What are the clinical symptoms of lumbar disc herniation? The clinical symptoms can vary greatly depending on the site of nucleus pulposus protrusion, size and sagittal diameter of the spinal canal, pathological characteristics, body status and individual sensitivity. Therefore, the recognition and determination of the symptoms of this disease must be fully understood and inferred from the perspective of its pathophysiology and pathological anatomy, and the common symptoms of this disease are described as follows 1, low back pain: more than 95% of patients with lumbar disc protrusion (prolapse) have this symptom, including those with vertebral body type ① Mechanism: mainly due to the degenerated nucleus pulposus entering the vertebral body or the posterior longitudinal ligament, causing mechanical irritation and pressure on adjacent tissues (mainly nerve roots and sinus-vertebral nerves). (1) Mechanism: Mainly due to mechanical irritation and compression of the adjacent tissues (mainly nerve roots and sinus-vertebral nerves) caused by the entry of the degenerated nucleus pulposus into the vertebral body or the posterior longitudinal ligament, or due to the release of glycoproteins, beta-proteins and histamine (substance H) in the nucleus pulposus, resulting in chemical and/or mechanical radiculitis. ② manifestation: clinically persistent low back dull pain is common, lying down to alleviate, standing is intensified, in general can be tolerated, and allow moderate lumbar activities and slow walking, mainly due to mechanical compression, another type of pain for the lumbar spasm-like severe pain, not only the onset of sudden, and more difficult to bear, non-bed rest can not be, this is mainly due to ischemic radiculitis, that is, sudden protrusion of the nucleus pulposus This is mainly due to ischemic radiculitis, in which the nucleus pulposus suddenly protrudes and compresses the nerve root, resulting in a series of changes such as ischemia, bruising, hypoxia and edema due to simultaneous compression of the root vessels. 2, lower limb radiating pain: more than 80% of the cases have this syndrome, of which the posterior type can reach more than 95%. ① Mechanism: the same mechanism as the former, mainly due to mechanical and/or chemical stimulation of the spinal nerve roots, in addition to reflex sciatica (or “pseudosciatica”) through the sinus nerve of the affected node ② Performance: the milder cases show radiating tingling or numbness from the lumbar region to the back of the thigh and calf In severe cases, the pain is severe like electric shock from the waist to the foot, and is accompanied by numbness, although the lighter pain can still walk, but the gait is unstable and lame; the waist is mostly taken forward or the waist is held by hand to relieve the tension on the sciatic nerve, and in severe cases, the patient rests in bed, and prefers to take the hip flexion, knee flexion, and side lying position, all factors that increase the abdominal pressure make the radiating pain worse, because the neck can be flexed by Since flexion of the neck can aggravate the stimulation of the spinal nerve by pulling on the dural sac (i.e., flexion test), the patient’s head and neck are mostly in the supine position, and the limbs of radiological pain are mostly one-sided, and only a very small number of central or paracentral nucleus pulposus herniated patients show symptoms of both lower limbs. This is mainly due to the stimulation of proprioceptive and tactile fibers within the spinal nerve roots, the extent and location of which depends on the number of nerve root sequences involved. 4. cold sensation in the limbs: a few cases (about 5% to 10%) have felt cold and chilly in the limbs, mainly due to the stimulation of sympathetic nerve fibers within the spinal canal. 5. intermittent claudication: the mechanism and clinical manifestations are similar to those of lumbar spinal stenosis, mainly due to the pathological and physiological basis of secondary lumbar spinal stenosis that can occur in the presence of a herniated nucleus pulposus. For those with congenital developmental sagittal narrowing of the spinal canal, the prolapsed nucleus accentuates the degree of spinal canal stenosis, thus predisposing to this symptom. 6. muscle paralysis: paralysis due to lumbar disc protrusion (prolapse) is very rare, but mostly due to root damage resulting in different degrees of paralysis of the innervated muscles. 7, cauda equina: mainly seen in the posterior central and paracentral type of myelomeningocele (prolapse) disease, so clinically rare, its main manifestations are numbness and tingling in the perineum, defecation and urination The main symptoms are numbness and tingling in the perineum, defecation and urination disorders, and sciatic nerve involvement in both lower limbs, and in severe cases, loss of control of urination and defecation and incomplete paralysis of both lower limbs. In addition, some patients with low lumbar disc herniation may also have pain in the inguinal region or anterior medial thigh, and 1/3 of those with lumbar 3-4 disc herniation have pain in the inguinal region or anterior medial thigh, and the rate of occurrence is basically equal in those with lumbar 4-5 and lumbar 5-sacral 1 disc herniation, and such pain is mostly referred pain. 9, lower skin temperature of the affected limb: similar to the cold sensation of the limb, also due to the pain of the affected limb, reflexively caused sympathetic vasoconstriction, or because of the provocation of the sympathetic nerve fibers of the paravertebral, triggering sciatica and lowering the skin temperature of the calf and toes, especially the toes, such a phenomenon of reduced skin temperature, in the sacral 1 nerve root compression than the lumbar 5 nerve root compression is more obvious, on the contrary, after the removal of the nucleus pulposus, the limb that appears In contrast, after nucleus pulposus removal, the limb will be warm. Depending on the location and degree of compression of the spinal nerve roots, the extent of involvement of adjacent tissues and other factors, some rare symptoms may occur, such as excessive sweating, swelling, sacrococcygeal pain and radiating pain in the knee.