Acute simple traumatic lumbar and leg pain

　　From the perspective of traditional Chinese medicine, traumatic lumbar and leg pain refers to lumbar pain caused by injury due to various reasons. That is, lumbar injury caused by external force such as falling, dropping, twisting, carrying heavy loads, etc., or injury to tendons, or bone damage, due to the injury of the meridians and collaterals, blood stasis and qi stagnation, sudden onset of lumbar pain, severe pain, sharp or distending pain, pain is localized, dare not lie on the stomach and turn over, movement causes severe pain, and the pain is difficult to bear and radiates to one or both lower limbs to the lower leg or sole. If the treatment is not timely or thorough, it will lead to chronic lumbar and leg pain over time.

　　The movement of the lumbosacral joint is mainly flexion, extension, and lateral flexion, with less rotation. The direction of the inferior articular process of the fifth lumbar vertebra and the superior articular process of the first sacral vertebra is different, some are parallel to the sagittal plane of the human body, so the flexion, extension, and lateral flexion of the spine, as well as rotation, are relatively flexible. Some are parallel to the frontal plane of the human body, so the lateral flexion and rotation of the spine are limited to a certain extent. Some people have asymmetric joints on both sides, which makes the direction and range of movement on both sides not coordinated. This is also one of the reasons why lumbar and sacral joints are easily sprained.

　　This disease is mainly characterized by the concurrent occurrence of scoliosis of the spine:

　　More than half of the patients have spinal curvature, varying degrees, which is related to the sprain, tear of the ligaments, and stimulation and compression of the nerves. The curvature is to reduce the pain of sprained or torn ligaments and to reduce the symptoms of nerve stimulation or compression. The presence or absence, direction, and degree of curvature can be determined by the pathological changes of the nerves and ligaments.

　　Firstly, the disease mainly has the following symptoms

　　1. Spontaneous lumbar and leg pain patients suddenly feel lumbar and back pain during twisting, severe and sharp pain, limited and obvious, which can be clearly pointed out to facilitate diagnosis. Sometimes, after sprain, a crisp sound or tearing sensation is felt, followed by pain relief, or pain is not obvious during twisting, and the pain in the waist becomes worse after rest or when getting out of bed the next day, the waist becomes rigid, movement is difficult, lumbar and back muscle spasm, and even leg pain radiates to the posterior part of the thigh.

　　2. Local tenderness Most patients have localized tenderness in the early stage of sprain, which can assist in diagnosis. Sometimes, due to the spasm of the piriformis muscle compressing the sciatic nerve trunk, the tenderness point is at the greater sciatic notch where the sciatic nerve exits.

　　3. Radiative or tractional neuralgia The site of radiative or tractional neuralgia is often the buttocks, the posterior part of the thigh, the anterior and medial part of the thigh root, etc., within the distribution area of the posterior cutaneous nerve of the thigh and the sciatic nerve.

　　Secondly, there are three reasons for the pain of this nerve

　　1. The ligaments, muscles, and other soft tissues around the lumbar sacral and sacroiliac joints are innervated by the fourth and fifth lumbar nerves and the posterior branches of the sacral nerves. The anterior branches form the sciatic nerve and the posterior cutaneous nerve of the thigh, so reflex neuralgia often occurs.

　　2. The sciatic nerve and the posterior cutaneous nerve bundle of the thigh, closely adhering to the anterior side of the sacroiliac joint and the piriformis muscle, are directly stimulated by the nerve when the ligaments in this area hemorrhage and swell due to sprain, causing radiating neuralgia. If the piriformis muscle spasms, it also compresses the sciatic nerve trunk, causing radiating neuralgia and localized tenderness at the sciatic notch. If the surrounding soft tissue of the intervertebral foramen swells after sprain, the sciatic nerve root is directly compressed within the intervertebral foramen, causing radiating sciatic neuralgia.

　　3. Spasm of the extensor muscles or gluteus maximus Many patients experience spasm of one or both extensor muscles or gluteus maximus after twisting. This is particularly evident when standing or bending over, and can be relieved by lying on the stomach. Muscle spasm immediately recovers when checking the tender points, which is helpful for diagnosis.

　　This disease is caused by traumatic factors, so attention to safety in production and daily life, and avoiding trauma, is the key to preventing and treating the disease. In addition, attention should also be paid to functional exercise, which plays an important role in the prevention and treatment of lumbar and leg pain. Traditional Chinese medicine believes that for acute attack type, functional exercise should focus on bed rest and limb function exercise. Through the functional exercise of the limbs, it increases the circulation of Qi and blood throughout the body. At the same time, the relative rest of the injured area also creates conditions for tissue repair. For chronic protracted type, the patient should mainly adopt an active exercise method. Movement facilitates circulation, and active functional exercise can fill the Qi and blood, nourish the whole body, smooth the meridians and collaterals, strengthen the muscles and tendons, improve the ability to resist diseases, rebuild the stability of the waist, and improve and consolidate the efficacy. The functional exercise should be comprehensively considered according to factors such as age and physical condition, and appropriate exercise methods should be chosen.

　　This disease is mainly checked by X-ray examination of the spine:

　　The sacroiliac joint surface is ear-shaped, uneven, and consists of the first, second, and third sacral vertebrae and the ilium. The bone vertebras are large at the top and small at the bottom, wide in front and narrow in the back, which prevents them from moving downward and backward, but there is a tendency to move forward, rotate, or move sideways. It is entirely reliant on strong sacroiliac ligaments, sacrotuberous ligaments, and sacral spine ligaments to stabilize it, prevent the sacrum from moving into the pelvic cavity, and these ligaments are of different directions, uneven lengths, and complex intersections. In addition, the sacroiliac joint surface is uneven, and slight displacement can cause the sacroiliac joint surface to be incompatible, resulting in sprains or tears of some ligaments, causing obvious lumbar and leg pain.

　　Eat more two elements, which refer to vitamins and fiber. Vitamin C, Vitamin D, and the B-complex vitamins are essential nutrients for the human body, but some fat-soluble vitamins are prone to deficiency, so it is appropriate to eat some milk, rice bran, bran, carrots, and other fresh vegetables and fruits to supplement. Dietary research has found that 30% of omnivorous people aged 60-90 have osteoporosis, while only 18% of lifelong vegetarians have osteoporosis. Osteoporosis is the pathological basis of lumbar and leg pain. Therefore, it is very important to increase the proportion of vegetarian food in the diet.

　　Traumatic lumbar and leg pain is a common and frequent disease in clinical practice. Many patients, although there are no changes in imaging examinations, may have persistent and incurable courses if treated improperly or not in time, which directly affects work and quality of life.

　　If the sprain is severe and small fractures such as joint prominences are found during the examination, treatment should be given according to fractures.

　　If it is only a tear of the tendon or ligament, bed rest is required for 3 to 6 weeks. Due to the repair of ligaments and other soft tissues, the absorption or dispersion of hematomas, and the recovery of muscle and ligament function, it takes 3 to 6 weeks, so it is not advisable to perform vigorous massage during this period, but appropriate physical therapy can be performed to assist recovery.