How to distinguish lumbar muscle strain from lumbar disc herniation

Lumbar intervertebral disc herniation: generally occurs between 20 and 40 years old, the incidence of young adults accounted for about 80%. Most of them are male. People who are too obese or too thin are prone to lumbar disc herniation. The intensity of labor is relatively high, and people who often sit at the desk and often stand are more common.

Lumbar muscle strain: Acute lumbar sprain in heavy manual workers can cause lumbar muscle strain if it is not treated or handled properly in time. Athletes or people who have been engaged in intense exercise for a long time cause long-term injury to the lumbar muscles during intense exercise. Long-term sitting study, or poor sitting posture in office, can also lead to chronic lumbar muscle strain.

Lumbar disc herniation: Low back pain is the first symptom in most patients. It is characterized by dull pain. Because the outer layer of the annulus fibrosus and the posterior longitudinal ligament are stimulated by the nucleus pulposus, the lower lumbar pain is induced by the sinus vertebral nerve, sometimes accompanied by hip pain.

Lumbar muscle strain: manifested as lumbar pain or swelling pain, part of the sting or burning pain. The degree of lumbar pain is strong and weak. It begins to show intermittent pain, gradually becomes persistent pain, and gradually intensifies. Pain changes with the weather, and increases in cold or rainy days. The painful parts are deeper, worse when moving, and less after bed rest.

Although high lumbar disc herniation (L2-3, L3-4) can cause femoral neuralgia, it is rare in clinic, less than 5%. The vast majority of patients had prominent lumbar 4-5 and lumbar 5-sacral 1 spaces, presenting as sciatica.

ypical sciatica is radiation pain from the lower waist to the buttocks, the back of the thighs, the outside of the lower leg to the feet, which is exacerbated by increased abdominal pressure such as sneezing and coughing. Radioactive pain is mostly on one side of the limb, and only a few cases of central or paracentral nucleus pulposus protrusion show symptoms of both lower limbs.

Lumbar muscle strain usually results from low back pain.

Protrusion of lumbar intervertebral disc: Some patients have tenderness in the spinous process or interspinous space. The tenderness point is mainly located near the spinous process, that is, in the middle of the back. When tenderness occurs, radiation pain of the lower extremity along the nerve root may occur.

Lumbar back muscle strain: usually there is no tenderness between the spinous processes of the lumbar spine, but there is tenderness in the local lumbar back muscle, mostly at the sacrospinal muscle, the posterior iliac spine, the insertion point of the sacrospinal muscle or the transverse process of the lumbar spine. That is, the muscles on both sides of the back far from the midline of the back.

It is more likely that lumbar disc-induced low back pain is caused by lumbar disc pain, which is professionally called lumbar discogenic low back pain.

In patients with lumbar disc herniation, the cauda equina nerve is compressed by the protruding nucleus pulposus or Prolapsed or free intervertebral disc tissue. The main manifestations are dyspepsia, dyspepsia, perineal and perianal sensation. Severe patients may suffer from uncontrolled stool and urine and incomplete paralysis of both lower limbs, which is rare in clinical practice.

Patients with lumbar muscle strain need to strengthen the exercise of lumbar and back muscles, enhance the strength of lumbar muscles and reduce lumbar muscle injury. As well as restoring and improving the lumbar spine protection of lumbar muscles and peripheral ligaments to prevent muscle tension imbalance. Through exercise, lumbar muscles, ligaments, often in a healthy and well-developed state, muscle strength and ligament elasticity are good, generally less chance of strain.

However, when exercising, we should do less intensive training using waist strength, such as hard pulling with heavy weight, squatting with heavy load and so on. It is suggested that the waist and back training without load or static force should be adopted at the beginning.