A herniated lumbar disc and a herniated lumbar disc are two different concepts. A herniated lumbar disc is the result of degeneration and injury to the intervertebral disc, and even if there is nerve compression on the imaging, a significant portion of people have no symptoms; 20% of normal people have a herniated lumbar disc (MRI shows a herniated disc), and this change is degeneration, which represents the aging stage of human growth and development, and is not a disease, and certainly does not require treatment. If the herniated disc irritates or compresses the nerves, resulting in back and leg pain, numbness and weakness, we call it a herniated disc, which is a disease and needs to be “treated”. The good thing is that more than 70% of lumbar disc herniation patients have self-limiting, generally within 3 weeks to 3 months the symptoms will disappear on their own. Conservative The so-called conservative treatment of lumbar disc herniation is actually a series of non-specific treatments that make use of the natural course of the disease – self-limiting, whether it is effective or not is mainly related to the characteristics of the disease itself, but also to the duration of the disease and the severity of nerve damage. The purpose and mechanism of conservative treatment The purpose and mechanism of conservative treatment: 1. to effectively relieve the symptoms of acute attacks of lumbar pain; 2. to create conditions for the elimination of nerve root inflammation; 3. to avoid all factors that aggravate nerve root compression and irritation; 4. to nourish the nerves and promote recovery from nerve injury (numbness); 5. to reduce the pressure on the intervertebral disc and promote the return and absorption of the herniated nucleus pulposus. -This happens in a few percent of very few patients. We emphasize that the purpose of conservative treatment is to reduce painful inflammation and avoid new disc-nerve irritation, not primarily the disappearance or return of the herniated disc. The duration of conservative treatment is 3 weeks to 3 months (= natural course of disease); that is to say, symptoms are not usually relieved within three weeks, and conservative treatment is generally ineffective (or ineffective) if symptoms are still apparent for more than 3 months. The effectiveness of conservative treatment is about 70-80%, with half of the symptoms disappearing and the other half remaining mildly symptomatic for a long time. When the pain is obvious, you can stay in bed for about 2-3 days; when the symptoms are relieved, you can do some activities, and if you are able to, you can go to work and do light activities. Such a rehabilitation program, compared with the previous strict bed rest for 1~3 months, has a higher percentage of pain relief, a conclusion that has been confirmed by a large sample of foreign controlled trials and is very different from the general concept of treatment and recuperation. Long-term bed rest is not only unhelpful to recovery, but also can cause a series of bed rest complications such as lumbar muscle atrophy; during treatment, you can do activities within your ability, so that recovery is faster. It can be combined with anti-inflammatory and analgesic drugs (such as Cilpro or Fotarim or Ankangxin, etc.), nerve-nourishing drugs (such as vitamin B12, Micropo, etc.), and blood-strengthening drugs (such as lumbar palsy, active luo Dan, etc.). Short-term lumbar circumference (2~3 weeks), physical therapy, some patients will benefit from it. Traditional therapies such as massage and traction, although widely popular, lack evidence-based medical evidence of efficacy. Surgery Minimally invasive intervertebral foraminoscopic surgery is preferred, with an incision of 0.6 cm, and the patient can leave bed and walk 2 hours after surgery and be discharged the next day. The efficiency is 95-99%, with immediate results and basically no damage to the spine and soft tissues. We carry out this leading technology and feel that “the problem of herniated disc is solved”. Classical pre-surgical selection: 20-30% of patients, for whom conservative treatment is ineffective, require surgical treatment. Before finally opting for conventional surgery, there are interventional or minimally invasive options, including epidural closure, plasma radiofrequency, foraminoscopy, discoscopy, etc. Epidural closure or sacral canal closure is 60-80% effective in the near term; 30-40% effective in the long term. Plasma radiofrequency and discoscopy have higher efficiency. Each of these therapies has optimal indications and requires the advice of an experienced specialist, with the patient making a choice based on advantages and disadvantages. Prevention In lumbar disc herniation in symptomatic remission, it is important to insist on exercising the lumbar back muscles. The purpose of this is that strong lumbar back muscles can effectively protect the lumbar spine, reduce abnormal forces and reduce the load on the lumbar disc. In addition, there is a relatively simple and easy to use method, is to walk backwards. Theoretically, walking backwards as a reverse movement can force the body’s center of gravity to move backwards, thus correcting posture. Conversely, high heels can cause and aggravate back pain symptoms because it acts to force the body’s center of gravity to move forward. From the human body mechanics point of view, shoes for people, is equivalent to the foundation of the building, the foundation tilted forward, the center of gravity is bound to move forward, the curvature of the spine increased, high heels are known as lumbar spine killer reason is also here. Therefore, doctors will caution patients with herniated discs should not wear high-heeled shoes, patients are also noted.