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Pathology and TCM Treatment of the Herniated Lumbar Disc |
| Pathogenesis An interverbral disc consists of a hyaline cartilage disc, a fibrous ring and a pulpiform nucleus. The fibrous ring is cartilage fibrous tissue, tough and tenacious. It is connected above and below to the vertebral bodies, effectively keeping the pulpiform nucleus from prolapsing in all directions. The pulpiform nucleus is elastic and is constrained between the cartilage disc and the fibrous ring. Once the pulpifrom nucleus is under too great a pressure, whatever origin the pressure comes from, it may break through the fibrous ring and be displaced. The usual presentation is a posterior prolapse, which will produce symptoms from the nerve roots, the cauda equina, and the spinal cord. Most victims of the disease are people between the ages of 20-50. The injury mostly occurs between L4 and L5 or between L5 and S1. Essential for Diagnosis 1. Sudden pain in the lumbar region, with or without a history of trauma, which may radiate towards the posterior or lateral sides of either the leg or foot. The pain hurts terribly in acute cases, and in patients with chronic prolapse of the lumbar intervertebral disc the pain varies from time to time. 2. Restricted movement of the lumbar portion. The physiological forward bending of the lumbar portion vanishes, but there is lateral flexion, mostly towards the affected side. 3. Tenderness around the spinous process of the corresponding vertebral body, which may be accompanied by shooting pain along the sciatic nerve. 4. Positive result in Laseque’s test. The tensile force of the crural muscles and the strength of the extensor/flexor digitorum are weakened. Knee reflex and Achilles jerk are debilitated or incapacitated. 5. MRI diagnosis is excellent for diagnosis of Prolapse of Lumbar Intervertebral disc. Patterns identification of TCM 1, Wind patterns: The pain is shooting and moves, and its location will vary. The pulse is floa! ting or String-like. The tongue is pale and has a white coating. 2, Damp patterns: The low back feel stiff and the leg feels heavy. The pulse is soggy and moderate. The tongue is pale and has a slimy white coating. 3, Cold patterns: The pain is stabbing and unlike wind patterns, is fixed in place. The pulse is string-like and tight or deep tight. The tongue is pale and has a white coating. Therapeutic principle Treatment of primary symptoms in emergency, such as dredging the obstructed channel immediately with acupuncture and TuiNa to relieve swelling and pain. This is accompanied by herbal treatment to activate blood circulation and resolve stasis, dredging collaterals to relieve pain and nourish the injured bone and soft tissue. Afterwards, root weaknesses are treated and any remaining blockages are cleared. Acupuncture The points: Du3, GB30, GB33, GB38, GB43, ST34, ST36, BL54, BL23 Herb Formulas HongHua, Safflower 9g TaoRen, Peach Seed 9g HuangQi, 12g XuDuan, 12g NiuXi, 9g GuSuiBu, 12g DiLong, 6g ChiShao, 12g GouJi, 9g GanCao, 3g All the above drugs were to be decocted in water for oral taking, 10 doses were prescribed, fat and greasy food was forbidden during treatment. Tui Na First massage for 5 minutes, then use turning and counter traction.( Note: During acute attack, don’t use the Tui Na.) Here is an introduction to Traditional Chinese Medicine by Dr. Chen. Powerpoint presentation |
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