Lumbar disc herniation is a common clinical condition that manifests itself as different symptoms as the disease progresses, and the treatment modalities are varied and differ from doctor to doctor, leaving patients at a loss as to what to do. This article attempts to categorize the various treatment methods according to the disease process, in order to provide reference for the majority of patients. The vast majority of herniated discs have a chronic degenerative cause, although trauma can also lead to acute herniation, but it is not common. People who work in a sedentary position for a long time, such as teachers, drivers, and office workers, are the most common group. Because the pressure on the disc is greater in the seated position, the nucleus pulposus at the center of the disc degenerates, compressing the posterior annulus fibrosus and further stimulating the posterior longitudinal ligament. The fibular ring and the posterior longitudinal ligament have sinus nerve distribution, so the patient will feel back pain and hip pain. The symptoms at this point are similar to those of lumbar strain. However, the lumbar strain has fixed pressure points. The pathological change at this stage is disc bulge, which should be said to be found in most adults who have MRI, but is not necessarily accompanied by clinical symptoms. The treatment is conservative, bed rest, sleeping on a hard bed as much as possible (to reduce the burden on the lumbar spine), hot massage on the back to activate blood circulation and remove blood stasis, and topical ointment can be applied to relieve pain. Pay attention to do lumbar back muscle exercise to maintain the physiological curvature of the lumbar spine and slow down the degeneration of the lumbar spine. Most of the patients with lumbar pain in clinical practice are in this stage. Many patients feel low back pain and think it is a herniated disc, and even feel the need for surgery, but in fact it is not. Most patients with lumbar pain are suffering from lumbar strain or first stage of nucleus pulposus. If care is not taken, the nucleus pulposus protrudes further backward, and the symptoms of low back pain and hip pain increase and may radiate to the back of the thigh, but generally not beyond the knee joint. At this time, the pathology is still a bulging nucleus pulposus, and MRI shows dural sac compression, and the treatment is mainly conservative. Absolute bed rest for 3~4 weeks (when lying in bed, the vertebral space becomes larger, and it is hoped that the nucleus pulposus will retract on its own and the ruptured annulus fibrosus will heal), symptomatic treatment, and hospital traction if available, are often effective. As for the specific symptomatic treatment, there are many ways, such as closure, massage, ancestral recipes and drugs, as long as they do not cost much and are effective. Some doctors advocate myelolysis at this stage to dissolve the bulging nucleus pulposus with ozone or collagenase, which is often effective. However, if the lysis is not complete, the remaining nucleus pulposus in the disc will still protrude later, leading to recurrence. As the disease progresses, the nucleus pulposus protrudes through the weak area of the posterior lateral fibrous ring to compress the nerve root, or it releases chemicals to irritate the nerve root, and MRI shows compression of the nerve root, and the clinical manifestation is low back pain, accompanied by radiating pain in one lower limb, with pain from the low back to the buttock, the back of the thigh, the back of the calf to the bottom of the foot, and the patient has numbness in the lateral calf or the dorsum of the foot, and the movement of the calf is also affected by weakness. This is a typical lumbar disc herniation, which is often called sciatica (sciatic nerve compression). At this stage, surgery is indicated, and surgical removal of the herniated nucleus pulposus is feasible. If the surgery is complete, the result is good and there is no recurrence. The risk of surgery is that the nerve root may be damaged during the removal of the nucleus pulposus, but this rarely happens with experienced surgeons. Some doctors recommend minimally invasive surgery, or discoscopy, which can be considered if the surgeon is proficient in this technique, but it is not necessary to pursue it deliberately. This technique has small incisions and minimal skin scars, but the impact on the muscles and lumbar spine differs little from that of traditional surgery. Undeniably, even at this stage, conservative treatment is still available and can provide symptomatic relief. The goals of conservative treatment at this stage include reduction of nerve root inflammation (anti-inflammatory, dehydration), bed braking, and symptomatic treatment for pain. When the symptoms are relieved, patients need to pay attention to lumbar health care and avoid doing less bending activities. If you have to bend your back because of your work, it is sure to recur in the future, or surgery. On the basis of herniated disc, if there is sprain or strenuous activity or even coughing, the nucleus pulposus may prolapse into the spinal canal and compress the nerve root or even the hard mode, when the performance is more serious and there are problems with urination and defecation in addition to the symptoms of the lower limbs, surgery should be performed immediately. In addition, the symptoms of cervical and lumbar pain are often affected by mental factors. In the case of middle-aged female patients, 45 to 60 years old or so, who feel neck pain in addition to low back pain and discomfort in many parts of the body, they may be considered to have neurological disorders as well, and such patients should not blindly consider surgery because the improvement is not obvious after surgery. The above described is simple disc herniation, which is mostly seen in young and middle-aged patients. In elderly patients with low back pain, in addition to herniated discs, there are also varying degrees of spinal stenosis and lumbar instability. Strictly speaking, this can no longer be considered a herniated disc. A herniated disc only requires removal of the disc and has little effect on spinal stability, so internal fixation can be dispensed with. However, for spinal stenosis, the purpose of the surgery is to expand the decompression, remove the disc, and the symptoms of back and leg pain disappear, but it will cause more instability in the spine, so internal fixation is also needed. The symptom of spinal stenosis is intermittent claudication, i.e., walking for a period of time and then feeling pain in the legs, such as 500 meters or even 100 meters, squatting down or sitting down to rest for a while to continue walking. Cycling, on the other hand, is not affected by distance. Once diagnosed, there is no conservative treatment method with obvious efficacy, and surgery should be performed. However, clinically, some patients with difficult conditions cannot have surgery, and it is observed that some patients have partial improvement of their symptoms after many years. Therefore, surgery is the first choice, but the family is really difficult to endure a little. Or surgery, or give up, some patients expect conservative treatment, basically is a waste.