The choice of treatment for lumbar disc herniation depends on the different pathological stages and clinical manifestations of the disease, as well as the physical and psychological condition of the patient. Surgical and non-surgical treatments have their own merits and cannot be generalized to one or the other. Most lumbar disc herniations can be relieved or cured by conservative treatment. Traction therapy is a very effective treatment for lumbar disc herniation. It has many strengths in clinical application. It has relatively small side effects, is easily accepted by patients, is simple and easy to perform, and is widely used in clinical practice. However, a deeper understanding of this therapy is needed to more effectively relieve the patient’s pain. I. Overview Traction therapy can be traced back to ancient Greece, when people used to treat patients with low back pain by pulling and pressing on the back. In ancient Greece, the patient’s ankle was also tied to an upright ladder with the head facing down and the body inverted, and the ladder was shaken to relieve the patient’s back and leg pain. Chinese medicine also pulls the lower limbs to form traction on the lumbar region. There are many methods of traction, such as manual traction, door frame traction, pelvic traction and electro-mechanical traction and self weight traction. Second, the mechanism (a), reduce the pressure of the intervertebral disc traction can make the pressure of the intervertebral disc reduced, so that the vertebral space increased, the posterior longitudinal ligament tension, conducive to the protruding nucleus pulposus to varying degrees back or change the relationship with the relative position of the nerve root. It is believed that intermittent traction on the intervertebral discs, which creates negative pressure, can have a suction-like effect, causing the discs to retract. Such experiments have been performed: a contrast agent was injected into the intervertebral disc of the experimental specimen, and then traction was applied, and films were taken of the intervertebral space before, during, and after traction, respectively. When the disc ruptured, the contrast agent flowed from the front to the back of the disc and even into the spinal canal. When the intervertebral space became larger during traction, the contrast agent flowed to the central part, and some of the contrast agent remained in the central part after removing traction. (ii), release muscle spasm Pain causes muscle spasm in the lumbar back and restricts lumbar spine activities. Intermittent use of traction can release muscle spasm, stretch and relax the tense muscles, and promote the recovery of normal lumbar spine activities. (c), promote the inflammation of the receding lumbar intervertebral herniation, the lesion intervertebral joints and surrounding ligaments, muscles and nerve roots congestion edema, inflammation. Traction therapy enables the patient’s spine to be braked and reduces motion stimulation, which is conducive to the decompensation and absorption of congestion and edema. (4), release the posterior lumbar joint load lumbar disc herniation can be accompanied by posterior lumbar joint dysfunction or subluxation, synovial imbrication, traction therapy can restore the normal alignment of the posterior joint. The patient is lying prone or supine, the assistant fixes the patient’s shoulder tightly, and the operator holds the patient’s ankle with both hands and pulls, and applies traction to the trunk. In the prone position, the patient tries to extend the spine posteriorly in traction. This kind of traction is often effective for synovial impaction or small herniated nucleus pulposus. 1.Manual traction and shaking therapy: the patient is in the prone position. If the pain is severe, disinfect both sides of L4-5 and L5-S1 with 0.25% procaine 60-80ml, injected on both sides of the vertebral body. It may not be necessary for those who do not have severe pain and are in good physical condition. In the patient’s lower thoracic and iliac femoral each pad a pillow, so that the lower lumbar suspension, both ends by the assistant traction, in order to widen the vertebral space, the operator rhythmically and quickly press shaking lumbar disc herniation vertebral segments. 2, door frame traction method: this method is suitable for young and strong male patients, the method is to let the patient stand on a small stool, choose the appropriate height of the door frame, the patient hands to climb the door frame, in order to prevent the hands off, the wrist can be protected by cloth belt, and then the feet step away from the small stool, the body suspended. At this time to practice bar movement like swinging back and forth, using the patient’s own weight for traction. Strong upper limbs, can also hang weights on the lower limbs to increase the traction force. 3, pelvic traction method: tools and methods: tools include: pelvic traction belt, rope, pulley, pulley fixed frame and heavy weight. Method: After enclosing the traction belt, lying on a plank bed, and the foot of the bed padded 20cm, so that the head low feet high, so that the weight can be used as counter traction. Traction once a day in the morning, afternoon and evening, half an hour to one hour each time, every 3 weeks for a course of treatment, each course of treatment interval of 5-6 days, can be carried out 2 to 3 courses of treatment. Generally, the patient’s symptoms are rapidly reduced in the first few days of traction, and the due effect is achieved at the end of the second week, and the third week is the consolidation stage. If the symptoms are not significantly reduced in the first week, the weight can be increased appropriately; if there is still no significant improvement, the traction is initially judged to be ineffective. Traction weight should be gradually increased and decreased. The weight should be determined according to the patient’s condition, physical fitness and muscle development. In order to consolidate the therapeutic effect, the patient should be bedridden after traction, together with functional exercise of lumbar and back muscles and physiotherapy. 