Patient consultation: four days ago, sudden special pain in the lower back, cramps in the right leg, leg pain when pumping, a moment of pumping and a moment of not pumping, back pain after sleeping for a long time, MRI was taken, diagnostic report card: lumbar 5/sacral 1 disc protrusion toward the posterior edge of the vertebral body compressing the corresponding dural sac, right side predominant, right nerve root significantly compressed. The image shows: 1 lumbar 5/sacral 1 disc protrusion and degeneration, right nerve root compression and spinal stenosis. Is the condition serious? Do I need surgery? When surgery is needed for lumbar disc herniation depends on two main aspects: 1. The time of onset of lumbar disc herniation. If the onset of the disease is more than 3 months, and the symptoms such as pain and numbness are not reduced despite various conservative treatments during this 3-month period, and it affects work and life, then surgery is considered. 2. The severity of the symptoms of lumbar disc herniation. If there are problems with urination and defecation, or weakening of the muscles of the lower limbs, surgery will be considered. The easiest way to test the weakened muscle strength of the lower limbs: walking on the heel and walking on the toe, if both can walk up, it means that the muscle strength is normal; if one foot can’t walk up, you have to consider whether the muscle strength has decreased. In summary, you have just had the onset of the disease for 4 days, and only the lower extremity pain, muscle strength and urination and defecation are normal, so conservative treatment is recommended: you can take oral painkillers, rest, physical therapy and acupuncture, but traction and massage are not recommended. If the conservative treatment is not effective after 3 months, surgery is recommended. During the conservative treatment, if there is loss of control of urination and defecation, or changes in the muscle strength of the lower limbs (can’t lift the feet), etc., emergency surgery is required.