The treatment always varies from person to person, “Chinese medicine looks, smells, asks questions, and cuts, while Western medicine depends on the amount of touch”, the doctor must ask a detailed medical history, carefully examine the body and combine the results of the photographs before treating the patient accurately. To what extent does a herniated lumbar disc require surgery? The first thing we can see is what the professional books say: Ling Qinjie, Department of Spine Surgery, The First Hospital of Guangzhou Medical University (Advanced Course in Orthopaedic Surgery, Part III, Spine Surgery, page 418): “After clinical diagnosis of lumbar disc herniation, 10% to 20% of patients require surgical treatment. 1. After strict conservative treatment is ineffective; or conservative treatment is effective, frequent recurrence and heavy pain; 2, the first episode of lumbar disc herniation pain is severe, especially in the lower extremities, the patient is difficult to move and sleep due to pain, forced to bend the hip and knee lateral position, or even kneeling position; 3, the appearance of unilateral nerve palsy or cauda equina nerve compression paralysis signs and symptoms; 4, middle-aged patients, a long history of disease, affecting work and life; 5. Although the medical history is not typical, it is confirmed by imaging, CT, MRI or imaging that the intervertebral disc has obvious and severe compression on the nerve or dural sac; 6. Lumbar disc herniation with lumbar spinal stenosis.” How to initially determine whether you belong to the above 10%-20% of people? A simple phrase: seriously affect the quality of life! Disrupt the order above for points 1, 2 and 4: focus on ineffectiveness! After 6 months of conservative treatment (including traction, massage tui-na, Chinese medicine so-called spinal misalignment reset, infrared, etc.) is ineffective, or the treatment process is constantly repeated, constantly aggravated. Such a painful state of life, I believe that no one will be satisfied, and such a life has no quality to speak of. Points 3 and 5, focus on paralysis! As long as there is paralysis of the lower limbs, urinary and fecal difficulties must be alert! This indicates that the nerve has been damaged by compression. When the muscle strength of the muscles innervated by the compressed nerve is decreasing, there is little chance that surgery can restore it. In clinical practice, I have seen many patients who first suffered from pain, then after a period of time, the pain stopped and became paralysis, and finally even the paralysis disappeared, resulting in the inability to move their feet. Again, such a life has no quality to speak of. Point 6, the focus on walking not far! The biggest feature of lumbar spinal stenosis is intermittent claudication, what is intermittent claudication? Every time you walk a small distance (less than 100 meters or even less than a few meters) you must stop and rest for a while before you can continue walking. If you can’t go anywhere, what quality of life is there to speak of? So as long as it does not affect your life, there is no need for surgery. But not surgery does not mean that it can be ignored, normal back muscle exercise, weight loss, swimming and other health care is still very necessary! This article is authorized by Dr. Ling Chin-Chieh, please do not reproduce without authorization!