I. Three major factors contribute to the occurrence of “lumbar protrusion”: 1. Physiological degeneration of the lumbar intervertebral disc Degenerative changes in the intervertebral disc have begun at about 20 years of age, degeneration of the annulus fibrosus, thickening, reduced elasticity; 30-40 years of age when the intervertebral disc further loss of elasticity and expansion properties. The intervertebral disc has no blood circulation, poor repair ability, coupled with the annual frequency of 4-5 million activities of the spine so that the lumbar intervertebral disc is subject to stress from different directions, prone to atrophy, reduced elasticity and other degenerative lesions. 2, trauma, strain injury trauma and accumulation of strain injury is an important cause of lumbar disc herniation. Although the lumbar spine is physiologically convex, the intervertebral disc is thin and thick, when people bend over, the nucleus pulposus moves to the rear and produces resistance elasticity, the size of its elasticity is proportional to the size of the weight-bearing pressure. If the weight-bearing pressure is too large, the degeneration of the fibrous ring and its own existing defects, the nucleus pulposus may break through the fibrous ring fixed and bulge, protrusion or prolapse. 3, cold intervertebral disc cold muscle spasm and small blood vessel contraction in the low back. Local blood circulation is reduced, which in turn affects the nutrition of the intervertebral disc. At the same time, muscle tension and spasm lead to increased internal pressure of the intervertebral disc, especially for the degenerated intervertebral disc, can cause further damage, resulting in the nucleus pulposus protrusion. One of the six misconceptions is that low back pain is not a disease. The diseases that cause low back pain can involve almost all systems of the body. Some of the primary diseases of low back pain are cured and the pain disappears, and some of them are not cured by themselves. However, lumbar pain caused by lumbar synostosis must be given great attention because this disease can not only cause lumbar pain, but also cause numbness, coldness, weakness of the lower limbs and even paralysis and bowel and urinary disorders, which seriously affects the quality of life. Myth No. 2: Low back pain is not curable. Lumbar synostosis is characterized by easy recurrence, especially for those with neurological dysfunction, and a longer repair process. Therefore, some patients think that this disease cannot be cured. In fact, the overall effect of lumbar synostosis treatment is very good, and the excellent rate is about 95% through strict and regular treatment. Myth No. 3: Superstitious imaging results. imaging devices such as CT and MRI provide direct images for the diagnosis of lumbar synostosis and can clarify the size, type and location of protrusion. These advantages make some patients easily ignore their shortcomings and enter the misconception that only imaging diagnosis is disconnected from the clinic. In fact, it is not uncommon to have false positive and false negative CT examinations, and it is very easy to miss and misdiagnose only CT examinations. the diagnostic accuracy of MRI (magnetic resonance imaging) for disc herniation is over 90%, but the diagnostic accuracy is often affected for those with lumbar spine deformity or poor machine performance. Therefore, the patient’s age of onset, the location, nature, degree of pain, attack pattern, lumbar shape and mobility, physical examination and other aspects should be combined to comprehensive analysis and judgment. Myth No. 4: Superstition in a particular treatment method. There are two types of treatment methods for lumbar dystrophy, surgical and non-surgical. There are many specific methods in each category, and each specific method has its own indications and contraindications, so no one method can be a “one-size-fits-all” solution. Therefore, cases should be strictly selected, and the doctor should choose the appropriate treatment according to the specific conditions of different patients. Myth #5: Misconceptions about surgery. Both blind surgery and refusal of surgery are undesirable. Indiscriminate surgical treatment of lumbar synostosis adds to the unnecessary economic burden of patients on the one hand and increases the chances of various surgical complications on the other hand; while expanding the negative effects of surgery, believing that surgery must not be done resolutely and that conservative treatment is equally harmful. Because some patients must receive surgical treatment, and the earlier the better, otherwise, the loss of nerve function may become permanent. Generally