Understanding Herniated Discs and Nerve Root Pain
Many patients are surprised to learn that a herniated disc does not always cause symptoms. In fact, some individuals show a large disc herniation on MRI but experience little to no pain. This occurs because the nerve roots in the spine are highly adaptable and can often shift away from tight or crowded spaces.
Why Surgery Is Often Not Necessary
Our research spanning more than 20 years shows that over 90% of disc herniations do not require spinal surgery. Procedures such as laminectomy may decompress the area, but they can also alter the natural biomechanics of the vertebrae above and below the treated region. **How Nerve Roots Become Compressed** Both the cervical and lumbar spine contain stabilizing ligaments—such as the transforaminal, radiating, and extraforaminal ligaments—that protect and support the nerve roots during daily movements like bending, rotating, or extending. When a disc herniates or when surrounding tissues become inflamed, these ligaments can become tight, compressed, or deformed. Instead of allowing normal movement, they may restrict the nerve root, trapping it in a narrowed space and contributing to nerve impingement symptoms.
A Targeted, Minimally Invasive Treatment Approach
A specialized needling technique—known in Chinese as *Structural Medical Acupuncture*—is used to treat the myofascial tissues and ligaments around the nerve foramen. This therapy helps: • Release tension in the ligaments • Reduce adhesions • Break down scar tissue • Restore mobility of the nerve root As the restricted tissues soften, the nerve root can escape the crowded space and symptoms typically improve. Most patients experience significant relief within 4–6 treatment sessions.
Expert Care Backed by Experience
Dr. Shan Jiang has practiced this technique since 1998 and has successfully treated nearly 10,000 patients with nerve impingement syndromes related to disc herniation. His extensive experience allows for individualized, effective, and evidence-informed care. If you would like to know whether this treatment may be appropriate for your condition, we are here to help.
不是所有的椎间盘突出患者都有症状，甚至有一些在MRI上观察突出物十分大，但是症状十分少或是完全沒有。为什么？主要是我们椎体的神经根很聪明，可以从狭窄的环境中逃逸出来。我們的團隊做了十多年的研究，發現有百分之九十以上的椎間盤突出用椎體手術治療沒有必要的，椎弓根切除減壓方法对于上下节段的椎體的生物力線有不少不利因素。
颈椎神经孔的颈椎椎间孔橫韧帶与椎間孔放射状韧帶的是固定颈神经根，腰椎有椎间孔橫韧帶和椎体間孔外韧帶，他們的功能是在椎体活动时，能够维持其位置不与其他组织产生撞击磨擦。但是由于椎间盘突出或神经孔周围结构产生病理性变化时，这些韧带将同时被挤压或者起止付着点改变而变形，成为压迫神经根的共犯，或者束缚着神经根，使其无法从因病变拥挤变窄的空间逃逸出来。现在各种椎间孔的松解疗法，帮助神经根逃逸的技术，是治疗椎间盘突出的杀手锏。
江医师在一九九八年已经学软组织外科等技术，近二十多年，他成功治愈近万例椎間盤突出引起的神經根壓迫症狀患者，一般情况下，四至六个治疗，神经根受压症状可以明显缓解。
Many patients are surprised to learn that a herniated disc does not always cause symptoms. In fact, some individuals show a large disc herniation on MRI but experience little to no pain. This occurs because the nerve roots in the spine are highly adaptable and can often shift away from tight or crowded spaces.
Why Surgery Is Often Not Necessary
Our research spanning more than 20 years shows that over 90% of disc herniations do not require spinal surgery. Procedures such as laminectomy may decompress the area, but they can also alter the natural biomechanics of the vertebrae above and below the treated region. **How Nerve Roots Become Compressed** Both the cervical and lumbar spine contain stabilizing ligaments—such as the transforaminal, radiating, and extraforaminal ligaments—that protect and support the nerve roots during daily movements like bending, rotating, or extending. When a disc herniates or when surrounding tissues become inflamed, these ligaments can become tight, compressed, or deformed. Instead of allowing normal movement, they may restrict the nerve root, trapping it in a narrowed space and contributing to nerve impingement symptoms.
