot bend and turn the waist!

Some patients act cautiously. Hearing that bending and turning of the waist may cause illness, they completely eliminate these two exercises. This is actually not conducive to the recovery of lumbar protrusion. Properly bending and turning the waist will help maintain the mobility of the lumbar spine, promote blood circulation around the intervertebral disc, and bring more nutrition to the repair of the intervertebral disc. If you do not bend and turn the waist at all, the lumbar joints will be more rigid , The mobility of the lumbar spine will be further reduced, which is not conducive to the recovery of the lumbar process!

What patients should avoid is not bending or turning, but rapid, sudden and frequent bending or turning!

For example, frequent bending, bending, lifting heavy objects, and turning around playing basketball, etc. Generally, in daily labor or strenuous exercise, these actions will suddenly increase the pressure on the lumbar intervertebral disc, thereby causing or aggravating the waist Sudden symptoms. Whether it is an acute or convalescent patient with lumbar protrusion, it is not recommended to perform frequent and high-intensity bending or turning movements. Be gentle with your waist!

For patients whose symptoms are aggravated by bending or turning the waist a little, the amplitude and frequency of the bending and turning movements should be controlled in time to give enough time for the waist to recover!

Can patients with lumbar protrusion run or walk? How to choose between the two?

Next, let's talk about how patients with lumbar protrusion should exercise. First of all, it is necessary to clarify the purpose of exercise. Through exercise, patients can maintain lumbar spine mobility, promote lumbar joint nutrition, reduce nerve sensitivity, enhance lumbar spine stability, increase social participation, improve patients’ mood, and exercise methods. For functional exercise and sports for the lumbar spine.

01 / Functional exercise for patients with lumbar protrusionThere are three main types of functional exercises for patients with lumbar protrusion: muscle strengthening exercises (improving lumbar spine stability), muscle stretching exercises (increasing lumbar spine flexibility), and nerve stretching exercises (decreasing nerve sensitivity). Muscle strengthening exercises can be exercises such as scissors legs, muscle stretching exercises can be exercises such as waist flexion stretching, nerve stretching exercises include femoral nerve stretching and sciatic nerve stretching, etc. The specific exercise method will not be today. In detail, a special introduction later.