⁠Lumbar disc herniation (LDH) is a common low back disorder. It is one of the most common diseases that produces low back pain and/or leg pain in adults[1]., A herniated disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space[2]. This herniation process begins from failure in the innermost annulus rings and progresses radially outward. The damage to the annulus of the disc appears to be associated with fully flexing the spine for a repeated or prolonged period of time. The nucleus loses its hydrostatic pressure and the annulus bulges outward during disc compression[3]. Other names used to describe this type of pathology are: prolapsed disc, herniated nucleus pulposus and discus protrusion[4][5][6]. Clinically Relevant Anatomy The lumbar vertebrae are the largest segments of the vertebral column. The intervertebral discs lie between the vertebral bodies. The height of the disc is one-third of the vertebral body. The main function is to transmit forces from the bodyweight and muscle activity through the spinal column. Another important function is to provide flexibility[7]. In disc herniation, it is the intervertebral disc that causes the problem. The disc consists of the annulus fibrosus (a complex series of fibrous rings) and the nucleus pulposus (a gelatinous core containing collagen fibers, elastin fibers and a hydrated gel)[7]. The vertebral canal is formed by the vertebral bodies, intervertebral discs and ligaments on the anterior wall and by the vertebral arches and ligaments on the lateral wall. The spinal cord lies in this vertebral canal[8]. A tear can occur within the annulus fibrosus. The material of the nucleus pulposus can track through this tear and into the intervertebral or vertebral foramen to impinge neural structure[8]. A disc herniation can cause mechanical irritation of these structures which in turn can cause pain. This is presented as low back pain with possible radiculopathy if a nerve is affected[9]. The disc can protrude posteriorly and impinge the roots of the lumbar nerves or it can protrude posterolaterally and impinge the descending root[8]. A disc has few blood vessels and some nerves. These nerves are mainly restricted to the outer lamellae of the annulus fibrosus. In the lumbar region, the level at which a disc herniates does not always correlate to the level of nerve root symptoms[7]. When the herniation is in the posterolateral direction the affected nerve root is the one that exits at the level below the disk herniation. This is because the nerve root at the hernia-level has already exited the transverse foramen. A foraminal herniation on the other hand affects the nerve root that is situated at the same level. There are four types of herniated discs 1. Bulging:extension of the disc margin beyond the margins of the adjacent vertebral endplates 2. Protrusion:the posterior longitudinal ligament remains intact but the nucleus pulposus impinges on the anulus fibrosus 3. Extrusion:the nuclear material emerges through the annular fibers but the posterior longitudinal ligament remains intact 4. Sequestration:the nuclear material emerges through the annular fibers and the posterior longitudinal ligament is disrupted. A portion of the nucleus pulposus has protruded into the epidural space Disc herniation occur often as a result of age-related degeneration of the annulus fibrosis. However trauma, straining, torsion and lifting injury are also involved. Disc herniation are asymptomatic most of the time, and 75% of the intervertebral disc herniation recover spontaneously within 6 months. It can occur in any disc in the spine, but lumbar disc herniation and cervical disc herniation are the two most common forms