Lumbar disc herniation is the most common type of spinal disease. With the development of medical technology, the detection rate of lumbar disc herniation has been increasing and the cure rate of lumbar disc herniation is also increasing. However, there is no unified standard for the prevention and treatment of lumbar disc herniation, and there are many treatment options, while the majority of lumbar disc herniation patients have insufficient knowledge about preventive care and treatment of lumbar disc herniation, making them overwhelmed in front of many treatment options and fearful of surgical treatment of lumbar disc herniation, and some patients even go into the misunderstanding of lumbar disc herniation treatment. These patients often bring more pain to lumbar disc herniation patients by choosing inappropriate treatment plans, taking inappropriate diagnostic and treatment measures, and choosing inappropriate timing of surgery. Lumbar disc herniation is caused by acute trauma or long-term chronic injury to the lumbar region, common causes of acute trauma are acute lumbar sprain, lumbar fall or high energy injury to the lumbar region caused by car accidents; and chronic injury such as sedentary, long bending and other poor posture is also the most common cause of lumbar disc herniation, the fibrous ring of the lumbar intervertebral disc in the long-term adverse stress stimulation of the local fibrous ring relaxation, aging, degeneration, the latter in a certain again. The latter can appear under certain re-injury conditions as local protrusion of the disc, or even rupture of the intervertebral disc annulus fibrosus and prolapse of the nucleus pulposus. The herniated or prolapsed disc will often cause varying degrees of lumbar pain and activity disorders, and some patients will experience unilateral or bilateral lower limb pain, numbness, weakness and other nerve root compression symptoms due to the protruding or prolapsed disc compressing the local nerve roots, and in severe cases, even injury to the cauda equina nerve in the spinal canal inducing large and small bowel dysfunction and lower limb paralysis. In general, most patients with lumbar disc herniation can obtain better treatment results through regular conservative treatment, and only a small number of patients with severe disc herniation and those for whom regular conservative treatment is ineffective will require further surgery. But when to conservative treatment and when to surgery, that is, how to correctly grasp the timing of conservative and surgical treatment has always troubled patients with lumbar disc herniation. Inappropriate conservative or surgical treatment can bring great pain to the patient’s life. Patients diagnosed with lumbar disc herniation without severe neurological symptoms generally require formal conservative treatment for 3 months to 6 months. The formal conservative treatment method is firstly bed rest, which is a treatment plan of natural traction of the lumbar spine that can effectively release or reduce the pressure on the injured disc and reduce the degree of disc herniation, while reducing lumbar activities to achieve symptom relief, and it is generally recommended that patients adopt a self-conscious and comfortable lying position. In addition, according to the patient’s clinical symptoms, some anti-swelling drugs, anti-inflammatory and analgesic drugs, blood-stasis activating drugs and neurotrophic drugs should be taken orally to further relieve the patient’s symptoms of back and leg pain. After the acute phase of lumbar disc herniation, local physical therapy, especially heat therapy, and appropriate functional exercise of the lumbar back muscles should be added appropriately to consolidate the treatment effect. Strong lumbar massage, massage, traction and other treatments are generally not recommended in the acute phase to avoid aggravating the signs and symptoms of herniated disc. After regular conservative treatment is ineffective, or even progressive aggravation of symptoms and signs, or sudden onset of severe neurological dysfunction, early surgical treatment is recommended to avoid delaying the best treatment time. For example, when imaging reveals a huge disc herniation or prolapse in the spinal canal, or when the patient develops severe lower limb numbness, weakness, foot drop, or even accompanied by perineal numbness or large or small bowel dysfunction, the patient is advised to have early surgical treatment, otherwise the patient will be left with sequelae that are difficult to recover from. To give you a real but case, one day in 2012, a male patient called me and told me that he now had severe numbness and pain in his lower back and legs, and asked me how to treat it. I asked him where he was and he said he was downstairs in our ward. I went downstairs and found this patient squatting on the floor in pain, sweating profusely, his clothes soaked with sweat, and with a face of unbearable pain. This was a patient who had been seen in my clinic for many times. He had a herniated disc in the lumbar 4-5 region due to lumbar trauma, and his symptoms were mild at the time, only pain in the lumbar region and occasional cramping in the lower limbs, which could be improved by lying in bed. I advised him to take more bed rest, apply local heat to the lumbar area, avoid prolonged sitting and bending postures, and to insist on functional exercises for the lumbar back muscles to obtain long-term therapeutic effects. He did pay attention to his posture and living habits for a period of time, and the treatment effect was remarkable, and he also called several times to report that he was in good health. Three months ago, this patient came back to the hospital with a recurrence of back and leg pain symptoms, and the MRI film of the lumbar spine on review suggested a huge protrusion of the lumbar 4-5 disc and severe lumbar spinal stenosis. When he was asked about the functional exercise of the lumbar back muscles, he was embarrassed to say that he was busy at work during this period of time and did not insist on exercising, and he often worked overtime to aggravate the recurrence of symptoms. Based on the examination, I found that his symptoms were significantly worse than the previous visit, and the imaging examination also indicated that the disc herniation had worsened and the spinal stenosis was severe, so I suggested him to have surgery in time to avoid more serious consequences. If the cauda equina syndrome occurs, i.e., numbness in the perineum, urinary and fecal dysfunction, foot drop, etc., it may be too late to operate at that time, and some neurological symptoms may be difficult to recover for life. However, this patient had difficulty in accepting surgical treatment for a while, worrying about the risks and sequelae of surgery, and repeatedly requested conservative treatment. After repeated explanations, the patient was instructed to come to the hospital as soon as his symptoms worsened. What I was worried about happened. Through careful understanding of the symptoms and physical examination, the patient showed signs and symptoms of large and small bowel dysfunction, perineal numbness and severe lower extremity numbness and weakness, and the presence of cauda equina syndrome. Although he was treated with medication in a timely manner and underwent emergency surgery for decompression of the spinal canal, removal of the prolapsed nucleus pulposus and reconstruction of spinal stability, and although the surgery went very well and the decompression of the spinal canal was adequate, and although the patient’s postoperative symptoms of back and leg pain improved significantly, due to the existence of severe cauda equina syndrome in this patient before surgery, although there was some recovery of urinary function after surgery, there has been residual numbness of the perineum, numbness of the lower extremities and The sequelae of urinary dysfunction. As spine surgeons, we sincerely hope that all patients with lumbar disc herniation can obtain the correct knowledge about the prevention and treatment of disc herniation from a regular spine specialist, follow the doctor’s orders correctly, and correctly grasp the timing of conservative treatment and surgery to ensure the best, long-term prevention and good treatment results and indeed improve the quality of life of patients with lumbar disc herniation.