A Targeted, Minimally Invasive Treatment Approach
A specialized needling technique—known in Chinese as *Structural Medical Acupuncture*—is used to treat the myofascial tissues and ligaments around the nerve foramen. This therapy helps: • Release tension in the ligaments • Reduce adhesions • Break down scar tissue • Restore mobility of the nerve root As the restricted tissues soften, the nerve root can escape the crowded space and symptoms typically improve. Most patients experience significant relief within 4–6 treatment sessions.
Expert Care Backed by Experience
Dr. Shan Jiang has practiced this technique since 1998 and has successfully treated nearly 10,000 patients with nerve impingement syndromes related to disc herniation. His extensive experience allows for individualized, effective, and evidence-informed care. If you would like to know whether this treatment may be appropriate for your condition, we are here to help.
不是所有的椎间盘突出患者都有症状，甚至有一些在MRI上观察突出物十分大，但是症状十分少或是完全沒有。为什么？主要是我们椎体的神经根很聪明，可以从狭窄的环境中逃逸出来。我們的團隊做了十多年的研究，發現有百分之九十以上的椎間盤突出用椎體手術治療沒有必要的，椎弓根切除減壓方法对于上下节段的椎體的生物力線有不少不利因素。
颈椎神经孔的颈椎椎间孔橫韧帶与椎間孔放射状韧帶的是固定颈神经根，腰椎有椎间孔橫韧帶和椎体間孔外韧帶，他們的功能是在椎体活动时，能够维持其位置不与其他组织产生撞击磨擦。但是由于椎间盘突出或神经孔周围结构产生病理性变化时，这些韧带将同时被挤压或者起止付着点改变而变形，成为压迫神经根的共犯，或者束缚着神经根，使其无法从因病变拥挤变窄的空间逃逸出来。现在各种椎间孔的松解疗法，帮助神经根逃逸的技术，是治疗椎间盘突出的杀手锏。
江医师在一九九八年已经学软组织外科等技术，近二十多年，他成功治愈近万例椎間盤突出引起的神經根壓迫症狀患者，一般情况下，四至六个治疗，神经根受压症状可以明显缓解。
Four dimensional traction device. This Traction device has 4 functions: Up and down angulation, lateral rotate , rotate and Longitudinal traction:
The primary purpose of lumbar traction is to apply directional forces to the vertebrae, producing biomechanical effects at the L4–L5 and L5–S1 segments. This helps to reduce high-tension factors around the nerve roots. During traction, the anterior and posterior longitudinal ligaments and the supraspinous ligament are stretched, which mobilizes the intervertebral discs, ligamentum flavum, intertransverse ligaments, interspinous ligaments, and joint capsules, thereby balancing surrounding tension and allowing the vertebral motion to shift from compensatory patterns toward symmetry.
Many studies on three-dimensional lumbar traction have suggested that traction increases the intervertebral space, reduces intradiscal pressure, improves disc nutrition, accelerates disc repair, and regulates the chemical environment of nociceptors within the annulus fibrosus.
However, most current research on the mechanisms of 3D lumbar traction relies on simplified models that cannot accurately depict the complex anatomical structure of the lumbar region. Based on the author’s over twenty years of clinical experience using 3D traction beds to treat relevant patients, treatment courses are typically long—requiring at least 20 sessions over three months—and the therapeutic effect is generally less rapid and pronounced than that achieved with acupotomy techniques.
