According to the location of protrusion typing water causes small-scale pathological changes such as vertebral joint instability and loosening; degeneration of the fibrous ring is mainly manifested as a decrease in toughness. 1, injury Long-term repeated external forces cause minor damage and aggravate the degree of degeneration. 2, weakness of the disc’s own anatomical factors The intervertebral disc gradually lacks blood circulation in adulthood and has poor repair ability. On the basis of the action of the above factors, some kind of triggering factor that can lead to a sudden increase in the pressure on the intervertebral disc, i.e., may cause the less elastic nucleus pulposus to pass through the fibrous ring that has become less tough, causing the nucleus pulposus to protrude. 3, genetic factors lumbar disc herniation has been reported to have familial onset, the incidence of this disease in people of color is low. 4, according to the degree of herniation of the nucleus pulposus, limited bulge in the canal, but the surface is smooth. Most of this type can be relieved or cured by conservative treatment. Protruding type, complete rupture of the fibrous ring, the nucleus pulposus protrudes into the spinal canal, covered only by the posterior longitudinal ligament or a layer of fiber membrane, the surface is uneven or cauliflower-shaped, often requiring surgery. In the prolapsed free type, the ruptured and protruding disc tissue or fragments are dislodged into the spinal canal or completely free. This type can cause not only nerve root symptoms but also cauda equina symptoms, and non-surgical treatment is often ineffective. In the case of nodules, the nucleus pulposus enters the cancellous bone of the vertebral body through the fissure of the upper and lower endplate cartilage, and there is usually only low back pain without nerve root symptoms, and surgical treatment is not required. Clinical symptoms 1. Low back pain is the first symptom that occurs in most patients, with an incidence of about 91%. Due to the outer layer of the fibrous ring and the posterior innervation area, the main manifestations are large and small bowel obstruction and abnormal perineal and perianal sensation. In severe cases, loss of control of urination and defecation and incomplete paralysis of both lower extremities may occur, which is rare in clinical practice. 2. Signs General signs (1) Lumbar scoliosis: It is a postural compensatory deformity to reduce pain. Depending on the relationship between the site of the herniated nucleus pulposus and the nerve root, the spine is bent to the healthy side or to the affected side. If the site of the herniated nucleus pulposus is located on the medial side of the spinal nerve root, the lumbar spine bends to the affected side because the spine bends to the affected side to reduce the tension of the spinal nerve root; conversely, if the herniated nucleus pulposus is located on the lateral side of the spinal nerve root, the lumbar spine bends to the healthy side. (2) Restriction of lumbar movement: Most patients have varying degrees of restriction of lumbar movement, which is especially obvious in the acute stage, with the most obvious restriction in forward flexion, because forward flexion can further promote the nucleus pulposus to shift backward and increase the pull on the compressed nerve roots. (3) Pressure pain, percussion pain and spasm of sacral spinal muscles: the site of pressure pain and percussion pain basically corresponds to the vertebral space of the lesion, which is positive in 80%-90% of cases. The percussion pain was obvious at the spinous process, which was caused by percussion vibration of the lesion. The pressure point is mainly located at 25 px of the paravertebral area, and radiating pain along the sciatic nerve may occur. About 1/3 of patients have lumbar sacrospinal muscle spasm. Sciatic nerve pull test Sometimes degenerative changes such as narrowing of the intervertebral space and vertebral marginal hyperplasia are seen as an indirect indication, and some patients can have spinal deflection and scoliosis. In addition, X-ray plain film can detect the presence of tuberculosis, tumors and other bone diseases, which has important differential diagnostic significance. 3.Examination It can show more clearly the site, size, morphology and nerve roots of the herniated disc and the displacement of the dural sac by pressure, and it can also show the hypertrophy of the vertebral plate and ligamentum flavum, hyperplasia and enlargement of the small joints, narrowing of the spinal canal and lateral saphenous fossa, etc. It has a greater diagnostic value for this disease and is now commonly used. MRI can comprehensively observe whether the lumbar intervertebral disc is diseased, and through sagittal images at different levels and cross-sectional images of the involved disc, it can clearly show the morphology of the herniated disc and its relationship with the dural sac, nerve roots and other surrounding tissues, in addition to identifying whether there are other occupying lesions in the spinal canal. However, the display of whether the herniated disc is calcified or not is not as good as CT examination. 5, lumbar pressure point examination Difficult, especially in today’s widely used CT and MRI technology. If there are only CT and MRI manifestations without clinical symptoms, the disease should not be diagnosed. 6.Non-surgical treatment Most patients with lumbar disc herniation can be relieved or cured by non-surgical treatment. Its treatment principle is not to put 7. imaging (1) Exercises for the lumbar back muscles should be strengthened to reduce the chances of recurrence. (2) Traction therapy The use of pelvic traction can increase the width of the intervertebral space, reduce the internal pressure of the disc, the herniated part of the disc retracts, and reduce the irritation and compression of the nerve root, which needs to be performed under the guidance of a professional doctor. (3) Physiotherapy, massage and tui-na can relieve muscle spasm and reduce pressure within the intervertebral disc, but note that violent massage and tui-na can lead to aggravation of the disease and should be done with caution. (4) Corticosteroid epidural injection Corticosteroid is a long-acting anti-inflammatory agent, which can reduce inflammation and adhesions around the nerve root. Generally, long-acting corticosteroid preparation + 2% lidocaine is used for epidural injection, once a week, 3 times as a course of treatment. 8, hormone epidural injection Worker needs to pay attention to the height of the table, chair, and regularly change the posture. Occupational work requires frequent bending movements, should regularly stretch, chest activities, and use a wide belt. The lumbar back muscle training should be strengthened to increase the intrinsic stability of the spine. Those who use lumbar girth for a long time need to pay particular attention to lumbar back muscle exercise to prevent the adverse consequences of disuse muscle atrophy. If you need to bend over to get something, it is best to use hip flexion, knee flexion squatting way to reduce the pressure on the back of the lumbar intervertebral disc.