Low back pain is one of the painful diseases. It may be because there are too many media presentations and advertisements, and many people immediately associate it with an orthopedic disease like lumbar disc herniation as soon as they have low back pain. In fact, you do not have to blindly treat yourself as soon as the symptoms appear. There are many kinds of diseases that can cause back pain, and the two most confusing ones are lumbar disc herniation and lumbar strain. Here I will explain in detail from several aspects, and I hope that you will not delay treatment due to misdiagnosis. The difference between lumbar disc herniation and lumbar strain: lumbar disc herniation is the lumbar disc pulp outwardly pressing the nerve causing painful symptoms, lumbar strain is the muscle soft tissue injury on both sides of the lumbar spine. The relationship between lumbar disc herniation and lumbar muscle strain: lumbar muscle strain is more common than lumbar disc herniation. Lumbar muscle strain is a lesion for the muscles and soft tissues around the lumbar area. If it is not effectively treated for a long time, then it will reduce the protective effect of the muscles and soft tissues on the lumbar spine, thus triggering the lesion of the intervertebral disc. After the lumbar disc herniation causes lumbar pain, it leads to the change of lumbar posture, which causes lumbar muscle strain or makes it worse. Therefore, lumbar disc herniation and lumbar muscle strain are two diseases, but they may exist at the same time. The significance of identifying lumbar disc herniation and lumbar muscle strain: Lumbar muscle strain does not require surgical treatment and is treated conservatively. This is not to say that the treatment of lumbar strain is not important. If you are sure that it is lumbar strain, you should pay attention to maintenance, rest and seize the treatment. This disease, if not effectively treated, will easily cause habitual injury and there will be shorter and shorter frequency of disease, heavier and heavier disease, more and more difficult to treat, longer and longer disease time, etc. The combination of multiple therapies used to treat lumbar strain can only be used as an adjunctive treatment, and its main treatment should be based on self-behavioral treatment. This is something that the majority of patients do not really understand, which is to change the habits of work and life that aggravate lumbar strain. In the case of lumbar disc herniation, although conservative treatment is also used when the first occurrence and symptoms are mild, surgery is required when conservative treatment is ineffective, when symptoms are severe, when there is spinal stenosis, and when the nucleus pulposus prolapses. What happens when a lumbar disc herniation is suspected 1. Low back pain: Low back pain is the first symptom that occurs in most patients with this disease, with an incidence of about 91%. A few patients have only leg pain without lumbar pain, so it is not certain that lumbar pain will occur in every patient. There are also some patients who have low back pain first and then leg pain after a period of time, while the low back pain reduces or disappears on its own and only complains of leg pain when they come to the clinic. 2. Lower limb radiating pain: low back and leg pain is easy to attack after trauma, exertion and cold, each time for about 2 to 3 weeks, and can be gradually relieved. Any factors that increase abdominal pressure, such as coughing, straining to defecate, laughing, sneezing, lifting heavy objects, chronic coughing, etc., can easily trigger lumbar pain or aggravate the already occurring lumbar pain. 3, lumbar activity is limited: the lumbar flexion and extension activities of the lumbar spine in patients with lumbar disc herniation are closely related to the degree of disc herniation. If the fibrous ring is not completely ruptured, the lumbar spine takes a forward-flexed position and posterior extension is restricted. 4. Scoliosis: This is a postural compensatory deformity adopted by patients with lumbar disc herniation to reduce pain. The lumbar vertebrae are bent to the left or right, and the spinous process can be found to be skewed by touching the spinous process in the median position on the back, but this is not a unique sign of lumbar disc herniation, and about 50% of normal people also have skewed spinous process of the spine. 5, claudication: the claudication that occurs in lumbar disc herniation is mostly intermittent, that is, pain and weakness in the lower limbs after walking a certain distance, and the symptoms can be relieved after bending down or squatting to rest, and can still continue to walk. With the passage of time, the symptoms of lumbar disc herniation will gradually and slowly aggravate. 6, sensory numbness: some patients with lumbar disc herniation do not experience pain in the lower limbs, but only numbness in the limbs, which is mostly caused by the compression of the nerve proprioceptive and tactile fibers by the intervertebral disc tissue. Most of the lateral thigh sensory disturbances are due to bulging rings or joint degeneration, but not to disc herniation.