四維過伸過屈牽引: 腰椎牵引的主要目的是通过对椎体方向的不同牵引力，对L4-L5和L5-S1节段的产生生物力学影响，以进一步减少神经根周围的高张力因素，同时牵引过程中，椎体前、后纵韧带和棘上韧带被拉紧，可带动椎间盘、黄韧带、横突间韧带、棘间韧带、关节囊的活动而平衡周围的张力，从而使椎体活动从代偿性回复到对称性。历来很多对三维腰椎牵引的论文，认为是牵引力增大椎体间间隙以减少椎间盘内压力，改善椎间盘的营养加快椎间盘的修复，调节纤维环内疼痛感受器的化学环境。目前对三维腰椎牵引的机理研究，可惜大部分的研究都用简化模型设计，而且无法准确描绘腰椎区域的复杂结构，但是根据既往笔者以往二十多年单纯运用三维牵引床对相关病患进行治疗的临床经验体会， 普遍疗程都是比较长，需要至少三个月20次的治疗，疗效远不如针刀快。
The primary purpose of lumbar traction is to apply directional forces to the vertebrae, producing biomechanical effects at the L4–L5 and L5–S1 segments. This helps to reduce high-tension factors around the nerve roots. During traction, the anterior and posterior longitudinal ligaments and the supraspinous ligament are stretched, which mobilizes the intervertebral discs, ligamentum flavum, intertransverse ligaments, interspinous ligaments, and joint capsules, thereby balancing surrounding tension and allowing the vertebral motion to shift from compensatory patterns toward symmetry.
Many studies on three-dimensional lumbar traction have suggested that traction increases the intervertebral space, reduces intradiscal pressure, improves disc nutrition, accelerates disc repair, and regulates the chemical environment of nociceptors within the annulus fibrosus.
However, most current research on the mechanisms of 3D lumbar traction relies on simplified models that cannot accurately depict the complex anatomical structure of the lumbar region. Based on the author’s over twenty years of clinical experience using 3D traction beds to treat relevant patients, treatment courses are typically long—requiring at least 20 sessions over three months—and the therapeutic effect is generally less rapid and pronounced than that achieved with acupotomy techniques.
四維過伸過屈牽引: 腰椎牵引的主要目的是通过对椎体方向的不同牵引力，对L4-L5和L5-S1节段的产生生物力学影响，以进一步减少神经根周围的高张力因素，同时牵引过程中，椎体前、后纵韧带和棘上韧带被拉紧，可带动椎间盘、黄韧带、横突间韧带、棘间韧带、关节囊的活动而平衡周围的张力，从而使椎体活动从代偿性回复到对称性。历来很多对三维腰椎牵引的论文，认为是牵引力增大椎体间间隙以减少椎间盘内压力，改善椎间盘的营养加快椎间盘的修复，调节纤维环内疼痛感受器的化学环境。目前对三维腰椎牵引的机理研究，可惜大部分的研究都用简化模型设计，而且无法准确描绘腰椎区域的复杂结构，但是根据既往笔者以往二十多年单纯运用三维牵引床对相关病患进行治疗的临床经验体会， 普遍疗程都是比较长，需要至少三个月20次的治疗，疗效远不如针刀快。
椎間孔神經根松解
拟采用小针刀针松解L4-5, 和（或）L5-S1间椎间孔高张力纤维与组织粘连帮助受卡压神经根获得可代偿的空间。
Medical Structure acupuncture will be performed to release hypertonic fibers and tissue adhesions within the L4–L5 and/or L5-S1 intervertebral foramen, thereby creating compensatory space for the compressed nerve root
Medical Structure acupuncture will be performed to release hypertonic fibers and tissue adhesions within the L4–L5 and/or L5-S1 intervertebral foramen, thereby creating compensatory space for the compressed nerve root
病例分享：
患者男，五十八歲，體重二百五十餘磅，左大腳內側和腹股溝痛，間歇性跛行。左腳直腳抬高加強試驗（＋）
頸靜脈壓迫試驗Naffziger徵（＋＋)，
屈頸試驗 （＋）
腱膝反射和跟腱反射未見明顯病理反應。
左大腿前側的股四頭肌以(股內側股、股中間肌、股直肌、股外側肌)、縫匠肌、髂肌疼痛痿縮。
患者雖而有腰4，5，骶1的椎間盤突出，但並沒有明顯症狀，應該把注意力放在腰2，3中，因為患者以閉孔神經症狀為主，從X光看腰2，3前移，故使用過屈牽引和椎間外孔針法松解：
患者男，五十八歲，體重二百五十餘磅，左大腳內側和腹股溝痛，間歇性跛行。左腳直腳抬高加強試驗（＋）
頸靜脈壓迫試驗Naffziger徵（＋＋)，
屈頸試驗 （＋）
腱膝反射和跟腱反射未見明顯病理反應。
