Low back pain is one of the most common clinical conditions that has been plaguing people and has a wide and profound impact on their health and lives. Unfortunately, we can only make a definitive diagnosis for about 15% of patients with low back pain. Discogenic lower back pain is one of these difficult to diagnose low back pain, which is now beginning and gradually gaining recognition and attention. By summarizing the pathogenesis and clinical manifestations of discogenic lower back pain, we can further understand this disease and have some reference value for guiding clinical diagnosis and treatment. The intervertebral disc is composed of the nucleus pulposus, the end plate and the annulus fibrosus. Low back pain caused by abnormalities in the internal structure and metabolic function of the intervertebral disc due to imbalance in the stress distribution of the annulus fibrosus and fracture of the inner annulus fibrosus as a result of degeneration of the nucleus pulposus is discogenic low back pain. The pathogenesis of such wall-derived low back pain includes mechanical pain and chemical inflammatory pain, with the latter being the main mechanism. Specifically, the inner layer of the fibrous annulus is distributed with sinus nerve branches, and when the inner layer of the fibrous annulus ruptures, due to the antigenic properties of the disc tissue, the immune inflammatory response is stimulated and the content of inflammatory mediators in the diseased disc is increased, and the inflammatory mediators act on the injury receptors at the end of the sinus nerve, resulting in electrophysiological changes that make them extremely sensitive, and nerve impulses can appear under slight mechanical pressure stimulation, causing low back pain. Excessive axial loading, vibration from transportation, smoking, and aging are common causes of discogenic lower back pain. Patients often have a clear history of trauma, such as injuries from heavy lifting, twisting, squatting, etc. The clinical picture is dominated by low back pain, postural change axial pain, and intractable pain in the lower back, which is not relieved by rest and often has a gradual aggravation process over several months. The pain can be aggravated after lumbar activities, and the use of lumbar brace or lumbar girth may also aggravate the lumbar pain. Lower extremity symptoms are variable, leg pain has no clear concept, often difficult to express, complaints of heavy feeling or cramps in the buttocks or lower extremities, skin sensation is not impaired, and the pain area lacks the characteristics of nerve distribution. Physical examination reveals pain during activities in all directions of the lumbar spine, especially pain during sitting, lying and standing posture changes, and the range of motion is limited by lumbar pain. The spinal or paravertebral muscle pressure is not clear, and there may be paravertebral muscle spasm. There is no nerve root compression and the neurological examination is normal. Auxiliary examinations include x-ray plain film, CT, MRI and discography. Among them, x-ray plain film showed basically normal performance, or showed single gap stenosis with endplate bone formation and sclerosis, while other vertebral spaces remained normal. MRI is an important, but not the only, test for the diagnosis of discogenic lower back pain, and can be used as a screening tool if the patient presents with persistent low back pain and normal radiographs. screening tool. Discography has high sensitivity and specificity, and is the gold standard for the diagnosis of discogenic lower back pain. It is the most important localization method used to determine the responsible disc and cannot be replaced by other methods. The treatment of discogenic lower back pain includes conservative treatment and surgical treatment. Its treatment is still mainly conservative and the course of treatment should be long. Commonly used methods are non-specific, such as bed rest, weight-free, brace, massage, physiotherapy, closure, functional exercise and application of anti-inflammatory and analgesic drugs, etc. can achieve certain efficacy, among which the application of Chinese medicine is also one of the optional methods of conservative treatment. Discogenic lower back pain, stubborn and lingering back pain, belongs to the category of “paralysis” and “paralysis” in traditional Chinese medicine, which is caused by blood stasis and phlegm condensation, paralysis and obstruction of lumbar ligaments, and should be treated by warming the meridians and resolving phlegm, dispelling stasis and opening ligaments, and stopping paralysis and pain. It is produced by Chengde Neck Fukang Pharmaceutical Group Co., Ltd. and is composed of strychnine, ephedra, frankincense, myrrh, tea atractylodes, turtle worms, scorpion, silkworm, Chuan Knee, licorice, etc. It has the function of dispelling wind and dampness, warming the meridians, opening the channels, activating blood circulation, eliminating blood stasis and relieving swelling and pain. Pharmacological analysis has strong analgesic and anti-inflammatory effects, and it has obvious inhibitory effects on pain reactions caused by physical, chemical and electrical stimuli. It can be clinically applied in the treatment of discogenic lower back pain, and can achieve more satisfactory results. The majority of patients with discogenic lower back pain do not need surgical treatment, and only a very small number of patients whose conservative treatment is ineffective need to choose surgical treatment, including minimally invasive radiofrequency treatment, artificial disc replacement and lumbar fusion, etc., among which lumbar fusion is the most effective treatment in the current surgical treatment.