Lumbar disc herniation is one of the common diseases in orthopedics, and about 1/5 of patients with low back pain are caused by lumbar disc herniation. It has been more than seventy years since Mixterher and Barr proposed this disease in 1934. From the epidemiologic analysis at home and abroad, the population rate and absolute value of its incidence are on the rise. The age of onset ranges from a few years to tens of years, and we have seen patients with lumbar disc prolapse as young as 9 years old. The rise in the incidence of this disease is related to changes in the environment we live in, our living and working habits. Chronic poor back habits are the main cause. In the past seventy years, the majority of medical workers have been working hard on research and have made great progress both in the understanding of the disease and treatment methods. From folk remedies, Chinese herbs, to traction massage physiotherapy, reset and so on intervention, minimally invasive, surgical treatment, treatment methods are endless and varied. How can we choose among the many treatment methods for individual patients? Patients are clueless, but also many doctors do not know, full of confusion. In fact, the treatment of the disease, the choice of indications is the key. That is to say, in the vast sea of treatment methods, to understand the degree of their own condition, choose the most targeted treatment methods, lumbar disc herniation can be completely cured very quickly. Here to years of clinical specialty experience to open the post, to guide you patients for symptomatic treatment, in order to reduce the patient’s confusion, no longer treatment on the detour. Due to my shallow knowledge, especially compared with domestic and foreign authoritative experts there is still a big gap, to a consultation suitable for the publication of the remarks just to provide reference, not for the final conclusion. The pathology of lumbar intervertebral disc herniation The intervertebral disc organization itself lacks blood supply, and the repair ability is extremely poor, coupled with the negative heavy activities. Generally after the age of 20, the intervertebral disc begins to undergo degenerative changes, and the toughness and elasticity of the annulus fibrosus gradually decreases. At this time, if the trauma `especially cumulative strain injury, it becomes the cause of the rupture of the annulus fibrosus. There are also many cases without a history of trauma, but after catching a cold, the tension of muscles and ligaments increases, which increases the internal pressure of the intervertebral disc and promotes the rupture of the atrophied annulus fibrosus. The intervertebral disc is a special structure made of connective tissue that is burdened with unique functions. Any alteration of the intervertebral disc affects its normal mechanical efficiency or interferes with its normal function of balancing, absorbing and redistributing its forces to the spine. The intervertebral disc consists of the nucleus pulposus, the annulus fibrosus, and the cartilaginous plate. The nucleus pulposus of the intervertebral disc contains a small amount of collagen fibers in addition to a soft matrix of mainly mucopolysaccharides. The nucleus pulposus accounts for more than half of the volume of the intervertebral disc, and because it is characterized by deformability, it is able to transmit load forces appropriately. The ability of the intervertebral disc to maintain proper function is closely related to its water content water volume, which in turn is stabilized by the content of polysaccharides. The annulus fibrosus is differentiated from the nucleus pulposus, although still significant. The collagen fibers of the annulus fibrosus are in the form of dense laminae, with the fibers of each layer interlacing with each other at right angles to each other and with the vertebrae at an angle of 45°, and this laminar structure accommodates the stresses of pressure and tension as well as the flexion and rotational stresses caused by the spinal column. The cartilage plate is glassy cartilage, which is scarfed between the vascularized vertebral cavernous bone and the avascular nucleus pulposus. On the surface of the glassy cartilage, the collagen fibers are parallel to each other on the surface and perpendicular to each other in the deeper layers near the bone. Proteoglycans ground an important part of the intervertebral disc matrix and are important structures for the mechanical and chemical function of the intervertebral disc. Proteoglycans are large molecules, extremely viscous, and very hydrophilic. Under normal conditions, the nucleus pulposus is highly compressible and has a strong loading capacity due to the properties of proteoglycans. If the glycan chains of the proteoglycans break down, they lose their ability to retain extracellular water. The biochemical integrity of the nucleus pulposus amidships is determined by its water-containing volume. Normally the intervertebral discs are under pressure and redistribute their forces to the spine and are an important part of accomplishing normal function. The formation of a herniated disc is normal with an excess of proteoglycans, which will cause the nucleus pulposus to fluid and increase, and the pressure within the nucleus pulposus to rise, predisposing the disc to herniation. However, mucopolysaccharides in the nucleus pulposus can produce a new equilibrium through reduction and reintegration. Protein polysaccharide progressive reduction, can promote collagen fibrosis, the nucleus pulposus due to collagen deposition, fibrosis increased and gradually lose the original compressibility and load capacity, the nucleus pulposus of the intervertebral disc at any time need to be in the weight-bearing situation to absorb and will be the stress redistributed to the spinal column to go to the function will not be able to do, thus causing disc injury. If external trauma or excessive stress is added to the damaged disc, it is more likely to cause disc herniation. It is believed that the glycoprotein and β-protein in the matrix of the nucleus pulposus form the antigen of autoimmunity, and it is the release of this antigen (referring to the release of β-protein from degenerative discs and herniated discs, which is normally encapsulated in the nucleus pulposus) that causes persistent stimulation of the organism, resulting in an immune response, and at the same time causes inflammatory reactions in the nerves, which results in pain. At present, due to people’s less exercise, resulting in lumbar back muscle relaxation, easily triggered lumbar disc herniation. 