Objective: To investigate the effects of warm needling combined with core muscle rehabilitation training on pain, lumbar function, inflammatory responses, and biomechanical parameters in patients with lumbar disc herniation (LDH). Methods: In this prospective study, 100 patients with LDH treated between January 2023 and October 2025 were randomly assigned to a control group (core muscle rehabilitation training alone) or an intervention group (warm needling plus the same training). Outcome measures included serum metabolites, inflammatory markers [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-23 (IL-23), and CXC chemokine ligand 8 (CXCL8)], lumbar biomechanical parameters, Visual Analog Scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, and clinical efficacy. Results: Baseline metabolites and inflammatory markers were comparable between groups (P > 0.05). After treatment, levels of β-cryptoxanthin, citric acid, and lysine increased in both groups, with significantly greater increases in the intervention group (P < 0.05). Inflammatory markers (TNF-α, IL-1β, IL-23, and CXCL8) decreased significantly after treatment, with more pronounced reductions in the intervention group (P < 0.05). Both groups showed significant reductions in VAS scores and improvements in JOA scores, favoring the intervention group (P < 0.05). Lumbar flexion/extension ratios decreased, while average power and peak extension moment increased, with superior improvements in the intervention group (P < 0.05). The excellent-good response rate was 93.88% in the intervention group versus 78.00% in the control group (P < 0.05). Conclusion: Warm needling combined with core muscle rehabilitation training effectively alleviates pain, improves lumbar function, suppresses inflammatory responses, and enhances clinical outcomes in patients with LDH.