Resting pain versus motor pain, cervical spine activity, effect of increased abdominal pressure on pain, changes in pain during the day, whether it radiates to the lower extremities of the chest and abdomen, nature of pain, evolutionary features of the disease course, extremes in the spinal canal. 1. Resting pain and motion pain Extravertebral soft tissue damage: pathological changes due to muscle contracture, muscle contracture degenerative adhesions. Soft tissue spasm, exacerbation of aseptic inflammation of soft tissue at the lesion. Exacerbated by active standing in those with altered spinal mechanics. Pain can be gradually relieved with appropriate activity or walking for soft tissue inflammation alone. Inflammatory reactions in the intradural epidural sac and nerve root extrasphincter fatty connective tissue can only be controlled or subside with a braked recumbent position (no longitudinal pressure on the spine). In the case of cervical lesions, upper extremity flexion in the supinated position can lead to symptomatic relief. Activity in the weight-bearing state of the lumbar spine exacerbates aseptic inflammation of the soft tissues outside the nerve sheath, and herniated lumbar discs or thickened ligamentum flavum are irritants of the dural sac and nerve roots. The pain is exacerbated by exercise, or sudden onset of pain after exercise, while this pathological irritation can be relieved during resting. 2, the effect of increased abdominal pressure on pain Thoracolumbar segment intravertebral lesions due to increased cerebrospinal fluid pressure and direct pressure on the nerve roots or dura, when the nerve is in an irritated state, naturally the pain will be aggravated by forceful defecation, coughing, sneezing, etc. In patients with lower back lesions, wearing a lumbar brace to reduce the axial pressure on the lumbar spine will offset some of the increased abdominal pressure, thus relieving the resulting pain. Pain due to soft tissue damage outside the spinal canal is less likely to be affected by changes in abdominal pressure. 3, a day of pain changes in extradural lesions characteristics: soft tissue damage: morning or fixed position pain is obvious, some patients in the lumbar segment even woke up in the early morning because of pain and can not lie down, must get up and move to relieve pain, daytime general work and activities without hindrance. Involvement: often accompanied by evening pain and resting pain, most of which cannot be relieved after activity. Depending on the stage of the primary disease and the range of organs involved, it is important to pay attention to other concomitant symptoms in addition to low back pain. Intervertebral lesion characteristics: intervertebral disc lesion: patients in the morning is the best time of the day to feel the back and legs, no pain or mild pain, such as walking in bed, the most obvious pain in the afternoon or evening, sitting position also makes the pain more quickly. In the case of intervertebral infection, the corresponding interspinous percussion pain is clear. Spinal canal occupations: often persistent, may be intermittently aggravated, progressive development, mostly accompanied by segmental spinal nerve area movement and sensory changes. Vertebral canal or vertebral body lesions: metastatic cancer is more common, with resting pain, but aggravated by activity. When vertebral compression changes in osteoporosis do not involve neuroanatomical channels, the thoracolumbar dorsal localization is predominant, aggravated by activities and improved by rest. 4, the nature of pain Intraspinal lesions: the nature of sharp pain, electrical irritation The location is clear, the thoracic segment is mostly accompanied by pain in the chest and abdomen, and the lumbar segment can radiate to the lower leg. Extravertebral lesion: deep dull pain, the location is not clear, and the pain is not over the knee. 5, the evolution of the disease process characteristics of extradural tissue damage: pain can be sudden onset, but generally in a short period of time can be relieved, and the interval (relief symptoms) is long, self-limiting obvious, do not need special treatment.