I. Acute stage Generally in the onset of 2-5 days, due to the local joint inflammatory irritation and nerve root inflammatory edema caused by the herniated nucleus pulposus; severe pain in the lower back and legs, severe limitation of activities, protruding paravertebral pressure pain and radiating pain in the lower extremities, straight leg elevation is obviously limited to less than 30°, walking difficulties, unable to take care of themselves, bed pain or continuous pain in a certain bed position is severe. Exercise prescriptions and precautions at this stage are as follows: 1. Bed rest should be the main focus, the bed should be a hard board bed with thick mattress, and the most comfortable position should be chosen for bed rest. When lying on your back, it is best to bend both knees, and soft objects (such as pillows) can be padded under the knees; when lying on your side, soft objects can be padded between the legs. 2, acute bed rest should not be completely braked, as long as no irritating symptoms, you should actively do some regular movement of the limbs in bed, especially the flexion and extension of the lower limbs. 1), alternating straight leg raise: supine, both legs repeatedly do straight leg raise action, repeat 10-15 times, 3-4 groups per day. 2), foot back extension exercise: repeat the foot back extension action, repeat 10-15 times, 3-4 groups per day. (3), inhalation waist: supine, can flex both knees, both upper limbs on the side of the body, deep inhalation gently lift the waist, exhale gently put down, repeat 10-15 times, 3-4 groups per day. The above exercises can be done separately at different times. 3, if the patient can go to the toilet by themselves, you can incidentally walk a little under the bed with the help of a walker or with the help of two chairs, put them on both sides of the body, support the back of the chairs on both sides with both arms and do in situ stepping (the toes do not leave the ground). If pain or increased pain occurs while stepping and walking, go to bed immediately and rest, and if the pain cannot be relieved in a shorter period of time after bed rest, the walking time should be reduced. 4.In addition to resting in bed during the acute period, any other activities should be done wearing a hard waist brace. 5.Physiotherapy items with strong warmth and muscle electrical excitation are contraindicated for patients in the acute stage. Second, the remission period Generally in 5-10 days after the onset of the disease, the patient’s pain is relieved, paravertebral pressure pain and lower limb radiating pain is reduced, straight leg elevation can generally reach 30-45°. Basic daily life can take care of themselves, and movements such as going to the toilet and washing can basically be completed. The pain is significantly reduced in the bed-ridden state. Exercise prescriptions and precautions at this stage are as follows: 1.Still be very slow and cautious when changing position. 2.In parallel with the physical exercises in bed, you can get out of bed and start walking slowly. At the beginning, you can exercise with the help of a walker or other things that can be used to support walking. As long as there is no fatigue or increased pain in the lower back and lower limbs, you can train for 15-20 minutes at most / times, but if pain occurs during the period, you must rest immediately, 2-3 times / day. 3. As long as you get out of bed, you should wear a hard lumbar brace. Third, 10-20 days after the onset of the disease, most of the back and leg pain is relieved, straight leg elevation is close to normal, but there are still restrictions on joint movement, or even swelling of the joint capsule. At this time, the principle of exercise therapy should focus on restoring the opening and closing function of the joints and increasing the strength training of the lumbar back muscles to strengthen the stability of the lumbar spine. Exercise prescriptions and precautions are as follows: 1. Patients need to change positions frequently (sitting, standing, lying, etc.). Each position should not be too long, generally not more than 15 minutes (lying position can be longer, but not more than 2 hours / time, except for night sleep), if less than 15 minutes that discomfort, you need to immediately change the position. 2, sitting position should be sitting back chair (and increase the lumbar pillow), not sitting on the sofa. 3.The speed and frequency of walking training at this stage can be accelerated appropriately. If the pain appears at the beginning of walking and disappears after walking for a longer period of time, record the time from the appearance of pain to its disappearance (this time gradually becomes shorter to indicate that the tension of the ligaments and muscles is gradually improving) and continue walking, but not more than 20 minutes at most. If the pain increases with continued walking, rest is required immediately. 4, “five points” type waist: bend both knees, both hands clenched fist, bend both elbows to the side of the body, the top of the head, both elbows, both feet at the same time as hard as possible to raise the waist, in the amount of high stay 3 seconds to recover. Repeat 10 times. 4, flying swallow movement: two arms straight to the side of the body, two arms, two lower limbs straight while lifting backward with force, while raising the chest and head, repeat 5-10 times. 5, hanging movement (self-weight traction): hands hanging on a single shoulder or door frame, feet off the ground hanging, waist relaxation, try to adhere to, but do not have to force, rest 3 minutes after landing, and then repeat 3 times. 6, “slow horse riding” exercise: this is a kind of lumbar pushing function basic training project, mainly to restore the basic opening and closing function of the joint after lumbar pushing, can increase the elasticity of the tissue around the joint and the basic coordination ability. Patients take a sitting position, raise the chest and abdomen to the upper limit, at this time, all the joints after the lumbar thrust are locked; relax and sink the chest thrust and lumbar thrust to its relaxation limit, at this time, the joints after the lumbar thrust are completely open, and the intervertebral ligaments are thus elongated. Repeat 10-20 times as a group, 4-6 groups of exercise per day. 7.Wear the waist circumference selectively, such as sitting in a car or walking for a long time, etc. Fourth, the recovery period The patient’s symptoms have basically disappeared, general life, work is basically unaffected, but still can not be competent for a long time static or dynamic activities, such as a long time to work, watch TV, play mahjong, etc., may cause symptoms again, but often disappear on their own after rest. Exercise prescriptions and precautions at this stage are as follows: 1. Fast walking training can be performed twice a day; each time should not exceed 20-30 minutes. In addition, shorter walks can be interspersed. 2, change the direction of variable speed walking: walking training 1-2 weeks, you can change the daily walking training from simple forward walking to backward and forward walking. Specific prescription: fast forward walking 8 minutes, and then change to backward slow retreat for 2 minutes, back and forth 3 times, a total of 30 minutes. This training is very beneficial to the rehabilitation of the posterior group of muscles of the lower limbs. 3, still need to change position frequently, each position maintenance time is not too long, in order not to cause a very fatigue or pain shall prevail. Sitting position time can be gradually extended. 4, weekly increase in whole-body fitness activities, generally 1-2 times a week, such as climbing, swimming (warm-up activities in advance, the water temperature should not be too cold), aerobics, tai chi, etc. (to avoid excessive stretching and pulling of joints) 5, can not be cold, weight bearing, pay attention to maintain the regularity of life, avoid sudden changes in habits and patterns of life. 6, general activities do not need to bring the waistband, long-distance do car (more than 1 hour) need to bring. V. Other issues that need attention ( 1 ) You cannot wear high heels. ( 2 ) Six months after the disappearance of clinical symptoms, you can resume some uncoordinated competitive sports appropriately, but must be gradual and develop the principle of regularity, and must do a good warm-up activity before exercise.