The main problem of lumbar disc herniation is that the protrusion compresses the nerve root, and aseptic inflammation around the nerve root follows. The key to treatment is to relieve the compression of nerve roots by the process, eliminate the chemical stimulation of aseptic inflammation and not increase the pain of patients. If the oppression is not completely relieved, as long as the inflammation subsides, it can be basically cured. There are many clinical treatment methods, but different patients should choose the appropriate treatment method according to different conditions.
Several treatment methods of lumbar disc herniation;
Non-surgical treatment is also called conservative treatment Commonly used methods are: direct external application of traditional Chinese medicine, various Chinese and western medicine treatments, traction therapy, massage therapy, physiotherapy, acupuncture therapy, fumigation and external application of traditional Chinese medicine, and even simple bed rest is also a traditional and effective treatment.
The surgical treatment of lumbar disc herniation has been mature after long-term development, including fusion, decompression and posterior surgery. Side effects are the factors of high risk, high cost and possible recurrence after operation. In addition, there are some side effects of interventional therapy between operation and non-operation, such as percutaneous aspiration of nucleus pulposus, collagenase dissolution and laser disc nucleolysis, which are also risky and relatively expensive.
In short, doctors and patients should choose appropriate treatment methods according to specific lesions, symptoms and economic conditions.
Conservative treatment mostly adopts the method of minimizing the patient's injury, so it is often called "conservative treatment". 80% ~ 90% of patients can be cured by non-surgical treatment, which is the safest, cheapest and best for patients.
Lumbar traction?
Lumbar traction can enlarge the lumbar intervertebral space and cause negative pressure in the intervertebral disc. The tension of the posterior longitudinal ligament will help to accommodate the protruding nucleus pulposus or change its relationship with nerve roots. With the enlargement of intervertebral space and the opening of articular process, the intervertebral foramen returns to its normal shape, thus relieving the compression on nerve roots. Traction can relieve muscle spasm and intervertebral pressure. Traction is beneficial to the recovery of normal relationship due to slight abnormal changes in the posterior joint of lumbar spine, to the reduction of impacted synovium of the posterior joint of spinal column, or to the reduction of slight dislocation of articular process, but it is difficult to achieve good results by traction alone. Practice has proved that cervical and lumbar traction combined with "Chinese medicine bonesetting" has the best effect and can achieve the ideal effect. In addition, excessive traction can easily lead to lumbar instability and aggravate pain.
Acupuncture treatment of lumbar disc herniation?
The clinical application of acupuncture therapy is mainly based on the basic theory of traditional Chinese medicine, which has the functions of dredging exterior and interior, connecting up and down, promoting qi and blood circulation and nourishing yin and yang. Acupuncture and moxibustion treatment directly acts on acupoints, and regulates the nutrition, qi and blood and viscera functions of human body through the conduction and reaction of meridians, so as to achieve the purpose of treating diseases. However, the curative effect of acupuncture can only be said to be an auxiliary therapy for lumbar disc herniation.
Massage Treatment of Lumbar Disc Herniation
Traditional Chinese medicine believes that the main function of massage therapy is to dredge meridians, promote blood circulation, adjust the function of viscera, relax tendons and activate collaterals, promote blood circulation and remove blood stasis, loosen adhesion and dredge joints. In addition, it can also be treated together with external application of traditional Chinese medicine, which can enhance the disease resistance of human body and achieve better health care and rehabilitation. The main mechanisms are: (1) decreasing the pressure inside the intervertebral disc and increasing the pressure outside the intervertebral disc; (2) resetting the protrusion and changing the position of the protrusion; (3) Adjust joint disorder, reset and relieve nerve root compression. (4) Promote local blood circulation, eliminate inflammatory reaction, loosen adhesion and reduce stimulation to nerve roots. (4) Relax the muscles of waist and legs, strengthen local blood circulation, and promote the recovery of injured nerve roots. (5) Relieve pain.
Treatment of lumbar disc herniation with traditional Chinese medicine
Drug therapy is an auxiliary means, and it is obvious to achieve the ideal effect with the use of external drugs. According to the basic theory of traditional Chinese medicine, combined with the specific situation of patients, choosing the appropriate formula of traditional Chinese medicine can effectively treat lumbar disc herniation.
(1) For patients with early onset and obvious qi stagnation and blood stasis, drugs such as Xiaohuoluo Pill, Dahuoluo Pill and Kanghyperosteogeny Tablet should be reused.
(2) those with severe cold and dampness should strengthen the spleen and promote diuresis; For patients with severe rheumatism, drugs such as "Duhuo Jisheng Decoction" are added.
(3) For patients with a long course of disease, some drugs for tonifying kidney yang or kidney yin can be selected, such as stewed Eucommia ulmoides, Lycium barbarum and Cistanche deserticola with pork loin, or "Liuwei Dihuang Pill".
In short, no matter how to prescribe drugs, we should take syndrome differentiation and treatment as the most important principle in order to achieve satisfactory curative effect.
External treatment of lumbar disc herniation with traditional Chinese medicine
External treatment of traditional Chinese medicine is one of the traditional Chinese medicine treatments. As early as the time of Neijing, there were records of various external treatments such as external application, medicated ironing, fumigation and washing. External treatment is widely used in orthopedics.
Clinically, applying self-heating Chinese medicine with the functions of promoting blood circulation, removing blood stasis, relaxing muscles and tendons, and relieving pain to the neck, waist, knees, and heels has a remarkable curative effect and a low price. For the convenience of use, many external Chinese medicines have been processed into plaster, pure Chinese medicine powder, tincture, oil and other Chinese medicines.
