80% of adults have more or less back and leg pain symptoms. Currently, lumbar degenerative disc disease is showing a clear trend of rejuvenation, with the incidence evolving from the original middle-aged group of 30-65 years old to the young-adult group between 15-50 years old, and its incidence is already much higher than that of hypertension and heart disease. The cause of lower back pain and disc herniation, although there are genetic factors, is fundamentally aging + strain. In my clinic, patients with lower back pain account for 4/5 of them, and most of them want my opinion on whether they can do minimally invasive spine. But what I am talking about here especially to emphasize is to start with formal conservative treatment. If conservative does not work for 3-6 months, or if symptoms remain, then move to minimally invasive treatment. Conservative overall principle one, if you can do without surgery, of course, conservative. Principle two, the principle of no harm, first from the green method to do. Principle three, before determining a conservative approach, have a regular spine doctor determine that conservative can be attempted. Principle four, know what circumstances must be operated, the rest are good to discuss. First of all, tell you three knowledge points: 1, the top ten occupations prone to lumbar disc herniation: students, teachers, accountants, drivers, office workers, health care workers, tailors, chefs, ticket takers, workers engaged in stooped work. 2. Sixteen activities that are prone to lumbar disc herniation: ambulatory work (writing, reporting, drawing, reading), watching TV, watching computer, playing WeChat, watching Ipad, driving, riding in a car, housework, long-distance flight, playing cards (mahjong), knitting sweater, holding children, doing surgery, pressing legs, sneezing, nesting in sofa. Long-term computer operation and ambulatory work are important causes of early degeneration of the intervertebral disc. Today many office white-collar sitting in front of the computer, a sitting is a few hours, research has confirmed that prolonged sitting, especially poor sitting posture when the lumbar discs bear the greatest load that pressure. Therefore, the incidence of low back pain is usually much higher than other groups of people who work long hours and operate computers. Exertion is mainly sitting (for example), or bending over to work (for example, doing housework, electrician, tiler, etc.). Poor learning posture, playing computer games, and early onset of lumbar disc herniation are becoming more common. The lumbar spine weight-bearing force is 100 when lying down, 150 when bending over, and 220 when leaning forward to take light things. 3, the 2 segments most likely to protrude: lumbar 45, lumbar 5 sacral 1. Green conservative methods: general principles, physiotherapy acupuncture status rise, bed traction status decline, caution massage! (1) physiotherapy Physiotherapy for the elimination of inflammation of the lesion site, improve local blood circulation and tissue nutrient status has a good role in promoting! If you have the conditions, first on the physiotherapy. ① ultrashort wave, no – micro heat, 12-15 minutes / time, 1 time / day, 10-15 times / 1 course of treatment. (Note: nerve root edema period absolutely use no heat 8-10 minutes / time) ② computerized intermediate frequency, 20-25 minutes / time, 1 time / day, 10-15 times / 1 course of treatment (nerve root edema period can also choose the audio electricity in the intermediate frequency electricity for treatment). Small combinations of punches, treated in the order of ultrashort wave first and then computerized intermediate frequency. (2) Acupuncture The mechanism of action of acupuncture is not clear, but it is generally less harmful and can be tried first. I am not prepared to evaluate small acupuncture here. Although the doctors who advertise the small needle technique may not all know the mechanism, I do know a certain mechanism through surgery and closed practice. I did see a few patients who suffered losses doing this technique. (3) Bed rest Earlier, all textbooks, in the conservative treatment of lumbar disc herniation, emphasized the importance of bed rest. However, doctors who copied books without thinking, reading widely, and correcting their academic views through clinical practice were lazy and subject to criticism. The importance of bed rest is currently declining. Never follow some textbooks that say to be absolutely bedridden for 2 weeks. It is important to understand that the root cause of the symptoms of a herniated lumbar disc is the physical compression + chemical stimulation of the nerve roots by the herniated disc, and bed rest will not fundamentally change this. However, bed rest is helpful in eliminating edema, but it also brings problems such as muscle atrophy. It is recommended to stay in bed for no more than 3 days. Find your most comfortable position when lying in bed, lying flat, on your side or on your stomach, and you can get down to eat and go to the toilet. Remember, after being bedridden, it is perfectly normal to still have pain when you get off the floor, so don’t be alarmed or discouraged. People with milder symptoms do not need to be bedridden, just pay proper attention to rest in life and work, and be careful of bending posture. (4) Beware of massage tui na massage Some patients say that where where the massage tui na is particularly great, a press, the symptoms are better. However, I have also seen many massage then comfortable and then not. I have also seen a lot of then pressed bad, need emergency surgery. Therefore, herniated discs massage need to be careful! In clinical findings, herniated discs appear cauda equina dysfunction (perineal numbness, tingling, urinary and fecal dysfunction, etc.) of patients, a lot of them because of irregular massage, precisely because the current social masseurs vary in skill, so, be cautious to take this approach. The right way is the first need to go to a regular hospital and get a diagnosis, and then according to the patient’s specific condition to choose the appropriate treatment plan. Swimming, low back muscle function exercise than massage is more environmentally friendly, more effective. (5) Traction The effectiveness of traction was originally exaggerated. I think the effect is not obvious. The reason is that the herniated disc cannot return to its original position. (6) Exercise (not an option in the acute phase) The role of physical exercise has been elevated. In fact, 80% of patients with lumbar disc herniation can be treated conservatively, even just by bed rest without medication, and most of them will improve their symptoms after a month, and they can participate in sports such as swimming, jogging, and functional exercises for the lumbar back muscles.