Low back pain as a painful experience is common in daily life, and although rare in children, it can develop in men, women and children. The most common cause of low back pain is due to degenerative changes in the intervertebral discs and small joints of the lumbar spine, known as aging, and the highest incidence of low back pain closely related to poor posture – “discogenic low back pain”. Low back pain as a disease includes: lumbar disc herniation, lumbar spondylolisthesis, lumbar spinal stenosis, osteoporosis, etc. In addition, there are malignant tumors (cancer) metastases, spinal osteomyelitis, spinal tuberculosis (TB), trauma (such as compression fractures). Generally the prognosis of low back pain is relatively good, and most of the pain is relieved after 1-2 weeks. However, special attention should be paid if there is severe pain, or prolonged pain, or if lower extremity symptoms (numbness, leg pain) are present in addition to low back pain. The structure of the intervertebral disc: the intervertebral disc is one of the components of the spine, which exists between the vertebrae of one section after another, and it has both the function of a spring cushion to cushion vibration and conduct stress, and the function of a joint to maintain the mobility of the spine. The central part of the disc is the nucleus pulposus, which is surrounded by a fibrous ring. The nucleus pulposus is made up of a water-rich peptide-like substance, and the fibrous ring is made up of sturdy bands of collagen fibers that repeatedly overlap and surround the central nucleus pulposus. Why the intervertebral disc ages: The intervertebral disc is usually subjected to mechanical loading. 15 to 20 years old, due to the disappearance of the blood vessels that originally supplied the intervertebral disc with nutrients, as age increases, the nucleus pulposus gradually becomes less watery and degenerative due to repeated strain stimulation, which is also known as degenerative aging. As a result of this aging, the supportive and spring cushion effect of the intervertebral disc begins to decline, and it becomes an irritant to the peripheral nerves and increases the burden on tissues such as ligaments, joints and muscles, becoming a cause of back pain. This condition of low back pain caused by disc degeneration is called discogenic low back pain, not lumbar disc herniation. Its symptoms are mainly acute and chronic low back pain, mostly aggravated by activities (especially forward bending position) and weight bearing, and can be accompanied by hip and thigh involvement pain, although the pain in the lower extremities usually does not exceed the leg curvature and is rarely accompanied by urinary and fecal symptoms. For discogenic low back pain, it is difficult to diagnose by physical examination alone, and most of the ordinary X-ray films do not show significant abnormalities, so it is necessary to do MRI examination. We mainly adopt the principle of “six ladder treatment – the more the front treatment is less traumatic, the more the back treatment is more relatively reliable”: 1. conservative treatment, 80% of patients are effective; 2. minimally invasive treatment (such as low temperature plasma) 3.Intervertebral disc decompression (minimally invasive or open surgery), the effect is similar to intervention, slightly more traumatic; 4.Elastic fixation, 90% effective; 5.Intervertebral disc replacement, 90% effective; 6.Intervertebral fusion internal fixation of disc removal, 90% effective. Conservative treatment mainly consists of oral pain medication and wearing a waist bra and corset, together with massage and physical therapy, most of the symptoms will be relieved. For the 20% of patients for whom conservative treatment is ineffective, we prefer minimally invasive low-temperature plasma intervention, which is effective in 7~8 out of 10 patients. Individuals with long-term persistent back pain that affects daily life and work will require surgery. One of the surgical options is to add a “spring” to the diseased disc to divert some of the stress from the disc and relieve the back pain while maintaining the structural integrity of the disc. The second surgical option is to remove the disc completely or to perform artificial disc replacement; the third option is to remove the disc and perform lumbar fixation and fusion with intervertebral bone graft. In order to determine if surgery is appropriate, discography is required at the time of admission. Of course, not all discs with abnormalities on MRI will have low back pain, and the diagnosis of discogenic low back pain requires extensive experience and expertise, so it is recommended to seek consultation with a spine specialist when there is chronic low back pain.