Prolapse of lumbar intervertebral disc is caused in most cases
by sprain, fatigue or cold. It often occurs between the cases by
sprain, fatigue or cold. It often occurs between the 4th and the
5th lumbar vertebrae or between the 5th lumbar vertebra and 1st
sacral vertebra, and often in youth and the middle-aged of
20-40, with the males surpassing the females in number.
Points of Diagnosis
1. Most of the patients have a history of trauma
or cold invasion.
2. There arises a sudden lumbago in one side, which radiates to
the lower limb. Cough, sneezing, bowel movement and other
actions which exert pressure on the belly can aggravate the in
the lumbus and the leg. The pain is sharp at the acute stage and
at the chronic stage it is sometimes relieved and sometimes
serious with frequent recurrences.
3. The physiological lordosis in the lumbar portion disappears.
There is tenderness beside the corresponding vertebral spinous
process, which can radiate to the lower limb. The raising test
of the straight-leg on the affected side shows positive. The
muscles are atrophic. The muscular tension is reduced. The force
of the toe extensor muscle and flexor muscle is decreased. The
reflex of the knee and the Achilles tendon is weakened or has
disappeared. The dermal sensation in the corresponding areas
controlled by the sciatic nerve of the shank is reduced or lost.
The dermal sensation in the saddle area and the function of the
sphincter muscles are also weakened or even lost. The movement
of the lumbus is distinctly limited. The extension of the lumbus
can increase the pain, while flexion or lying on the side can
4. X-ray film shows that the corresponding intervertebral space
becomes narrow, or narrow in the anterior part and wide in the
anterior part and wide in the posterior part. There may be
labial hyperosteogeny at the margin of the vertebral body.
5. CT scanning can confirm the diagnosis.
Differentiation and Treatment of Common Syndromes
1. Replacement by Manipulation
The patient is told to sit on a stool. An assistant fixes the
lower limbs and pelvis of the patient. If the patient has pain
in the lumbus and the leg of the right side and the spinous
processes are inclined toward the right side for example, the
operator stands by the right side, runs his right arm past the
patient's right armpit, gets hold of the patient's neck in his
hand and makes the patient's head a bit forwardly-inclined. He
presses with his left thumb the patient's spinous processes
which are inclined to the right. The patient's upper part of the
body is to be bent forward to the full extent, next turned to
the right, and then rotated forcefully backward to the maximum
extent. At the same time, the operator presses firmly leftward
the inclined spinous processes with his left thumb. If a sound
is heard, the replacement is indicated.
5-7 days' rest in hard bed is required after the operation.
2. Replacement by Traction
Pelvic hammock can be used for the traction. The traction cord
runs through the trochlea over the bed head and is tied to the
two sides of the hammock. The traction weight is 10-13 kg for
each side. The foot side of the bed is raised. The traction is
done for 1-2 hours a day. If it is combined with massage
therapy, the result will be better.
3. Herbal Therapy according to Syndromes
1) Early Stage
Main symptoms and Signs: The lumbago comes suddenly and is very
sharp. Prostrating or turning aside is impossible. the illness
involves the lower limb. It manifests itself in pain, numbness
Therapeutic Principle: Promoting blood circulation, removing
blood stasis and clearing away obstruction in the channels to
Recipe: decoction of Four Ingredients for Relieving Pain.
2) Late Stage
Main Symptoms and Signs: The illness has had a long duration.
The muscles have become atrophic or numb. The lassitude in the
loin and knee. The illness becomes severe after fatigue,
intolerable to long-time standing or walking.
Therapeutic Principle: Tonifying and replenishing the liver and
kidney, strengthening muscles and bones, relaxing muscles and
tendons and activating collaterals.
Recipe: Decoction for Tonifying the Kidney and Promoting Blood
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