Lumbar muscle strain is generally thought of as pain in the lower back caused by overworking the psoas muscles, and imaging often reveals no abnormalities. True lumbar muscle strain mostly recovers within 1 week, and a few can drag on for up to 3 months; those that last longer than 3 months are called chronic lumbar muscle strain. Most of the untreated lumbar muscle strain is misdiagnosed, and the real lesions are often the following: 1, discogenic low back pain, i.e., low back pain caused by disc degeneration. The performance of the lower lumbar pain in the middle, localization ambiguous, sedentary aggravation, bed reduction. Magnetic resonance examination can confirm the diagnosis. Treatment methods include ozone ablation, radiofrequency ablation, discoscopic decompression, artificial disc replacement and so on. Posterior Crestal Nerve Syndrome The posterior branch of the crural nerve is compressed by fibrous and tendinous tissues. It is aggravated when the lumbar region moves in a certain direction, and there are pressure points next to the vertebrae. The lumbar pain may disperse to the lower limbs, but does not exceed the knee joint. Lumbar isthmus fracture: It is caused by lumbar isthmus discontinuity, and the affected vertebral synchondrosis is painful. x-ray double oblique position film can find “dog neck fracture sign” and confirm the diagnosis. The main treatment method is posterior fusion internal fixation surgery. 4.Osteoporosis Lower back pain, aggravated by activities, lumbar spine extensive pressure pain, doctor’s physical examination and bone densitometer examination can confirm the diagnosis. Three types of basic drugs are most commonly used: (1) osteoclast inhibitors such as diphosphonates, Fosamax tablets, and Kupang tablets; (2) calcium preparations such as calcium gluconate; and (3) vitamin D, such as Alfadisan, etc. There are also estrogens, hypoglycemic agents, and other medications. In addition, there are estrogen, calcitonin, strontium ranelate, bone peptide, bone melon extracts and Chinese medicinal preparations, etc., all of which have their own indications and should be used reasonably under the guidance of doctors. Elderly patients with compression fracture can be treated with percutaneous posterior synostosis molding or vertebral body molding, which is less traumatic and has precise effect. 5, visceral origin of low back pain nephritis, hydronephrosis, pelvic inflammatory disease, adnexitis and other visceral pathology can cause lumbar referred pain, mostly with little relationship with the position, mostly accompanied by related organ abnormalities, visceral ultrasonography, MR, CT examination can confirm the diagnosis. 6.Ankylosing cristitis and other autoimmune diseases are mostly night pain and morning pain. Blood test erythrocyte sedimentation rate, HlAB27 antibody, ultrasensitive C-reactive protein and other indicators are often elevated. At present, it is mainly treated by immunosuppressive drugs. 7, Crestal tumor Malignant tumor mostly has gradual aggravation, weight loss and other consumptive manifestations. Nocturnal pain is obvious. Benign tumors mostly present chronic process, both may be accompanied by lower limb pain and weakness. MR, CT, PET can be found. In addition to chemoradiotherapy, interventional therapy is gradually increasing. 8.Crest infection General bacterial infection is often accompanied by fever and chills, fierce; tuberculosis, Borrelia burgdorferi and other specific infections are often chronic process. Laboratory tests, MR, CT, biopsy and culture of the lesion can confirm the diagnosis. Surgery to remove the lesion and antibiotics are often required.