In clinical work, we often encounter patients who visit the doctor because of lumbar pain, numbness and intermittent claudication, but there is more than one disease that causes such conditions, such as atherosclerosis occlusive disease. This is a simple analysis of the differences between lumbar disc herniation and arteriosclerosis occlusive disease, to give you a reference: 1, pathogenesis: lumbar disc herniation: is due to degenerative changes in the lumbar intervertebral disc or due to trauma, or trauma as a cause, resulting in the rupture of the intervertebral disc fiber ring, the nucleus pulposus and the posterior protrusion of the fiber ring compression of the spinal cord or nerve roots caused by lumbar and leg pain, numbness and other conditions. Arteriosclerosis occlusive disease: is due to long-term hypertension, hyperlipidemia to increase the vascular load, arterial wall thickening and hardening, accompanied by lipid deposition and plaque formation, eventually leading to arterial hardening, luminal narrowing, distal limb blood supply is impaired and cause a series of diseases. 2, vulnerable groups: lumbar disc herniation: long-term bending work, sedentary workers, heavy physical labor activities, tall lumbar muscle strength weak people. Arteriosclerosis occlusive disease: hypertension, hyperlipidemia, diabetes mellitus patients, long-term alcoholic smokers, obese patients, long-term mental tension and stress. 3, clinical manifestations: generally have leg pain, leg numbness and intermittent claudication and other manifestations. However, patients with lumbar disc herniation often have triggering factors, such as sudden twisting of the body, heavy lifting, and aggravation of symptoms after strenuous exercise, while patients with atherosclerosis rarely have triggering factors of this physical nature, and the symptoms of patients with lumbar disc herniation can often be relieved when lying down, without leg pain and discomfort during sleep at night, and aggravated after activities on the ground, while patients with atherosclerosis can have night pain and resting pain when the condition is serious, and general pain medication cannot I have encountered patients who were unable to sleep at night for up to six months, but the pain was relieved after upright position, because the blood supply to the distal lower extremities improved after standing, and the pain was relieved. 4. Signs: (1) Lumbar disc herniation: pressure pain in the spinous process or paravertebral process of the diseased lumbar vertebrae may radiate to the lower extremities, and the straight leg raising test may be positive, but the femoral, N and dorsalis pedis, and posterior tibial artery pulsations in the lower extremities may be palpable. (2) Arteriosclerosis occlusive disease: There is no obvious pressure pain and percussion pain in the lumbar region, but the distal extremities of the affected limbs often show pale skin color and low skin temperature, and severe cases may show cyanosis or even gangrene of the toes, and the pulsation of the femoral, N, dorsalis pedis and posterior tibial arteries may be weak, faint or not palpable. 5. Auxiliary means of differentiation: MR and CT of the lumbar spine can reveal the presence or absence of lumbar lesions and the severity of lumbar lesions. Arterial pressure measurement and vascular Doppler and vascular enhancement CT examination can clarify whether there are obvious stenosis and occluded segments of arteries. Some patients have both lumbar disc herniation and atherosclerotic occlusive disease, so the clinician needs to decide which lesion contributes the most to the patient’s current symptoms and signs based on the history, physical examination and laboratory results, and then prioritize the symptomatic treatment.