Lumbar disc herniation is a syndrome caused by disc degeneration, rupture, protrusion, irritation or compression of the spinal cord or nerve roots, and is one of the most common causes of back and leg pain. I. Overview (a) Etiology 1. degeneration Degeneration of the intervertebral disc is the basic factor of the intervertebral disc. With age, the water content of the annulus fibrosus and nucleus pulposus gradually decreases, the tension and elasticity of the nucleus pulposus decreases, and the disc structure relaxes, and the changes are more obvious on the posterior lateral side of the annulus fibrosus, which is not supported by the posterior longitudinal ligament. 2.Injury Accumulated injury is the main cause of intervertebral disc degeneration. At the same time, injury is also a common cause of lumbar disc herniation. 3, occupation People with a history of long-term bending and lumbar torsion work are the susceptible group of lumbar disc herniation, such as drivers and students. 4, genetic It is reported that the incidence of this disease is lower in people of color. 5. Pregnancy The relative relaxation of the pelvic cavity and various tissue structures in the lower back during pregnancy, as well as the increased weight-bearing, can easily cause damage to the intervertebral disc. (2) Pathological types 1, bulging type The fibrous ring is partially ruptured, while the surface layer is intact, at this time the nucleus pulposus is confined to the vertebral canal due to pressure, but the surface layer is smooth. 2.Protruding type The fibrous ring is completely ruptured and the nucleus pulposus protrudes into the spinal canal, covered only by the posterior longitudinal ligament or a layer of fibrous membrane, and the surface is uneven or cauliflower-shaped. 3.Prolapse type The ruptured and protruding disc tissue or fragments are dislodged into the spinal canal or completely free. Second, rehabilitation assessment Clinical performance Common in young adults, more men than women, more bending labor or sitting work history, the first onset is often in the process of semi-bending holding weight or sudden twisting action. 1, low back pain is the earliest symptom, mostly deep distension, extending from the midline of the spine to both sides, accompanied by unilateral lower limb radiating pain, also seen bilaterally. The pain is aggravated by increased abdominal pressure such as coughing and deep breathing. 2, gait and posture No significant changes in mild cases, more severe cases have a restrained gait, slow walking, often accompanied by intermittent claudication, while there may be scoliosis deformity. 3. Sciatica The vast majority of herniated discs in the lower lumbar region are accompanied by sciatica, and typical sciatica radiates from the lower lumbar region to the buttocks, posterior thighs, lateral calves and up to the feet. 4. compression of the cauda equina nerve The herniated nucleus pulposus or prolapsed or free disc tissue may compress the cauda equina nerve, resulting in obstruction of bowel movement and urination, and abnormal sensation in the saddle area. 5.Other symptoms such as numbness and swelling of limbs may occur in a few patients.