Overview: With the continuous development of modern society, the pressure of survival competition is also intensifying, the pace of work and life of most people has become increasingly stressful, especially urban people, people only care about working hard, but neglected to exercise and health care, many people have prematurely appeared back and leg pain. Some data show that about 80% of the staff have had or are suffering from low back pain, thus losing a large number of working days, it can be seen that low back pain is not only harmful to the patient itself, but also to the society directly or indirectly caused by the economic loss is also very serious. Therefore, how to prevent and treat low back pain has become a topic of great concern. 1. anatomy, physiology and biomechanical characteristics of lumbar spine; 2. treatment of lumbar pain; 3. how to prevent lumbar pain. The anatomical, physiological and biomechanical characteristics of the lumbar spine The causes of lumbar pain are complex and numerous, mainly degenerative, inflammatory, congenital, traumatic, tumor and other disorders, among which lumbar disc herniation and non-disc nerve root compression are the most common in clinical practice among the degenerative disorders. This is closely related to the anatomical, physiological and biomechanical characteristics of the lumbar spine. The structure of each vertebra can be seen functionally as three parts, the vertebral body that bears weight, the vertebral arch that protects the spinal cord and neurovascular, and the spinous and transverse processes that take up the muscle starting and ending points. The intervertebral disc is the main structure that connects the vertebral bodies and is the main joint for the movement of the spine. The intervertebral disc consists of a centrally located nucleus pulposus and a fibrous ring. The hydrodynamics of the nucleus pulposus transmits the upper body weight evenly to the vertebral body surface and acts as a shock absorber during vertical body movements. However, when the disc degenerates or herniates, it becomes an important cause of back and leg pain. There are strong muscles and fascia in the low back, a structure that stabilizes the spine and produces motion, but is susceptible to lesions due to trauma, strain or wind and cold, and is one of the common factors that produce low back pain. Humans have been moving upright for 300 to 500 years. With continuous evolution, the human spine has developed four physiological bends: the anterior convexity of the cervical and lumbar vertebrae, and the posterior convexity of the thoracic vertebrae and sacrum. In the standing position, the line of gravity should pass through the junction of each bend, and then down through the hip joint and both lower limbs and reach the ground, the bend of the spine can assist the intervertebral discs to reduce the oscillations generated by human movement, but it reduces the support force, and at the junction of the bend is prone to injury and chronic strain injury. This is also one of the reasons why lumbar pain is likely to occur. The lumbar spine resides in the middle section of the trunk and is the hub of spinal movement. At the same time, the lumbar spine is in the lower part of the spine, the load is heavy. Because of the load and activity of the lower back, it is easy to produce degenerative changes, the nucleus pulposus, fibular ring ligament and other degeneration of the intervertebral joint is easy to narrow, loosening and instability, after aggravation, there is a narrowing of the intervertebral space, disc protrusion, at the same time, the bone and protruding ligament can make the nerve root or cauda equina nerve stimulation or compression. And produce back and leg pain. Due to the above reasons, the lumbar spine is prone to disc herniation, spinal stenosis, lumbar muscle strain and other degenerative changes, so that lumbar pain has become a common disease, multi-morbidity. Treatment of low back pain 1, non-surgical methods Most patients with low back pain, such as: early lumbar disc herniation, lumbar strain, early lumbar spinal stenosis, etc. can be cured or basically cured by non-surgical methods. 1) Drug therapy Taking drugs is one of the common methods for treating low back pain 2) Physical therapy 3) Improving and adjusting sleep status: lying on a hard bed, bending the hip and knee, lying on the back or side 4) Correcting and changing poor body position at work Regular or discretionary body position; insisting on workplace activities; wide belt protection; improving workplace conditions 5) Home traction Pelvic traction 6) Sports therapy Extremity therapy Lumbar back muscle exercise 7) Brace protection In recent years, with the rapid development of modern medical imaging, the diagnosis of spinal disorders has been greatly improved, while the in-depth study of the anatomy and biomechanics of the spine has pushed the spinal surgery has made great progress. The technology of lumbar spine surgery has gradually matured, and the effect of surgical treatment is more accurate. The indications for surgery for lumbar disc herniation are: the diagnosis of lumbar disc herniation is clear, the diagnosis is invalidated by regular non-surgical treatment for 6 months, recurrent attacks and severe symptoms; sudden lumbar disc herniation with severe radicular pain that cannot be relieved and continues to intensify; lumbar disc herniation combined with loss of nerve root function, or cauda equina nerve dysfunction, etc. all require surgery. For those who have the first attack of lumbar disc herniation, whose symptoms are mild and can be relieved by non-surgical treatment; those who have no obvious impact on their work and life and those whose imaging diagnosis of lumbar disc herniation is not clear, surgery is not recommended. Treatment of lumbar spinal stenosis is determined on a case-by-case basis and should be considered and weighed according to the severity of the pain, the attack and whether it can be relieved, age and physical condition. In most cases, the symptoms are mild and can be relieved or disappear with rest or reduced labor. If the symptoms are severe or gradually worsen, affecting normal life and work, and if non-surgical treatment does not work for a period of time (usually 3 months), surgery should be chosen. Prevention of low back pain Low back pain is a common disease, which is complex and troublesome to treat. It can be avoided if prevention is strengthened. Therefore, the publicity and education in this area should be strengthened. 