I encounter many patients with low back pain in my outpatient clinic visits, and what they all have in common is that they are worried that they have a herniated lumbar disc, and that they come to the clinic not because the low back pain is so severe, but because they want to be checked to see if they are suffering from this disease. So was their concern warranted? In fact, only a very small number of these patients end up being diagnosed with lumbar disc herniation, and low back pain and lumbar disc herniation cannot be equated. Lower back pain is not necessarily a herniated disc. There are many patients with herniated discs who do not have obvious lower back pain, but rather have lower extremity symptoms after their nerves and spinal cord are compressed by the herniated disc. Lumbar disc herniation is a common disease in orthopedics and spinal surgery, which is mainly caused by external forces, degeneration and other factors, resulting in the rupture of the annulus fibrosus, the nucleus pulposus tissue from the rupture to varying degrees of intrusion into the spinal canal, resulting in different degrees of stimulation or compression of the corresponding parts of the spinal cord or spinal nerve roots, resulting in lumbar pain accompanied by a series of unilateral or bilateral numbness in the lower extremities, pain, weakness, urinary and defecatory dysfunction, and other clinical symptoms and signs. Clinical symptoms and signs. Typical lumbar disc herniation will show the above symptoms, but in reality, the performance of many patients in the clinic is not so typical, and patients without low back pain but only lower extremity symptoms may also be diagnosed as lumbar disc herniation. There are many possible causes of low back pain. Simple low back pain does not necessarily mean lumbar disc herniation, but should be combined with medical history, symptoms, and signs to make a comprehensive judgment. The first thing to look at is whether there is a history of recent trauma, strenuous physical activity or heavy labor, which can cause acute and chronic injury to muscle ligaments, fasciitis, or even fracture of the lumbar pain. Long-term sedentary lack of exercise is also very easy to produce chronic strain injury of muscle ligaments, the third lumbar vertebra transverse process syndrome produces low back pain, this is my clinic encountered the most cases, patients of all ages can be seen, the age of very young, teenage high school students are not uncommon. Low back pain in middle-aged and elderly patients is most often caused by lumbar spine osteophytes, small joint disorders, lumbar spinal stenosis, lumbar spondylolisthesis, lumbar spondylolisthesis, lumbar spondylolisthesis, lumbar spondylolisthesis, and other degenerative spinal diseases and osteoporotic vertebral compression fractures. In addition to orthopedic disorders, the possibility of other systemic disorders should be considered. Kidney stones and ureteral stones in the urinary system can also cause low back pain, and these pains are often severe, with symptoms that can come on and off suddenly. Ovarian and pelvic inflammation in gynecology is also a common cause of low back pain in female patients. Besides, various primary and metastatic tumors of the spine can also cause different degrees of low back pain, which is not as common as the above reasons, but cannot be ignored. To summarize, there is no necessary causal relationship between low back pain and lumbar disc herniation, of course, it is worth advocating timely medical treatment after low back pain, but there is no need to panic too much, even if the diagnosis has been made, there are many treatments, and the treatment effect is accurate. According to the specific situation of low back pain, the doctor will conduct a rigorous examination, and generally recommend that patients undergo a lumbar spine X-ray, CT or MRI examination to make a clear diagnosis. It is emphasized that many patients may find that the lumbar intervertebral discs do have different degrees of “herniation” after lumbar spine CT or MRI, but the patients do not show symptoms of nerve compression, so this situation can only be called “lumbar herniation” and not “lumbar intervertebral disc”. The difference between the word “herniation” and “lumbar disc herniation” is a fundamental difference, so don’t be overly concerned when you see the word “herniation” on the examination report because the object of the doctor’s diagnosis and treatment is the patient himself and not the “film”. The doctor’s object is the patient himself and not the “disk”.