Pain is an unpleasant somatic sensation and emotional experience that accompanies tissue damage in our body. Among many diseases, pain is often the main symptom, such as: cervical spondylosis, lumbar disc herniation, osteoarthrosis, headache, neuralgia, cancer pain, etc., which is also clinically known as painful diseases, the incidence of such diseases is high, but many patients are not effectively diagnosed and treated. -In 2007, the Ministry of Health of the People’s Republic of China added “pain medicine” to the list of medical institutions, which mainly focuses on the diagnosis and minimally invasive treatment of chronic pain. Since 2004, the International Pain Society has designated the third week of October as “World Analgesia Day”, with a different theme each year, and China has designated the third week of October as “China Analgesia Week”, with activities held at the same time. In recent years, in order to raise the attention to various pain diseases and strengthen the research and propaganda of various pain diseases, October to October of each year is set as the “World Anti-Pain Year”. The theme of this year’s World Analgesia Day is “Care for Joint Pain”. Lumbar small joint-derived low back pain is a degenerative disease of the elderly, which can be accompanied by vertebral slippage, intervertebral disc degeneration, and increased pain if the patient moves the lower back, even radiating to the hip thigh and sacrococcygeal region. It does not usually involve the lower leg, especially when turning or changing position. At present, most of the conservative treatments for lumbar joint-derived lumbar pain are drugs and bed rest, but the efficacy of drugs is poor and the side effects of long-term use lead to poor patient compliance. The quality of life of elderly patients is seriously affected. As a senior cadre medical institution, the aging problem is more prominent in East China Hospital. As the “top priority” discipline of East China Hospital, the hospital has been focusing on chronic spinal pain in elderly patients as one of the key areas of concern. Lumbar small joint-derived lower back pain is a common cause of chronic lower back pain, mostly due to the uncoordinated movement of the lumbar region, which causes subtle changes in the anatomical position of the lumbar small joints. The small joints of the lumbar spine are constantly subjected to shear, pressure and torsional forces during daily activities. When the spine is fully flexed, the cartilage of the small joints is subjected to the greatest shear forces; when the spine is extended, the cartilage of the small joints of the lumbar spine is subjected to the greatest pressure. Repeated hyperflexion, extension or torsion can eventually lead to small joint pathology. With narrowing of the spinal space, more than 70% of the pressure acting on the disc is transferred to the small joints. Mild congenital microarticular deformity, asymmetry, or vertebral slippage can be the basis for lumbar microarticular pathology. Although the traditional conservative treatment can achieve certain efficacy in the short term, specific methods include massage, acupuncture, physical therapy, local closure, etc.. However, the long-term effect is poor. Therefore, how to choose an accurate, safe and long-term effective treatment method has become one of the key issues in the treatment of such diseases in China and abroad. In order to improve the accuracy of puncture, X-ray fluoroscopy and CT are often applied clinically as the guidance tools, but there are disadvantages such as single overlapping image and radiation radiation using X-ray guidance, especially in the case of many treatment segments and the need for repeated puncture positioning; CT guidance, although good in accuracy, has disadvantages such as inability to guide in real time, high radiation and expensive. As a new imaging intervention, ultrasound guidance has been gradually applied to pain management and the treatment of pain caused by spinal joint diseases. With the improvement of the resolution of ultrasound instruments and the improvement of physicians’ skills, ultrasound has been applied to detect the accessory structures of the spinal bones such as the spinous process, spinous process gap, and transverse process, and has played a guiding role in some spine-related obstructions. In recent years, domestic and international studies have reported that ultrasound can clearly detect the small joint structures of the cervical and lumbar spine, thus providing an objective basis for ultrasound-guided treatment of lumbar small joint syndrome. A 79-year-old mother-in-law, Chen, had perennial back pain due to severe osteoporosis and was unable to turn over. She had difficulty moving around and was bedridden for a long time, and repeated conservative treatments failed to achieve better results. The diagnosis and extent of the lesion were further clarified by an ultrasound-guided diagnostic block of the medial branch of the lumbar spine, followed by minimally invasive ablation of the dorsal medial branch of the lumbar spinal nerve. Only a few small wounds were left after the surgery. After the surgery, the patient was able to turn over and go to the toilet from the bed on her own and walk on the floor. Chen said that she had not slept well for several years because of her back pain, but the symptoms disappeared that night and she finally slept well. Chen was very satisfied with the results of the surgery.