There are many kinds of self-heating traditional Chinese medicines for external use, such as Kanlisha, Huajian Ointment, External Application for Hyperplasia, Neck, Waist and Leg Pain Ointment, Anting Ointment for Hyperplasia and Gubi External Application Powder. They are all self-heating drugs, which are proved to be effective and cheap in clinic. External application of traditional Chinese medicine is the most economical and safe, and its curative effect reaches the focus directly. The side effect is that each application time should not be too long (note: all drugs are externally applied and can be mixed with water, vinegar or low-alcohol liquor. After adjustment, it will automatically heat up when applied to the affected area, so it is not allowed to apply it indefinitely every time to avoid redness and blistering of the skin.
Kanlisha, Huajian Ointment, External Use for Osteoproliferation, Health Care Ointment for Neck, Back and Leg Pain, Anting Health Care Ointment for Osteoarthralgia are all suitable for elderly patients with aseptic inflammation such as hyperosteogeny, lumbar disc herniation, arthritis, lumbar muscle strain, neck, shoulder, back and leg pain, and also suitable for young and middle-aged patients.
Generally speaking, the external application of traditional Chinese medicine has the following functions: dredging meridians, dispelling cold and removing dampness, dredging orifices and diminishing inflammation, dispersing stagnation and relieving swelling, and relieving pain. Its principle of action: through the skin directly to the focus, dredge obstacles, stimulate the skin to improve microcirculation and stimulate the regulatory function of the human body, and promote the metabolism of cartilage joints to restore balance, thus eliminating the focus and achieving the ideal goal.
stay in bed
The degeneration of the spine is closely related to load bearing. Strict and scientific bed rest, first of all, removes the main factors that further develop lumbar spondylosis and creates the necessary conditions for the recovery of the disease.
Bed rest is the most basic treatment for lumbar disc herniation. Bed rest can reduce the absorption of neurotoxic substances, promote the regression and recovery of inflammation and prevent the occurrence of nerve fiber adhesion. Absolute bed rest means that patients are allowed to lie flat on a hard bed and can only turn over in bed, but they can't sit up or stand up, and they can't stand up when eating or urinating. Generally, bed rest for 3 ~ 4 weeks can be effective. Patients with severe symptoms during acute attack can also consider using traction therapy and external application of traditional Chinese medicine while resting in bed to obtain better therapeutic effect.
After lying in bed for a period of time, if combined with oral and external application of traditional Chinese medicine, massage, acupuncture, physical therapy and other methods for comprehensive treatment, it will achieve better curative effect.
Waist wear
Waist circumference is one of the commonly used braces in orthopedics, and its main function is braking and protection.
(1) braking function. When wearing the waist line, it will limit the activities of the lumbar spine, especially the flexion activities, so that the local tissues of the lumbar spine can get a relatively full rest, relieve muscle spasm, promote the recovery of blood supply, dissipate pain-causing substances, and alleviate or disappear the inflammatory reaction around nerve roots and intervertebral joints.
(2) protection. Waist circumference can strengthen the stability of lumbar spine. Therefore, when patients with lumbar disc herniation start to move on the ground after lying in bed or traction, wearing waist circumference can strengthen protection, limit the range and amplitude of lumbar movement to a certain extent, and consolidate the effect of early treatment.
Waist circumference is widely used in the treatment of lumbar disc herniation, but it is not optional to wear and use it. Generally wear a waistline for 4 ~ 6 weeks, and the longest is not more than 3 months. The waist size should be suitable for the patient's body shape.
Nursing care of patients with lumbar disc herniation?
In the acute stage, you should sleep on a hard bed and stay in bed for 3 weeks absolutely, with oral drugs and external application of traditional Chinese medicine.
Avoid coughing and sneezing to prevent constipation.
If the symptoms are obviously improved, you can gradually exercise your back muscles and do light activities in the wild under the protection of your waistline.
Prevention of recurrence of lumbar disc herniation
After treatment and rest, patients with lumbar disc herniation can be relieved or cured, but the recurrence rate of the disease is quite high, because:
(1) After treatment, although the symptoms of lumbar disc herniation basically disappeared, the nucleus pulposus of many patients was not completely restored, but the compression degree of nerve roots was reduced or the adhesion with nerve roots was reduced.
(2) Although the condition of patients with lumbar disc herniation has been stable or healed, in a short time, once they are tired or sprained, the nucleus pulposus will protrude again, leading to the recurrence of the disease.
(3) Failing to keep warm in the cold and humid season, wind, cold and humidity invade the diseased parts of human body, and fatigue can easily induce the recurrence of the disease.
(4) Liver and kidney loss failed to recover in time. Chinese medicine believes that kidney stores essence and governs bone; Liver stores blood, main reinforcement. Sufficient kidney essence and full liver blood make the bones and muscles strong and the joints flexible. Deficiency of liver and kidney, physiological dysfunction, and deficiency of essence and blood of liver and kidney lead to malnutrition of bones and muscles, which is easy to lead to recurrence of osteoarthropathy or refractory bone disease. Therefore, it is necessary to tonify the kidney and strengthen the waist at ordinary times, so that osteopathy is not easy to recur.
(5) Although the nucleus pulposus of this segment has been removed, the stability of the upper and lower vertebrae in this segment is not good after operation, so the intervertebral discs in the upper and lower segments of the surgical segment are prone to prolapse, leading to the recurrence of lumbar disc herniation.