Text|Traditional Chinese Medicine Surgery|Inheriting the Good Prescription of the Ages, Promoting the Golden Book of Traditional Chinese Medicine
In the previous article, we mentioned the causes, symptoms, and types of bone hyperplasia (bone spurs), as well as the common sites of the lumbar spine, cervical spine, knee joint, in addition to the sacral spine, foot root (heel) and other parts of the body.
Although they are all bone hyperplasia (bone spurs), the treatment methods are different according to the location, course, severity, and individuality.
In this article, we will talk about the treatment of lumbar hyperostosis in the lumbar spine.
The etiology of lumbar hyperostosis is related to degenerative changes in the articular cartilage. After middle age, with the increase of age, the physiological functions of the cells of various tissues of the body gradually decline and age, the degenerated intervertebral disc gradually loses moisture, the intervertebral space narrows, the fibrous annulus relaxes and bulges to the periphery, the vertebral body is unstable, and the fibrous annulus is torn outside the edge of the vertebral body, resulting in the protrusion of the nucleus pulposus, the periosteum of the posterior longitudinal ligament is pushed up, and new bone is produced under it, forming bone spurs or bone hyperplasia.
It is also believed that after the degeneration and atrophy of the intervertebral disc, the vertebral body tilts forward, the anterior edge of the vertebral body is blocked by the anterior longitudinal ligament in the midline, and the periosteum on both sides lifts up, and new bone forms under the periosteum. In addition, local compression factors are also the main factors causing bone hyperplasia.
In addition to changes with age, it is also related to factors such as long-term excessive flexion and extension activities of the lumbar spine and weight-bearing injury, which are external factors for lumbar degeneration and morbidity.
For example, heavy manual laborers, people who often carry heavy objects on their shoulders, and some athletes such as weightlifting, gymnastics, wrestling and other strenuous sports are easy to damage the lumbar spine and aggravate the strain and degeneration of the lumbar spine. It is not difficult to understand that there are many professional athletes and manual laborers who are prone to lumbar spine bone hyperplasia after middle and old age.
In recent years, the proportion of young patients with lumbar hyperostosis is increasing, such as some people who must sit for a long time, stand for a long time, and maintain the same posture for a long time.
Check the diagnosis
For lumbar hyperostosis, there are a few other diagnostic criteria in addition to x-rays, including the following:
(1) Low back pain, heavy in the morning, relieved after activity; The low back pain worsens after more activity or weight-bearing, mainly soreness and discomfort;
(2) There are no clear tender points;
(3) limited movement of the lower back;
(4) Waist smash is comfortable;
(5) no signs of nerve compression;
(6) X-ray showed osteophyte hyperplasia of the vertebral body and narrowing of the intervertebral space.
Clinical symptoms
Lumbar hyperostosis is a chronic, progressive joint pathology, with L3 and L4 being the most common. If the sciatic nerve is compressed, sciatitis can be caused, with severe numbness, burning, throbbing, and string pain in the affected limb that radiates to the entire lower extremity.
(1) Early stage: When the early degree is mild, the waist and leg pain are the main symptoms, the symptoms are not very obvious, sometimes heavy and sometimes light, it is easy to be ignored, and there will be obvious pain after exertion or standing and sitting for a long time, which will be alleviated after appropriate rest.
(2) Medium-stage: As the disease progresses and gradually worsens, there will be intervertebral disc degeneration, vertebral deformation, laxity and instability between adjacent vertebral bodies, and feeling stiffness and pain and weakness in the lower back during activity. The stimulation of osteophytes formed after degeneration can make the stiffness of the waist more obvious, heavy at rest, relieved after a little activity, and exacerbated by overexertion.
(3) Later stage (severe stage): hyperbiostimulation or compression of spinal nerves, which can cause radiating pain in the lower back, low back and leg pain and numbness in the lower limbs. When the anterior edge of the vertebral body is hyperplasia and lateral hyperplasia, it can compress and stimulate nearby blood vessels and autonomic nerves.
