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.  

Main 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 relieve it.

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 or bulging.

Therapeutic Principle: Promoting blood circulation, removing blood stasis and clearing away obstruction in the channels to relieve pain.

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 Flow.

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