In the 1970s, Feng Tianyou researched and summarized the orthopedic techniques of traditional Chinese medicine with the theory of modern medicine, and proposed the fixed-point rotational repositioning method for the treatment of lumbar disc herniation. It has attracted a lot of attention in the medical field and has been hailed as a major breakthrough in the medical field. It has broken the traditional non-surgical treatment of lumbar disc herniation and formed a unique chiropractic medicine with the characteristics of accurate positioning, simple and effective techniques. With the rapid development of shadow medicine, people’s understanding of lumbar disc herniation has gradually deepened, and research on treatment mechanism, treatment techniques and adjuvant therapy has been very extensive. However, there is still no breakthrough in the research of treatment mechanism, thus causing blindness and confusion in treatment methods. 1, the treatment of lumbar disc herniation of the main techniques Sitting fixed point rotation reset method: the patient is sitting, feet on the ground. The doctor sits behind the patient and presses one hand through the patient’s armpit at the back of the neck and thumb on the affected spinous process. The doctor makes the patient’s body bend forward with one hand and then rotate laterally while pushing the affected spinous process with the other hand. This is currently the most popular technique in clinical practice. Lateral position fixed-point rotational repositioning method: The patient is lying on the healthy side, slightly bent, and holding the head with both hands. The assistant is located in front of the patient, and the hands are placed on the patient’s crotch. The physician is located behind the patient and instructs the patient to rotate the chest to the ventral side as far as possible, with both hands on the patient’s shoulder and the affected spinous process, and exerts force in the opposite direction at the same time with the assistant. This is a modified method of seated fixed-point rotational repositioning. Although this technique is safer, it is inconvenient and less effective than the previous one, and is only used for special patients. Prone position fixed-point rotational repositioning method: the patient is in prone position with both lower limbs separated. The doctor stands on the affected side of the patient, holding the leg with one hand and pulling it outward to the upper side, while the other hand pushes the affected spinal process outward to the front. This method is rarely used clinically because the spine does not have sufficient anterior bending and lateral rotation angle, and the effect is poor. Traction position rotation reset method: This is a treatment method that uses the principle of rotation reset method and rotation by mechanical traction. It is to fix the patient on the traction bed and use the computer digital control technology to rotate the lumbar spine under traction, and achieve the purpose of reset. Although this method has certain curative effect, it is easy to cause injury to the adjacent intervertebral disc due to inaccurate positioning. 2, treatment of lumbar disc herniation mechanism The anatomy and characteristics of the intervertebral disc: the intervertebral disc is the fibrocartilage tissue connecting the upper and lower two vertebrae. The nucleus pulposus in the center of the disc is a soft and elastic gel, and the fibrous ring around the disc is a myriad of fibrocartilage tissues arranged in concentric circles, firmly connecting the upper and lower vertebrae together. It acts as a cushion when subjected to external forces. The pathogenesis of lumbar disc herniation: under normal circumstances the lumbar disc can withstand considerable force without rupture. With age, chronic loss occurs due to long-term stresses such as pressure and torsion, while degenerative changes occur, reducing its water content, decreasing its elasticity and increasing its brittleness. When the human body is bending over, the lumbar disc will rupture and cause the disease when it is subjected to huge external forces up and down and in front, or when there is chronic loss of the disc due to little pressure. The mechanism of treating lumbar disc herniation The fixed-point rotational repositioning method has good efficacy in treating lumbar disc herniation, which has been confirmed by a large number of clinical practices. However, the majority of researchers have found that although the herniated lumbar disc can be observed to reduce or release the compression on the nerve root after the manual repositioning. However, the herniated disc did not show signs of return. Therefore, finding the exact treatment mechanism is the key to improve Feng’s theoretical system. Therefore, combined with clinical practice, I believe that the doctrine of disc displacement is the main mechanism of Feng’s manipulation in treating lumbar disc herniation. Lumbar intervertebral disc herniation is a symptom caused by the rupture of the intervertebral disc under the action of external force and its protrusion into the spinal canal, compressing the spinal nerve root. The herniated disc protrudes into the spinal canal in the shape of a triangle. The size, shape and location of the triangle and the compensatory gap in the spinal canal play a decisive role in the onset, progression and treatment of the disease. The tip of the triangle creates compression of the nerve roots. During manipulation, the spine is rotated and the upper and lower vertebrae at the site of the lesion are forced into misalignment, thus causing further damage to the intervertebral disc. The result of the injury caused a change in the shape and position of the triangle. With no change in the contents or total area, its tip necessarily drops or pans out. Eventually, the pressure of the tip of the herniated disc on the nerve root is released, thus achieving the purpose of treatment. 