Ms. Liang, a 34-year-old company employee, noticed some pain in her lower back two years ago. At that time, she was busy with work and often sat in front of the computer, so Ms. Liang thought it was a muscle strain. After the busy period, Ms. Liang rested for a few days, the pain was relieved, and she didn’t care too much.

After a period of time, the lower back of the two ladies became more and more painful. From the left waist to the left leg, the left hip was hurting. Ms. Liang went to the hospital for an examination. The doctor initially concluded that Ms. Liang was the cause of the pain due to herniated lumbar disc. However, after the doctor prescribes the right medicine, the condition worsens repeatedly. What is going on?

I. Lumbar disc herniation

< span>First of all, let’s take a look at lumbar disc herniation. Lumbar disc herniation is a common disease in chiropractic. Students who often sit in chairs to study, as well as office workers, are all likely to experience lumbar disc herniation. The probability of lumbar disc herniation is generally higher in men than in women. The early symptoms of lumbar disc herniation are repeated pain in the waist.

Ms. Liang suffers from back pain and leg pain, which is completely in line with the early symptoms of lumbar disc herniation. And many patients with lumbar disc herniation even have urinary and urination disorders and abnormal saddle area. The pathogenesis of lumbar intervertebral disc herniation is a combination of degeneration of the lumbar intervertebral disc, partial or complete rupture of the annulus fibrosus, and prolapse of the nucleus pulposus to stimulate or compress the nerve root and cauda equina. sign.

1. Types of lumbar disc herniation

There are 4 types of lumbar disc herniation. The first is bulging lumbar disc herniation. This disease is not particularly serious, and most doctors will treat patients conservatively and will not choose direct surgery. This is because in this condition, only the inner layer of the annulus fibrosus is partially ruptured, but the outer layer is intact. By conservative treatment, a cure or relief effect can be achieved.

The second type is herniated lumbar disc herniation, which is more serious than the previous one. The annulus fibrosus was completely ruptured, the nucleus pulposus protruded into the spinal canal, but the posterior longitudinal ligament remained intact. At this time, conservative treatment options may not be available, and surgery can be decided according to the severity of the patient’s condition.

The third type of prolapsed lumbar disc herniation is more serious than the first two. The nucleus pulposus penetrates the posterior longitudinal ligament and enters the spinal canal, but its root is still in the intervertebral space. However, the situation is similar to the above, and it depends on the patient’s own condition to decide whether to undergo surgery.

The fourth type of free lumbar disc herniation, the nucleus pulposus penetrates the annulus fibrosus and the posterior machine ligament, completely protrudes into the spinal canal, and is completely different from the original lumbar disc herniation. Disc detachment. It can be understood through language that this disease can be regarded as more serious. Similarly, the decision to perform surgery should also be based on the patient’s own condition and the severity of the disease course. In addition to the above 4 kinds of diseases, there is actually one more, which is Schmorl’s nodules.

2. Symptoms and Treatment

Lumbar disc herniation is caused by the pressure on the outer layer of the annulus fibrosus and the ligaments on the top of the intervertebral disc, which stimulates the nerves in the spinal canal. The typical symptom is low back pain. Most patients have low back pain that occurs repeatedly, and it also leads to leg pain. but someThe patient will have only one of the low back pain and the leg pain, and some patients will have two kinds of pain that repeat each other.

Some patients also experience lower extremity numbness, which is caused by the nerves compressed by the herniated disc in the legs. numbness. At the same time, the muscle strength of the lower limbs will decrease, which will compress the nerves. Over time, the nerve roots will be damaged, and the muscles innervated by the nerves will also be numb. Mild symptoms are only lower extremity numbness, and severe cases may cause paralysis.

However, paralysis due to this condition is relatively rare. The other is the bladder and bowel dysfunction that we mentioned, and the saddle area is abnormal, which can be called cauda equina syndrome. Lumbar disc herniation generally requires less surgery, and the recommendations adopted by doctors are all requiring conservative treatment, such as drug therapy or physical therapy.

However, in patients with severe symptoms, doctors may choose surgery based on their condition. Medical treatment will include non-steroidal anti-inflammatory analgesics such as ibuprofen, diclofenac, meloxicam, etc. There are also muscle relaxants. A small number of patients will have muscle spasms. At this time, muscle relaxants are needed, such as chlorzoxazone, flupirtine, tizanidine, etc. .

A small number of patients with lumbar disc herniation will also cause nerve edema. At this time, dehydrating agents such as mannitol are needed. When patients have pain and inflammation, glucocorticoids can also be used for short-term pain relief. Severe lumbar disc patients may undergo surgery.

According to the patient’s condition, the following operations are used, including endoscopic intervertebral discectomy, simple interlaminar fenestration of the nucleus pulposus Enucleation, hemilaminectomy, total laminectomy, interbody fusion. However, more doctors would recommend TCM treatment for patients with lumbar disc herniation, such as acupuncture, physiotherapy massage, and massage, all of which can be relieved to a certain extent.

3. Maintenance

< span>Patients with lumbar disc herniation should pay attention to their living habits when their symptoms improve and return to their daily life. The first and most important thing is to pay attention to physical and mental rest and stop working at a desk for as long as before. At the same time, avoid high-intensity exercise and rotating bending movement, so as to reduce the damage to the waist to a certain extent.

