Symptoms and Treatment Options for Herniated Discs - Orthopedics

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Symptoms of suspected herniated disc?


Hello Doctor, I have already gone to a major hospital for relevant examinations (X-ray, electromyography, MRI) and confirmed that there is a herniation at the third and fourth lumbar vertebrae.
Following the doctor's advice, I started rehabilitation (heat therapy, electrical stimulation, lumbar traction) but have not been prescribed any medication.
It has been over two weeks of rehabilitation, and initially, I experienced a burning and tingling sensation from my left calf to the sole of my foot.
However, today I suddenly felt a similar condition in my right foot as well.
I would like to ask if this indicates a worsening of my condition? Can I continue with the rehabilitation? Additionally, the physician at the rehabilitation clinic suggested that if there is no improvement after a period of rehabilitation, I could receive an injection of glucose into the lumbar region to use the fluid pressure to push the lumbar vertebrae back into place.
Is this approach correct? Thank you for addressing these questions.

Mr. Hsieh, 40~49 year old female. Ask Date: 2023/11/08

Dr. Chen Yongxue reply Orthopedics


Hello, generally speaking, a herniated intervertebral disc between the third and fourth lumbar vertebrae typically presents with unilateral symptoms such as numbness, tingling, and pain in the inner side of the calf, as well as difficulty walking for extended periods.
It is quite rare to experience bilateral symptoms.
If you feel that your symptoms are worsening, it would be advisable to undergo further examination of the lumbar nerves.
Additionally, using injections to alleviate symptoms can be considered; however, it is recommended to use other types of medication for injection rather than glucose.
Thank you.

Reply Date: 2023/11/08

More Info


Understanding symptoms and treatment options for herniated discs is crucial for managing pain and preventing further complications. Based on your description, it appears that you have been diagnosed with a herniated disc between the third and fourth lumbar vertebrae, which is a common condition that can lead to various symptoms, including pain, numbness, and tingling in the legs.
Initially, you experienced symptoms in your left leg, specifically a sensation of heat and tingling from the calf to the foot. The recent development of similar symptoms in your right leg could indicate that the condition is affecting more than just the left side, which may suggest an exacerbation of your condition or increased nerve involvement. It is essential to monitor these changes closely, as they can inform your healthcare provider about the progression of your condition.

Regarding your rehabilitation efforts, it is generally advisable to continue with physical therapy, especially if you are under the supervision of a qualified therapist. Rehabilitation techniques such as heat therapy, electrical stimulation, and lumbar traction are often beneficial for alleviating pain and improving mobility. However, if you notice a significant increase in symptoms or if new symptoms arise, it is crucial to communicate this with your therapist or physician. They may need to adjust your treatment plan based on your current condition.

As for the suggestion of injecting glucose into the lumbar region to help reposition the herniated disc, this technique is known as "nucleoplasty" or "percutaneous discectomy." It involves using a needle to inject a substance into the disc to reduce its volume and relieve pressure on the surrounding nerves. While some practitioners advocate for this method, the effectiveness and appropriateness of such treatments can vary widely among patients. It is essential to discuss the potential risks and benefits with your healthcare provider, as well as to consider other options such as corticosteroid injections, which can help reduce inflammation and pain.

In summary, it is vital to maintain open communication with your healthcare team regarding any changes in your symptoms. Continuing rehabilitation is generally recommended, but adjustments may be necessary based on your progress. If your symptoms worsen or do not improve, further diagnostic imaging or alternative treatments may be warranted. Always consult with your physician before making decisions about your treatment plan to ensure that you are receiving the most appropriate care for your specific situation.

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