What is the cause of lumbar disc herniation

Nowadays, many people suddenly suffer from lumbar disc herniation due to some minor dissatisfaction or pathological factors in their daily lives. The patient's condition will continue to deteriorate. If not treated in time, it will be difficult to cure for life. The cause of lumbar disc herniation is mainly that the waist bears too much force, is under pressure for a long time, and does not pay attention to correct sitting posture. Occupational and environmental factors can cause lumbar disc herniation, so timely prevention is required in normal times.

What are the main causes of lumbar disc herniation?

1. Lumbar trauma is one of the main causes of lumbar disc disease. In acute trauma, structures such as the annulus fibrosus and cartilage plate will be affected, which will in turn cause the degenerated nucleus pulposus to protrude.

2. Increased abdominal pressure, such as severe coughing, constipation, etc., will cause symptoms of lumbar disc.

3. If patients with lumbar disc herniation suddenly bear weight without sufficient preparation, the sudden increase in the load on the waist can cause nucleus pulposus herniation, which fundamentally causes lumbar disc herniation.

4. Incorrect sitting posture can also cause lumbar disc herniation. When the waist is bent and suddenly rotated, it will cause nucleus pulposus herniation.

5. Due to some occupational factors, for example, white-collar workers, drivers, etc. are in a sitting position for a long time, which can easily cause lumbar disc herniation.

1. Clinical symptoms of lumbar disc herniation The clinical symptoms can vary greatly depending on the location and size of the nucleus pulposus herniation, the sagittal diameter of the spinal canal, pathological characteristics, body condition and individual sensitivity. Therefore, the recognition and judgment of the symptoms of this disease must be fully understood and inferred from the perspective of its pathophysiology and pathological anatomy. The common symptoms of this disease are described below.

(1) Low back pain: More than 95% of patients with lumbar disc herniation have this symptom, including those with vertebral disc herniation.

① Mechanism: It is mainly due to the degenerated nucleus pulposus entering the vertebral body or the posterior longitudinal ligament, causing mechanical stimulation and compression to the adjacent tissues (mainly nerve roots and sinus-vertebral nerves), or due to the overflow of glycoproteins and β-proteins in the nucleus pulposus and the release of histamine (H substance), which stimulates the adjacent spinal nerve roots or sinus-vertebral nerves and causes chemical and/or mechanical radiculitis.

②Manifestations: Clinically, persistent dull pain in the lower back and back is the most common, which is relieved in the supine position and aggravated when standing. It is generally tolerable and allows moderate waist movement and slow walking. It is mainly caused by mechanical compression. The duration can be as short as 2 weeks or as long as several months or even years. Another type of pain is severe spasmodic pain in the lower back, which not only occurs suddenly but is also often unbearable and requires bed rest. This is mainly due to ischemic radiculitis, that is, the nucleus pulposus suddenly protrudes and compresses the nerve roots, causing the blood vessels at the roots to be compressed at the same time, resulting in a series of changes such as ischemia, congestion, hypoxia and edema, which can last for several days to several weeks (this symptom may also occur in people with spinal stenosis, but the duration is very short, only a few minutes). Lying on a plank bed, blockade therapy and various dehydrating agents can help relieve the symptoms early.

(2) Radiating pain in the lower limbs : This symptom occurs in more than 80% of cases, of which the posterior type can reach more than 95%.

①Mechanism: The same mechanism as the previous one, mainly due to mechanical and (or) chemical stimulation of the spinal nerve roots. In addition, reflex sciatica (also known as "pseudo-sciatica") may also occur through the sinovertebral nerve of the affected segment.

②Symptoms: In mild cases, symptoms include radiating tingling or numbness from the waist to the thighs and back of the calves, reaching the soles of the feet; generally tolerable. In severe cases, the symptoms include electric shock-like severe pain from the waist to the feet, often accompanied by numbness. Although those with mild pain can still walk, their gait is unstable and they limp; they often lean forward or support their waist with their hands to relieve the tension on the sciatic nerve. For severe cases, the patient should rest in bed, and preferably lie on the side with the hips and knees flexed. Any factor that increases abdominal pressure will aggravate the radiating pain. Since neck flexion can aggravate the stimulation to the spinal nerves by pulling on the dura mater sac (ie, neck flexion test), the patient's head and neck are usually in the extended position.