Etiology 1, degenerative changes of the lumbar intervertebral disc: degeneration of the nucleus pulposus is mainly manifested as a decrease in water content, and can cause small-scale pathological changes such as destabilization and loosening of the push joints due to water loss; degeneration of the fibrous ring is mainly manifested as a decrease in the degree of toughness. 2, the role of external forces: long-term repeated external forces caused by the slight damage accumulated over time on the lumbar intervertebral disc, aggravating the degree of degeneration. 3, the weakness of the disc’s own anatomical factors: the disc gradually lacks blood circulation and poor repair ability after adulthood, and on the basis of the above factors some triggering factors that can lead to a sudden increase in the pressure on the disc may cause the less elastic nucleus pulposus to pass through the fiber ring that has become less tough, thus causing the nucleus pulposus to herniate. The triggering factors of lumbar disc herniation can be: ① sudden weight-bearing or flashing back is the main reason for the formation of rupture of the annulus fibrosus ② lumbar trauma makes the degenerated nucleus pulposus protrude ③ improper posture induces nucleus pulposus protrusion ④ protrusion of the nucleus pulposus can also occur when the abdominal pressure increases ⑤ cold and moisture cold or moisture can cause small blood vessel contraction, muscle spasm, which increases the pressure of the disc and may also cause the degenerated disc to crack ⑥ external factors are The main change is the dehydration of the nucleus pulposus, and the disc loses its normal elasticity and tension after dehydration, and on this basis the disc loses its normal elasticity and tension due to heavy trauma or repeated inconspicuous injuries. The nucleus pulposus protrudes from this area due to severe trauma or repeated inconspicuous injuries, resulting in weakness or rupture of the annulus fibrosus. The nucleus pulposus mostly protrudes into the spinal canal from the lateral posterior side (a few can be on both sides at the same time), compressing the nerve root and producing signs of nerve root injury; it can also protrude posteriorly from the center, compressing the cauda equina and causing urinary and fecal disorders. If the annulus fibrosus ruptures completely, the broken nucleus pulposus enters the spinal canal, causing extensive damage to the cauda equina. Because of the heavy load and activities in the lower back, protrusion mostly occurs in the lumbar 4-5 and lumbar 5-sacral 1 spaces. Chinese medicine believes that the formation of osteoarthrosis is due to the following: 1. Liver and kidney deficiency: Chinese medicine believes that the kidney collects essence and bones; the liver collects blood and tendons. Kidney essence is sufficient, liver blood is full, the tendons and bones are strong, flexible joints. People in middle and old age, physiological decline in function, liver and kidney blood deficiency, resulting in the loss of tendons and bones, over time, prone to bone and joint disease. 2, feeling external evil: weakness of the viscera, external defense is not solid, wind, cold, moisture invasion, affecting the flow of Qi and blood, the flow of Qi is not smooth, is also a common cause of the formation of osteoarthrosis. 3, chronic strain injury: often engaged in low head, bending, standing and other work, resulting in qi and blood, tendons and veins running unfavorable, blood stasis blockage, resulting in muscle, tendons and bones nutritional disorders, local damage, resulting in pain, joint flexion and extension of unfavorable, activity disorders and other clinical manifestations. 4.Fall, flash and contusion: due to violent trauma or excessive force on the affected part, damage to the tendons and veins, resulting in the poor operation of qi and blood, stagnation and impassability, and the occurrence of osteoarthrosis. 5, congenital deformity: some patients with bone and joint deformity, although young and strong when there are no symptoms, but after middle age, due to physical weakness, exertion or feeling external evil, the deformed parts are easy to appear lesions. In addition, the onset of the disease may also be related to genetic, physical and metabolic factors. Pathology The intervertebral disc is located between two adjacent vertebral bodies and is composed of two parts: the outer part is the fibrous ring, which consists of multiple layers of fibrocartilage rings arranged in a circular pattern around the nucleus pulposus, preventing the nucleus pulposus from protruding outward, and the inner part is the nucleus pulposus, which is an elastic gelatinous substance that has the effect of moderating impact. In adults, the intervertebral disc undergoes degenerative changes, the fibers in the annulus fibrosus become thicker, glass degeneration occurs and finally rupture, so that the disc loses its original elasticity and cannot bear the original pressure. In overstrain, sudden change in position, violent action or violent impact, the annulus fibrosus can expand outward, so that the nucleus pulposus can also protrude outward through the fissure of the ruptured annulus fibrosus, which is called disc herniation.