Lumbar disc herniation is getting more and more painful when sleeping on the sofa, will it lead to the protrusion becoming bigger?

Patients with lumbar disc herniation, why sleeping on a hard bed will not cause the protrusion to become bigger? This problem needs to understand the state of intervertebral disc, that is, the pathological mechanism of intervertebral disc.

We can imagine a human intervertebral disc as a jelly, which is similar in shape. There is a jelly-like viscous structure in the center, surrounded by layers of solids and movable rings. The picture above shows the intervertebral disc of our normal human body.

If we press hard from the upper surface, lower surface or horizontal surface of this jelly, the deformation of this ring will not be too great (the state of sleeping on a hard bed); On the contrary, just press backward in front of the ring, and the jelly in the middle will be pushed behind the ring (bending state). If there are cracks or small holes in the ring, the jelly in the center will overflow from here. This state is what doctors often call disc herniation.

As shown in the above picture, it shows that the stress on our intervertebral disc is different in different positions. More precisely, microglia (nucleus pulposus) bear asymmetric pressure acting on the intervertebral disc. When bending over, the pressure acting on the nucleus pulposus will push the nucleus pulposus backward. When the body leans backward, the nucleus pulposus is pushed forward, as opposed to bending over. This also explains that only when bending, the pressure of nucleus pulposus will be too large, which will lead to the increase of protrusions. When you lie down, there is basically no pressure, so you won't see the change of the protrusion.

Why is the disc herniation? The more you sleep in a hard bed, the more painful it is. Isn't that what doctors say?

It is true that many doctors will advise patients with lumbar processes to sleep on hard beds. But there are some details, such as patients with acute lumbar disc herniation. It is highly recommended that patients stay in bed for a week and sleep on a hard bed. Objective To stimulate inflammation in acute phase, not to advocate excessive exercise, and to image the pressure changes of nucleus pulposus. At this time, dehydration drugs, such as mannitol, are also advocated. The choice of hard bed is not to sleep directly on the bed board, but the one with bedding. It is advisable for people to step on it for about 2-3 cm.

Therefore, Simmons used by many families is not desirable.

Secondly, if you don't need exercise in the acute stage, but in the chronic stage, you just sleep on the hard bed and keep a certain posture without corresponding exercise, which will make the paraspinal muscles of your back in a state of long-term adaptation shortening. The most important feature of this state is that the shortening of organizational structure will hinder our body from changing to a more comfortable posture. Of course, patients usually don't notice this, because our bodies are very good at finding compensatory actions to complete the posture you want. Shortening tissue can lead to imbalance of the body. Over time, sleeping in a hard bed will become more and more painful.

Conclusion: For people with lumbar disc herniation, sleeping on a hard bed will not lead to the increase of the protrusion. At the same time, it should be noted that sleeping on a hard bed needs to be combined with exercise, rather than relying on sleeping position to relieve pain. More importantly, knowing more about our body structure and having some basic common sense is more beneficial to our health.

This is a very realistic and common problem. Clinically, many patients with lumbar processes go to see a doctor and are advised by doctors to go home and sleep on a hard bed. Then the patient goes home and honestly finds a hard bed to sleep in. As a result, the symptoms have not been alleviated, but have become more and more serious.

Listen to the doctor, why are the symptoms getting worse?

This stems from a misunderstanding that the "hard bed" in the doctor's mouth and the "hard bed" in the patient's mind are not the same concept.

The hard bed in the patient's mind is as hard as possible, while the hard bed in the doctor's mouth is a hard bed covered with mattresses and bedding.

Our spine has a physiological curvature, which is convex and concave, not a straight line. We work and live during the day, our spine is always under pressure, and we can only relax and rest at night. If we sleep on a flat hard board, the pressure of the whole body needs to be supported by our head, back, hips and heels, and the lumbar spine is suspended and we can't rest. In this way, the lumbar spine will never rest, and there will definitely be symptoms such as backache and backache.

In order to avoid this situation, we should add a mattress to the hard bed, but this mattress should not be too soft. It is best to customize a mattress that suits you, so that your lumbar spine can be supported when you lie on your back and side, and it will not be suspended, which will better protect your lumbar spine.

The relationship between pain and prominence!

There is no absolute connection between pain and protrusion. The patient's pain worsened after sleeping on a hard bed. I thought that the protrusion was getting bigger and the condition was getting worse. In fact, the pain had little to do with the protrusion.

In clinical practice for so many years, I have seen too many patients with lumbar process, many of whom have no symptoms, which is incredible to outsiders. After all, their lumbar vertebrae have been examined and highlighted, but there are no symptoms; Moreover, the size of the protrusion is not directly related to the degree of symptoms (pain). Many patients have severe pain in the early stage, and after a period of conservative treatment, the symptoms gradually ease or even disappear. However, if they have an MRI, they may find that the protrusion of the lumbar intervertebral disc has not shrunk.

This is not surprising. In fact, the relief of symptoms in patients with lumbar process benefits from reducing the stimulation of nerve roots by protrusions and related inflammatory reactions.

That's a process. It hurts to start sleeping, so you need to recover slowly. It will definitely hurt to go back to your prominent place. Do some anti-inflammatory treatment when sleeping, because inflammation will hurt, understand?

In fact, many patients are not used to sleeping in hard beds, because too hard beds are easy to oppress local soft tissues, which will slow down blood circulation, but will easily cause local muscle spasms and cause pain and discomfort. Therefore, it is generally recommended to spread a thin quilt on a hard bed or replace it with a palm pad.

Whether there is a prominent aggravation is mainly to observe whether there is a manifestation of nerve compression, such as whether there is numbness and weakness in the lower limbs due to limited leg lifting. If it continues to get worse, it is necessary to take a film to check for abnormalities.