speaking, patients with bulging and incomplete protrusion can be cured by conservative treatment, while patients with complete protrusion, ruptured protrusion and free nucleus pulposus can only be cured by surgical methods. Myth No. 6: Misunderstanding of basic concepts in diagnosis. Two concepts should be clarified: 1, disc bulge is not equal to herniation When the disc degenerates, the loss of elasticity of the fibrous ring undergoes increased pressure, the height decreases, the periphery of the fibrous ring bulges, the diameter of the disc increases, the edge of the vertebral body over the edge of the formation of disc bulge, while the position of the nucleus pulposus is approximately normal. Disc herniation is the disc degeneration, due to external forces or the role of cumulative strain, the fibrous ring rupture, the nucleus pulposus protrusion. 2, protrusion is not the same as herniation There are some patients with lumbar disc herniation, but there are no symptoms. The herniated lumbar discs in different segments stimulate or compress the adjacent nerves will have different symptoms, so in the diagnosis of lumbar disc herniation, both the lumbar disc herniation is found through the examination and also its coincidence with the patient’s symptoms. For example, if we find a herniated lumbar 4-5 disc on a CT film, but the patient does not have symptoms of irritation or compression of the adjacent nerve roots, we cannot diagnose lumbar disc herniation. In the first few days of the acute attack of lumbar herniation, the patient’s conscious symptoms are very serious, and a simple and more effective measure should be taken to relieve the symptoms, which is bed rest. Since the occurrence and development of lumbar synostosis is related to weight and weight, bed rest can eliminate the pressure of weight on the intervertebral disc, and to a large extent release the muscle contraction and the tension of the ligaments around the lumbar spine from the extrusion of the disc, so that the herniated nucleus pulposus can be dehydrated and reduced, so that the damaged disc can be fibrotic as soon as possible and the pressure on the nerve roots can be eliminated. In addition, bed rest can avoid greater bending and weight bearing, thus eliminating the “hidden danger” of aggravating the disease. By ensuring sufficient time in bed, the contraction, tension and spasm of the lumbar muscles can be minimized or released. The best bed to lie on is a hard bed. Because the use of too soft bed, the human body under the pressure of its own gravity, the physiological curvature of the spine will change, resulting in tension and spasm of the lumbar muscles and ligaments, aggravating clinical symptoms. While lying on a hard bed can make the human body in the supine position to maintain the normal physiological convexity of the lumbar vertebrae, side lying to keep the lumbar vertebrae are not scoliosis. Third, non-surgical therapy 1, bed rest: bed rest is a very simple, but more effective measures that can be used by patients with lumbar disc herniation, bed rest is the basis of non-surgical therapy. 2, lumbar circumference and support belt: lumbar circumference and support belt for lumbar disc herniation patients is the main purpose of braking, can make the damaged lumbar intervertebral disc to obtain local adequate rest, to create good conditions for the recovery of the patient’s body. 3, traction therapy: traction therapy is one of the common therapies for patients with lumbar disc herniation, and the current method of traction therapy has gained a lot of development. 4, tui na therapy: tui na therapy is a part of Chinese medicine, with the advantages of simple methods and few complications. 5, acupuncture therapy: acupuncture therapy includes body acupuncture, auricular acupuncture, electroacupuncture, blood cupping, manual acupuncture, scraping and other therapies. 6.Closure therapy: It includes painful point closure therapy, epidural cavity closure therapy, pushing the nerve root closure of the interstitial pore and other methods. Advantages of non-surgical therapy: safe, simple, non-invasive, less painful for patients, effective for patients with short medical history and light clinical symptoms and signs. Disadvantages of non-surgical treatment: the treatment effect is relatively poor, the effect is slow, the treatment is not complete, and the degree of lesion and the timing of treatment must be grasped. When non-surgical treatment is ineffective for more than three months and seriously affects work and life, surgery should be considered instead of early abandonment. Blindly prolonged conservative treatment often delays diagnosis and treatment or causes complications.