Lumbar small joint disorder refers to the small misalignment of the lumbar synovial joints due to external force, which cannot be reset by itself and causes pain and dysfunction. The main manifestations are severe pain in the lumbar region, often in a forced position, restricted movement in all directions of the lumbar region, aggravated by coughing and sneezing, and some patients hear a popping sound when they are injured. Treatment methods are diverse, but the efficacy varies. In the clinical practice, Shi Lao summed up a unique set of massage techniques for the treatment of small joint disorders of the lumbar spine. This technique is characterized by the stroking and kneading method and the positioning trigger method, of which the positioning trigger method is the most critical. Master’s unique lumbar spine positioning trigger method has the characteristics of accurate positioning, fast force, flexible style and high success rate, applicable to the lumbar spine spinous process deviation, lumbar spine small joint disorder, synovial inlay, etc., Master applied this method to correct the spinous process deviation, can be said to be comfortable and, often play an immediate effect. Its specific operation method is as follows: a. Shi’s stroking smooth take kneading method Its principle of action is: dredging meridians, smooth tendons and flesh, strengthen the stability of the anatomical structures of the lumbar region, regulate the tension of deep ligaments, improve local blood circulation, promote the absorption of edema and inflammation, and restore the elasticity of muscles. The specific operation is as follows: 1. The patient is in prone position, the doctor overlaps the thumbs of both hands and strokes the bilateral lumbar muscles from outside to inside. 2, from light to heavy rubbing the tissues around the painful point, and gradually expand the application area, so as to improve local blood circulation and relieve muscle spasm. 3.Stroke from inside to outside along three lines: the arc from the posterior superior iliac spine along the upper edge of the iliac bone, the horizontal line from the secondary s point outward, and the straight line from the sacral canal fissure to the greater trochanter. Note that the strokes are along the muscles in a parallel direction, not a vertical flick. These three lines cover several diseased tissues that cause low back pain and important acupuncture points for the treatment of low back pain, which are especially important for the treatment of low back pain and are mainly on the affected side. 4. Have the patient lie on his or her side, facing the practitioner, and use the tip of the elbow to rub the sensitive points around the ring jump point in a counterclockwise direction, with emphasis on applying force in the direction of the practitioner. This can also be combined with the dynamic method of implementation. 5.Take and rub the posterior side of both lower limbs to relax the posterior muscles of the thighs and calves. 6.According to clinical dialectic, select Taixi, Gongsun, Yanglingquan, Sanyinjiao, Feet Sanli, Neiguan, Hands Sanli, Daling, Yangchi, and Shenmen points. Second, Shi’s lumbar spine toggle method Before implementing the lumbar spine toggle method proposed by Shi, it is necessary to understand the principle of its action and the concept of fixed and moving points. The fixed point usually plays the role of fixing the pelvic vertebrae or trunk, while the dynamic point is often the point of force applied by the operator to correct the skewed spinous process, which usually also refers to the above three parts. The principle of fixation at a fixed point and the use of leverage to apply explosive force at the dynamic point to rotate the vertebral body to correct the spinous process is the principle of the positioning trigger. According to whether the direct action on the vertebral body, can be divided into direct rotation of the vertebral body method and indirect rotation of the vertebral body method. Indirect rotation of the vertebral body method is applicable to the correction of L5 spinous distortion, taking the 5th lumbar spinous distortion to the right side as an example, the operation method is as follows: the patient takes the right side lying position, facing the operator, the left knee is flexed and placed naturally outside the bed, the trunk is posteriorly extended and left rotated as far as possible, the operator’s left thumb fixes the L4 spinous process as the fixed point, the right elbow acts on the patient’s left buttock as the moving point, and the pelvis is rotated forward and downward by the internal force, thus driving the 5th lumbar vertebra The cone rotates to the left. (1) The thumb fixes the spinous process of the fourth lumbar vertebra as a fixed point to fix the trunk above it; (2) the tip of the elbow acts on the hip as a moving point to rotate the pelvis; (3) the pelvis rotates to drive the fifth lumbar vertebra to rotate. Direct rotation of the vertebral body method according to the patient’s body shape and correction of the vertebral body, there are usually the following methods of operation: 1, fixed pelvic rotation method: applicable to correct the deviation of the spinous process above the fourth lumbar vertebra. Take the fourth lumbar spinous process deviation to the right side as an example, the operation method is as follows: the patient takes the left side lying position, facing the operator, the right knee is flexed and placed naturally outside the bed. The right hand takes the operator’s right arm, the operator’s left elbow acts on the patient’s right hip to fix the pelvis, the left thumb acts on the patient’s fourth lumbar spinous process laterally above, the operator’s right forearm is placed on the patient’s right upper arm, and this is used as a moving point to force forward, so that the patient’s trunk rotates to the right, and at the same time the left thumb presses downward and inward, so that the fourth lumbar vertebrae rotate to the left, the operator can also use the right hand to push forward the patient’s right shoulder, and this is used as a moving point to make the The trunk is rotated. (1) The tip of one elbow acts on the right buttock as a fixed point to fix the pelvis; (2) the thumb acts on the top of the lateral side of the deviated spinous process as a moving point to force downward; (3) the forearm is placed on the upper arm of the patient as a moving point to make the trunk above the waist rotate. 