Does lumbar pain necessarily mean a herniated disc? Lower back pain is a common clinical symptom, and most patients report that they have undergone CT or MRI examinations and have been found to have a “herniated disc”. But does low back pain necessarily mean a herniated disc? Low back pain can be caused by a variety of factors. According to statistics, only 35% of patients with low back pain in the adult population have herniated discs, while most low back pain is caused by other factors. But what is the cause of a CT or MRI finding of a “herniated disc”? The intervertebral disc is a cartilaginous cushion in the human spine that acts as a cushion against shock, consisting of a fibrous ring on the outside, a nucleus pulposus on the inside, and a cartilaginous plate on the top. When the annulus ruptures and the nucleus pulposus falls out, it is called a “herniated disc”. It is important to note that “lumbar disc herniation” and “lumbar disc herniation” are two different concepts. “A herniated disc is only a pathological phenomenon. Low back pain occurs only when the ruptured annulus fibrosus irritates the surrounding tissues, and numbness and pain in the lower limbs occur only when the herniated nucleus pulposus presses on the nerve roots, which is called “lumbar herniation”. It is only when the herniated nucleus pulposus presses on the nerve roots that numbness and pain in the lower limbs occur, and then it can be called “lumbar disc herniation. Therefore, a herniated disc does not necessarily mean low back pain. This is why many patients with lumbar disc herniation do not have symptoms because they do not have the disease. What about a “bulging disc”? A “bulging disc” is a sub-healthy condition of the intervertebral disc in which the annulus fibrosus has been damaged but has not yet ruptured. Since the annulus fibrosus of the intervertebral disc is intact, there is no nucleus pulposus to fall out, and there will be no irritation to the local tissues and nerve roots, so there are mostly no clinical symptoms, or only localized mild pain. To summarize, “lumbar disc herniation” does not necessarily mean that it is the cause of low back pain, not to mention that it is “lumbar disc herniation”, which needs to be comprehensively judged by the specialist in combination with the patient’s symptoms, signs, and imaging tests.