1, bed rest: in the conservative treatment of lumbar disc herniation, bed rest is the most important, generally accounting for 70% of the efficacy. A common misconception is to “nest” in bed, on the sofa, reading books, watching TV – limbs at rest, the waist is still “bowed”, still straining. Say “rest”, in fact, the waist did not rest, in fact, rest is the limbs. Preferably hard bed (hard bed, hard Simmons, brown cushion can be), lying down, side, lying down can be. Bed does not need to move, “stretching arms and legs” can be, as long as the back does not hurt. If the symptoms are not serious, you can also go down to eat and go to the toilet. Most of the symptoms will be relieved by themselves after 3-5 days of absolute bed rest and 2-4 weeks of proper rest for the more severe cases. People with milder symptoms are not necessarily strictly bedridden and do not have to go to work. In fact, as long as you pay proper attention to your posture and move around at work, you can. 2, the efficacy of other conservative treatment methods accounted for about 30%. Including: orthopedic, massage, traction, physical therapy, acupuncture, cupping, plaster, oral Chinese and Western medicine, etc.. All conservative treatment methods can only relieve symptoms and cannot correct herniated discs – aging is irreversible. Even surgery (including minimally invasive surgery) cannot reverse aging. Surgery only makes the herniated disc smaller (relieves compression), not younger. Orthopedic and massage are for back pain and are not effective for leg numbness and leg pain. Traction is effective for leg symptoms, but a common problem is that it takes a lot of effort to get to the hospital, traction for 30 minutes, and a lot of effort to get home – the strain of being on the road causes not much of the effect of traction to remain. Traction is more effective in young and middle-aged patients and less effective in older patients. Commonly used drugs: (1) For milder symptoms, Chinese herbal medicine Root and Pain (blood activation), and Western medicine Microphylline (advanced vitamin B12). Generally, the medication is used for 1~2 weeks. (2) For more severe pain, absolute bed rest for 3~5 days, supplemented with analgesics. For example, Fenbid (moderate), Taylanin (moderately strong), OxyContin (strong, similar to oral morphine). Take analgesics for 3~5 days to reduce or stop the medication when the symptoms are relieved. (3) More severe acute pain – requires outpatient consultation at a major hospital. (4) The presence of foot drop or weakness in urination and defecation requires emergency surgery. 3. After the symptoms are relieved, three things need to be noted. (1) Good posture. The computer is elevated, the book is elevated, the person sits low, to ensure that sitting straight, flat eyes. When watching TV, driving lumbar back pillow – a good sofa, car backrest are forward convex, top up the waist and neck. Hard bed when sleeping. You can ask your family and colleagues to help you correct your sitting and working habits. (2) diligent activity. Don’t do housework for a long time, drive, look at the computer every half hour to move, turn around, every hour to get up and walk. (3) strengthen the exercise of the lumbar muscles, such as breaststroke, small swallow fly (force 20 seconds, gradually extend the time to adhere to, the longer the better, no need to buckle very high, just eat on the strength). Exercise is something that happens after the symptoms get better, not when you are having a hard time, otherwise the more you exercise the harder it is. But a common misconception is that there is usually no pain and no time to exercise. 4, do not do the indications for surgery, whether minimally invasive or incisional surgery, are the same. (1) cause foot drop or cauda equina nerve damage (urinary and fecal difficulties) (2) conservative six weeks of ineffective severe back and leg pain, numbness, seriously affect work and life; the current domestic and foreign standard surgical treatment method is still “minimally invasive” small incision open discectomy, incision 4-5 cm, 15-20 years after surgery The satisfaction rate is 80%. “Minimally invasive” surgery has been the dream of physicians and patients for many years, with the hope of achieving less trauma and faster recovery. The existing methods are collagenase nucleolysis, radiofrequency nucleolysis, ozone, laser, etc. The advantage is the small incision (2-3 cm). But in practice there is still room for further improvement – small incision ≠ small complications, small incision ≠ small danger. Possible disadvantages are more intraoperative radiation, less complete resection due to the small incision and not direct vision, slightly higher complications, and slightly worse satisfaction rate (European statistics 2010). In general, “minimally invasive” surgery can be used for patients with mild disc herniation and little or no bone fragmentation – especially if the herniation is not severe but the symptoms are severe. The specific choice of treatment (conservative or surgical) is up to the patient, not the physician – the physician is providing expertise + advice. The specific modalities and details of the procedure are determined by the physician. Having a lumbar discectomy does not mean a clean break. The surgery only removes 10-20% of the “bad” discs, while the relatively “good” discs remain. If you continue to live and work in the same way as before, the chance of recurrence after surgery is 5-10%. Therefore, it is still important to protect yourself: pay attention to your posture, move around regularly, and strengthen your back muscles.