First, traction treatment of lumbar disc herniation

Traction treatment of lumbar disc herniation is a method to achieve the therapeutic purpose by using the relationship between acting force and reaction force in mechanics and through special traction device.

Main functions:

(1) plays the role of fixing and braking the waist: during traction, under the balance of acting force and reaction force, the pulled waist is in a relatively fixed normal alignment state, and the range and amplitude of movement of the waist are further limited compared with those when resting in bed and threading the waist line, thus alleviating or eliminating local inflammatory reactions such as congestion, exudation and edema.

(2) Back muscle relaxation: Lumbar disc herniation, due to the compression or stimulation of spinal nerves, is often accompanied by back muscle spasm, which not only leads to pain symptoms in the waist, but also constitutes the alignment of the lumbar spine. Traction therapy can gradually relax back muscles and relieve muscle spasms.

(3) Restore the normal alignment of the lumbar spine: If the lumbar spine of the patient is in a physiological curve shape during traction, with the extension of traction time, the phenomenon of improper alignment can gradually return to normal.

(4) Improve the relationship between protrusion and nerve: For patients with mild or early lumbar disc herniation, traction therapy can gradually lengthen the intervertebral space, which is beneficial to the recovery of protrusion. For patients with a relatively long course of disease, pulling adhesion tissue, contracture ligament and joint capsule can widen the space of spinal canal correspondingly, and at the same time, it can also pull the narrow intervertebral foramen on both sides, thus reducing or eliminating the oppression and stimulation to nerve roots, which has a good effect on relieving numbness and pain of lower limbs.

Second, physical therapy for acute lumbar disc herniation

Physiotherapy commonly used in acute phase includes:

(1) Short-wave and ultrashort-wave therapy: In the early stage of the disease, in order to improve the blood circulation of the affected part, eliminate inflammatory reactions such as exudation and edema, and relieve the pain caused by nerve root compression or stimulation, short-wave and ultrashort-wave electrotherapy are generally used. During the treatment, the two polar plates can be opposite at the lumbosacral part, or they can be juxtaposed at the lumbosacral part and the back of the affected leg. Temperature and heat, daily 1 time, 20-40 minutes each time. The multiple of 15-20 is 1.

(2) Intermittent electrotherapy: the lumbosacral region and the walking area along the sciatic nerve can be treated point by point with small circular electrodes, and the waves are concentrated for 2-5 minutes; Sparse waves for 5 minutes; Five minutes of intermittent rising waves. 1-2 times a day, 15-20 times is 1 course of treatment.

(3) Hyperstimulation current therapy: Two electrodes with the size of 8 *12cm2 can be used, one is placed horizontally in the sacrum, and the other is placed vertically at the waist. After turning on the power supply, adjust the power to 8- 12 mA as soon as possible, and increase it to 18-23 within 2-7 minutes after the strong electrifying feeling disappears. The total treatment time was 15 minutes. 1 once a day or every other day. If effective, you can continue the treatment for 6- 12 times. Three, western medicine treatment of lumbar disc herniation.

This kind of manual therapy is a kind of treatment method that the patient's joints are pushed, pulled and rotated by the operator's hands. It is based on the functional anatomy of bones and joints, guided by the biomechanical principles of bone and joint activities, and adopts corresponding massage techniques to improve the functions of bones and joints and relieve clinical symptoms.

For lumbar disc herniation, Western-style manipulations adopt different auxiliary actions or passive physiological actions, such as pushing and shaking lumbar spinous process or articular side, rotating and pulling lumbar spine. Several manipulations can be used at the same time, and four strength levels of 1, 2, 3 and 4 can be applied according to the patient's condition. Among them, light manipulation can be used for patients with acute lumbar disc herniation, severe pain and great pressure; Patients with chronic or impaired joint motor function should use heavy manipulation. Generally, the duration is 45 seconds, 60 seconds or 90 seconds, and the frequency is 1-2 times per second. The intensity and time can be appropriately selected. Each course of treatment is 5- 10 times, with a rest between two courses 10-20 days.

Fourth, drug treatment of lumbar disc herniation.

Drug treatment of lumbar disc herniation is generally only as an auxiliary treatment, with the main purpose of relieving symptoms.

(1) Patients with unbearable pain symptoms and unable to sleep on their back can take anti-inflammatory and analgesic drugs orally. Or topical antispasmodic analgesic tincture to relieve local pain. Minimizing the pain of patients is beneficial to the implementation of other rehabilitation treatment methods.

(2) In the acute stage of lumbar disc herniation, the edema of the sleeve of spinal nerve root is obvious, which is not only one of the main causes of severe pain, but also can cause secondary arachnoid adhesion. In order to eliminate local reactive edema, steroid drugs can be injected intravenously, diuretics such as dihydrocarburettor can be taken, and dehydrating agents such as mannitol can be pressurized intravenously.

(3) For patients with degenerative lumbar disc herniation, especially elderly patients, chondroitin sulfate A (Kangdeling) can be taken three times a day, 8- 12 tablets each time, about 1 month; Alternatively, compound chondroitin tablets can be used, in which the main components are chondroitin sulfate A75mg, aconite extract (equivalent to 250mg crude drug), Radix Paeoniae Alba extract (equivalent to 40mg crude drug) and licorice extract 20mg. Usage and dosage are the same as chondroitin sulfate A. If the patient has muscle atrophy in different degrees after lumbar disc herniation, vitamin E can be taken orally, 300 mg per day, once or three times per minute/kloc-0.

