It is true that lumbar disc herniation is a common and frequent disease, and patients with lumbar disc herniation are in great pain. Looking at these patients with puzzled faces, I can only look at the films carefully, explain patiently, and find the best solution for the patients. Do all lumbar disc herniations require surgery? Modern life is fast-paced, stressful, with long overtime hours and little sleep, and back pain is a frequent occurrence. Some patients get nervous when they have back pain, rush to the hospital for examination, take a film, and say it is fine. Continue to work overtime. Later, the legs also began to hurt, or a numb feeling. This time nervous, and then find a doctor, do a magnetic resonance examination, the report is: lumbar disc herniation. This can be a bit dumbfounded, rushed to the Internet to check, only to know the seriousness of the problem. The reason is that many people say that a lumbar disc herniation requires surgery. In fact, there are two types of lumbar disc herniation: bulging discs and herniated discs (or prolapsed discs), with bulging discs accounting for the majority. Especially young patients, if it is the first onset, do lumbar MRI, the majority of performance for disc bulge, disc bulge can not be overly nervous than. Generally through regular conservative treatment are able to relieve or even heal. The conservative treatment of disc herniation is actually very simple, oral anti-inflammatory and pain medication, bed rest, supine abdominal exercises can promote the return of the bulging disc, etc., are very effective. For this type of patient in the clinic, I usually give him 1 to 2 weeks of oral medication, combined with rest and physical therapy, most of the symptoms have disappeared, there is no need for surgery. And what kind of disc herniation needs surgery? Generally, there are the following cases: 1. repeatedly have multiple episodes of lumbar disc herniation. In other words, the patient is not the first time to see the doctor, most of these patients are not bulging disc stage, if you do lumbar MRI, you can find that the disc’s annulus fibrosus has ruptured, the nucleus pulposus of the disc has broken through the barrier to directly compress the nerve, such patients generally pain is obvious, oral medication is difficult to relieve. Surgery is the fundamental solution. 2, combined with the lumbar spinal stenosis of the disc herniation. As we know, there is a bony canal in the center of the lumbar spine, called the spinal canal, and the nerves that innervate the limbs travel inside the canal. If the spinal canal is narrowed by congenital development, then once the disc is herniated, the nerve compression will be inescapable and the patient will experience severe pain and numbness. Neither medication nor physical therapy can significantly relieve the symptoms. Surgery should also be considered at this time. Through surgery, the volume of the narrowed spinal canal can be enlarged to completely release the compression and promote the recovery of nerve function. 3, disc prolapse into the spinal canal: this is the worst case, I have seen individual patients of this type in the outpatient clinic. Mostly, the disc herniation is already quite serious, and the doctor has given a hint of hospitalization. But the patient delays due to various concerns or fear of surgery, only to go home and suddenly explode into aggravation due to a certain improper posture, with paralysis of the limbs, incontinence and other manifestations of cauda equina syndrome rushing to the clinic. Of course, it is a little too late for surgery at that point. The chances of restoration of urinary and fecal function are more limited. In conclusion, lumbar disc herniation is a common disease, and among all the people with the disease, the chances of young patients needing surgery are generally small, mostly bulging, and can be cured by appropriate conservative treatment. A few are acute, more severe herniations that require surgical treatment. In contrast, most middle-aged and elderly patients have a history of multiple recurrent episodes, and the intervertebral disc’s annulus fibrosus has aged and cracked through repeated “tossing”, and the nucleus pulposus has broken out. This is the time to choose the appropriate surgical method for treatment to obtain the best results.