Both are diagnostic imaging terms and are not clinical disease diagnoses. As the name implies, they refer to degenerative changes in the vertebrae and their attachments (plates, tuberosities, transverse processes, etc.) or in the intervertebral discs. In other words, it is an aging phenomenon of the spine, like wrinkles and gray hair, which can occur after the age of 20, either mildly or severely, and most do not cause clinical symptoms. Since this is the case, no specific treatment is needed. Only a small percentage of the population requires treatment. Osteomalacia requires appropriate treatment, such as nerve root compression, osteoarthritis, foraminal stenosis or spinal stenosis. However, with the exception of open surgery, the lesions cannot be relieved, which is also known as “root removal”. In fact, understanding that the disease is an aging degeneration, there is no need to pursue the “root cause”. Strictly speaking, surgery cannot “get rid of the root” because aging degeneration is not fundamentally solved, and it cannot make the aging bones younger. In this case, conservative treatment options are preferred, such as oral medication, topical medication, physical therapy, proper rest, and rehabilitation exercises (without weight bearing). Herniated discs also require appropriate treatment. Regardless of the imaging diagnosis of bulging, prolapse, or herniation, all are herniations, just indicating different forms of protrusion. However, it is important to first clarify whether the symptomatic presentation is indeed caused by a herniated disc, otherwise it is extremely easy to misdiagnose and mistreat. It is not uncommon to find out that the original symptoms are not related to a herniated disc even though the pain is still there after surgery. Since the herniated disc is also a degeneration, the same should not pursue the “root”, but prefer conservative treatment, such as oral medication, intravenous dehydration (acute radiculitis), physical therapy, bed rest, lumbar back muscle exercise, etc.. Patients for whom the standard conservative treatment is ineffective can opt for local injectable drugs, minimally invasive interventional techniques (radiofrequency, laser, plasma ablation, rotary cut, ozone, etc.), and finally consider open surgery.