Back cramps like a fork in the road may be caused by physiological factors such as overstrain and cold irritation, or by pathologic causes such as lumbar triple transverse syndrome and pleural disease. 1. Physiological factors: most of the back cramps are symptoms caused by tension and spasm of the myofascia. Long-term stooping or prolonged standing and sitting may cause fatigue of the myofascia of the back, resulting in the accumulation of lactic acid and other metabolic products and the above symptoms; cold and humid environment may cause local vasoconstriction of the back, which may also lead to the above symptoms. 2. Pathological causes: the transverse process of the third lumbar vertebra is the longest one in the lumbar vertebra, and the lateral edge of the transverse process is prone to external injuries, causing pain and spasm in the lumbar back, which is clinically known as lumbar transverse process syndrome, and acute injuries may also result in limited lumbar activities and pain in the lower limbs. Pleural diseases can cause the pleura to be pulled during respiratory movements, and the above symptoms may also occur, such as pleurisy and pleural tuberculosis. There may be other causes of back cramps like a fork in the road, so it is recommended to go to the hospital in time, improve the examination to clarify the cause of the disease, and then give targeted treatment or therapy under the guidance of the doctor.