Many patients are aware of the disease “lumbar disc herniation”, which causes low back pain with lower limb pain, pain in the lower leg and even in the back of the foot. However, a large number of patients say, “I went for a CT or MRI, and the doctor said that my herniation is not very big and the nerve roots are not significantly compressed, but I have back pain and leg pain. If the nerve roots are not overwhelming the back and legs, how can they hurt? This is often called “discogenic low back pain”, the cause of which is still the disc, but the nerve that is compressed or stimulated is different, which was rarely understood in the past. What is the sinus nerve? The sinus vertebral nerve is a branch of the sympathetic nerve that enters the spinal canal through the intervertebral foramen. Within the spinal canal, the sinus vertebral nerve splits into larger ascending and smaller descending branches, with each adjacent ascending and descending branch anastomosing with each other to form the anterior and posterior spinal plexus, which spreads throughout the length of the spinal membrane and extends into the skull. The sinus vertebral nerve is distributed to the spinal membrane, the spinal canal, the ligaments of the vertebrae and the blood vessels of the spinal cord, and also from the spinal canal to the joint capsule of the intervertebral joints. It has several branches in the human intervertebral foramen, one is the main sinus nerve, consisting of spinal nerve roots and sympathetic nerve roots, which mainly innervates the anterior dural space and surrounding tissues, and 3-6 thinner parasympathetic sinus vertebral nerves mainly innervate the epidural space and surrounding tissues, including the intervertebral disc fibrocartilage ring, articular eminence, ligamentum flavum, lateral saphenous fossa, etc. It usually travels with blood vessels and is distributed in the spinal canal The tissues of the inner wall, which are unmyelinated or thin myelinated fibers less than 5 mm in diameter, are the conduction system that causes neck, shoulder and back pain in the presence of sterile inflammation, chemical or mechanical damage in the spinal canal. What is the relationship between the sinus vertebral nerve and the lumbar intervertebral disc? The lumbar intervertebral disc has a rich distribution of nerves in the outer third of the annulus fibrosus and the end plate, whereas the inner third of the annulus fibrosus and the nucleus pulposus normally lack nerve distribution. The anterior side of the disc and the posterior lateral side of the disc have different sources of nerve distribution. The anterior side mainly comes from the sympathetic nerve and its traffic branch, and the fibers of the plexus surrounding the arterial vessels in the phase, while the posterior lateral side is mainly distributed by the sinus vertebral nerve, and this kind of discogenic low back pain is closely related to the stimulation of the sinus vertebral nerve. Clinical manifestations (a) Clinical features 1. The patient cannot sit for a long time, standing up from the seat will cause pain. The pain can be radiated, but the radiated pain rarely continues below the knee, and generally radiates mainly to the hip and above the knee; 3. (2) Clinical characteristics 1. The patient cannot sit for a long time, and standing up from the seat will cause pain. The pain can be radiated, but the radiated pain rarely continues below the knee, and generally radiates mainly to the hip and above the knee; 3. (3) Clinical characteristics 1. The patient cannot sit for a long time and has to stand or walk for about 20 minutes. X-rays and CT films can only reveal degenerative change features and cannot see the rupture of the annulus fibrosus or intra-disc rupture. Treatment is mainly for the disc, one is direct treatment, one is indirect treatment. Direct treatment is currently common: 1) radiofrequency or plasma ablation of the intervertebral disc; 2) disc removal. Indirect treatment currently common are 1, small needle knife or plasma needle knife; 2, acupuncture or tui na.