It is also supplemented with dynamic lumbar back and abdominal muscle functional exercises to prevent recurrence of lumbar disc herniation. The combination of the four techniques can achieve both primary and secondary treatment, which can not only eliminate symptoms such as lumbar pain and leg pain, lower limb numbness and weakness faster, but also restore the biomechanical structure of the lumbar spine and restore the series of functions such as lumbar flexion and extension and weight bearing. I. According to the specific signs and symptoms, the operating procedures are as follows: lumbar disc herniation is actually a syndrome group with lumbar disc degeneration, nucleus pulposus herniation, inflammation and nerve root inflammation and injury in the vertebral canal as the main pathology, and lumbar hip and lower limb pain, numbness and lumbar leg dysfunction as the main clinical manifestations, often combined with soft tissue injury outside the lumbar spinal canal and misalignment of the intervertebral joints. In the process of clinical diagnosis and treatment, the pathology, location and course of the disease should be identified, and then targeted treatment should be given. (A) The first division of lesions inside and outside the spinal canal: 1. Those with predominantly intraspinal lesions: lumbar pain and lower extremity radiating pain are obvious and intense; or the lower extremity shows typical sciatica or hyperalgesia and hypotonia in the sciatic innervation area; the lumbar spine shows spastic compensatory lateral flexion; the straight leg raise test is strongly positive; the spinal canal percussion pain is positive, the chest pad pillow test is positive, and the abdominal pad pillow test is negative. Clinical consideration was given to significant nucleus pulposus herniation and heavy inflammation in the spinal canal. Treatment was based on sacral injection of Chinese herbal medicine to open the meridians and activate the channels, together with external application of pain-relieving cream and manipulation by pulling method. 2.Patients with both internal and external lesions in the spinal canal: severe lumbar pain and lower limb pain, shallow lateral or physiological anterior curvature or retroflexion of the lumbar vertebrae; multi-point pressure pain of the lumbar paravertebral muscles, obvious increase in muscle tone, pressure pain of the gluteus medius, pear-shaped muscles and broad fascial tensor muscle, positive thoracic pillow test and abdominal pillow test. Treatment: combination of sacral nerve block, topical antispasmodic and blood-activating cream and manipulation with antispasmodic and pain relief and pulling method. 3, mainly extravertebral lesions: low back pain, lower limb radiating pain can be mild or severe, but not consistent with the sciatic nerve distribution area; negative percussion pain of the spinal canal; negative chest pillow test and positive abdominal pillow test; MRI showed that the gap and size of the herniated nucleus pulposus did not parallel the severity of clinical symptoms and signs; multi-point pressure pain of the paravertebral muscles and gluteal muscles; negative tibial nerve flick test. If the paravertebral muscles are mainly spastic, external application of antispasmodic and blood-activating cream and blood-activating and energizing cream, and manipulation to sedate and relieve pain and spasm are the main treatment; if the paravertebral muscles are prolonged and mainly sclerotic, silver needle release of the paravertebral muscles is performed, and external application of blood-supporting and tendon-relieving cream is applied after surgery. (2) For lesions in the spinal canal, the presence or absence of nerve root and cauda equina injury and the degree of inflammation should be identified again. 1. If the inflammation of the spinal nerve root is serious, inject formula 1 for sacral canal injection; 2. If the acute period of spinal nerve injury has passed and the patient is in the recovery period, inject formula 2 for sacral canal injection; 3. If the nerve root injury is serious or there is cauda equina injury, medullary nucleus removal or medullary nucleolysis should be performed, which is not included in the treatment scope of this technique. (C) After the pain symptoms are relieved in the acute stage, instruct the lumbar back muscle and abdominal muscle functional exercise to speed up the treatment and prevent recurrence. Analysis of safety and effectiveness This technique is further developed on the basis of the “85” scientific and technological research project of the army in the early 1990s “Research on the mechanism of manipulation for lumbar intervertebral disc herniation”, and has nearly 30 years of clinical experience. In the past 30 years, there has not been a single case of serious complications and side effects, and the effective rate of treatment is over 95%, the clinical cure rate is 85%, and the recurrence rate is only 7%. External application of Chinese medicine and manipulation are convenient and do not require special equipment and medical conditions, so it is easy to promote. The back and abdominal muscles exercise method is simple and easy to implement, and patients can practice at home every day, which is easy to adhere to. The key technology can be mastered by 2-5 days training, and the operation risk is small and easy to promote. (C) Benefit analysis Lumbar disc herniation is a common clinical disease, and most of them are treated by non-surgical treatment, but due to the inconsistency of conservative treatment methods or the unity of treatment in various hospitals, the efficacy is inaccurate and the recurrence rate is high, which leads to the increasing rate of surgical treatment. However, surgical treatment is associated with high risks and complications and can cause secondary lesions due to reduced stability of adjacent vertebrae. In addition, the cost of surgery is increasing, ranging from 5,000-30,000 per case depending on the procedure, with an average of 10,000 to 50,000 yuan, while treatment with our technology is 2,000-5,000 yuan per case, which will save patients and society more than 10,000 yuan.