How Do I Recognize Back Pain from a Herniated Disk?

The most important clinical feature of discogenic low back pain is decreased tolerability of sitting. The pain often aggravates in the sitting position, and patients usually only sit for about 20 minutes. The pain is mainly located in the lower back, and it can sometimes be released to the lower limbs. 65% of patients have pain below the knees, but there are no specific signs of diagnosis.

Discogenic low back pain

Intervertebral disc-derived low back pain is a very common disease in clinical practice. It is a chronic low back pain caused by intravertebral disc disorders (IDD) such as degeneration, intrafibrous fissure, and discitis that stimulate pain receptors in the disc. Symptoms, no radiological evidence of nerve root compression or excessive displacement of the vertebral body segments can be described as chemically mediated discogenic pain.

Clinical features of discogenic low back pain

The most important clinical feature of discogenic low back pain is decreased tolerability of sitting. The pain often aggravates in the sitting position, and patients usually only sit for about 20 minutes. The pain is mainly located in the lower back, and it can sometimes be released to the lower limbs. 65% of patients have pain below the knees, but there are no specific signs of diagnosis.

Most patients with lumbar discogenic low back pain can have recurring low back pain for a long time. After exhaustion or standing for a long time, most patients can increase the pressure in the intervertebral disc, which can further stimulate the nerve endings on the surface of the lumbar disc fibrous ring, causing low back pain Aggravated; In addition, after cooling, it can also increase the sensitivity of nerve endings to adverse stimuli, causing aggravation of low back pain. Conversely, after resting, especially after bed rest, the pressure in the intervertebral disc is reduced, and after good warmth, the nerve endings on the surface of the fibrous ring can be less affected by bad stimuli, thereby reducing back pain.

Intervertebral disc back pain

CT CT examination of discogenic low back pain

It can clearly show the osteophytes at the anterior and posterior edges of the vertebrae, the compression sites and degrees of the dural sac, spinal cord, and nerve roots. The anterior and transverse diameters of the spinal canal can be measured. No narrowness, no laminar hypertrophy.

X X-ray of discogenic lumbar pain

It is a routine examination for patients with back pain. -Normally, the lateral, lateral, and left and right oblique films must be taken. If necessary, the lateral films of the neck forward flexion and extension are added. Orthotopic radiographs may see vertebral space stenosis, osteoarticular hyperplasia of the articulated vertebrae, and thickened pedicles. Lateral radiographs showed that the physiological lordosis of the cervical spine disappeared, the lip formed at the anterior and posterior edges of the vertebral body, the intervertebral space was narrowed and the spinal canal was narrowed. The oblique film can determine the condition of the intervertebral foramen.

Discogenic low back pain magnetic resonance

It can clearly show the disc herniation, compression of the dural sac and spinal cord, and the presence or absence of venous return obstruction and compression, and the presence of cystic lesions in the local spinal cord.

Intervertebral discogenic low back pain pay attention to the following aspects in life

1, a balanced diet, protein, vitamin content should be high, fat, cholesterol should be low, prevent obesity, quit smoking and control alcohol.

2.Pay attention to the combination of work and rest during work, correct posture, do not sit for long periods of time, make preparations before strenuous physical activity.

3.For bed rest, a hard board bed should be used to maintain the physiological curvature of the spine.

4, keep away from cold and keep warm.

5, the precautionary principle requires reducing exercise and relaxing.

6, usually should strengthen the back muscle exercise to strengthen the stability of the lumbar spine.

7, be careful not to exercise vigorously and sedentary work

Here, we recommend a set of easy-to-learn low back muscle exercises:

Lie on your back with your legs straight and lifted up in turns, making your movements easier and faster. Do it 8-10 times without causing pain.

Lie on your back, bend your knees, put your thighs on your abdomen, hold your knees with your hands, and put your back on the bed to relax the lumbar and lower back muscles, then separate your hands and straighten your legs, doing 3-5 times.

Sit-ups.If you have difficulty doing sit-ups, you can use two hands to help the bed. After sitting up, do not bend forward, and do it 3-5 times.

Etiology and pathology of discogenic low back pain

Caused by diseases of the spine bone joints and the surrounding soft tissues. Such as local injuries caused by bruises, sprains, bleeding, edema, adhesions and muscle spasms.

Caused by spinal and spinal neurological disorders. Such as spinal cord tumors, myelitis and other low back pain.

Caused by diseases of internal organs. Such as infection of the uterus and its accessories, tumors can cause lumbosacral pain, these patients are often accompanied by corresponding gynecological symptoms.

