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Guang Ming Daily – February 2022

When talking about lower back pain in the past, many people would picture an elderly man holding a cane with one hand and supporting his waist with the other. However, in recent years, people who gets lower back pain is getting younger, and lumbar intervertebral disc herniation is a very common symptom. In addition to accidental injuries, poor living habits and posture are the main factors for lumbar intervertebral disc herniation.


Avoid Injuries from Overuse of the Spine

Dr Lee Joon Kiong, Consultant Orthopaedic Surgeon, pointed out that lumbar disc herniation is the most common clinical problem in orthopaedics. In the past, most patients with lower back pain were elderly, and the reason was mostly related to body degeneration, but today’s patients are mostly young people, mostly sports injuries and accumulated injuries due to poor posture in daily life.

He said that due to lower back pain, patients are not only troubled by their daily work and rest, but also suffer from lower back pain that affects their work, or have to rest for a long time, which increases the financial burden and leads to physical and mental exhaustion. Therefore, understanding the harm caused by lumbar disc herniation, and learning how to prevent them is the personal health way that everyone must master in this era.


MRI is more accurate without radiation damage

“Because the herniated intervertebral disc will compress the nerve root in the spinal cavity and cause nerve root injury, the pain that the patient complains at this time includes lower back pain, lack of strength, tension and even lower limb paralysis, etc., a seemingly inconspicuous little action, such as occasional sneezing, coughing or bending forward can exacerbate pain or paralysis.”

He pointed out that the imaging examination includes magnetic resonance imaging (MRI), which can accurately diagnose the location and severity of intervertebral disc herniation, including whether the herniated intervertebral disc has pressed against the nerve root, or which segment is pressing on the nerve root etc., the MRI can clearly see where the problem lies.

“It is worth mentioning that MRI has a higher accuracy in detecting lumbar disc herniation, and it can even be used to detect signs of premature degeneration of the intervertebral disc.”


Medication Rehabilitation, Lifestyle Changes, Prioritizing Non-Surgical Treatment

Since lumbar intervertebral disc herniation is related to poor lifestyles, the most basic element of treatment is to change the poor lifestyle habits from the past, rather than blindly thinking that surgery can solve the problem “once and for all”. Surgery is only considered when all non-surgical treatments did not improve the situation.


Crouch Down Before Picking Up Objects

Dr Lee Joon Kiong also reminded that the posture and movements in our daily lives should be done properly to try to reduce the pressure in the intervertebral disc and avoid the disc protrusion. For example, when a person wants to pick up an object from the ground, no matter how big or small, heavy or light, you should squat down before picking up the object, rather than bending forward.


Obesity Increases the Burden on The Spine

He reminded that obese people increase the load on the spine due to their weight, which will lead to compression of the intervertebral disc over time. Therefore, for patients with lumbar disc herniation and obesity, appropriate weight loss can achieve improvement. ”


Paralysis of the lower limbs, Final option for surgery

Surgical treatment for lumbar disc herniation is the last option. Many patients have hesitation and reservations about surgical treatment. However, if the condition is very serious and even causes paralysis of the lower limbs, surgery may be the best choice.


Surgery May Be Used if Appropriate

Dr Lee Joon Kiong said that the current operations include excision of herniated intervertebral discs, resection and fixation of damaged intervertebral discs, reduction and fixation of vertebrae, and intervertebral disc replacement surgery. The entire surgical process, risks, surgical success rate, postoperative rehabilitation, matters that must be paid attention to after surgery and possible sequelae, etc., and finally decide whether to perform surgical treatment after the patient understands it.

The doctor will look at your situation and decide on which surgery is more appropriate. At the same time, the doctor will also explain to the patients on the entire surgery process, risks, success rate of the surgery, postoperative rehabilitation, things to pay attention to after surgery, and possible side effects from the surgery etc. Finally, after the patient understands, then only decide whether to proceed with surgery.


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