Acute lumbar sprain is an acute trauma to the muscles, ligaments, fascia and posterior joints of the lumbar region caused by excessive lifting, poor posture, excessive or improper movement, including various soft tissue tears, bleeding, muscle spasm and synovial impaction of the synovial joints. I. Diagnosis basis: 1. It is usually seen in young and strong manual laborers, sportsmen, sedentary and long-distance transportation or taxi drivers with prolonged lumbar shock and middle-aged women, posterior joints and lumbosacral angle abnormalities. It is often attacked by sudden position change, bending and weight-bearing, and can be combined with lumbar joint capsule tear, or even joint synapse and spinous process fracture. 2, lumbar pain (or with interlocking sensation), lumbar tilted forward and forced position, limited activities, walking difficulties; in more serious cases, the lumbar stiffness and severe pain, and lumbar pain is unbearable for slight activities and even for talking and breathing. When injured, there may be a ringing or tearing sensation in the lumbar region, and severe pain in the lumbar region immediately after the injury. 3. Palpation of lumbar stiffness and muscle spasm, and changes in the physiological curvature of the spine. There is pressure pain in the paraspinous, interspinous, lumbosacral joints, erector spinae or transverse process; there are usually no signs of nerve root irritation such as pain or numbness in the lower extremities; positive flexion and flexion test suggests interspinous ligament or lumbosacral and iliolumbar ligament injury. 4, should be photographed lumbar spine frontal and lateral x-ray, to exclude bony changes, and further analysis of lumbar degeneration, to provide a basis for the selection of massage techniques, some patients can add double oblique x-ray. Classification of symptoms: 1. Qi stagnation and blood stasis: severe pain in the lumbar region after flashing and strong weight-bearing, spasm of the lumbar muscles, inability to straighten the lumbar region, difficulty in pitching, flexing and extending laterally. The tongue is dark red or with stasis, the tongue coating is thin, and the pulse is tight. 2. Vertebral misalignment: after sudden position change, lumbar pain with interlocking or dislocation sensation, straightening of the waist and difficulty in moving. The tongue is light red with thin coating, and the pulse is tight. Treatment plan: 1. Qi stagnation and blood stasis evidence: activating blood circulation, removing blood stasis, moving Qi and relieving pain. Local refusal to press should first take the distal acupuncture points, to be turned into time, and then use the local treatment techniques, local techniques should be used to press and rub method, etc.; local relaxation, available back method, or lumbar rotation trigger method. 2, vertebral misalignment evidence: dredge the meridians and channels, adjust the pain. The lumbar area is applied with the method of pressing and kneading, rolling method. Local application of pressing and rubbing method, flicking method, rubbing method. After local relaxation, use lumbar lateral oblique trigger method or seated rotating trigger method to adjust the joint protrusion joint misalignment. 3, other therapies a, acupuncture: local acupuncture points and distal acupuncture points combined. b, hot compress: available Chinese medicine hot compress formula wet hot compress, to match the method of treatment. c, compress: applicable to patients with qi stagnation and blood stasis evidence, external use of blood-activating and pain-relieving ointment compress. d, fire cupping: applicable to patients with Qi stagnation and blood stasis evidence. e. Traction: pelvic traction has obvious effect on some patients with vertebral misalignment evidence. f. Closure: local pressure pain point closure. g, drugs: available compound salvia to improve microcirculation, mannitol or sodium heptaerythroside dehydration. h. Rest on a hard bed, reduce lumbar movement, increase lumbar activity or use a lumbar girth. IV. Complication management If skin breakage occurs at the treatment site, manual therapy and hot compress should be stopped immediately and anti-infection measures should be taken. Precautions: 1. Excluding bony injuries and serious ligament tears, patients with acute lumbar sprains of all types can be treated with massage. 2. Lie on a hard bed and brake the lumbar region for 3-5 days. 3.After the symptoms are relieved, gradually strengthen the lumbar muscle exercise. 6.Efficacy assessment 1.Cure: lumbar pain disappears, spinal activity is normal. 2.Improved: the lumbar pain is reduced, and the spinal activity is basically normal. 3.Not healed: no improvement of symptoms.