Caused by mental factors. For example, patients with rickets may also complain of lumbar disease, but they have no objective signs, or diseases that cannot be explained by physiological anatomy and pathology with objective examination and subjective narrative.

Intervertebral discogenic low back pain

The cause of back pain in the morning is most likely due to the bed. Traditional brown or nylon wire trampolines, steel wire trampolines, steel wire trampoline beds, soft sofas or too soft or inflexible Simmons mattresses, etc., can cause people to lie on it. Due to the weight, the body appears central. Low, four-corner high state, the waist muscles are in a state of convulsion for a long time, and the intervertebral disc cannot be fully rested and relaxed, and a back pain will occur. Many people sleep on such a bed and will feel back pain and weakness after getting up in the morning the next morning. In the long run, it can easily cause lumbar muscle strain and can also induce lumbar disc herniation. In the morning, back pain caused by this situation, changing the bedding can generally improve the symptoms.

If it is not a bedding problem, it may be due to chronic lumbar muscle strain. This kind of low back pain needs to be treated with lumbar traction, manual massage, hot Chinese medicine compress and oral Shujin Huoxue tablets.

In addition, you can take some small measures to prevent back pain in the morning.

1. Get up in the morning and move your waist first. After getting up every morning, move your waist first. Doing more exercises for contracting the abdominal muscles and stretching the lumbar muscles, as well as walking, walking backwards, and riding a bicycle can prevent and reduce back pain.

2. Learn to relax and reduce tension. Tension can increase the hormones in the blood and cause lumbar disc enlargement and cause back pain. Therefore, reasonable work and rest, and maintaining a happy mood will greatly help prevent back pain.

3 Maintain correct posture. No matter what you do, you cannot violate physiological functions. Sedentary people should keep their backs close to the back of the chair to relax and rest the waist muscles, and stretching back sometimes is a good way to prevent back pain.

4 Improve diet and avoid obesity. If the body has become fat, we must implement scientific weight loss. Because obesity will cause an excessive load on the spine, and it cannot support the spine due to the relaxation of the abdominal muscles, which will force the spine to deform.

General treatment of discogenic low back pain

Back pain is medically a symptom, a symptom, there are many diseases that can cause back pain, but in general, it is nothing more than the following two types of diseases:

1. Inflammatory diseases, including urinary system infection, genital system infection, this type of disease can be cured through active anti-inflammatory treatment.

2. Physical and mechanical injuries: These diseases include lumbar muscle strain, acute and chronic lumbar sprains, rheumatoid rheumatism, kidney deficiency, disc herniation, and lumbar bone hyperplasia. These diseases can cause waist muscle ischemia, calcium deficiency, cold, and excessive stretching of the lumbar ligament fibers. Either the disc herniation or bone hyperplasia can cause lumbar nerve compression, which can cause lumbar muscle weakness and pain.

Therefore, from the perspective of treatment, promoting blood circulation, dissolving collaterals, removing stasis, and cooperating with necessary traction and fixation are common methods for treating waist pain. These methods can be effective for different types of diseases. However, the key to the treatment of low back pain is persistence. Most customers do not have effective relief of low back pain, repeated delays, and incomplete cure, which is because they cannot get symptomatic methods and cannot adhere to treatment themselves. [In this regard, it is recommended that patients with low back pain pay more attention to some medical devices commonly used in China during daily home treatment, such as low back pain treatment belts, etc., which are common methods of domestic multifunctional treatment. It is a medical device product, and the product design structure has four major functions of magnetic therapy, heat steaming, traction and fixation.

1. For low back pain caused by poor blood circulation, congestion, edema, etc. due to sprains, sedentary, cold, etc., it can improve microcirculation and tissue metabolism, and promote blood flow to achieve pain relief. For low back pain caused by lumbar inflammation and degenerative changes in the lumbar spine, the activity of the hydrolyzing enzymes of the pain substances can be increased, and the pain substances such as bradykinin, histamine, and serotonin can be hydrolyzed or transformed to achieve analgesic effect. For kidney deficiency and low back pain, low back pain, etc., the back pain treatment belt acts on the human body, and enhances the electromagnetic energy through the meridian points, which can promote the operation of meridian qi, dredge the meridians, and achieve the effect of analgesia and analgesia.

2. The unique design of the leather thick airtight belt body ensures that the covered affected part maintains a high skin temperature and humidity, and produces its own thermal steam physiotherapy effect, which is beneficial to increase local blood circulation.

