It is not uncommon for lumbar truncal syndrome to be misdiagnosed as lumbar disc herniation in clinical practice. The symptoms of lumbar truncal syndrome are similar to those of lumbar herniation in terms of lumbar and leg pain and limitation of movement. However, in the case of lumbar triple transverse process syndrome, there are obvious pressure points in the transverse processes of the 3rd lumbar vertebra bilaterally, and the pain is reflected downward along the thighs to above the knee level, and the lumbar pain increases when bending and rotating. In addition, there may be fixed pressure pain at the top of the third lumbar transverse process and movable nodules and cords may be palpated, or there may be a peeling sensation after myofibrillar calcification, and the hip flexion test in lateral position is positive, while the straight leg raising and strengthening test is negative. Lumbar spine x-ray may show hypertrophy of the transverse process of the third lumbar vertebra. It is usually more frequent in people with long and lean body types. The onset of the third lumbar transverse process syndrome is closely related to its anatomical features. The third lumbar vertebra is located at the apex of the physiological lumbar convexity, which is the center of lumbar activity, so both sides of the transverse processes are subjected to the greatest tension stress, therefore, during growth and development, its development is the longest, there are transverse ligaments between the transverse processes, and the end of the transverse processes are attached to the transverse abdominal machine, lumbodorsal fascia, lumbaris major and lumbar square muscles, etc. When the lumbar and abdominal muscles contract strongly, the ligaments, muscles, fascia and peritoneal attachments at the end of the transverse processes are subjected to high tension and leverage forces Therefore, the end tissue has the most chance of injury. In addition, the lumbar spinal nerve is divided into two branches out of the intervertebral foramen, the anterior branch is thicker and constitutes the lumbosacral plexus, while the posterior branch is thinner and divided into medial and lateral branches, the medial branch is distributed in the muscle and the lateral branch is the nerve. This anatomical feature causes the end to be vulnerable to injury, and when the lumbar force is uneven, it causes acute injury or repeated minor injury to the tissues around the transverse process of the third lumbar vertebra, resulting in tearing, bleeding, hematoma and adhesions and scarring at the attachment of the transverse process, fascia and ligaments, leading to muscle tension and muscle spasm. Long-term repeated injuries lead to fibrosis around the tip of the L3 transverse process, forming a series of changes such as scar adhesions, fascial thickening and myotendinous membrane contractures.