4, thoracic, pelvic traction: the patient is prone or supine, can be selected according to the following, if the patient has pain in the posterior extension of the lumbar spine during the examination, can first take the prone position, traction belt passing under the body. In addition, traction is performed in the position in which the patient is most comfortable in bed. The traction time is usually half an hour to one hour, twice a day. The pain is mostly relieved or disappears after a few minutes of traction, but it does not mean that the traction force is sufficient, because the purpose of traction is not only to temporarily relieve the symptoms, but also to strive for as much retraction of the herniated nucleus pulposus as possible and to adjust the relationship with the nerve root. If the patient’s pain does not decrease after a few days of traction, the patient’s position and the position and direction of the traction belt should be adjusted. Many patients are effective only in the second week, if not, it is not advisable to continue. Patients with significant effect usually have traction for more than 3 weeks. The patient’s low back and lower extremity radiating pain gradually disappears, the straight leg raising test reaches the normal range, and the active movement of the low back does not cause low back and leg pain. However, some patients may have posterior thigh pain when doing straight leg elevation test when they are close to healing. 3, mechanical traction: there are many traction bed frame manufacturing and clinical application. Clinically used are self-control pulse traction treatment bed, vibration traction bed, vertical automatic control lumbar traction device, etc.. Specific use has detailed instructions, can refer to use. 4.Vertical suspension traction This therapy uses the body’s own weight as traction force. This method is different from flat traction, the latter because of the torso and bed friction force, so traction weight, although heavy, but the role of traction in the waist is small. In addition, when swinging under suspension, the traction force can be increased. The upper body weight accounts for about 40% of the whole body, and the pressure on the lumbar intervertebral disc is greater. After removing the load, the pressure in the lumbar intervertebral disc is reduced, and the pelvic and lower limb traction further reduces the pressure on the lumbar intervertebral disc, so that the posterior longitudinal ligament is tense and the nucleus pulposus is partially retracted, thus the symptoms can be reduced or disappeared. By observing the lumbar spine radiographs of patients under traction, the gap can be widened by 0.2-2.5 mm, with the most obvious being lumbar 3-5. The method is particularly suitable for patients treated non-operatively, and intermittent application of the method on a daily basis can lead to repair of the annulus fibrosus and nucleus pulposus. Experimental reports have confirmed that CT examinations of the lumbar spine before and after treatment have shown that this method can lead to a significant reduction in the nucleus pulposus of the herniated disc. According to the pathological typing and clinical manifestations, the method is suitable for the following three conditions: (1) the nucleus pulposus has caused protrusion of the fibrous ring and the posterior longitudinal ligament, and the pain is located in the lumbar region or radiates to the buttocks and the back of the knee, but rarely to the foot. (2) The nucleus pulposus has protruded under the posterior longitudinal ligament of the fibrous ring, resulting in typical sciatica, with pain radiating from the low back to the ankle and foot along the upper extremity. (3) The nucleus pulposus has protruded under the posterior longitudinal ligament but has not yet become a free nucleus pulposus. This method is not suitable for patients with excessive weight and heart and lung diseases. This method is not recommended when the nucleus pulposus has protruded behind the posterior longitudinal ligament and is free in the spinal canal. This method should be discontinued if sciatica increases within the first few days of use. Method: The patient is strapped with a traction belt on the chest and lies supine on an automatically controlled suspension traction bed, with the bed surface angled to the ground, starting at 30° and increasing by 5° every day, reaching 70° to 90° to the ground within 8 days. The traction time is 1-2 hours per day and is completed in several sessions. The length of traction time depends on the patient’s tolerance level. After traction, the patient can rest in bed. There are also experimental reports confirming that in a group of patients with lumbar disc herniation treated with this method, 70% were relieved or cured, 5% could not tolerate this therapy, and the remaining cases required nucleus pulposus therapy or surgery. Although traction therapy has the above effects, it is necessary to choose the appropriate type of traction method according to the actual situation of the patient when applying it. Especially in the acute phase, the patient’s response to traction should be observed, and its use should be continued if the pain is relieved or not aggravated, or stopped immediately if the pain is aggravated. For central and free type of herniated nucleus pulposus and huge herniated nucleus pulposus, it should not be used to avoid aggravating the condition.