Back pain is commonly caused by localized bone or soft tissue disease in the shoulder and back. Other pains are caused by reflexes from organ disease to the shoulder and back or by tumors that have metastasized to the shoulder and back from other sites. Therefore, back pain may be just a symptom and not the real cause of the disease. Giving massage, gua sha, cupping, etc. without clinical investigation of the cause can lead to misdiagnosis and mistreatment, making the patient lose the best time for treatment. Therefore, for patients with back pain, it is necessary to exclude whether the symptoms are caused by reflexes of other parts of the disease or tumor metastasis to avoid misdiagnosis and mistreatment. Diseases that need to be distinguished include: 1, respiratory system diseases: many respiratory system diseases can cause shoulder and back pain, the location is usually in the back, side back or scapula, more common are pleural adhesions, lung cancer and tuberculosis. 2, circulatory system diseases: cardiovascular diseases with chest pain, angina pectoris and myocardial infarction are the most common. 3.Digestive system diseases: Many digestive system diseases can cause pain in the back of the shoulder, the common ones are biliary colic, pancreatic diseases, stomach and duodenal tumors, etc. 4. Bone tumor or organ tumor metastasis bone tumor or other organs, such as kidney, bladder, uterus, lung and other tumors metastasized to the scapula, vertebral bone, ribs. It is recommended to give a comprehensive examination in hospital and give reasonable treatment after diagnosis.