How can the general population determine whether their low back pain is serious due to the lack of professional medical knowledge and the occurrence of low back pain? Or is it an ordinary chronic strain and acute strain? Because there are some diseases that require orthopedic surgery, such as lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, and intravertebral tumor. Lumbar disc herniation: persistent lumbar pain is the main cause, which is relieved by lying down and aggravated by standing up. Generally, there is lumbar pain first, followed by radiating pain of the lower limbs. The lower limbs show pain and numbness, mostly radiating to the calves or soles of the feet. Spinal stenosis: The low back pain is more widespread, often with heavy symptoms and few signs. Typical symptoms are back pain and leg pain after the patient walks one or two hundred meters, numbness and weakness of the lower extremities to the point of limping, and leg pain that is aggravated when the waist is extended backward and alleviated by bending forward. There are some diseases that are within the scope of pain management, such as lumbar spine arthropathy, small joint synovial impingement, chronic low back pain, myofasciitis, etc. So how to self-judge and avoid detours? First of all, changes in the condition can provide clearer information. 1, pain site: for example, low back pain, such as accompanied by lower limb pain and numbness, mostly radiating to the calf or foot, suggesting a greater possibility of lumbar disc herniation, while only the emergence of low back pain, no lower limb symptoms, the first consideration is the possibility of soft tissue injury outside the lumbar spinal canal, and then combined with other conditions to make a comprehensive judgment. 2, time change: back and leg pain is obvious in the morning after waking up, even at night because of pain waking up and can not lie down, must get up and move to relieve the pain, general work during the day and so on without hindrance. This is a characteristic of soft tissue damage pain outside the lumbar spinal canal, such as ankylosing spondylitis. In contrast, patients with lumbar spinal canal lesions wake up in the morning when they feel the best in their back and legs, with no pain or mild pain, while the pain is most pronounced when they get out of bed or in the afternoon, and the sitting position also makes the pain worse more quickly. Pain caused by extradural tissue damage may come on suddenly and be relieved within a short period of time with a long interval. Intravertebral lesions cause sudden and frequent episodes of low back pain, with intervals that become progressively shorter as the number of episodes increases, and long intervals that generally require several weeks of specialized treatment to resolve. If the symptoms of low back pain are mild and severe, the attacks are repeated. There is no obvious cause, and the frequency of attacks is increasing, and the interval is shortening. If the episodes change from self-relieving to unrelieving, a mixed type of lesion inside and outside the lumbar spinal canal should be considered. Suggests that two different types of damage lead to the destruction of the stability of the lumbar spine, but also the manifestation of the seriousness of the disease. 3, the impact of exercise and bed rest: lumbar spinal canal outside the soft tissue damage as long as the blood supply to the soft tissues of the lumbar region is improved, pain can be gradually relieved, such as acute lumbar sprain, a simple trauma cream can be relieved. In contrast, inflammation of fatty connective tissue in the lumbar spinal canal can only be made to reduce inflammation by adopting a braked recumbent posture. Activity in the upright position can only exacerbate aseptic inflammation of the soft tissues because the protruding disc or thickened ligamentum flavum are irritants to the dural sac and nerve roots. The more you move, the more the pain will be exacerbated, sometimes manifesting as sudden onset of pain after exercise, and this irritation can be relieved only when lying still. 4. Triggering factors: the effect of increased abdominal pressure on pain. The pain is aggravated by the increase in cerebrospinal fluid pressure due to forceful defecation, coughing, sneezing, etc., which produces direct pressure on the nerve roots or dura mater. In this case, if a lumbar brace is worn to reduce the axial pressure in the lumbar spine, it will reduce some of the increased abdominal pressure and thus relieve the pain. The pain caused by soft tissue damage outside the spinal canal is rarely affected by changes in abdominal pressure. Next, you can do some self-examination 1, pillow test: positive chest pillow test (after the pillow appears or aggravated), suggesting lumbar spinal canal lesions. Positive abdominal cushion test (appearing or aggravated after cushion pillow) can be considered as pain related to soft tissue outside the spinal canal. 2, lumbar scoliosis test clinical significance: spinal curvature to the affected side triggers hip and lower limb radiating pain or soreness, can be judged to have intra-vertebral canal pathogenesis factors. Spinal curvature to the healthy side to reach the extreme, so that the original affected side of the scoliosis test induced deep lumbosacral pain and lower extremity signs completely disappeared, also indicates that the test is positive. If the spine is bent to the healthy side and the affected side of the back pain occurs, it can be judged as soft tissue damage outside the lumbar spinal canal. If pain in the lumbar or lumbosacral region is induced either when the spine is bent to the affected side or to the healthy side, it is judged to be lumbago caused by mixed lesions inside and outside the lumbar spinal canal.