Lumbar disc herniation is a very common clinical condition, as evidenced by the number of online consultations, for which many people seek answers to treatment. This article will hopefully provide some help for such patients. As the name implies, lumbar disc herniation is a series of clinical symptoms caused by the nucleus pulposus breaking through the fibrous ring in the disc-like structure between the lumbar vertebrae (composed of the fibrous ring and the nucleus pulposus, which mainly plays a role in buffering the force between the five vertebrae of the lumbar spine) to compress the nerve roots behind the vertebrae, such as lumbar pain, leg radiating pain or numbness, and different segments of the disc herniation compressing the corresponding nerve roots, and the site of pain or numbness in the lower limbs. The doctor can determine the location of the herniated disc through clinical examination and consultation, and then compare it with CT and MRI imaging to determine the diagnosis. It is very important to confirm the diagnosis because the symptoms of herniated disc are easily similar to some other lesions (for differential diagnosis, please refer to my previous scientific article – Causes of low back pain). Although the clinical symptoms caused by lumbar disc herniation are all low back and leg pain, the treatment adopted for different degrees of disc herniation varies from person to person. According to the classification of imaging examination, herniated discs can be classified into four degrees according to the degree of nucleus pulposus protrusion: bulging, herniated, prolapsed, and free; and according to the orientation of the protrusion: central, paracentral, and radicular. In addition, the size of the spinal canal (a tubular structure that accommodates the passage of nerve roots) varies greatly from person to person, and the spinal canal is surrounded by bones and ligaments; osteophytes and ligamentous hypertrophy can cause spinal stenosis, and a herniated disc can also compress the spinal canal and cause stenosis, and patients with spinal stenosis may have more severe clinical symptoms. Due to the large number of patients with disc herniation, the majority of patients have mild symptoms or herniation and recover only through conservative treatment, such as bed rest and massage, and do not require special treatment. A small number of patients have more severe pain symptoms due to nerve root compression by herniated discs, which are difficult to be relieved by conservative treatment, and can be treated by interventional therapy. Interventional treatment methods currently used clinically include: percutaneous disc spinotomy, disc ozone (O3) ablation, disc laser vaporization, disc electrocoagulation and thermal coagulation, disc plasma ablation, and disc collagenase lysis. The three techniques of disc laser vaporization, disc electrocoagulation and thermal coagulation, and disc plasma ablation require special equipment and are relatively expensive. The scope of disc ablation is small, and it is effective for mild disc herniation, but it is relatively ineffective for patients with heavy herniation, and the clinical application is relatively small. Collagenase lysis of the disc nucleus pulposus has been used in clinical practice for a long time, and the pressure on the nerve root is relieved by injecting collagenase to dissolve the nucleus pulposus. This method can be used for patients with prolapsed or free discs, but because it is a chemical dissolution of the nucleus pulposus, very few patients have allergic reactions, and if collagenase enters the spinal canal, it can lead to serious complications due to chemical inflammation of the arachnoid membrane. In addition, the use of collagenase may lead to adhesions in the peri-disc tissue, which has some implications for surgery. Disc ozone ablation, which treats disc herniation through the ablative properties of ozone on the nucleus pulposus, was first used by the Italians and has been used and gradually promoted in China since 2000. Ozone has a wide range of clinical applications and can be used for a variety of diseases. Its unique anti-inflammatory and analgesic properties and its ability to dissolve the nucleus pulposus of the disc can successfully treat disc herniation and soft tissue non-infectious inflammation due to lumbar spine degeneration. Percutaneous lumbar disc spinotomy is a minimally invasive treatment technique invented by Professor Teng Gaogaojun in 1990 on the basis of foreign experience. This technique only requires skin puncture through the lumbar side to enter the intervertebral disc, and special instruments are used to cut out the nucleus pulposus and relieve the compression on the nerve root by negative pressure. This treatment technique has been used for more than 20 years and has trained a large number of medical personnel in China, benefiting hundreds of thousands of patients. We currently use a combination of disc spinotomy and ozone ablation for the treatment of lumbar disc herniation, which further improves the efficacy. However, although interventional techniques can provide effective treatment for many patients, there are still many patients who are treated by orthopedic surgery due to combined spinal stenosis, slipped vertebrae, and heavily herniated or free nucleus pulposus. Therefore, the diagnosis of the condition and the selection of the appropriate treatment is crucial.