A herniated disc and a lumbar disc herniation are two different concepts. A herniated lumbar disc is the result of degeneration and injury to the intervertebral disc, and even if there is compression of the nerve on the imaging, a significant percentage of people have no symptoms. 20% of normal people have a herniated lumbar disc, and this change is degeneration, which represents the aging stage of human growth and development, and is not a disease and certainly does not require treatment. If a herniated disc irritates or compresses the nerves, causing pain, numbness and weakness in the back and legs, we call it a herniated disc, which is a disease and needs to be “treated”. However, more than 70% of patients with lumbar disc herniation are self-limiting, with symptoms generally disappearing on their own within 3 weeks to 3 months. In terms of treatment, lumbar disc herniation can be treated conservatively, surgically and minimally invasively depending on the duration of the disease, the severity of the symptoms and the frequency of attacks. Conservative treatment The conservative treatment of lumbar disc herniation is mainly a series of non-specific treatment using the natural course of the disease – self-limiting, whether it is effective or not is mainly related to the characteristics of the disease itself, and also related to the duration of disease onset and the severity of nerve damage. The purpose and mechanism of conservative treatment: 1. to effectively relieve the symptoms of acute attacks of lumbar pain; 2. to create conditions for the elimination of nerve root inflammation; 3. to avoid all factors that aggravate nerve root compression and irritation; 4. to nourish the nerves and promote recovery from nerve injury (numbness); 5. to reduce the pressure on the intervertebral disc and promote the return and absorption of the herniated nucleus pulposus. -This happens in a few percent of very few patients. We emphasize that the goal of conservative treatment is to subside painful inflammation and avoid new disc-nerve irritation, not primarily the disappearance or return of the herniated disc. The duration of conservative treatment is 3 weeks-3 months (= natural course of disease); that is to say, symptoms do not usually resolve within 3 weeks, and conservative treatment is generally ineffective (or ineffective) if symptoms are still apparent for more than 3 months. The effectiveness of conservative treatment is about 70-80%, with half of the symptoms disappearing and the other half remaining mildly symptomatic for a long time. When the pain is obvious, you can stay in bed for about 2-3 days; when the symptoms are relieved, you can do some activities, and if you are able to, you can keep going to work and doing light activities. Such a rehabilitation program has resulted in a higher percentage of pain relief compared to the previous strict bed rest for 1~3 months, a conclusion that has been confirmed by a large sample of controlled trials abroad and is very different from the general concept of treatment and recuperation. Long-term bed rest is not only unhelpful to recovery, but also can cause a series of bed rest complications such as lumbar muscle atrophy; during the treatment period, you can do activities within your ability, so that you can recover faster. It can be combined with anti-inflammatory and analgesic drugs (such as Cilpro, or Fotarine, or Ankangxin, etc.), nerve-nourishing drugs (such as vitamin B12, Micropol, etc.), and drugs to relax the tendons and activate the blood (such as lumbar palsy, activator, etc.). Short-term lumbar circumference (2-3 weeks), physical therapy, some patients will benefit from it. Traditional therapies such as massage and traction, although widely popular, lack evidence-based medical evidence of efficacy. Surgical treatment 20-30% of patients with ineffective conservative treatment, recurrent episodes, and serious impact on work life require surgical treatment. Surgical treatment is fast and efficient (90-95%), but it is invasive. Surgery is usually performed in 7-10 days of hospitalization, and patients can leave bed and walk 2-5 days after surgery. The recovery period varies depending on the condition and the type of surgery, with the fastest being 3 weeks for office work. Minimally invasive treatment Before finally opting for traditional surgical treatment, there are also interventional or minimally invasive procedures, including epidural closure, plasma radiofrequency, discoscopy, etc. Epidural closure or sacral canal closure is 60-80% effective in the near term; 30-40% effective in the long term. Plasma radiofrequency and discoscopy are more effective. Each of these therapies has optimal indications and requires the advice of an experienced specialist, with the patient making a choice based on advantages and disadvantages. Protection and prevention In lumbar disc herniation in symptomatic remission, it is very important to insist on exercising the lumbar back muscles. The purpose of this is that strong lumbar back muscles can effectively protect the lumbar spine, reduce abnormal forces and reduce the load on the lumbar disc. In addition, there is a relatively simple and easy to use method, is to walk backwards. Theoretically, walking backwards as a reverse movement can force the body’s center of gravity to move backwards, thus correcting posture. Conversely, high heels can cause and aggravate back pain symptoms because it acts to force the body’s center of gravity to move forward. From the human body mechanics point of view, shoes for people, is equivalent to the foundation of the building, the foundation tilted forward, the center of gravity is bound to move forward, the curvature of the spine increased, high heels are known as lumbar spine killer reason is also here. Therefore, doctors will caution patients with herniated discs should not wear high-heeled shoes, patients are also noted.