3, there are problems Naming problem: According to the doctrine of displacement fixed-point rotational reset method should be renamed as fixed-point rotational displacement method or Feng’s maneuver, which is more accurate and scientific. This provides strong evidence for the good effect of Feng’s manipulation in treating lumbar disc herniation and perfecting the criteria for judging the efficacy. Rotation direction problem: At present, the clinical method of bilateral rotation is mostly used, which is a blind treatment technique and undoubtedly aggravates the unnecessary re-injury of the intervertebral disc, is not conducive to the repair of the disc and prolongs the recovery period. In our practice, we use the rotation method to the healthy side and have achieved better results. Because, in the process of rotation, the upper and lower vertebral bodies are displaced by the midpoint of the middle line of the upper and lower articular processes on both sides as the fulcrum vertebral body and spinous process. The herniated intervertebral disc is pulled toward the central position, thus relieving the compression of the nerve root. Rotational force problem: The force required for manipulative treatment cannot be measured by loudness and angle alone. It should be tailored to the individual, depending on each person’s height, weight and resistance in rotation. Too much force will further aggravate the re-injury of the intervertebral disc and cause further protrusion or prolapse of the nucleus pulposus, which will aggravate the condition. The problem of the number of treatments: At present, the clinical treatment plan of twice a week is mostly used, which is rather blind. How to define a reasonable number of treatments, we divide the whole treatment period into three stages, the first stage is the efficacy observation period: that is, the first manipulation treatment to the time used when the effect, this stage takes 1-7 days ranging, generally need 3 – 5 days. The length of time required depends mainly on the severity of the disease and the accuracy of the manipulative treatment. If the condition is mild and the manipulation is applied reasonably, immediate results are often seen. If the condition is serious and the manipulation is not reasonable, a second manipulation is needed. The second phase is the repair phase, that is, after the effect of manipulation, the ruptured disc is repaired and the nerve root is restored after the release of compression. This phase takes about 2 – 3 weeks, and the need for manipulation depends on the progress of the disease. If, after the first stage of treatment, the symptoms gradually decrease until they disappear when lying down, no further manipulation is needed. Further manipulation will disrupt the repair process of the intervertebral disc and will not be conducive to recovery. The third stage is the rehabilitation period, that is, the functional exercise period, most patients can properly move to the ground and carry out lumbar muscle exercise, no need for manipulation treatment at all. 3.5 adjuvant treatment problem Bed rest: At present, about 80% of patients with non-surgical treatment are treated in outpatient clinics and do not get effective rest, which is the main reason for the poor effect of manipulative treatment. Bed rest can release the weight, muscle strength and external load on the disc pressure, is the key second only to manipulation. Some milder patients can still fully recover without manipulation by bed rest alone. Bed rest is the process of ensuring that the ruptured disc has a good external environment for relative quiescence to undergo fibrosis and calcification. Bed rest can be divided into three phases. This is a basic match with the three phases of the treatment period, i.e. absolute bed rest, bed rest and relative bed rest. The absolute bed rest period is to lie flat in bed 24 hours a day, generally 1-2 weeks; the bed rest period is to lie flat in bed except for urination and defecation, generally 2-3 weeks; the relative bed rest period is to carry out some activities and functional exercises in addition to bed rest. As the course of the disease continues, the time spent in bed gradually decreases while the time spent in activity gradually increases. Physiotherapy: infrared therapy instrument, ultra-short therapy instrument, etc. can be used. It is used to improve the local blood circulation and promote the recovery of sterile inflammation. There is no definite conclusion as to whether it has the effect of promoting the repair of ruptured intervertebral discs and promoting the recovery of sterile inflammation of nerve roots after decompression. Drug treatment: It is mainly symptomatic treatment, which can be divided into internal and external drugs. Internal medications include dehydrating drugs, neurotrophic drugs and antibiotics. Topical medications include topical medications and drug ionization. There is no exact report on their efficacy. Functional exercise: The main purpose is to strengthen the function of the muscles of the low back, increase muscle strength, restore and enhance the external balance of the spine, better consolidate the therapeutic effect and reduce recurrence. In short, the author summed up four sentences in many years of clinical practice, the direction of rotation should be single rather than double; the rotational force should be light rather than heavy; the number of manipulation treatment should be less rather than more; the auxiliary treatment should be simple rather than complicated. 4. Outlook Feng’s manipulation is currently the most representative method for non-surgical treatment of lumbar disc herniation. Although there is still no breakthrough in the research of treatment mechanism, the research of other aspects is still lagging behind, and the treatment method still needs to be further standardized. It is believed that with the further improvement of scientific research means and scientific research mechanism, the formation of the theoretical system and treatment system of Feng’s manipulation will be accelerated through the joint efforts of everyone.