When sleeping, you should also pay attention to sleeping on your back as much as possible, instead of sleeping on your side and stomach. A pillow can be placed under the knee joint and head, which is also a more comfortable position for patients with lumbar disc herniation. It is also good for the waist. Usually, you should pay attention to your posture when walking and standing, so as not to cause damage to the waist.

Be careful when you need to take some heavy objects occasionally, and handle them with care. When bending down, bend down slowly, and then slowly get up. You can also choose massage and acupuncture appropriately, which should be selected according to the patient’s own situation.

In daily life, while exercising, be careful not to let the waistHead and legs get cold. Furthermore, it is recommended to eat more vegetables and fruits in the diet, and supplement some calcium appropriately. You can choose to drink more milk and eat some foods high in calcium.

Second, the walnut-cracker phenomenon

The above mentioned With so much, it can be found that Ms. Jiang’s symptoms are very consistent with herniated lumbar disc, otherwise the doctor would not have concluded from the beginning that Ms. Jiang had herniated lumbar disc. Ms. Jiang also obeyed the doctor’s advice for treatment. After she was discharged from the hospital, Ms. Jiang chose to change her job, because the doctor told Ms. Jiang that she was working at a desk for a long time. Cause lumbar disc herniation.

But it didn’t take long for Ms. Jiang to relapse. And this time the recurrence is more serious. It used to be only the waist and legs, but now even the abdomen is starting to hurt. One time Ms. Jiang noticed red when she was going to the toilet, and it was not her period. This scares Ms. Jiang, and there are some suspicions that something is wrong with her kidneys.

So Ms. Jiang came to the hospital again to check her kidneys. After a series of examinations, the result was that Ms. Jiang’s urine red blood cells were 3+. It goes without saying that Ms. Jiang may have a kidney problem. A doctor examined Ms. Jiang and arranged for a renal vein ultrasound, which finally confirmed Ms. Jiang’s condition. Ms. Liang’s left renal vein was clamped.

1. What is the Nutcracker Phenomenon

The nutcracker phenomenon is also known as left renal vein compression syndrome. This condition generally occurs in males, and in children, the age of onset is 4-7 years old, and the most common age is 13-16 years old. Because the left renal vein is pinched by two arteries, the venous blood flow is not smooth, like a small walnut. Doctors usually call this the nutcracker phenomenon.

This also relieved both Ms. Jiang and the doctor, because the nutcracker phenomenon is not an intractable disease. Ms. Jiang will urinate blood because the blood vessels in the kidneys are dilated. If this goes on like this, the capillaries will rupture. Then the blood test results will be positive after the red blood cells in the kidneys flow out. The pain in the abdomen and lower back that Ms. Jiang mentioned was also due to this disease. The pain would be caused by the long-term congestion of his kidneys.

2. Treatment

< strong>The treatment methods are divided into conservative treatment and surgical treatment. Most patients will adopt conservative treatment. This also needs to be based on the severity of the patient’s condition. A small number of patients will have varicose veins with severe anemia. At this time, the patient will experience pain and need surgery. Obviously, Ms. Jiang fits the second situation, and she also needs surgery.

Why did Ms. Jiang get this disease? The doctor speculates that Ms. Jiang may be due to congenital developmental problems. Some diseases are already present at a young age, but those symptoms will gradually emerge after adulthood. Fortunately, Ms. Jiang has already been diagnosed with the disease. As long as she takes medicine on time, she can be discharged from the hospital in a healthy time after the operation.

III. Protection and Prevention

Patients with the nutcracker phenomenon are generally thin, and sometimes, doctors will recommend that patients choose to gain weight to reduce symptoms according to their physical conditions. Because the nutcracker phenomenon is when a vein is pinched by an artery.

Once the patient gains weight, moveThe angle between the veins will become larger, so that the pinched veins will be relieved to a certain extent. Here we still recommend that you go to the hospital for an examination if you experience hematuria in your life, or if, like Ms. Jiang, you have discomfort in the left waist and abdomen.

In addition, patients with Nutcracker Syndrome should also pay attention to some living habits in their daily life. For example, in their diet, they should eat some light food as much as possible, and eat less spicy and high-fat food. This kind of food will give our own blood vessels Causing a certain burden, it will affect blood circulation, thereby indirectly aggravating the condition of the Nutcracker.

Patients should also maintain physical and mental health, be less angry, and maintain appropriate daily activities. However, it should be noted here that such patients must avoid standing or walking for a long time. Be careful not to do strenuous exercise when exercising, ensure adequate sleep every day, go to bed early and don’t stay up late.

Conclusion

Although Ms. Jiang has been diagnosed with the disease and has been discharged from the hospital in good health, whether it is herniated lumbar disc or nutcracker disease, these have brought pain to Ms. Jiang both physically and mentally. The early back pain has affected his daily life. During the later examination, he did not know that the mental stress caused by the disease would affect Ms. Jiang’s body and mind.

So we need to prevent these diseases in our daily life, instead of working at a desk for a long time. After working for a while, you should get up and exercise. This not only relieves our fatigue, but also relaxes the brain to a certain extent. After a break, you can devote yourself to work, and the effect will be better.