Epiglottic neuritis mainly presents with low back, hip and leg pain, sometimes with limited straight leg raising, and has similarities to lumbar disc herniation. However, epiglottic neuritis can produce localized diffuse pain, which is stabbing and tearing, radiating to the buttocks and posterior lateral thighs, usually without crossing the knee. Patients often complain of deeper areas of pain, with vague areas and no clear demarcation. The most obvious site of pain on examination is often at the point where the lateral border of the erector spinae muscle intersects with the iliac crest, where a “cord-like” hardness can be palpated and pressure pain is evident. The superior gluteal cutaneous nerve originates from the lateral branch of the posterior branch of the 1st-3rd lumbar spinal nerve, crosses the iliac crest inferiorly into the gluteal region, passes through the fibrous canal formed by the lumbar dorsal fascia at the attachment of the upper edge of the iliac crest, and penetrates into the subcutaneous region at the junction of the lateral edge of the sacrospinal muscle and the iliac crest, distributing in the gluteal region and the posterior lateral skin. Most of this nerve is in soft tissue, and with the lumbar nerve penetrating the intervertebral foramen it is divided into four segments and six fixation points, namely the superficial, intramuscular, subfascial and subcutaneous segments. The six points are the exit point, the transverse process point, the entry point, the exit point, the fascial point and the entry point of the gluteus. The anatomical features of the gluteal epiphysis, such as multiple sharp turns in the anatomical path, passing through fascial fissures and fibro-osseous ducts, and the proximity of fat, are very likely to cause pain due to nerve entrapment. Discussion Modern medical research believes that lumbar disc herniation and degeneration is the pathological basis for the occurrence of lumbar pain, so in clinical treatment, more attention is paid to the lesions of the lumbar disc itself, and the existence of other disorders is ignored due to preconceptions. Moreover, due to the limitations of physician’s skill level and the development of specialty business, misdiagnosis and mistreatment may occur. Physicians should improve theoretical knowledge and accumulate clinical experience, and the diagnosis of lumbar disc herniation should be based on the patient’s complaints and positive clinical physical examination signs, such as weakened tendon reflexes due to compression of the spinal dural sac and spinal nerve roots, muscle atrophy, positive neck flexion test, abdominal erection test, straight leg raising and strengthening test, and obvious pressure pain points in the intervertebral space during the compression phase, etc., and then further combined with the comprehensive imaging examination. The correct diagnosis can be made after further analysis in combination with imaging examinations in order to reduce the rate of misdiagnosis and mistreatment of lumbar disc herniation to a certain extent. The correct diagnosis provides a scientific basis for the next step of treatment, so that corresponding treatment measures can be taken to bring about rapid relief of symptoms and improve clinical efficacy. The focus of treatment for the third lumbar transverse herniation syndrome is localized, and acupoint injection, acupuncture and acupressure can be used to improve local microcirculation, accelerate the absorption of metabolic substances, release muscle spasm and increase the pain threshold. The use of small needle knife to peel and release the tip of the third lumbar transverse process can eliminate symptoms and restore dynamic balance to achieve better clinical results. For the treatment of pear-shaped muscle syndrome, local closure and massage techniques are used to loosen adhesions and relieve pain. Experienced ones can enter the needle at the site where the pressure and pain points are obvious to improve the clinical efficacy. At the same time, bed rest or control of gait speed can achieve satisfactory results. Superior gluteal neuritis can also be treated with acupuncture injections,, acupuncture, tui-na manipulation and small needle knife to achieve better results. Clinically, truncal lumbar syndrome, pear-shaped muscle syndrome and gluteal epicutaneous neuritis can arise alone or in conjunction with lumbar disc herniation. It is very easy to be confused with multiple diseases of lumbar disc herniation, which leads to insignificant clinical efficacy. Therefore, we clinicians should be alert to patients with complex conditions, recurrent attacks and poor treatment, and do relevant examinations at an early stage in order to make a clear diagnosis and take correct and reasonable treatment.