Lumbar disc herniation is a clinically common disease that occurs most often in people aged 30-50 years; herniation is common in the lumbar 4-5 disc and the lumbar 5-sacral 1 disc, and is one of the most common causes of back and leg pain. Medically speaking, the underlying cause is the herniated nucleus pulposus, which irritates or compresses the nerve roots, causing symptoms such as low back pain, sciatica and hyperalgesia in the corresponding skin area. When it comes to the nucleus pulposus, we need to understand what is an intervertebral disc. The human intervertebral disc can be thought of as a rubber gasket that is placed between the vertebrae of the spine to act as a cushion. The intervertebral disc consists of two main parts, the middle part is called the nucleus pulposus, long similar to jelly, jelly outside surrounded by rubber band-like material, called the fiber ring; intervertebral disc can be imagined as a dozen rubber bands, the middle wrapped in a jelly. For various reasons, the rubber band has cracks and the jelly is squeezed out from the gap, which is what we call a herniated nucleus pulposus, or lumbar disc herniation. So, what causes lumbar disc herniation? We speak that the etiological basis of this disease is mainly the degeneration of the intervertebral disc. When you go to the hospital to take pictures of the cervical spine, lumbar spine and knee, as long as you get older, the report often says four words, degenerative changes, what does it mean? This degeneration, to be precise, refers to an abnormal change in the tissues and organs of the body as we age. In layman’s terms, degeneration is aging. If you compare a person to a car, after decades of driving, the parts are aging. Specifically, the degeneration of the intervertebral disc mainly includes two aspects, on the one hand, the nucleus pulposus, that is, the jelly contains less water and reduces elasticity. On the other hand, the annulus fibrosus also degenerates, creating tiny fissures. (As shown in the picture, imaging shows the disc darkening and narrowing of the intervertebral space, often suggesting degeneration) The jelly elasticity becomes lower and tiny fissures appear in the rubber band. At this time there is a huge external violence, or repeated tiny injuries in life, it is easy to squeeze the jelly out of the rubber band fissures and get a lumbar disc herniation. For example, there are occupations that require frequent heavy lifting, or require frequent twisting or bending, all of which can increase the risk of disc herniation. The clinic has seen a patient who repeatedly visited the clinic with lumbar disc herniation and had relatively obvious results with strictly conservative treatment, but his symptoms worsened as soon as he worked, and his occupation was auto repair. In addition to the above etiology, there is also a part of genetic factors. In addition, smoking and obesity are both high risk factors for lumbar disc herniation. This is because when smoking, many harmful substances, especially nicotine, enter the bloodstream and vasospasm occurs, reducing the blood supply to the tissues. The carbon monoxide that enters the blood when smoking has a better affinity for oxygen, causing the red blood cells to lose their ability to carry oxygen. Reduced blood supply, insufficient oxygen supply, and failure to keep up with tissue nutrition will accelerate degeneration. In addition to obesity, some time ago our team admitted a patient in his 20s, about 1 meter 7, weighing 100 kg. He was fat and obsessed with computer games, so he came to the hospital with back pain and leg numbness. For people who are overweight, every pound of excess body weight increases the load on the intervertebral discs, especially for weight-bearing areas like the lumbar spine and knee joints, where the discs are under too much pressure and it is easy to squeeze the jelly out of the cracks in the rubber bands, thus inducing lumbar disc herniation. The picture shows an obese patient under X-ray