First of all, I would like to introduce to you what is lumbar strain and lumbar disc herniation. Lumbar muscle strain, also known as functional lumbago, chronic lower back injury, lumbar gluteal fasciitis, etc., is a chronic injury inflammation of the lumbar muscles and their attachment points fascia or periosteum, is one of the common causes of lumbago, the main symptoms are lumbar or lumbosacral distension, soreness, recurrent, pain can change with climate change or the degree of exertion, such as daytime exertion aggravated, after rest can be reduced when light, sometimes heavy, as a common clinical disease, multiple morbidity It is a common clinical disease with many factors. It is a common clinical condition with many factors. Over time, it can degenerate the muscle fibers and even tear them in small amounts, forming scarring, fibrous cords or adhesions, leaving long-term chronic low back pain. Lumbar disc herniation is a rupture of the annulus fibrosus and herniation of the nucleus pulposus due to a variety of causes, confirmed by imaging CT or MRI, and is generally less symptomatic or asymptomatic. “Lumbar disc herniation” is a series of clinical syndromes with lumbar and leg pain and sciatica as a result of compression of nerve roots and cauda equina by the herniated nucleus pulposus or ruptured annulus fibrosus. How to distinguish between lumbar strain and lumbar disc herniation? Patients with lumbar muscle strain and lumbar disc herniation can both have symptoms such as low back pain and weakness, which have certain similarities, but of course there are also differences between the two, and it is not difficult to distinguish them. 1, with or without leg pain The lumbar disc herniation mostly occurs in the lumbar 4-lumbar 5 and lumbar 5-sacral 1 intervertebral space, and the sciatic nerve comes from the lumbar 4, lumbar 5 and sacral 1-3 nerve roots, so patients with lumbar disc herniation mostly have sciatic nerve pain. In some patients, the pain starts from the buttocks and gradually launches to the lateral posterior thigh, lateral calf, dorsal foot and lateral plantar foot; in patients with lumbar strain, the main symptom is pain in the lumbar or lumbosacral region, mostly soreness or swelling, and very rarely leg pain. When distinguishing between the two, the first thing to look at is whether the patient has leg pain. 2. Different location of pressure pain points Some patients with lumbar disc herniation have pressure pain in the spinous process or spinous space, and the pressure pain points are mainly located next to the spinous process, 1.5~3cm from the midline, that is, the middle of the back. When pressure pain is present, radiating pain of the lower extremities along the nerve roots may appear; patients with lumbar muscle strain usually have no pressure pain between the spinous processes of the lumbar vertebrae, while there is local pressure pain in the lumbar back muscles, that is, the pressure pain point is located in the muscles on both sides of the lumbar back away from the midline of the back; the pressure pain point of lumbar disc herniation is located in the middle of the back, while the pressure pain point of lumbar muscle strain is located in the muscles on both sides of the lumbar back. The pain sensation of lumbar disc herniation is often expressed as vague pain; lumbar muscle strain is sore and swollen pain, or even severe pain. 4, straight leg elevation test This test is the most strained lumbar 5 nerve root, followed by the lumbar 4 nerve root. When the elevation angle exceeds 60 degrees, the lumbar 5 nerve root is subjected to maximum tension and is sufficient to move downward in the spinal canal. Because of the greater pulling force on the lumbar 5 and lumbar 4 nerve roots, the straight leg raise test is mostly positive in patients with lumbar 5 to sacral 1 and lumbar 4 to 5 disc herniation. In contrast, this test is generally negative in patients with lumbar muscle strain.