Since the Department of Rehabilitation Medicine of our hospital has carried out the bone and joint rehabilitation specialty, many patients with low back pain have come to the hospital, suspecting that they have a lumbar disc herniation and feeling anxious and nervous. It seems that the problem of low back pain has aroused widespread concern, and I have organized a few questions that are of most concern to you and answered them accordingly to help more friends. Question 1: I just had low back pain and I suspected that it was a herniated disc, but the doctor didn’t think it was caused by a herniated disc; what’s the situation? Answer: Low back pain is not necessarily caused by a herniated disc. In the opinion of rehabilitation doctors, low back pain is mainly divided into traumatic and degenerative low back pain. Traumatic lumbago includes acute lumbar sprain and chronic fatigue injury, of which chronic lumbago is the most common and includes strain of lumbar muscles, fascia and ligaments. Degenerative low back pain is caused by degenerative changes in the lumbar structure, including lumbar joint degeneration and disc herniation. In addition, diseases such as kidney stones and ureteral stones can also cause acute low back pain, which is manifested as cramping pain. Question 2: The herniated disc on my MRI is not very serious, why is it very painful in the lower limbs? Answer: People used to think that when a lumbar disc herniates, it compresses the nerve and causes pain. In fact, this is only the mechanical compression theory of lumbar disc herniation producing low back pain. There are other theories to explain the cause of pain, such as the chemical radiculitis theory, which refers to the chemical substances in the disc that stimulate the nerve roots to produce inflammation and cause pain, and the autoimmune theory, which refers to the release of some substances in the disc that cause the body to produce specific antibodies that trigger an immune response and thus produce low back pain. Question 3: What is the relationship between lumbar disc herniation and sciatica? Answer: 95% of lumbar disc herniations are located in the lumbar 4/5 and lumbar 5/sacral 1 segments, and the sciatic nerve mainly emanates from these two places, so many patients with lumbar disc herniations have sciatica, which mainly manifests as pain in the lumbosacral region, buttocks, posterior lateral thigh, lateral calf to the heel or dorsum of the foot. The coughing, defecation and straight leg raising of patients with lumbar disc herniation can pull and stimulate the sciatic nerve and aggravate the pain. Severe sciatica needs to be relieved by medication. Question 4: My MRI report says that the disc is herniated, and I have been advised to have surgery and others to be conservative. What kind of herniated discs can be treated conservatively? What kind is suitable for surgery? Answer: The majority of lumbar disc herniations can be cured by non-surgical treatment. For patients with mild herniation and symptoms, conservative treatment can be chosen, including traction, massage, massage and nerve root injection therapy. Whether during conservative treatment or after recovery, care must be taken to avoid sedentary and bent-over weight-bearing postures, which are the two most likely to hurt the back. For patients with a history of more than six months, for whom strict conservative treatment has not been effective, and whose symptoms continue to worsen, affecting life and work, or who have developed abnormal urinary and fecal function (cauda equina syndrome), surgery is required to remove the herniated disc and release the nerve compression. Some patients who do not have the severe symptoms described above, but whose MRI or CT shows a large herniated disc, will also require surgery to avoid nerve damage. This is because any herniated disc cannot be restored to its original position and can only be removed artificially. Question 5: How do I train my low back muscles? Answer: For patients with severe low back pain, you can start with simple movements, we suggest you start with “five point props”, three times a day, morning, noon and night, three groups of 30 each, with slow movements, stay in the air for 5 seconds, and do not land completely on the bed each time you fall. When the lumbar back muscle has a certain basis, and then start to follow the same frequency and method of small swallow fly exercise.