As a pain specialist, it is necessary to actively search for the causes of pain and eliminate them through various minimally invasive treatments to treat pain dialectically! 1, lumbosacral myofasciitis: chronic mostly manifests as soreness and swelling pain, stiffness and discomfort, activities are basically not restricted, waking up at night, more so in the morning, activities can be relieved, symptoms can be aggravated after getting cold, hot compresses can be relieved; acute mostly manifests as pulling-like pain or soreness and swelling pain, activities can be restricted, special position can be presented, hot compresses can be relieved. Infrared thermography has abnormal findings, but the rest of the examination has no abnormal findings. In the acute stage, braking and resting, physiotherapy such as acupuncture, massage, cupping and closed treatment are effective, but in the chronic stage, the effect of the above treatment is limited, and our department mostly adopts ozone injection therapy or intensive silver needle release treatment, which has positive effect in the near and distant future. Pay more attention to keep the lumbosacral tissues warm, remove some bad habits, and perform functional exercise of lumbosacral area appropriately, which is the key to prevention. 2.Lumbar 3 transverse process syndrome: the pain in the lumbar region is mostly soreness and swelling or pulling-like pain, and the pain sometimes radiates to the hip, ipsilateral adductor muscle and anterior thigh, but does not exceed the knee joint. The pain at the tip of the transverse process of the third lumbar vertebra is obvious, and muscle spasm nodules or striated material can be palpated; lumbar movement is slightly restricted, and it is more obvious when bending over and turning over in bed. Infrared thermography can show local high temperature performance, and X-ray plain film generally has no abnormal findings. In the acute stage, braking and resting combined with physiotherapy drug treatment can be chosen, and local injection treatment can be chosen if necessary; in the chronic stage, intensive silver needle release treatment has miraculous effect. 3, discogenic lumbago: discogenic lumbago is an extremely common clinical condition, which is a chronic lower back pain caused by intravertebral disc disorders such as degeneration, fibrous ring endolysis, discitis, etc. stimulating pain receptors in the disc, without root symptoms. The pain increases when the pressure on the disc increases due to prolonged sitting and standing. Discography can confirm the diagnosis, but there are certain false positives or false negatives, and radiofrequency thermal coagulation therapy of the intervertebral disc has certain efficacy. 4, lumbar disc herniation: a variety of factors lead to the rupture of the intervertebral disc’s fibrous ring, the nucleus pulposus tissue from the rupture of the protrusion (or prolapse) in the posterior or spinal canal, resulting in adjacent spinal nerve roots suffer from stimulation or compression, resulting in a series of clinical symptoms such as lumbar pain, numbness and pain in one or both lower extremities. Most of the symptoms are aggravated by prolonged walking and standing or sitting, and relieved by lying down and resting. Scoliosis can be detected during physical examination, and may be accompanied by myofascial damage in the lumbosacral region if it is chronic, localized pressure pain, positive straight leg raise test on the affected side, and CT or MRI examination can be clarified. The pain department mostly adopts minimally invasive treatment methods, which can achieve better results, so as to say goodbye to the pain of open surgery. 5, lumbar spine tuberculosis or lumbar vertebral metastases: lumbar pain is the most common symptom of lumbar spine tuberculosis, the nature of the pain is mostly dull or aching, accompanied by pressure and percussion pain, and the pain is aggravated by exertion, coughing and before sleep. The upper lumbar spine tuberculosis may have thigh pain, and the lower lumbar spine tuberculosis may have radiating pain in the lower extremities. In addition, lumbar spine tuberculosis is often accompanied by systemic metabolic symptoms such as hypothermia, night sweats, poor appetite and weight loss. Lumbar vertebral metastases have the clinical characteristics of the primary tumor because they have a primary lesion, but they can be traced back to the primary lesion only when the clinical symptoms of lumbar vertebral pain are seen, and lumbar vertebral metastases can manifest as blast-like pain in the lumbar spine, more so at night, local percussion pain, and radicular pain if there is nerve compression. Interventional treatment of the vertebral body can significantly relieve the symptoms of lumbar pain. 6.Intravertebral canal tumor: a general term including primary tumors or metastatic tumors occurring in the spinal cord itself and various tissues adjacent to the spinal cord within the spinal canal. Intravertebral tumor can compress the spinal cord and nerves, which can cause motor and sensory disorders of limbs, sphincter dysfunction and vegetative nerve dysfunction. The main symptoms and signs are nerve root damage in the plane where the tumor is located and the involvement of the cone bundle below that level. Spinal MRI or subarachnoid angiography can be used for diagnosis. Surgery is the better radical treatment. 7, lumbar spine small joint disorder syndrome: lumbar injury immediately after the occurrence of unusual severe lumbar pain, often bending sideways, the waist can not straighten, afraid to move, but fear that others touch , often misdiagnosed as acute lumbar muscle sprain. Infrared thermographic examination has a certain identification significance, and treatment requires braking, local physiotherapy, medication, and local injection therapy if necessary. In short, each cause of low back pain is different, the clinical manifestations are also different, and thus the treatment means are also different, only careful and dialectical treatment, in the cure of the disease can also reduce the cost of treatment, less detours!