Five, local blocking therapy of lumbar disc herniation

There are two kinds of local blocking therapy for lumbar disc herniation: acupoint blocking and local area blocking.

(1) Acupoint blocking: It has the comprehensive therapeutic effect of acupuncture and drugs, so it has more obvious analgesic effect than acupuncture or drug treatment alone. Commonly used closed acupoints are Sanjiaoshu, Shenshu, Dachangshu, Fructus Aurantii Immaturus, Zusanli, Huantiao, Weizhong and Chengshan. Common methods: 1, 2% procaine hydrochloride injection 4 ml, prednisolone acetate 1 ml, mixed evenly, injected into the above 3-4 points respectively, and closed every 5-7 days 1 time. 3-5 times is 1 course of treatment. 2. Inject vitamin B 12 injection (1-3ml) into the above 3-4 acupoints. Closed every day 1 time. 10 is 1 course of treatment. 3. Inject 2-4 ml of 5% glucose or 30% Danshen solution into the above 3-4 acupoints respectively, and block them every day or every other day 1 time. 10- 15 times is 1 course of treatment. In addition, vitamin B 1 and compound angelica liquid were used as sealing liquid to seal the points of lumbar disc herniation.

(2) Local area closure: it can be divided into shallow closure and deep closure: 1. Shallow closure: the closure range includes the starting and ending points of lumbar fascia, psoas muscle, supraspinous ligament and interspinous ligament. Generally, it is required to combine tenderness points with accurate anatomical sites.

How to treat lumbar disc herniation-drug collection

Analgesic medicine for treating lumbar disc herniation

Drug therapy can play an auxiliary role in the symptomatic treatment of lumbar disc herniation.

The severe pain caused by lumbar disc herniation not only brings unbearable pain to patients, but also affects sleep and rest, and even causes some physiological obstacles to patients. Therefore, appropriate analgesic drugs can be taken before definite treatment. Representative drugs are: Le Song, celebrex, Qiangtongding and Tramadol.

Le Song and celebrex are new NSAIDs. Because it greatly reduces the adverse reactions to kidney and stomach, and retains good analgesic and anti-inflammatory effects, it is welcomed by more patients. Le Song imported drugs from Japan. In Japan, 800,000-900,000 people use Le Song every day, and it has become the most commonly used anti-inflammatory and analgesic drug. It is characterized by rapid pain relief. However, if it is a patient with severe cardiac and renal insufficiency, serious blood system diseases and peptic ulcer, please do not use it.

Celecoxib is a new class of anti-inflammatory and anti-rheumatic drugs. It can be used with many antihypertensive drugs and diabetes drugs without obvious interaction. Safe and effective to use.

You may not be familiar with ibuprofen, but you may not be familiar with its sustained-release capsule Fenbid. Its powerful effect of relieving joint pain and neuralgia and slight side effects make it popular with patients. In addition to sustained-release capsules, ibuprofen also provides tablets, granules and oral solutions. Use with caution in patients with gastric ulcer and duodenal ulcer.

How to treat lumbar disc herniation

If you have diseases of spinal cord and joint surgery, I recommend you to see Yan Jinglong, director of the Second Department of Bone, Second Hospital of Harbin Medical University. He is good at anterior and posterior surgery for difficult cervical diseases, as well as anterior and posterior surgery for thoracolumbar spinal canal diseases, total hip replacement and total knee replacement. It is the first in China to carry out a new type of enlarged cervical spinal canal plasty with spinous process suspension, and it is the first in Northeast China to carry out total vertebral body resection and spinal reconstruction for spinal tumors. Director Yan Jinglong makes house calls every Wednesday morning.

If you have degenerative disease, trauma, tumor or inflammation of the spine, you can also come to Wan Litian, an associate professor of orthopedics in the Second Hospital of Harbin Medical University. He is proficient in the surgical treatment of these diseases. He is especially good at surgical treatment of spinal tumor and aseptic necrosis of femoral head. Professor Tian Wan Li makes house calls all day every Thursday.

If you need artificial joint replacement, I recommend you to come to Su Enliang, vice president and director of orthopedics of Harbin Orthopedic Hospital. Engaged in orthopedic treatment 19 years. Since the beginning of artificial joint replacement in 1990, he has completed more than 0/000 operations/kloc, with a success rate of over 90%. Dean Su Enliang is also good at bone metastasis, bone trauma and nonunion. Visit every Friday afternoon.

The Department of Orthopaedics of Harbin Red Cross Central Hospital, under the leadership of Yu Jingyuan, director of Orthopaedics, has carried out a variety of complicated operations, including replantation of severed fingers, and achieved success. Director Yu not only has rich clinical experience in the treatment of complex hip fractures and limb fractures, but also is good at the surgical and non-surgical treatment of lumbar disc herniation, lumbar spinal stenosis and femoral head necrosis. Director Yu makes house calls all day every Tuesday.