Objective To investigate the effects of acupuncture at Shenshu (BL23), Dachangshu (BL25), and Jiaji (EX-B2) points combined with prone position traction-oblique pulling manipulation on pain degree, lumbar function, and sleep quality in patients with lumbar disc herniation (LDH). Methods A total of 104 LDH patients admitted between November 2023 and November 2025 were selected as study subjects. They were randomly divided into a control group and an observation group using a random number table, with 52 cases in each group. The control group was treated with prone position traction-oblique pulling manipulation alone, while the observation group received additional acupuncture at Shenshu, Dachangshu, and Jiaji points on the basis of the control group's treatment. Both groups underwent 2 treatment courses. Clinical efficacy was evaluated. Pain degree [Numerical Rating Scale (NRS)],lumbar function [Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were assessed before and after treatment. In addition, the improvement in lumbar spine function (straight leg raising test angle, sensory disturbance score, muscle strength score) was observed in both groups. Results A total of 49 cases in the observation group and 47 cases in the control group completed the study. The total effective rate was 89.80% (44/49) in the observation group, which was significantly higher than that in the control group (76.60%, 36/47) (P<0.05). After 2 treatment courses, NRS pain score, ODI score, PSQI total score, and sensory disturbance score decreased in both groups compared with before treatment (P<0.05), and all these indicators were lower in the observation group than in the control group: NRS score (2.34±0.73) vs. (3.52±1.21), ODI score (24.22±4.18) vs. (32.51±4.62), PSQI total score (8.12±2.04) vs. (11.78±2.65), sensory disturbance score (2.6±0.8) vs. (4.1±1.0) (P<0.05) . JOA score, straight leg raising angle, and muscle strength score increased in both groups compared with before treatment (P<0.05), and all these indicators were higher in the observation group than in the control group：JOA score (21.12±3.08) vs. (18.53±2.91), straight leg raising angle (60.1±5.0)°vs. (50.5±6.1)°, muscle strength score (4.5±0.4) vs. (4.0±0.5) (P<0.05) . Conclusion Acupuncture at Shenshu, Dachangshu, and Jiaji points combined with prone position traction-oblique pulling manipulation can effectively alleviate pain, improve lumbar function and sleep quality, and aid in the recovery of lower limb sensation and muscle strength in LDH patients.