3 The inner layer of the large cortical band is attached with a supporting curvature steel sheet, which emphasizes the advantages of traction and fixed treatment. It can effectively support the spine and lumbar spine, enhance the contractility of lumbar muscles, and better treat lumbar disc herniation, ankylosing spondylitis, and lumbar spine. Low back pain caused by bone hyperplasia, lumbar hypertrophy, and spinal stenosis.

4 It is very convenient to use, you can adjust the lace according to your body type or comfort level, whether it is walking exercise or desk work or bed rest will not affect the treatment.

Therefore, comprehensively consider, use symptomatic methods, pay attention to persistent treatment, and low back pain can be cured.

Treatment of discogenic low back pain

Non-surgical treatment of discogenic low back pain includes

1. Daily home treatment

2. Drug treatment

3.traction therapy

4.Physiotherapy

5. Massage therapy

6. Acupuncture treatment

7, closed therapy

8.Small needle knife therapy

Intervertebral disc-derived low back pain surgery includes

1. Routine open surgery (including: hemi-laminectomy, total laminectomy, trans-abdominal disc surgery) 2. Discectomy

3. Artificial lumbar disc replacement

Minimally invasive interventional therapy for discogenic low back pain

1. Collagenase chemical dissolution therapy 2. Ozone injection therapy 3. Percutaneous laser disc decompression 4. Radiofrequency thermocoagulation target puncture technology

(A): physical therapy , massage therapy, acupuncture therapy

Physical therapy includes methods such as electrotherapy, three-dimensional traction, traditional Chinese medicine vaporization, and hyperthermia, which are basically the same as treatments such as massage and acupuncture. It is mainly to relieve the clinical symptoms of patients, rather than radical cure. Because most patients with lumbar process accompany chronic lumbar muscle strain, piriformis muscle tension, muscle spasm in the nerves compressed by the lumbar disc herniation, causing lumbago and leg pain, general hospitals will use physical therapy, massage, acupuncture and other treatment methods. To relieve muscle tension and cramps. Therefore, patients who have undergone physical therapy will be more comfortable when doing physical therapy. Physical therapy, massage, acupuncture and other treatment methods are only used in combination with lumbar disc herniation. If the condition is serious, only other treatments can be found.

(B): surgical treatment

1. Routine open surgery:

Conventional open surgery includes: total laminectomy, hemi-laminectomy, trans-abdominal disc surgery, and vertebral fusion. The purpose of surgery is to directly remove the diseased lumbar intervertebral disc nucleus pulposus and relieve nerve root compression to achieve the purpose of treatment. Due to the limitation of the special physiological position of the lumbar spine, the surgery destroys the normal physiological structure of the lumbar vertebra, resulting in large surgical damage, easy to cause postoperative instability of the lumbar spine, postoperative scar tissue adhesion, and accidental injury to the nerve root during the operation. So most patients are afraid of surgery. How to avoid the above adverse reactions caused by surgery? This has been a major problem for the medical community.

2. Collagenase dissolution

The main component of the human intervertebral disc is collagen tissue. Using the specific solubility of collagenase to collagen molecules, by injecting collagenase into the protruding part of the intervertebral disc, the collagen component in the protrusion is destroyed and dissolved, and the protrusion can be completely achieved. It becomes smaller and disappears, so as to relieve nerve compression and improve clinical symptoms.

3. Ozone nucleolysis (PIMOI): This therapy uses fine needle puncture into the intervertebral disc, and injects a small amount of ozone gas to dehydrate and shrink the nucleus pulposus tissue to achieve the purpose of decompressing the disc. The main principle is to use the instantaneous and powerful oxidation function of ozone to achieve dehydration, anti-inflammatory and analgesic effects.

4. Percutaneous laser lumbar disc decompression (PLDD): the use of laser energy to cavity the nucleus pulposus of the lesion, reduce the pressure in the disc, relieve and eliminate the compression of the sciatic nerve or spinal nerve to achieve the purpose of treatment.

5. Percutaneous endoscopic discectomy (PED): discectomy is divided into lateral discectomy and posterior discectomy. Lateral discectomy is based on incision and suction, and an additional discectomy system is added. Make the aspiration under the monitoring of discoscopy more safe and effective. The posterior endoscope is a combination of the advantages of the lateral laminoscope and the small interlaminar window-opening technique. Only a small opening is opened at the corresponding point of the intervertebral disc lesion, and the intervertebral disc endoscope system is inserted into the disc. Nuclear process to achieve the purpose of treatment.

