How to relieve severe lumbar disc herniation pain?

Produced by: Science Popularization China

Author: Mai Bo, Huang Rui

Producer: Guangdong Provincial Association for Science and Technology

This article offers practical tips to manage lumbar disc herniation pain through lifestyle changes and moderate exercise.

Last month, the reporter often felt discomfort in the lower back and would frequently apply two patches before going to bed at night, allowing for a comfortable return to work the next day. Professor Ding Yue, Secretary of the Orthopedic Party Branch at Sun Yat-sen Memorial Hospital of Sun Yat-sen University, pointed out that the cold weather causes blood vessels to constrict, which reduces blood supply to the nerves and leads to muscle spasms in the lower back, increasing pressure on the intervertebral discs. Additionally, factors such as colds and coughing can exacerbate lumbar disc herniation, leading to the onset or worsening of pain.

The pathology of lumbar disc herniation involves the degeneration of intervertebral discs, leading to the displacement of the nucleus pulposus through the annulus fibrosus. This can cause compression of adjacent spinal nerves and the spinal cord, resulting in symptoms such as pain, numbness, and weakness in the legs or lower back. The condition is often linked to factors such as aging, repetitive strain, and injury, which ultimately cause inflammation and irritation of surrounding tissues.

In daily work and life, the lumbar spine is the most active and stress-bearing part of the spine. The intervertebral discs repeatedly endure loads such as compression, bending, and twisting that lead to accelerated structural degeneration; the posterior part of the fibrous ring is particularly prone to fissures and weakening. Ding Yue explains that excessive fatigue or trauma can easily cause degeneration of intervertebral disc tissue to occur at the weak points of the fibrous ring, leading to displacement beyond the normal edges of the disc. Damage to the fibrous ring can itself result in lower back pain, while protrusion of the nucleus pulposus, fibrous ring, or cartilage end plate can compress nerve roots or the cauda equina, resulting in corresponding symptoms of nerve dysfunction, such as radiating pain, numbness, weakness, and abnormalities in bowel and bladder function in the innervated areas.

Is it possible to prevent lumbar disc herniation? What actions should be taken?

Ding Yue stated that based on the aforementioned mechanisms, it is crucial to maintain correct and standardized behavior habits in daily work and life to prevent lumbar disc herniation. This includes appropriate exercise, weight management, enhanced self-protection awareness, avoiding poor postures, refraining from prolonged standing or sitting, and avoiding actions that increase the load on the lumbar region, such as bending and lifting heavy objects. Additionally, individuals should engage in exercise within tolerable limits and strengthen their core muscles in the lower back through activities like swimming and calisthenics to enhance lumbar stability.

What are the available treatment methods?

Ding Yue noted that lumbar disc herniation generally has a favorable natural course, with most patients experiencing improvement following conservative treatment. Therefore, non-surgical treatment is preferred for early-stage lumbar disc herniation patients without severe neurological damage. During the acute phase, when symptoms are pronounced, it is advisable to rest in bed on a medium-firm mattress. Once symptoms improve, patients are encouraged to gradually resume normal moderate activities. Alongside this, medications for inflammation reduction, pain relief, muscle relaxation, and nerve nutrition can be utilized. For patients with significant root symptoms, epidural steroid injections may be employed to alleviate pain. Furthermore, treatments such as traction, hot compresses, acupuncture, massage, and traditional Chinese medicine have varying degrees of efficacy in symptom relief, although individual responses to these treatments can differ.

Ding Yue suggested that if symptoms do not significantly improve after 6 to 12 weeks of conservative treatment, or if symptoms severely impact daily life and work, or if signs of cauda equina syndrome emerge, appropriate surgical treatment may be considered based on the situation. The surgical options can be categorized into open surgery and minimally invasive techniques, with commonly used procedures including endoscopic or percutaneous discectomy for disc nucleus removal or radiofrequency ablation, as well as lumbar discectomy combined with bone graft fusion and internal fixation.

In the absence of medical resources, how can one alleviate suffering?

Ding Yue addressed the issue of farmers in remote mountainous areas working under heavy loads who may be reluctant to seek treatment for lumbar disc herniation. In such cases, he advised patients to eliminate factors in their daily lives that provoke or worsen their condition. They should control their weight, quit smoking and drinking, and develop good living habits, avoiding poor posture that strains the lower back and refraining from prolonged standing or sitting. If engaged in high-intensity work, lumbar supports should be used, and regular breaks should be taken. For those who must sit for extended periods, using ergonomically designed lumbar cushions and seat pads can help maintain proper posture. During acute phases, bed rest and symptomatic medications are recommended. As symptoms improve, individuals should engage in core strength exercises for the lumbar region tailored to their personal situations to enhance spinal stability.

Why does the feeling of pain intensify when the weather is cold?

Ding Yue noted that many people experience increased pain from lumbar disc herniation during winter due to cold weather causing blood vessels to constrict, which reduces blood supply to already compressed nerves and results in increased nerve ischemia and pain. Preventive and treatment measures include keeping warm, using local heat packs, electrotherapy, and combining these with massage.

Cold weather may also increase muscle contraction in the lower back, resulting in muscle spasms and stiffness. This intensifies pressure on the lumbar vertebrae, worsening herniated discs and back pain. In addition to warming measures, plenty of bed rest or lumbar traction therapy should also be included.

Increased abdominal pressure from colds and coughs may worsen lumbar disc herniation and lead to lower back pain. Preventive measures include keeping warm and avoiding fatigue and exposure to cold.

Content from: Guangdong Provincial Association for Science and Technology

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