Low back pain is one of the common reasons for patients to visit the clinic. Perhaps because of too many media presentations and advertisements, many people immediately associate a herniated lumbar disc with the appearance of low back pain. In fact, you do not have to blindly seek medical attention as soon as symptoms appear, because there are many kinds of diseases that can cause back pain, and the two most confusing ones are lumbar disc herniation and lumbar strain. The following is a detailed explanation from several aspects, and I hope that you will not delay treatment due to misdiagnosis. The difference between lumbar disc herniation and lumbar muscle strain: lumbar disc herniation is the outward expansion or protrusion of the lumbar intervertebral discs. Lumbar muscle strain is a lesion that targets the muscles and soft tissues around the lumbar region. If it is not effectively treated for a long period of time, then the protective effect of the muscles and soft tissues on the lumbar spine will be reduced, thus triggering the lesion of the intervertebral disc. After the lumbar disc herniation causes lumbar pain, it leads to the change of lumbar posture, which causes lumbar muscle strain or makes it worse. Therefore, lumbar disc herniation and lumbar muscle strain are two diseases, but they may exist at the same time. The significance of identifying lumbar disc herniation and lumbar strain: Lumbar strain does not require surgical treatment and is treated conservatively. This is not to say that the treatment of lumbar strain is not important. If you are sure that it is a lumbar strain, you should pay attention to maintenance, rest and catch up on treatment. This disease, if not treated effectively, can easily cause habitual damage and can result in increasing frequency of the disease, increasing severity of the disease, increasing difficulty in treatment and increasing duration of the disease. The combination of multiple therapies used to treat lumbar strain can only be used as an adjunctive treatment, and its main treatment should be based on self-behavioral treatment. This is something that the majority of patients do not really understand, in fact the essence is to change the bad habits of work and life that aggravate lumbar muscle strain. In the case of lumbar disc herniation, although conservative treatment is also used when the first occurrence and symptoms are mild, surgery is required when conservative treatment is ineffective, when symptoms are severe, when there is spinal stenosis, and when the nucleus pulposus prolapses. What occurs when a herniated disc is suspected: 1. Low back pain Low back pain is the first symptom that occurs in most patients with this condition, with an incidence of about 91%. A small number of patients have only leg pain without lumbar pain, so it is not certain that lumbar pain will occur in every patient. Some patients have low back pain first and then leg pain after a period of time, and at the same time, the low back pain reduces or disappears on its own, and when they come to the clinic, they only complain of leg pain. 2.Radiation pain of lower extremities Low back pain is easy to come on after trauma, exertion and cold, each time for about 2 – 3 weeks, and can be gradually relieved. Any factors that increase abdominal pressure, such as coughing, straining to defecate, laughing, sneezing, lifting heavy objects, chronic coughing, etc., are likely to trigger lumbar pain or aggravate the already occurring lumbar pain. 3, restricted lumbar activities The forward flexion and backward extension activities of the lumbar spine in patients with lumbar disc herniation are closely related to the degree of disc herniation. If the annulus fibrosus is not completely ruptured, the lumbar spine takes the forward flexion position and the posterior extension is restricted. 4, crestal scoliosis This is a postural compensatory deformity adopted by patients with lumbar disc herniation to reduce pain. The lumbar spine is bent to the left or right, and the spinous process can be found to be skewed by touching the spinous process in the middle of the back, but this is not a unique sign of lumbar disc herniation, as about 50% of normal people also have a skewed crestal spinous process. 5. claudication The claudication that occurs in lumbar disc herniation is mostly intermittent, that is, pain and weakness in the lower limbs after walking a certain distance, and the symptoms can be relieved after bending down or squatting to rest, and can still continue to walk. With the passage of time, the symptoms of lumbar disc herniation will gradually and slowly aggravate. 6. sensory numbness Some patients with lumbar disc herniation do not experience pain in the lower extremities, but only numbness in the extremities, which is mostly caused by the compression of the proprioceptive and tactile fibers of the nerves by the disc tissue.