The difference between lumbar disc herniation and pear-shaped muscle syndrome is mainly in the following aspects: First, the clinical manifestations are different. Lumbar disc herniation is mainly lumbar pain, restricted activity, and radioactive pain in the buttocks and lower extremities. In contrast, pear-shaped muscle syndrome is caused by the irritation of nerves in the hip muscles, resulting in radioactive pain in the hip and lower limbs, usually without lumbar symptoms. Physical examination will reveal atrophy of the hip muscles and deep pressure pain in the hip, and the nerve localization signs are mostly less clear. The symptoms can be induced when the hip joint is resisted in abduction and external rotation position. Second, the imaging difference, lumbar disc herniation mainly in the lumbar spine CT or MRI shows disc herniation and nerve compression. In contrast, pear-shaped muscle syndrome usually shows sciatic nerve conduction dysfunction in the electromyogram of the lower extremities, while there are no specific changes on the lumbar spine examination.