For a spinal surgeon, bulging, protrusion and prolapse are meaningless. Such descriptions, which are made by radiologists based on the degree and pattern of lumbar disc herniation as revealed by imaging, especially CT and MRI, are understood to be more severe for prolapse than for herniation, and greater for protrusion than for bulge, according to the literal degree. In reality, the spinal surgeon is more concerned with the protruding disc and whether it is compressing the nerve roots and causing definite manifestations of nerve damage.
If there are clear signs of nerve damage, such as radiating pain in the lower limbs, loss of sensation or numbness, muscle weakness, inability to move part of the limb, such as inability to lift the foot, incontinence, etc., then surgery is usually considered if there are clear signs of nerve damage, but if there is no clear nerve damage, surgery is not necessary and conservative treatment is sufficient.
If there are no symptoms and the herniation is even bigger, it is not necessary to take care of it. A herniated lumbar disc that falls into the spinal canal, i.e. a prolapsed disc, does not need to be treated if there are no clear symptoms or nerve damage, and most of them will eventually absorb on their own.