Treatment of lumbar bone spurs
Before talking about specific treatment, we must first clarify a problem, the key to the treatment of bone hyperplasia is not to eliminate the bone spurs, but to eliminate the aseptic inflammation around the bone hyperplasia, so that the body's own regulatory mechanism gradually eliminates the bone spurs.
If the bone spurs or hyperplasia are removed directly and violently without eliminating the inflammation and relieving the compression, it may further stimulate our self-protection mechanism and stimulate the compensatory mechanism, which in turn will lead to more bone hyperplasia.
1. Traditional Chinese medicine treatment
The treatment of bone hyperplasia in TCM is based on the holistic concept of TCM and the principle of syndrome differentiation. Therefore, in the treatment of bone hyperplasia, it is necessary not only to treat local lesions, but also to pay attention to the overall conditioning and the recovery of visceral function.
The principle of external treatment is mainly to use the meridian pathway to play the function of the drug to pass the meridians, stagnate and remove stasis, treat bones and remove dampness, relax tendons and invigorate blood, and dispel wind and cold.
(1) External treatment of traditional Chinese medicine, external application of black plaster and other drugs, the advantage of this method lies in the continuity of the drug, through long-term medication according to the course of medication, the effective drug ingredients can continue to form a certain concentration in the affected area for a long time, and gradually eliminate inflammation, effusion, swelling, etc., and can often be maintained for a long time.
(2) Acupuncture, acupuncture can invigorate blood and have analgesic effects. It can eliminate local edema and inflammation, but acupuncture can only play an auxiliary role in bone hyperplasia.
(3) Massage and traction rely entirely on the action of external force, only the local treatment is carried out but the overall regulation of the human body is neglected, therefore, it can only play a temporary analgesic effect, but can not achieve the purpose of treatment.
(4) Internal regulation of traditional Chinese medicine, according to the specific symptoms and constitution of the patient, syndrome differentiation treatment, taking traditional Chinese medicine or Chinese patent medicine with the effects of nourishing the liver and kidney, invigorating blood circulation and removing stasis, dispelling wind and cold, dehumidifying and channeling.
It should be noted that (2), (3), and (4) are mainly auxiliary. In addition, there are some traditional therapies of ethnic minorities, which will not be introduced too much here.
2. Other conservative treatments
(1) Direct current drug iontophoresis
The direct current drug iontophoresis method gives full play to the effect of the drug, but because the introduced drug is liquid, it is volatile, and the effect is not long-lasting, which limits the therapeutic effect of this method.
(2) Ultraviolet therapy: its therapeutic effect is mainly manifested in the following aspects:
(1) Bactericidal effect; (2) anti-inflammatory effect; (3) analgesic effect; (4) promote wound healing; (5) desensitization; (6) promotes the formation of vitamin D3; (7) Regulate the body's immune function.
3. Surgery and Western medicine treatment
Generally speaking, surgical treatment is not advocated, due to its high risk and high recurrence problem, but now the problem of surgical profit, resulting in many similar patients being recommended to have surgery, and finally end up with the condition recurring and becoming more serious.
(1) Minimally invasive arthroscopic surgery; (2) Open surgery; (3) Artificial joint replacement surgery; (4) Microwave radiofrequency ablation surgery; (5) Enlarged foraminal decompression; (6) Minimally invasive interbody fusion, etc. It is often accompanied by the use of some Western medicine during surgery.
Pure Western medicine treatment. Western medicine has no effective treatment for this disease, and symptomatic treatment is often used, such as taking some antipyretic and analgesic drugs when pain; B vitamins are commonly used in people who are numb.
Misconceptions are vigilant
Doctors are tasked with treating a range of symptoms and signs caused by local tissue congestion, edema, inflammation and adhesions caused by hyperostosis and the resulting compression of nerves and blood vessels. All treatments can only improve the symptoms, pain, numbness and soreness. The idea and practice of trying to get rid of the hypertrophic bone is unrealistic. The claim that it can dissolve the hypertrophic bone (bone spurs) is ridiculous.
Note: Some of the pictures in the article are from the Internet, invaded and deleted!