Objective To research the best application time of manipulations for lumbar disc herniation （LDH） and evaluate its therapeutic effect. Methods Totally 300 cases of LDH from three hospitals were randomized into recovery application group

remission application group

traditional massage group and western medicine group

with 75 in each. The recovery application group was given herbal fumigation

wet packing and applicator during the acute period

soft tissue relaxation and traction during the remission period and manipulations

traction and functional training exercise during the recovery period. The remission application group was given manipulations in remission. The traditional massage group was given manipulations during the acute

remission and recovery period. The western medicine group was given 1g nabumetone tablets orally once daily

intravenous infusion of Neurotropin in the acute phase

traction in remission and traction and functional training exercise during the recovery period. One treatment course lasted for 30 days. The levels of nitric oxide （NO） and interleukin-6 （IL-6）

symptom score

musculoskeletal ultrasound score and surface electromyography frequency were observed before and after treatment. The therapeutic effect was evaluated after one treatment course. The recurrence rate was observed in the follow-up （6 months after the end of treatment）. Results The levels of NO and IL-6

symptom score and musculoskeletal ultrasound score were significantly decreased

but the surface electromyography frequency was significantly increased in all groups after treatment （P<0.05）. The levels of NO and IL-6 in the recovery application group and remission application group were significantly lower than those in the traditional massage group and western medicine group （P<0.05）. The scores of symptom and musculoskeletal ultrasound in the recovery application group were significantly lower than those in the other three groups

but the surface electromyography frequency was significantly higher than that in other three groups （P<0.05）. The effective rate of the recovery application group

remission application group

traditional massage group and western medicine group was 98.6%

89.2%

77.5% and 75.4% respectively. The recurrence rate of the recovery application group

remission application group

traditional massage group and western medicine group was 1.4%

11.59%

12.31% and 14.29% respectively. The efficacy of the recovery application group was significantly higher than that of other groups

but the recurrence rate was significantly lower than that of other groups （P<0.05）. There was no significant difference in the efficacy and recurrence rate among remission application group

traditional massage group and western medicine group （P>0.05）. Conclusion The application of manipulations during the recovery period is a preferred and effective solution for LDH.