Objective To optimize the treatment regimen of acupuncture in the treatment of lumbar disc herniation. Methods A total of 48 patients with lumbar disc herniation were enrolled as subjects. With Visual Analogue Scale (VAS) and the Japanese Orthopaedic Association (JOA) scoring system as the evaluation indices and acupuncture at waist Jiaji points as the main treatment method, the four-factor two-level orthogonal design was used to optimize the combined regimen of enhanced local acupoint selection, distal acupoint selection along the meridians, electroacupuncture frequency, and acupuncture interval. Results There were significant differences in VAS and JOA scores between the two levels of enhanced local acupoint selection, distal acupoint selection along the meridians, and electroacupuncture frequency (P<0.05), while there were no significant differences in VAS and JOA scores between the two levels of acupuncture interval (P>0.05). The interaction analysis showed the strongest interaction between enhanced local acupoint selection and an electroacupuncture frequency of 4 Hz, as well as between distal acupoint selection along the meridians and an electroacupuncture frequency of 4 Hz. Conclusion The best acupuncture treatment regimen for lumbar disc herniation is acupuncture at Jiaji points, combined with enhanced local acupoint selection, distal acupoint selection along the meridians, and an electroacupuncture frequency of 4 Hz, every other day.