Low back pain is one of the common ailments that confuse humans, with more than 80% of adults experiencing it. After the flu, low back pain is the second most common reason for patients to seek medical care. In the U.S., the annual socioeconomic cost exceeds $100 billion. It is extremely difficult to identify the cause of low back pain, and treatment is a clinical challenge, especially for chronic low back pain. However, low back pain has a certain natural history and prognosis. Patients with low back pain typically go through an acute, subacute to chronic phase, and most recover quickly without functional impairment. Nearly 60% of patients recover within 6 weeks and 80% improve within 12 weeks. If the low back pain persists after 12 weeks, recovery will be slow and difficult, and will be even slower for combined sciatica. In this case, the cause needs to be clarified and appropriate medical interventions taken. The lumbar spine is a coupling of five lumbar vertebrae that move in a coordinated manner through three joint structures. It supports the body while performing complex activities in three dimensions. The lumbar spine is similar to, but far more complex than, the knee joint. While the knee joint is prone to pain, the lumbar spine is more likely to experience pain. Aging of the lumbar spine is a natural process, but low back pain is often present. Lumbar spine degeneration (aging) is an important cause of chronic low back pain and is usually divided into periods of segmental dysfunction, instability, and stability. Different pathological changes and certain clinical signs and symptoms often occur in different periods. For example, in the segmental incompetence phase, there are pathological changes such as tearing of the annulus fibrosus of the intervertebral disc, synovitis of the small joints and reduced mobility of the small joints, and the corresponding clinical manifestations are axial pain in the low back and easy sprain and strain of the low back. The pathological changes and clinical symptoms are more complicated in the segmental instability and stability phases. The aging of the lumbar spine is a dynamic process, so lumbar pain requires a dynamic understanding of its occurrence and regression pattern in order to develop a reasonable treatment plan. It cannot be solved by a “one-size-fits-all” drug or treatment, but requires targeted intervention and targeted treatment for its etiological pathological changes.