左大腿前側的股四頭肌以(股內側股、股中間肌、股直肌、股外側肌)、縫匠肌、髂肌疼痛痿縮。
患者雖而有腰4，5，骶1的椎間盤突出，但並沒有明顯症狀，應該把注意力放在腰2，3中，因為患者以閉孔神經症狀為主，從X光看腰2，3前移，故使用過屈牽引和椎間外孔針法松解：
- Case Sharing:
The patient is a 58-year-old male, weighing over 250 pounds, presenting with pain on the medial side of the left big toe and in the groin area, accompanied by intermittent claudication.
Left leg straight-leg raise test: positive (+) - Cervical vein compression test (Naffziger sign): strongly positive (++)
- Neck flexion test: positive (+)
- Patellar and Achilles tendon reflexes: no significant pathological response observed.
- There is pain and atrophy in the quadriceps of the left anterior thigh (including vastus medialis, vastus intermedius, rectus femoris, vastus lateralis), as well as in the sartorius and iliopsoas muscles.
Although the patient has L4-L5 and S1 disc herniations, they are not associated with significant symptoms. Attention should be focused on the L2-L3 level, as the patient’s symptoms primarily involve the obturator nerve. X-ray shows anterolisthesis at L2-L3. Therefore, flexion traction and foraminal acupotomy techniques were used for decompression.
这个患者主要表現為大腿內側疼痛的闭孔神经症状（L2-3)，却没有大腿後側的坐骨神经痛，所以针刀治療主要在L2-3椎间孔松解另加三維腰椎牵引，治疗后8次後，症状完全消失。从第二次的MRI与第一次对比，L2-3椎体上緣部分突出物消失，但L2-3間盤突出還明顯嚴重壓迫椎管神经和脊髓液，但患者的症状却消失了，证明一点空间给神经根便可产生足够的代偿能力了。
The patient primarily presented with obturator nerve symptoms (L2–3), manifested as pain along the medial thigh, without accompanying sciatica in the posterior thigh. Accordingly, acupotomy therapy was targeted at decompressing the L2–3 intervertebral foramen, supplemented by three-dimensional lumbar traction. After eight treatment sessions, the patient’s symptoms completely resolved.
Comparison of MRI scans before and after treatment revealed that at L2-3 the previously demonstrated disc herniation with inferior disc material migration is no longer seen although there is continue very severe central spinal stenosis at L2-3 Level. Nevertheless, the patient’s symptoms were gone, demonstrating that even a small increase in space around the nerve root can provide sufficient compensatory capacity.
The patient primarily presented with obturator nerve symptoms (L2–3), manifested as pain along the medial thigh, without accompanying sciatica in the posterior thigh. Accordingly, acupotomy therapy was targeted at decompressing the L2–3 intervertebral foramen, supplemented by three-dimensional lumbar traction. After eight treatment sessions, the patient’s symptoms completely resolved.
Comparison of MRI scans before and after treatment revealed that at L2-3 the previously demonstrated disc herniation with inferior disc material migration is no longer seen although there is continue very severe central spinal stenosis at L2-3 Level. Nevertheless, the patient’s symptoms were gone, demonstrating that even a small increase in space around the nerve root can provide sufficient compensatory capacity.