It has been observed that elderly people in almost every family have varying degrees of back and leg pain. With the rapid development of the economy, living conditions have also improved. The younger generation has almost said goodbye to farming in the fields, and is moving more towards urban development, with physical work gradually being taken over by mental work. Then in fact, the number of patients specializing in neck, shoulder, waist and legs is increasing day by day. While the older generation occupies the majority, the number of young people is also gradually increasing!
Contemporary medical methods are developing rapidly, and the treatment techniques for neck, shoulder, waist and legs are also changing with each passing day. Everyone is familiar with massage, physical therapy, equipment, infrared microwave, acupuncture needle knife, surgical resection, fixation and even replacement of joint bones. Other methods have also been heard. In addition to causing severe physical trauma, huge medical expenses are also a huge burden.
However, the reaction of many patients around me is that the pain returns, relapses, becomes serious again, and they need surgery, sealing, effusion removal, and magnetic resonance imaging* **Vibrate! Why is the probability of recovery so low even though we have such cutting-edge medical technology?
So today I will analyze for you why lumbar disc herniation is difficult to cure after long-term treatment?
What is lumbar disc herniation or even spondylolisthesis, dislocation and dislocation? (The following is an introduction from Baidu Encyclopedia)
Lumbar disc herniation is one of the more common diseases, mainly because the various parts of the lumbar intervertebral disc (nucleus pulposus, annulus fibrosus and cartilage plate), especially the nucleus pulposus, have After varying degrees of degenerative changes, under the action of external force factors, the annulus fibrosus of the intervertebral disc ruptures, and the nucleus pulposus tissue protrudes (or protrudes) from the rupture point to the rear or into the spinal canal, causing irritation or compression of the adjacent spinal nerve roots. This results in a series of clinical symptoms such as waist pain, numbness and pain in one or both lower limbs. Lumbar disc herniation has the highest incidence rate in L4-5 and L5-S1, accounting for approximately 95% of cases.
? From this we can draw two core issues: 1. Rupture of the annulus fibrosus, 2. Extrusion of the nucleus pulposus. We can summarize it as: 1. Destruction of tissue integrity, 2. Abnormal tissue metabolism. OK, let’s take a look at the current treatments! (Baidu Encyclopedia)
1. Non-surgical treatment
(1) Absolute bed rest When the first attack occurs, strict bed rest should be carried out, emphasizing that neither getting out of bed nor sitting up to urinate or defecate , only in this way can we have better results. After 3 weeks of bed rest, you can get up and move around while wearing waist protection. Do not bend down or hold objects within 3 months. This method is simple and effective, but difficult to adhere to. After remission, low back muscle exercises should be strengthened to reduce the chance of recurrence.
(2) Traction treatment uses pelvic traction, which can increase the width of the intervertebral space, reduce the intravertebral disc pressure, retract the herniated disc, and reduce the stimulation and compression of the nerve roots. It needs to be performed under the guidance of a professional doctor.
(3) Physiotherapy, massage, and massage can relieve muscle spasms and reduce intravertebral disc pressure. However, please note that violent massage can aggravate the condition and should be used with caution.
(4) Supportive treatment can be tried using glucosamine sulfate and chondroitin sulfate. Glucosamine sulfate and chondroitin sulfate are clinically used to treat osteoarthritis in various parts of the body. These chondroprotective agents have a certain degree of anti-inflammatory and anti-cartilage decomposition effects. Basic research shows that glucosamine can inhibit the production of inflammatory factors by spinal nucleus pulposus cells and promote the synthesis of glycosaminoglycans, a component of the intervertebral disc cartilage matrix. Clinical studies have found that injecting glucosamine into the intervertebral disc can significantly reduce low back pain caused by degenerative disc disease while improving spinal function. There are case reports suggesting that oral administration of glucosamine sulfate and chondroitin sulfate can reverse degenerative changes in the intervertebral disc to a certain extent.
