Myofasciitis of the back is a non-specific inflammatory lesion of the tissues, fascia, myofascia, tendons, and ligaments of the human shoulder and back caused by trauma, strain, or external wind and cold. Clinical symptoms include back pain, swelling, pressure pain, muscle stiffness, heaviness, and lack of flexibility in movement. This disease belongs to the category of “paralysis” in Chinese medicine, and it is believed that the combination of wind, cold, dampness and heat is the cause of paralysis. The most common cause is the humid and cold climate, which can make the muscles of the low back vasoconstricted, ischemic, edematous causing local fibroplasma exudation and eventually forming fibrous tissue inflammation, chronic strain is another important pathogenic factor, the low back muscles and fascia damaged by fibrotic changes, so that the soft tissue is in a state of high tension. The more mature doctrine of myofasciitis is the doctrine of “soft tissue aseptic inflammation causing pain”. The dual role of the knife and needle is integrated in the small needle knife, which can loosen the local adhesions and muscles, release the neurovascular compression, improve local blood circulation, reduce the concentration of pain-causing substances, eliminate local aseptic inflammation, and provide rapid pain relief. The pain is relieved rapidly. Small needle knife therapy has the effect of peeling off adhesions, unblocking tissues, flowing qi and blood, scraping away scars, loosening muscles, relieving spasm and analgesia, thus rapidly restoring the dynamic balance of the motor system and organs and tissues, which is in line with the theory of Chinese medicine that “if it does not pass, it hurts, and if it passes, it does not hurt”. When using small needle knife to treat this disease, selecting the right indications and finding the right pain point is the key to improve the efficacy.