Most people experience low back pain at some point in their lives
Especially when you wake up
After bending over to carry heavy objects, or sitting at a desk for a long time...
According to the survey
About 80% of people experience low back pain to varying degrees
The prevalence is second only to colds
Recently
Low back pain is no longer the preserve of the elderly
There is a clear trend towards younger people
Many people are already 20 years old and 60 years old
And lumbar disc herniation
It is one of the most common causes of low back pain
01
Why do lumbar intervertebral discs herniate?
The spine of our human body is like a stacked of bricks, made up of bones called "vertebral bodies", but between every two adjacent vertebral bones, there are soft and elastic pads, which can not only reduce the friction between the bones, but also cushion the shock impact caused by bouncing, and this elastic pad is the intervertebral disc.
If the spine is the backbone of the human body, the lumbar spine is the foundation of the spine. The lumbar intervertebral disc, as a "soft cushion" in the middle of the lumbar spine, plays a role in supporting, connecting and cushioning the lumbar spine.
However, the intervertebral disc is only functionally like a cushion, but the structure is more like the rice balls we are familiar with, the outer skin is called the fibrous ring, and the inner filling is called the nucleus pulposus.
With the growth of age and the activity of the waist, the intervertebral disc will gradually age, the elasticity will decrease, and it is easy to produce cracks in the rear of the lumbar intervertebral disc where the stress is greatest, that is, the back part of the fibrous ring from the inside to the outside.
On this basis, due to a more serious trauma, or repeated multiple minor trauma, or even some daily activities such as sitting for a long time, bending over for a long time, lifting heavy objects and other postures increase the pressure of the intervertebral disc, it can promote the further rupture of the fibrous annulus of degeneration and cumulative damage, and the internal stuffing - the degenerated nucleus pulposus tissue will be easy to "protrude" from the rupture or weak place, which is the lumbar intervertebral disc herniation.
02
Symptoms of lumbar disc herniation
At a certain age, the lumbar intervertebral disc will be a little herniated, as long as it is within the normal range and does not stimulate the nerves and spinal cord, there is no need to worry too much about the general problem, and there will be no symptoms. Only when it is severe enough to a certain extent is it called "lumbar disc herniation".
Lumbar intervertebral disc herniation is often manifested as low back pain, radiating pain in the lower limbs, numbness in the lower limbs, weakness in the lower limbs, and urinary and urinary dysfunction.
Low back pain: most patients have a history of low back pain, but when the nerve roots are irritated, the pain radiates to the lower extremities, causing sciatica.
Radiating pain in the lower extremities: because lumbar disc herniation occurs in the intervertebral space of the lumbar 4/5 and lumbar 5sacral-1 intervertebral space, most patients have sciatica, and the typical sciatica is radiating pain from the lumbosacral region to the hips, posterolateral thighs, lateral or posterior calves to the feet. Pain may worsen when the patient increases abdominal pressure (eg, coughing, sneezing, etc.) or changes body position.
Paresthesias: numbness in the innervated area, coldness of the lower limbs, and lack of sweating.
Muscle weakness and muscle atrophy: In severe cases, muscle atrophy of the lower limbs may occur, and the dorsal extensor muscles of the hallux flexion toes are more common.
Cauda equina nerve damage: When the lumbar intervertebral disc protrudes posteriorly and medianly or the nucleus pulposus prolapses, the cauda equina nerve in the dural sac can be compressed, and the patient may have numbness in the saddle area, urinary and urinary dysfunction, and in severe cases, urinary retention.
03
People who are prone to herniated lumbar discs
<年龄>
It is more common in young adults
<性别>
It is more common in men
<体型>
Being obese or thin
<职业>
Labor-intensive workers
<姿势>
Occupations that work at desks for a long time, or sit in an improper posture and sit for long periods of time, often bend over to stand up or carry weights, such as drivers, sales clerks, etc
04
Treatment of lumbar disc herniation
80% of lumbar disc herniations do not require surgery.
For lumbar disc herniation, non-surgical treatment is preferred. 80% of people can self-relieve themselves with physiotherapy, traction, recuperation and medication.
Surgery is indicated only in patients with a long history who do not respond to conservative treatment, and in patients with severe disease (numbness of the skin of the legs, hypoesthesia, and dysfunction of the legs).
