Although this diagnostic term, lumbar strain, is very old and has been used clinically for a long time, the treatment is slowly developing and disorganized. Why is it so easy to misdiagnose and underdiagnose? Why is it easy to have recurrent attacks even though it has been diagnosed as lumbar strain and given medicine? It cannot be cured. The main reason is that we do not fully understand the pathogenesis of lumbar muscle strain. The third lumbar vertebra in the human body is at the place where the posterior convexity of the thorax and the anterior convexity of the waist turn, and the stress on the turning place is relatively large. Maximum. If you sit for a long time and force the position for a long time, so that these muscles are contracted for a long time without being stretched and rested, it will become strained, congested, aseptic inflammation and even later fibrosis and adhesions will occur, which will cause lumbar pain, and can stimulate the 2 small nerve branches from the posterior branch of the crestal nerve of lumbar 1, 2 and 3 called the posterior branch of the crestal nerve and the sinus vertebral nerve, which innervate They innervate the fibrous rings of the lumbar discs 1 to 3, the small joints of the lumbar spine and part of the paravertebral muscles. Patients can have symptoms like disc pain or pain radiating to the lower abdomen (if on the right side, the right lower abdomen pain can be misdiagnosed as chronic appendicitis by the general surgeon). Therefore, another pressure point for lumbar strain can be found in the outer upper 1/4 of the buttock (equivalent to the location of the gluteal muscle injection). When the lumbar muscle strain is stimulated, this muscle will become contracted and weak, and the hip joint will have the feeling of “stepping on air”. Many orthopedic surgeons often misdiagnose it as a hip joint lesion, and the hip X-ray results are negative. Some of the so-called specialist doctors who promote the treatment of osteonecrosis of the femoral head use this to diagnose osteonecrosis of the femoral head to promote such drugs, but the result is that the examination to the Union Medical College is simply normal, the pain of patients with lumbar strain can also be radiated down the broad fascia of the thigh, but only to the knee joint, a few patients have fatigue and soreness in the stomach area of the calf. Some old ladies put musk paste from the outer thigh of the crotch to the knee joint and asked the doctor to prescribe more, saying that she didn’t have enough, I laughed and said to the old lady, “You’re taking my musk paste for pants! You are not in the right place, you are the switchboard is broken, but repair the telephone line, where is the switchboard? In the waist three horizontal convexity (waist eye place) and the outer hip, this is the main, paste the right these two parts can be”. The closed hollow nerve, which dominates the medial thigh adductor muscle, also originates from the lumbar 1, 2 and 3 nerves, which is of the same origin as the sinus vertebral nerve and the primary posterior branch of the crestal nerve. When stimulated, it can also cause the phenomenon of irritation of the closed hollow nerve through a generalized response, appearing in its innervated muscle – the pain of the adductor muscle originating from the root of the thigh, so the groin appears painful, with localized pain and pressure points, and limited stretches of the diagonal leg. The urologist examining the patient is touching the patient with pain in the groin, which is easily diagnosed as epididymitis, spermatorrhea, etc. Female patients are misdiagnosed with adnexitis during gynecological examinations. Look, a small lumbar strain can have such a wide range of effects that it can “fool” orthopedic surgeons, general surgeons, urologists, obstetricians and gynecologists …… If you understand the pathogenesis of the problem, combined with the clinical The age and occupation of the patient is also a regular factor. If a young white-collar worker, a driver, an accountant, etc., who sits as an occupational group, has recurrent pain radiating only in the buttocks or outer thighs, and there are no major problems with examination and photography, then this disease should be suspected, and then combined with the above-mentioned inherent pressure points, then the diagnosis can be made. This makes it easy to differentiate.