Why does lumbar disc herniation get worse despite treatment?

In general, worsening of lumbar disc herniation may be caused by psychological factors, improper massage or manipulation, calcification or ossification of the intervertebral disc, disc extrusion or sequestration, or aggravated nerve root adhesion or compression. It is recommended to seek medical attention promptly and receive treatment under a doctor's guidance. Specific causes are analyzed as follows:

1. Psychological Factors

Long-term pain and other symptoms may lead patients to develop anxiety, depression, or other psychological issues, which can affect treatment outcomes and make symptoms appear worse. Pay close attention to the patient’s mental health, encourage active participation in treatment, and help build confidence in overcoming the disease. In severe cases, psychological counseling or medication may be pursued under a physician’s recommendation.

2. Improper Massage or Manipulation

Inappropriate or excessive traction, or incorrect massage techniques, may increase intradiscal pressure, causing the herniated material to further compress the nerve roots and worsen symptoms. It is important to follow a doctor’s advice when selecting appropriate physical therapies, such as heat therapy, gentle stretching exercises, and core muscle strengthening training.

3. Disc Calcification or Ossification

Disc calcification is a pathological change resulting from disc degeneration. In pathology, calcification refers to the deposition of calcium salts in normal or damaged tissues, while ossification involves the formation of bone tissue accompanied by calcium deposition in collagenous matrix, both of which increase treatment difficulty and make symptom relief challenging. This condition may also be associated with pain, numbness, and other symptoms. Depending on the specific situation, minimally invasive surgical procedures—such as percutaneous endoscopic discectomy—may be performed under medical guidance. This technique involves removing calcified or ossified disc tissue through a 2–3 mm incision.

4. Disc Extrusion or Sequestration

In severe disc herniation, the nucleus pulposus may completely rupture through the annulus fibrosus, forming free-floating fragments. These fragments can intensify nerve root compression and potentially disrupt cerebrospinal fluid circulation. Symptoms may include severe lower back pain, radiating leg pain, sensory disturbances, and even dysfunction of bowel or bladder control. Under a doctor’s recommendation, microsurgical procedures may be necessary to remove the sequestered disc material and relieve nerve compression.

5. Worsened Nerve Root Adhesion or Compression

During treatment, increased nerve root adhesion or compression can restrict nerve mobility and heighten susceptibility to irritation, thereby triggering or exacerbating pain, numbness, and other symptoms. Patients may also experience increased limitations in movement. Under medical guidance, medications such as mecobalamin tablets, adenosylcobalamin tablets, and vitamin B1 may be used to alleviate symptoms.

In daily life, avoid maintaining the same posture for prolonged periods to prevent fatigue of the back and腰部 muscles. Pay attention to keeping warm, avoiding cold and damp environments, and maintain proper sitting posture. When seated, choose a chair with adequate height and armrests, and ensure an appropriate distance between your body and the desk. These habits contribute to a healthier and more enjoyable later life!