Commonly used conservative treatment methods include: massage, acupuncture, traditional Chinese medicine decoction, non-steroidal anti-inflammatory, neurotrophic drugs, physiotherapy, rehabilitation exercises, lifestyle correction, etc.
05
Exercises for lumbar disc herniation
Strengthen the exercise of the lower back muscles every day, increase the flexibility and strength of the lumbar muscles by accelerating metabolism and improving blood circulation, and you can find time to do more waist exercises at home.
Gluteal bridge training method
Exercise can be done using a five-point or three-point method.
The five-point method is to lie on the bed on your back, go to the pillow and bend your knees, and support the whole body with your head, elbows and heels at 5 points when you inhale, so that your back is stretched back or lie on your back;
The duration of both methods is 3-5s, the waist muscles are relaxed when exhaling, and the buttocks are lowered to rest for 3-5s, this is 1 cycle, 10-20 cycles are 1 set, and 2 sets or 3 sets are completed every day.
06
Care for lumbar disc herniation
01
Sitting: The correct sitting posture should be the upper body straight, the lower jaw slightly retracted, the lower limbs together, and the appropriate seat should also be selected to keep the waist in a relatively relaxed state and reduce the chance of strain. When sitting on a chair with a backrest, you should try to keep your back close to and lean on the back of the chair on the basis of the above posture so that the lumbosacral muscles do not get tired.
02
Lying: The height of the pillow is generally equivalent or slightly lower than the height of your fist after compression, the length is more than 10~15cm of your shoulder width, and the part in contact with the back of the neck is the highest, so as to set off the neck curve and maintain the normal physiological curvature of the neck, while the part in contact with the back occipital part should be lower, softer, and play an auxiliary role. The firmness of the pillow should also be appropriate. Try to sleep on a hardboard cushioned bed, with your knees slightly bent when lying on your back, a small pillow under the popliteal fossa, your whole body relaxed, and your waist will naturally fall on the bed.
03
Bend over to carry heavy objects: The correct posture is to first move your body as close to the heavy object as possible, then bend your knees and hips, and then hold the object with both hands, stretch your knees and hips, and the heavy object can be lifted. In addition, when lifting heavy objects, it is necessary to pay attention to keeping the knees in a semi-flexed state and keeping the objects as close to the body as possible, which can reduce the burden on the lower back muscles and reduce the chance of injury. (This position is forbidden for patients with knee joint disease)
04
Washing: After getting up, move the waist slightly, do the back extension, left and right rotation, "stretch the waist" and other actions, so that the waist will not be transferred from a relatively static state to an action that increases the load on the waist, in addition, the washbasin position should not be placed too low, to avoid the burden of the waist due to excessive forward bending of the lumbar spine.
05
Housework: When washing small items and washing rice, choosing vegetables, and washing vegetables, it is best not to put the basin directly on the ground, but should be placed on a table of appropriate height or sit on a stool of appropriate height to choose vegetables, so as to avoid excessive forward flexion of the waist. When sweeping and mopping the floor, the handle of the broom or mop should be lengthened to avoid excessive bending of the waist and causing strain on the psoas muscles. If the living room is too large, you can clean it several times, and you can move your waist appropriately in the interval to avoid low back pain.
06
Diet:
(1) Pay attention to supplementing calcium, magnesium, vitamin D and vitamin B in the diet. Calcium-rich foods such as milk, beans, dried shrimp, kelp, etc
(2) Eat more foods rich in vitamins and fiber, such as vegetables and fruits, to keep your stools smooth. Eat less meat and fatty foods as much as possible, as they tend to cause dry stools, and straining to defecate can lead to aggravation of the condition.
(3) If you have a history of coughing and wheezing, you should eat less or no irritating foods such as chili peppers to avoid causing cough and asthma and aggravating the symptoms of low back and leg pain.
Popular science content contributor: Hu Yanping, attending physician of the Department of Tuina, Wuhan Hospital of Traditional Chinese Medicine
Audit expert: He Shenghua, chief physician of the Tuina Department of Wuhan Hospital of Traditional Chinese Medicine
Editor-in-charge: Summer
Editor: Wang Jun