6. Percutaneous lumbar discectomy (PLD): Under image monitoring, the working cannula is directly inserted into the disc, and a portion of the nucleus pulposus is removed using a clamp cutting and negative pressure system, thereby reducing the pressure in the disc and making the fiber ring pressure Relieve and relieve compression on nerve roots.

Safety principles of radiofrequency thermocoagulation target therapy for discogenic low back pain

Intervertebral disc-derived low back pain is efficient and safe

The therapeutic electrode of the special-purpose radiofrequency instrument for the nervous system is only 0.7mm, just like an acupuncture needle. The entire treatment does not require anesthesia, analgesics, antibiotics, and hormones. There is only one physical change process without any side effects on the human body. The tissue is directly removed without damaging normal tissue, making the treatment more green and humane.

Precise positioning of discogenic low back pain

The radiofrequency thermocoagulation target treatment is accurately positioned by the C-arm X-ray machine, and constantly detected under digital subtraction. The precise guidance of the navigation system directly acts on the nucleus pulposus. The data is accurate to less than 1mm, and the angle error is less than 1 degree. Treatment is more precise and effective.

Disc-Derived Low Back Pain

Nervous system-specific radio frequency instrument has a unique neural system for accurate identification and stimulation. It can measure nerves within 1cm of the treatment range and accurately distinguish motor and sensory nerves. That is to say, during treatment, you want to damage the patient's nerves. Nerve is impossible.

Disc discogenic low back pain

The unique impedance display function of this device can accurately distinguish the nucleus pulposus fibrous ring, calcification points, bone and blood vessels, and accurately display the tone and numbers, making the treatment more accurate and safe.

Controllable temperature of discogenic low back pain

The radio frequency instrument can adjust the temperature arbitrarily, and the error is below 2 ° C to ensure the safety during treatment. There is no infection and no thermal damage after treatment.

Precise calculation of discogenic low back pain

Before the treatment, the volume of the lesion to be removed is accurately calculated and a plan is made, that is, as much as the nucleus pulposus of the lesion is removed, so that the treatment is more efficient.

Radiofrequency thermocoagulation target therapy is to directly degenerate, coagulate, shrink, reduce the volume of the prominent pathogenic nucleus, relieve pressure, rarely damage normal nucleus pulposus, and directly block glycoproteins and in nucleus pulposus. The release of protein and the warming effect play a good role in treating damaged fibrous rings, nerve root edema and inflammatory reactions in the spinal canal. The symptoms disappear and reduce immediately after treatment, and the efficiency is high. Local anesthetics and hormones are not needed during treatment. And antibiotics to make the treatment green and safe. The radio frequency puncture needle is only 0.2 mm thick, and the patient has minimal pain during puncture. The operation is safe. The nerve monitoring function and time and temperature controllability will not cause heat loss of the nerve root. The impedance display can determine the nature of the tissue being treated. Temperatures of 85-90 ° C rarely cause bleeding, and very few wounds and high temperatures make the chance of infection very low. Radiofrequency target for the treatment of intervertebral disc herniation is a new, minimally invasive treatment method which is efficient, safe, easy to operate and low in cost. It is a qualitative leap in minimally invasive treatment of disc herniation.

Minimally invasive treatment of discogenic low back pain

Minimally invasive treatments for discogenic low back pain are:

1) Percutaneous puncture cryoplasty;

2) Percutaneous disc radiofrequency treatment;

3) Percutaneous transcutaneous stimulation photovaporization treatment;

4) Joimax foraminal diagnosis plus various RF, laser and ablation techniques.

Intervertebral discogenic low back pain

He Shisheng, male, Ph.D., associate professor, deputy chief physician, master's tutor, and scholar in Britain. Deputy Director of Orthopaedics, Shanghai Tenth People's Hospital Affiliated to Tongji University; Director of Spinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University; Director of Spinal Minimally Invasive Center, Shanghai Tenth People's Hospital Affiliated to Tongji University Former Associate Professor and Deputy Chief Physician of Orthopedics, Changhai Hospital, Second Military Medical University, specializing in spine surgery clinical and scientific research for more than ten years, has in-depth research on various conventional and difficult diseases of the spine, has accumulated rich clinical experience, and has participated so far And completed more than 3000 cases of various types of spine surgery, covering a variety of conventional and difficult diseases of spine surgery, the excellent and good rate of more than 99%, so far no patient due to complications caused by surgical errors.