2.Fixed lumbar spine rotation method: Applicable to the correction of the 11th and 12th thoracic vertebrae and the 4th lumbar vertebrae above the deviated spinous process. When correcting a deviated spinous process, the thumb or elbow tip should be used to fix the spinous process of the next vertebra. Take the fourth lumbar spinous process deviation to the right side as an example, the operation is as follows: the patient is lying on the left side, facing the operator, the right knee is flexed and naturally placed outside the bed, the right hand takes the operator’s right arm, the operator’s left thumb acts on the patient’s fifth lumbar spinous process above the side of the pelvis, the right thumb acts on the fourth lumbar spinous process above the side, the operator’s right forearm is placed on the patient’s right upper arm, and this is the moving point to force forward, so that the patient’s trunk rotates to the right. At the same time, the thumb of the right hand is forced downward and inward so that the vertebral body of the fourth lumbar vertebra is rotated to the left. Key points of operation: (1) the thumb acts on the lateral upper part of the spinous process of the next vertebrae of the deviated spinous process as a fixed point; (2) the other thumb acts on the lateral upper part of the deviated spinous process as a moving point to push downward and inward; (3) the forearm is placed on the upper arm of the patient as a moving point to make the trunk rotate. For patients with small lumbar joint disorders with synovial impaction, the method of lumbar spine lifting in sitting position can also be used. The patient sits on the stool, hands together in front of the chest, the doctor half squatting with both knees, stands behind him, passes through his armpits, holds his hands, while holding his abdomen against the lesion at the waist, makes him fully relaxed while straightening the knee joint, lifts his waist, and generally can hear the sound of joint reset. Third, the experience of Shi’s lumbar spine trigger method Wu Qian of the Qing Dynasty believes that: manipulation is the first task of orthopedic. Medical Zong Jinjian” cloud: “because of the fall and flash, so that the bone seams open wrong, blood and Qi stagnation, for swelling, for pain, it is appropriate to use the massage method, according to its meridians, in order to pass the depressed closed gas, Mo its congestion, in order to disperse the swelling of the depression, the patient can be healed”. Through massage techniques to apply force to the local, one can rectify the bone and joint misalignment displacement, the other can activate the blood to reduce swelling, soothe tendons and relieve spasm and pain. Before performing the operation, Shi repeatedly emphasized that it is necessary to examine clearly and palpate in detail, which has an important role in the diagnosis, differential diagnosis, treatment and prognosis of the disease. To clarify the lesion site, choose the appropriate trigger method, and pay attention to two points when performing Shi’s lumbar spine trigger method: (1) To fully release the soft tissues of the lumbar region and reduce the antagonistic force due to muscle spasm. (2) The lumbar spine should be put in a “weightless” state when resetting to eliminate resistance factors, which is conducive to correcting small joint misalignments and loosening synovial inlay. To sum up, the characteristics of Shi Lao’s lumbar spine wrenching method are: accurate positioning, fast force, flexible and variable style and high success rate. At the same time, when implementing Shi’s lumbar spine positioning trigger method, we should also pay attention to the following points: (1) First of all, we should clarify the applicability of the trigger method, fully understand the condition, when the trigger is triggered, the thumb or elbow tip’s pressure point should be located on the side of the lateral upper part of the deviated spinous process, so as to give the lumbar spine joint a rotating external force to avoid contusion. For obese patients or beginners, positioning with the tip of the elbow is less forceful and the force is deeper and more penetrating. (2) When correcting the deviation of the spinous process with the trigger method, it all depends on the feeling of the thumb or the tip of the elbow that presses on the spinous process, and it is not necessary to hear a loud sound, and it is usually necessary to rub and press with the thumb or the tip of the elbow in the intervertebral space after the trigger to apply the stabilization method, and to let the patient rest in bed for 5 to 10 minutes, especially for patients with chronic lumbar pain whose muscles and ligaments are relatively lax, in order to retain the therapeutic effect. (3) When learning Shi’s trigger method, one should not simply imitate the style of the trigger method, but should understand the principle of the action of the trigger method, fully practice and master the angle and degree of force, reasonably with the help of the weight and standing position of the doctor, so as to achieve accurate positioning. (4) Shi Lao in the clinical application of the trigger method when the action is light, often in the patient inadvertently administered, the patient’s mental tension, lumbar muscle tension, lumbar spine curvature is too large, as well as after the trigger does not pay attention to rest and other factors are affecting the effectiveness of the trigger method. The treatment of lumbar spine disorders such as lumbar spine small joint disorder by Shi’s lumbar spine positioning trigger method is the summary of Shi’s 40 years of clinical experience. After a large number of clinical cases to verify its therapeutic effect is particularly outstanding. During the study period, we witnessed many cases of patients who were suffering from lumbar pains and diseases and were cured by the hands of Elder. We also realized that it would take a long and arduous process to dig and organize the experience of the old generation. Admittedly, as a conservative therapy, Shi’s lumbar positioning trigger method cannot solve all problems of all patients. How to define and quantify its indications is the next step we need to think about and solve. Finally, I would like to borrow a phrase from Qu Yuan’s work “Li Sao”: “The road is long, and I will go up and down to find a way”, to encourage colleagues.