(5) Corticosteroids Epidural injection of corticosteroids is a long-acting anti-inflammatory agent that can reduce inflammation and adhesions around nerve roots. Generally, long-acting corticosteroid preparation 2 lidocaine is used for epidural injection, once a week, 3 times as a course of treatment, and another course of treatment can be used after 2 to 4 weeks.
(6) The chemical dissolution method of the nucleus pulposus uses collagenase or papain to inject into the intervertebral disc or between the dura mater and the protruding nucleus pulposus to selectively dissolve the nucleus pulposus and annulus fibrosus without damaging the nerves. root to reduce intradiscal pressure or reduce the size of the herniated nucleus pulposus to relieve symptoms. However, this method carries the risk of allergic reactions.
2. Percutaneous nucleus pulposus aspiration/nucleus pulposus laser vaporization
Special instruments are used to enter the intervertebral space under X-ray monitoring, and part of the nucleus pulposus is minced and sucked out or Laser vaporization can reduce the pressure in the intervertebral disc to relieve symptoms. It is suitable for patients with bulging or mild herniation. It is not suitable for patients with lateral recess stenosis or obvious herniation and those whose nucleus pulposus has prolapsed into the spinal canal. .
3. Surgical treatment
(1) Indications for surgery ① Those with a medical history of more than three months and strict conservative treatment is ineffective or conservative treatment is effective but often relapses and the pain is severe; ② The first attack, but the pain is severe, especially in the lower limbs. The patient has difficulty moving and sleeping, and is in a forced position; ③ combined with cauda equina compression; ④ single nerve root paralysis, accompanied by muscle atrophy and decreased muscle strength; ⑤ Combined with spinal stenosis.
(2) Surgical method: through posterior lumbar dorsal incision, partial laminectomy and articular process resection, or intervertebral disc resection through the interlaminar space. For central disc herniation, after laminectomy, epidural or intradural disc resection is performed. Patients with lumbar instability and lumbar spinal stenosis require spinal fusion at the same time.
? ?In fact, after reading this, you will find that our current treatment methods can remove the protruding nucleus pulposus tissue that causes compression, correct the intervertebral disc, reduce intra-disc pressure, thereby alleviating the disease. But from the two core issues we analyzed above, they have not really been solved! First of all, the cause of protruding nucleus pulposus comes from the damaged annulus fibrosus, so if this tissue cannot be completely repaired, no matter what medical methods are used, it will not solve the root cause of the disease. There is also a core protruding nucleus pulposus that cannot be removed by surgery alone to improve the compression of peripheral nerves or spinal cord. This requires enhancing the body's own metabolic function to achieve self-rescue!
? So how to solve these two cores?
Step one: We need to improve our bad living habits, reduce external triggers for the lumbar intervertebral disc, try to avoid external pressure, avoid improper work, and pay attention to adequate rest.
Step 2: Provide nutrient supply to the tissues. Without nutrients, our body cannot have enough energy to repair damaged tissues. Without nutrients, the annulus fibrosus cannot heal itself, and there is no metabolism of nutritious tissues. The ability is very weak and it is impossible to remove the protruding nucleus pulposus. Then our symptoms will reoccur according to the treatments we do. How to provide tissue nutrition to complete our damaged lumbar disc? The method is actually very simple, but it is not easy to find!
? We can use our traditional method, which is to apply plaster. This valuable method passed down from China for thousands of years is still very popular today, but many patients have also used many brands of plasters, but the results are not good! I analyze there are two reasons: 1. Most of the plasters focus on promoting blood circulation. Blood circulation activation does not mean nutrient supply, and its effect is extremely limited! 2. The compatibility of medicinal materials was not paid attention to, and the nutrients of Chinese medicinal materials were not absorbed into the tissues! Therefore, choosing a good plaster patch that can truly continuously provide nutrition to the patient's tissues is something that patients need to work hard to discover.
? I sincerely wish that friends all over the world who suffer from bone diseases such as neck, shoulders, waist and legs, while receiving treatment, must not forget to provide sufficient nutrition to the patient's tissues to achieve tissue integrity repair and enhance metabolic capacity. Get back on the track of healthy living as soon as possible!