The main change is the dehydration of the nucleus pulposus, after which the intervertebral disc loses its normal elasticity and tension, and on this basis, due to heavy trauma or repeated inconspicuous injuries, the fibrous ring becomes weak or ruptures, and the nucleus pulposus protrudes from the area, compressing the nerve root and producing signs of nerve root injury; it can also protrude from the center backward, compressing the cauda equina nerve and causing urinary and fecal disorders. The nucleus pulposus may also protrude posteriorly from the center, compressing the cauda equina nerve and causing urinary and fecal disorders. If the fibrous ring is completely ruptured, the broken nucleus pulposus enters the spinal canal and can cause extensive damage to the cauda equina. Since the lower back is heavily loaded and there are many activities, the protrusion mostly occurs in the lumbar 4-5 and lumbar 5-sacral 1 spaces. Symptoms 1. Low back pain and radiating pain of one lower limb are the main symptoms of the disease. Low back pain often occurs before leg pain, or both can occur at the same time; most of them have a history of trauma, and there may be no clear cause. The pain has the following characteristics: (1) The radiating pain is transmitted along the sciatic nerve and goes straight to the lateral calf, dorsum of the foot or toes. In case of lumbar 3-4 interval herniation, radiating pain to the front of the thigh is produced due to compression of the lumbar 4 nerve root. (2) All actions that increase the pressure of cerebrospinal fluid, such as coughing, sneezing and defecation, can aggravate the lumbago and radiating pain. (3) Pain increases with activity and decreases with rest. Bed position: Most patients adopt lateral recumbency and flex the affected limbs; individual severe cases have pain in all positions and can only bend their hips and knees in bed to relieve symptoms. In combination with lumbar spinal stenosis, there is often intermittent claudication. 2, scoliosis deformity: the main bend in the lower back, more obvious when forward bending. The direction of scoliosis depends on the relationship between the herniated nucleus pulposus and the nerve root: if the herniation is located in front of the nerve root, the trunk is generally bent to the affected side. 3, restricted spinal activity: the nucleus pulposus protrudes, compressing the nerve root and causing protective tension in the lumbar muscles, which can occur unilaterally or bilaterally. As a result of lumbar muscle tension, the physiological anterior convexity of the lumbar spine disappears. The anterior flexion and posterior extension activities of the spine are restricted, and radiating pain to one lower limb can occur during anterior flexion or posterior extension. 4.Lumbar pressure pain with radiating pain: There is a limited pressure pain point next to the spinous process on the affected side of the disc herniation site, and it is accompanied by radiating pain to the calf or foot. 5. numbness: sensory impairment in the innervation area compressed by the intervertebral disc 6. dysfunction and sexual dysfunction: severe manifestations that appear to indicate a poor prognosis. Examination In most patients with lumbar disc herniation, a correct diagnosis can be made based on clinical symptoms or physical signs. X-rays should be taken for the frontal and lateral views of the lumbosacral spine, plus left and right oblique views if necessary, and although the X-ray signs cannot be used as a basis for confirming the diagnosis of lumbar disc herniation, they can be used to rule out some disorders. Special examinations such as CT scan and magnetic resonance can clarify the diagnosis and the site of herniation. Treatment 1. Non-surgical treatment. Rest on a hard bed, supplemented by physical therapy and massage, can often be relieved or cured. Prone traction and shaking reset is easy, with high cure rate and easy for patients to accept, so it is a common non-surgical treatment. 2.Surgical treatment. The indications for surgery are: (1) non-surgical treatment is ineffective or relapse, and the symptoms are heavy and affect work and life. (2) The symptoms of nerve damage are obvious and widespread, and even continue to deteriorate, and it is suspected that the nucleus pulposus fragment is protruding into the spinal canal with complete rupture of the intervertebral disc. â‘¢Those with central type lumbar disc herniation with urinary and fecal dysfunction. (iv) Those with combined obvious lumbar spinal stenosis. Heavy physical work should be avoided for six months after surgery.