10 lumbar rehabilitation exercise is very effective for lumbar disc herniation in the acute stage, the late stage and the longer course of the disease patients. If the exercises are performed in the acute stage of lumbar disc herniation, adaptive pulling activities and relaxation activities are used to release the spasm of lumbar muscles and improve blood circulation, it can promote the elimination of inflammation and prevent the adhesion of the nerve root; if it is in the late stage, exercises to increase the strength of the lumbar back muscles and improve the function of the waist and legs can be carried out, in order to correct the bad posture of the waist and increase the stability of the lumbar spine, and to prevent the recurrence of the disease. For patients with a longer course of the disease, muscle atrophy or decreased muscle strength in the lower limbs on the affected side, and diminished strength of the lumbar back muscles or imbalance between the two sides, these 10 exercises can also be used to improve these symptoms. —Bed exercises– Section 1: Leg extension exercises. Lie on your back, alternately bend the knees of both lower limbs and lift them up, as close as possible to the lower abdomen, repeat 10-20 times. Section 2: Lift the waist exercise. Lie on your back, bend both knees, make a fist with both hands, bend both hands to the side of the body, lift your waist and buttocks up as much as possible, lift your chest, and perform 10 to 20 times slowly. Section 3: Back Extension Exercise. Prone position, arms and legs naturally straight, double lower limbs alternately upward as far as possible to lift, each repeated 10 to 20 times. Section 4: Boat Row Exercise. Prone position, both elbows flexed, arms crossed behind the waist, both lower limbs rhythmically lifted and lowered backward as hard as possible, at the same time lifting the chest and head up, repeat 10 to 20 times. Section 5: Push-ups. Prone position, both elbows flexed, both hands placed in front of the chest and press the bed, both legs naturally straightened, both elbows straightened and propped up, at the same time the whole body lifted upward, chest up and head up, repeat 10 to 20 times. —Upright Position Exercise– Section 1: Upside Down Foot Exercise. Upright position, feet together, heels rhythmically lifted off the ground, then put down, so alternately, for 1 to 2 minutes. Section 2: Kicking Exercise. Hands on the waist or one hand to support the object, the two lower limbs rhythmically alternating best efforts to kick forward, back stretch. Each lasts 10 to 20 times. Section 3: Stretching exercise. Hold the object with both hands, stretch backward alternately with both lower limbs, land on your toes, and try your best to stretch your waist backward. Each lasting 10 to 20 times. Section 4: Waist Turning Exercise. Stand naturally, feet apart and shoulder-width apart, elbow joints of both upper limbs flexed and stretched out, and then rhythmically move both upper limbs left and right, driving the waist to rotate. Continue for 1 to 2 minutes. Section 5: Hanging Exercise. Grasp the bar or door frame with both hands, two feet hanging in the air, waist relaxation or for abdominal, abdominal movement, try to adhere to, but do not force. Almost all adults have experienced low back pain, and one in five patients with low back pain is lumbar disc herniation. However, there are some misconceptions about lumbar disc herniation treatment: Traction is not always effective. Traction can reduce the pressure on the intervertebral disc, promote the nucleus pulposus to different degrees, promote the inflammation to subside, relieve muscle spasm, and restore the normal relationship between the posterior joints. However, if the herniated disc is in the inner side of the nerve root, it will be more and more painful, and it is not suitable for central type, free type herniation and huge nucleus pulposus herniation. Tui na massage is not suitable for all patients. Massage can inhibit and regulate the nervous system, play an analgesic effect, relieve muscle spasm, improve blood circulation, promote the inflammation around the nerves to subside, relieve the nerve root extrusion, and may make the protruding nucleus pulposus partially return. However, severe pain of central herniation and accompanied by spinal stenosis, generally should not massage. It should not be used reluctantly in complicated conditions with a long course of disease, severe pain, obvious symptoms of nerve compression or rapid deterioration. The choice of minimally invasive surgical and interventional indications is limited. These include chemical dissolution of the nucleus pulposus, percutaneous lumbar discectomy, endoscopic disc surgery, ozone injection, and laser vaporization. The advantages of these methods are small damage, quick results, short recovery time, and fewer after-effects of surgery. However, the disadvantage is that the indications for treatment are very strict, if your condition is not in the scope of treatment, you do not have any effect, and will have other adverse consequences. Which patients need surgery? 1. Patients who have been diagnosed with lumbar disc herniation for more than half a year, and whose symptoms have worsened after non-surgical treatments are ineffective. 2. The first severe attack of lumbar disc herniation, the patient is forced to bend the hip and knee to lie on the side or even kneel due to the pain, which makes it difficult for the patient to move and sleep. 3. Single nerve palsy or cauda equina palsy, manifested by muscle paralysis or defecation and urination disorders. 4. Middle-aged patients, who have been sick for a long time, affecting their work and life. 5. Total disc degeneration or large herniation confirmed by reliable examination. 6. Surgery is recommended for patients who have been treated effectively with non-surgical treatment but have recurrent symptoms and severe pain for more than 3 times. Herniated disc and other causes of lumbar spinal stenosis. Having said that, how should we choose? Is there not a method can be effective? Is it that this disease can not be treated? No, it is easy to treat. Among my patients, not to say that 100% of them are cured at one time, but more than 95% of them are cured at one time. Where is the key to this? The grasp of the indications! It is one sentence: the treatment method that suits your condition is the best method. Depending on the condition, you should be treated how to treat, do not avoid, do not have a chance. If your condition requires surgery, you can’t escape. In the above categories of treatment methods, are effective ways to cure lumbar disc herniation, each has its own advantages and disadvantages, and each has its own scope of treatment. You do not know how to choose, you are very confused, the reason is that our country does not have such a specialized hospital, can be all the treatment methods together, with all the purchase of therapeutic equipment and professionals, the formation of a lumbar herniated disc treatment “supermarket”, so that each patient can find a reliable method suitable for them. The result is a “supermarket” of lumbar disc herniation treatments, so that every patient can find a reliable method suitable for him or her. But we live in the information age, we have the network.