【History Taking】 1. Predisposing factors: weak resistance, poor adaptability, physical defects, personal characteristics, age. 2.Causes: trauma, strain, poor working posture and habits. 3.Symptoms: (一) Prodromal symptoms: 1. acute low back pain 2. recurrent low back pain 3. chronic persistent low back pain 4. cervical and lumbar syndromes (二)腰背痛：Low back pain can occur either before or after leg pain. Clinically seen low back pain is divided into two types: one is a wide range of dull pain in the lower back, slow onset, the other is the onset of low back pain suddenly and abruptly, lumbar pain is very serious, lumbar pain part of the spasm, due to the pain of the lumbar part of the various activities are limited. (C) Sciatica: sciatica occurs gradually, the pain is dull at the beginning, gradually aggravated, mostly radiating pain, from the buttocks, the posterior lateral thighs, the lateral calves, radiating to the heel or the dorsum of the foot. (D) Lower abdominal or anterior thigh pain: in high lumbar disc herniation, the protruding disc can compress the lumbar 1 to 3 nerve roots, resulting in pain in the inguinal area innervated by the corresponding nerve roots or pain in the inner thigh. (E) Intermittent claudication: When the patient walks, with the increase of walking distance, gradually appearing back pain or discomfort, and at the same time feel the pain and numbness of the affected limbs aggravated, take the squatting position or lying down in bed, the symptoms can gradually disappear. (F) Muscle paralysis: When the herniated lumbar intervertebral disc compresses the nerve root severely, nerve paralysis and muscle paralysis may occur. (G) Numbness: Some patients with lumbar disc herniation do not have lower limb pain, but show numbness of limbs. (H) cauda equina syndrome: centralized lumbar intervertebral space herniation, when suddenly huge protrusion, often compress the cauda equina nerve below the protruding plane. (ix) Coldness of the affected limbs: some patients have low temperature of the affected limbs, especially at the distal end of the toes. (X) Tail pain: some clinical symptoms of lumbar disc herniation can be manifested as tailbone pain, (XI) calf edema 【Physical Examination】 1, general examination: body temperature, pulse, respiration, blood pressure, sanity, body position, color, and systemic examination. (2) Specialized examination: 3. Examination of primary disease (1) Gait: those with more severe symptoms prefer to take the posture of leaning forward with the buttocks convex to one side, and show claudication. (2) Spinal shape: physiologic curvature can be increased or decreased or abnormal. (3) Pressure points: the pressure points of lumbar disc herniation are mostly beside the spinous processes with diseased intervertebral space. (4) Lumbar mobility: the mobility of lumbar disc herniation patients in all directions will be affected to different degrees. (5) Lower limb muscle atrophy. (6) Decreased sensation: the sensation of lumbar disc herniation can be subjective numbness or objective numbness, both of which are informative. (7) Altered tendon reflexes: knee reflexes and Achilles tendon reflexes on the affected side can be diminished or absent. (8) Straight leg raising test. (9) Straight leg raising strengthening test. Laboratory tests: blood, urine routine, blood lipids, blood sugar, electrolytes. 2. Plain film of lumbar vertebrae: the width of the intervertebral space is mostly unchanged in the early stage of the lesion; if the disease is of long duration, it will show narrowing of the space, and various forms of bone spurs appear on the edge of the vertebral body. 3, CT and MRI: the three-dimensional structure of lumbar vertebrae can be obtained, so not only can we observe the anatomical state of lumbar vertebrae inside and outside of the spinal canal from the sagittal plane, coronal plane and transverse plane with or without variation, 4, isotope bone scanning: isotope bone scanning can’t be used to diagnose lumbar intervertebral disc herniation, but it is very meaningful in the differential diagnosis of bone tumors, ankylosing inflammatory colitis and intervertebral disc inflammation. [Diagnosis] 1, leg pain is heavier than lumbar pain, leg pain is typical of the sciatic nerve distribution area of pain. 2, Numbness of skin sensation according to the area of nerve distribution. 3.Straight leg elevation is 50% less than normal, with or without a positive leg elevation test, and a positive bow test, i.e., tibial nerve compression in the region of the national fossa, causing radiating pain at the distal and proximal ends of the limb. 4. Two of the four neurological signs (muscle atrophy, motor weakness, hyperalgesia and decreased reflexes) are present. 5. Imaging findings at a level consistent with the clinical examination, including vertebral angiography, CT or MRI. [Differential diagnosis] 1, lumbar posterior joint disorder 2, lumbar spinal stenosis 3, lumbar tuberculosis 4, vertebral metastases [Treatment principle] 1, bed rest: the patient must rest in bed until the symptoms are significantly relieved. 2.Drug therapy: drug therapy, including therapeutic drugs and symptom-relieving drugs. 3.Rehabilitation physiotherapy: traction therapy Traction is only suitable for patients with simple lumbar disc bulging, and must be used when the symptoms are not severe, for the purpose of relieving clinical symptoms, and is prohibited for patients with lumbar disc herniation, prolapse, accompanied by spinal stenosis, and patients with lumbar protuberance in the acute stage. Physical therapy: including electrotherapy, infrared radiation, heat therapy and other methods. Tui na therapy: the technique should be a combination of rigid and soft, do not be rough. Acupuncture and moxibustion treatment. Injection therapy: epidural injection and sacral injection. Small needle knife treatment 4, radiofrequency treatment method: the patient lies prone on the CT bed. Abdominal pillows to widen the intervertebral space in order to facilitate the entry of the needle. ct scanning localization. Combined with clinical symptoms and physical signs to determine the vertebral space of bipolar radiofrequency thermocoagulation and marking. The lumbar spine was punctured by a safe triangular approach. The entry point was 8-10 cm from the midline, with routine disinfection of the towel and local anesthesia of 2-3 mL of 1% lidocaine. Under CT guidance, two radiofrequency needles were inserted from the puncture point into the corresponding intervertebral disc target point to confirm that the distance between the anterior ends of the two needles was no more than 0.5 cm, and 50 Hz sensory test and 2 HZ kinesiology test were used first. After confirming that there was no nerve root irritation, bipolar radiofrequency thermo-coagulation was started, and five consecutive cycles of radiofrequency treatment were given at 80°C for 120 S and 90°C for 120 S. After the operation, the patient was returned to the ward, and anti-inflammatory and symptomatic supportive treatment was given. (1) Improve the labor posture and avoid long-term stooping and exertion. (2) Strengthen muscle exercise Strong back muscles can prevent soft tissue injury in the low back; abdominal and intercostal exercises can increase intra-abdominal and intrathoracic pressure, which can help reduce the load on the lumbar spine. (3) Prevention in family life. (4) Prevention education. [Efficacy assessment] (1) Cure: lumbar and leg pain disappears, straight leg elevation of more than 70°, can resume the original work, and can walk more than 2 kilometers. (2) Improvement: the low back pain is reduced and the function of lumbar activity is improved. (3) Not cured: no improvement in symptoms and signs.