1, strengthen the back and abdominal muscles exercise human bones and posture is dependent on muscle to maintain. Regularly adhere to the back and abdominal muscle exercise activities, can enhance the back and abdominal muscle strength, not only to avoid the occurrence of spinal deformities, but also to maintain the stability of the spinal joints. It is very effective in preventing back and leg pain. Common and easy to adhere to the exercise methods are: various gymnastics, ball activities, swimming, sit-ups, prone position “swallow” and so on. 2. Prevention of low back pain in life 1) The physiological convexity of the waist deepens when standing, which increases the pressure on the joints and discs of the lumbar vertebrae, and this will cause low back pain over time. If the knee joints on both sides can be kept in light flexion during standing, the degree of lumbar lordosis can be reduced and the occurrence of lumbago can be reduced. 2) Many patients often have low back pain when they get up after sitting for a long time. Because the pressure on the lumbar intervertebral disc is highest when sitting, especially when the trunk is tilted forward 20 degrees in the sitting position. Modern workers are more engaged in mental labor, working in a sitting posture, 3) Sleeping posture is most beneficial to the lumbar region when lying on the side and keeping the hip and knee joints flexed. When the lower limbs are straight, often make the waist is convex position. Easy to make the waist fatigue. 4) Wearing high heels will increase the pelvic tilt, abdominal convexity to maintain body balance, which will increase the strain on the waist. When you are young and muscular can play a part in compensating for the protective role, after middle age muscle strength will decline to increase the burden on the lumbar joints and cause back pain. People who wear high heels had better often make the exercise of holding both knees in front of the chest in the lying position. 3. Prevention of low back pain at work or in labor 1) Don’t force yourself to move heavy things to avoid lumbar sprain. When lifting heavy things from the ground, such as bending over with both knees straight, the load on the waist is the greatest and it is easy to damage the muscles, ligaments and intervertebral discs of the waist. The study found that the knee joint straight when bending and bending under the knee, the latter lumbar pressure to 40% less. Therefore, the correct posture is to bend the hip and knee. That is, squatting position to carry heavy objects. As the muscles of the thighs and calves involved in the work, the force can be dispersed to avoid injury to the lumbar region, in addition to take the heavier objects should be moved closer to the body and keep the knee joint in a lightly flexed position. This can reduce the load on the lower back and avoid the occurrence of back pain. 2) People who work in a standing position are prone to lumbar fatigue. It is best to take turns to put one foot on a small stool in front of the work, so that the hip and knee joints are lightly flexed, and the body is slightly leaning forward. This is a smaller load on the waist, which can reduce the chronic strain on the waist caused by years of work in the standing position. 3) People who work in sitting position should prevent the occurrence of lumbago. Because lying, standing, sitting three postures, sitting posture to the lumbar load is the largest. Therefore, people who work in a sitting position for a long period of time would be better off stepping on a small stool in front of them and putting the knee joint above the hip level. Doing so can reduce the strain on the lumbar region. In addition, people who work in a sitting position should get up after working for a period of time to do some lumbar activities. 4, sports in the prevention of back pain engaged in professional sports should pay more attention to the protection of the waist, so as to avoid lumbar trauma, strain injury, resulting in the impact of sports performance, or sports life of the aborted. Adequate preparation should be made before each strenuous exercise or competition, and certain items should be protected by the coach and necessary protective equipment. Sports venues and facilities should be supervised by a sports physician to prevent sports injuries from occurring. After strenuous exercise, you should not use electric fans to blow your back or use cold water to take a shower immediately. During exercise, the blood vessels in the body expand and there is a high risk of minor muscle damage and bleeding. For a moment of comfort will lead to the legacy of long-term low back pain. 5, enhance physical fitness, early treatment of various primary diseases regular life system, regular physical activity to enhance physical fitness, you can reduce or avoid the occurrence of disease. Hygiene and frequent bathing protect the cleanliness of the skin. The reduction of skin infectious diseases also eliminates the primary foci that can cause some low back pain. Low temperature and humidity is one of the main causes of chronic low back pain, especially for middle-aged and elderly women and postpartum women should pay more attention to prevention and avoidance.