Low back pain is one of the common reasons for orthopedic patients to visit the doctor. Probably because there are too many media presentations and advertisements, many people immediately associate the appearance of low back pain with orthopedic diseases such as herniated lumbar disc. 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 strain: Lumbar 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 a lumbar strain, you should pay attention to maintenance, rest and catch up on treatment. This disease, if not effectively treated, will easily cause habitual damage and will result in shorter and shorter disease frequency, heavier and heavier disease, more and more difficult treatment, longer and longer disease duration, 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 muscle strain. In the case of lumbar disc herniation, although conservative treatment is used when the symptoms are mild at the beginning, surgery is required when conservative treatment is ineffective, when the symptoms are severe, when there is spinal stenosis, and when the nucleus pulposus prolapses. What occurs when a herniated disc is suspected: 1. Low back pain: Low back pain is the first symptom that occurs in most patients with this condition, with an incidence of about 91%. A few patients have only leg pain without lumbar pain, so that not every patient will necessarily have lumbar pain. 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 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 middle of the back, but this is not a unique sign of lumbar disc herniation, and about 50% of normal people also have skewed spinal spinous process. 5, claudication: lumbar disc herniation occurrence of claudication is mostly intermittent, that is, walking a distance after the lower extremity pain, weakness, bending or squatting to rest after the symptoms can be alleviated, still can continue to walk. With the passage of time, the symptoms of lumbar disc herniation will gradually and slowly aggravate. 6, sensory numbness: some of the 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 proprioceptive and tactile fibers of the nerve by the disc tissue. In contrast, most of the lateral thigh sensory disturbances are due to bulging of the annulus fibrosus or joint degeneration, and not due to disc herniation.