Low back pain is a condition with pain in the lower back and legs as the main symptom, which can be caused by a variety of reasons. Low back pain is a multiple disease, often co-existing with leg pain, and has a higher incidence among manual workers, such as porters, underground miners, carpenters and automobile drivers. It is noteworthy that low back pain is also common among those who work in institutions and work in long-term ambulatory jobs. So the common concern is whether low back and leg pain should be operated or not? The answer to this question cannot be generalized, first of all, we must clarify the causes of low back pain, and secondly, we must combine the patient’s specific symptoms and examination results to determine a scientific and reasonable treatment plan. We first talk about the common causes of low back pain, mainly the following: 1, age-related lumbar degenerative diseases (commonly known as “natural aging”), including lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, degenerative scoliosis, etc.; 2, work reasons such as sedentary, heavy lifting, work or exercise intensity, etc. 3, congenital developmental abnormalities: including congenital spina bifida, scoliosis deformity, lumbar spine sacralization and sacral spine lumbarization and other structural abnormalities. If the patient only shows lumbar pain, and the lumbar magnetic resonance imaging (MRI) excludes lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, degenerative scoliosis and other diseases, such cases usually do not require surgery, and conservative treatment methods such as drugs, injections, traction, massage, physical therapy, acupuncture, and small acupuncture can usually achieve good results or even cure. If the patient also has a combination of leg symptoms, including unilateral or bilateral lower extremity soreness, swelling, pain, numbness one or more of the performance, then be alert, because at this time the nerve may be affected, in this case you need to go to the hospital as soon as possible to do a detailed examination, in order to clarify whether the lumbar nerve is compressed, and if so, what the degree of compression is exactly. An MRI of the lumbar spine is the best way to answer these questions. As we have already mentioned, if you have not only low back pain, but also leg pain, then you should be concerned about possible problems with the lumbar nerve. If you have a lumbar disc herniation, lumbar spinal stenosis, or lumbar spondylolisthesis, this means that your leg pain symptoms may be related to the nerve compression caused by these diseases, but of course, this requires a doctor with extensive clinical experience to establish a diagnosis based on the location of your leg pain, the characteristics and patterns of attacks, and then combined with imaging. This is why it is important that the patient be present at the hospital visit, and not just be replaced by a family member with the patient’s examination data. At the same time, the doctor’s clinical experience is also very important, need to carefully observe and analyze the patient’s clinical information, especially the imaging data, not to let go of any possible traces, so that when the patient comes to the hospital, if the patient has already taken the film in other hospitals, please make sure to bring it again, never just bring a foreign hospital examination report, because this is the conclusion of other hospitals after the imaging doctor has seen written on that report, and this report is written in the hospital. The accuracy of this conclusion depends on both clinical experience and responsibility, and is usually for reference only. It is not known that two doctors with completely different experience may come to completely different conclusions when confronted with the same film, which is certainly objective and does not tell lies. Ignorance of these issues is a common cause of clinical misdiagnosis and missed diagnosis. If it is finally determined that your back and leg pain is related to nerve compression caused by lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis and other aging diseases of the spine, then whether or not surgery is needed must be judged by combining symptoms and imaging examinations, one without the other. If your back and leg pain is only mild and occasional (once a week, or once a month, etc.), you can usually be treated conservatively for a period of time. If your back and leg pain symptoms have reached the point of affecting your daily life, such as walking and sleeping pain, or pain after sitting or standing for a while, this usually indicates that the degree of nerve compression is already very heavy. If severe lumbar nerve compression is not removed as soon as possible, the damage to the lumbar nerve will enter an irreversible state, which is clinically referred to as nerve degeneration, and then even if the compression is removed through surgery, the nerve function will not be restored to normal. The conservative treatment methods including medicine, injection, traction, massage, physiotherapy, acupuncture, small needle knife, etc. do not make the nerve compression disappear out of thin air, but only treat the pain caused by the nerve compression, so that it is temporarily relieved, if the conservative treatment stops, after a while the back and leg pain relapses, and more and more serious, which is usually called recurrent attacks, getting heavier. At that time, if you choose surgery, you may have already missed the best time for surgery, because even if you operate, the function of the nerve can not be restored to normal, resulting in irreversible consequences and regret for life.