As we all know, low back and leg pain disease is a multi-morbidity and common disease. With modern transportation and communication tools and the continuous improvement of living standards, coupled with the fact that people in China have been studying for too long since childhood, working long hours at their desks, surfing the Internet, playing cards, going out in cars, going home in elevators, etc., there is little time and opportunity to walk or exercise. More serious is the school in order to test education, the focus on grasping the academic results, on the one hand, there is due to the school site is small and for safety reasons fear of responsibility, physical education classes are virtual null and void. On the other hand, it has led to a large number of adolescents obesity, myopia, scoliosis, etc. Due to excessive ischemia and hypoxia of the sedentary lumbar back muscles, tendon ligament elasticity is reduced, premature strain injury, as well as cervical and lumbar disc expansion and spinal deformation, seriously affecting the physical and mental health of adolescents and normal growth and development. Now the author on my 20 years of clinical practice experience, only on the part of the back and leg pain to do a analysis and summary. I. (typology) according to the etiology of Chinese medicine and the preliminary diagnosis: 1, trauma qi stagnation blood stasis meridian inaccessibility type: (1) there is a clear history of trauma, or because of the hours of play, sports, fall, fall history; weather changes, posture position, activity after exertion aggravated, after rest alleviated, rest pain or activity pain, repeated episodes, sometimes good and sometimes bad. (2) On examination, there are obvious pressure points, percussion pain, and with the special examination method of bone and joint, positive signs are found, and tendon knots or abnormal parts of bone and joint can be clearly felt on palpation of soft tissues. (3) The pulse is smooth and strong, the moss is absent or light yellow, the tongue is blue and the tendons on the tongue are dilated. 2, kidney deficiency type (divided into: kidney Yang deficiency, kidney Yin deficiency): (1) old age, physical weakness, or overwork, kidney essence deficiency, or congenital kidney essence deficiency, acquired spleen, stomach failure to timely replenishment of water and grain essence; slow onset, vague pain, waist and knee soreness, cold extremities, warmth, cold hands and feet, lower extremities perineal swelling, urine clear and long, symptoms see fatigue, face bam white, light tongue, sunken pulse for Yang deficiency. Those who are accompanied by false annoyance and night sweating, five heart trouble, flushed face, red and red tongue, and fine pulse are kidney yin deficiency. (2) On physical examination, there is no obvious percussion pain in the lumbar region, the pain is lamellar, and there is no restricted pressure point. 3. Wind-cold-damp type: (1) Long-term residence in a cold and humid place, or trekking through the mountains and rain, after exertion and sweating, feeling wind-cold-damp evil, resulting in poor circulation of the meridians, blocking the flow of qi and blood and developing lumbago; the symptoms are cold pain in the lumbar region, unfavorable turning, or detained and unable to stoop, or pain even in the waist, spine, hip and leg. The pain does not decrease even when lying in bed, and the onset is aggravated by cold weather and rainy seasonal changes. (2) Examination of lumbar dull pain, pain is widespread and indefinite, sometimes wandering, with difficulty in movement, unfavorable flexion and extension, fatigue and fatigue, white complexion, white and greasy tongue coating, and sunken and moist pulse. Second, according to the etiology and pathology of modern medicine: 1, acute and chronic soft tissue injury due to various causes of trauma: (1) supraspinous ligament injury. (2) Interspinous ligament injury. (3) supraspinous ligament stripping. (4) Synovitis of the spinous process. (5) Hypertrophy of the ligamentum flavum. (6) Sacrospinous muscle strain. (7) Lumbosacral fasciitis. (8) Iliac crest fascial injury (gluteal epineural foramen). (9) Sacroiliac fat globus. (10) Gluteus medius injury (gluteal myofasciitis). (11) Gluteal muscle-specific fibrosing contracture. (12) Broad fascial tensor injury. (13)Transverse lumbar spine syndrome. (14) Lumbar major muscle injury. (15) Pear-shaped muscle syndrome. (16) sciatic nerve outlet syndrome. 2, orthopedic injury (1) bone joint misalignment, lumbar posterior joint misalignment, sacroiliac joint misalignment, hip joint misalignment, etc. (2)Fracture and dislocation. (3)Compression lumbar spine fracture. (4) Traumatic hip, knee and ankle arthritis. (5) Isthmus fracture (combined with true slippage after trauma). (6)Lumbar disc herniation. (7) Lumbar spinal stenosis. (8) Lumbar spinal nerve canal stenosis. 3, due to senile degenerative disease (1) hypertrophic spondylitis, osteoarthrosis, acute attacks of osteophytes. (2) Age-related osteoporosis. (3) degenerative lesions of the lumbar intervertebral disc, pseudoslip. 4, due to lumbar spine bone and joint infection inflammation (1) lumbar spine septic osteomyelitis. (2)Combined infection of the lumbar spine. (3) Lumbar intervertebral discitis, or lumbar tuberculosis. (4) Hypotoxic, septic, vertebral inflammation. (5) Due to lumbar tumor (1) Bone primary cancer and tumor, such as myeloma, hemangioma, osteogenic or osteolytic tumor. (2) Metastatic cancer: often metastasized from prostate cancer, lung cancer, thymus or bone, etc. (3) Extravertebral tumor: Mostly invaded by primary tumors of neighboring tissues and organs, such as tumor or cancer of kidney. 6, lumbar spinal bone disease due to (1) rheumatic, rheumatoid spondylitis. (2) Ankylosing spondylitis. (3) Parathyroid hyperfunction. (4) Intra-epiphyseal chondromalacia of the vertebral body, youthful round back. (5) Traumatic arthritis of the posterior lumbar spine joint. (6) Dense iliac osteoarthritis. 7, congenital disorders caused by (1) occult spina bifida, occult bifida spinalis adhesions, spina bulge. (2) Isthmus bifida combined with slippage. (3) Lumbosacral deformity; lumbar sacralization, sacral lumbarization, thoracic lumbarization, lumbar ribs, sacral cleft combined with free spinous process, lumbar five posterior joints asymmetry, lumbar transverse process overgrowth, hooked spinous process. (4) horizontal sacral vertebrae (lumbosacral angle enlargement). 8, functional, postural, compensatory, secondary causes (1) primary or secondary lumbar scoliosis. (2) Various causes of lower limb inequality, such as fracture sequelae of lower limb inequality. (3) Various lower limb deformities, such as internal and external knee roll, posterior knee roll and K-leg. (4)Dysfunction of the joints of the lower limbs caused by various diseases, flexion and extension contracture of the joints of the lower limbs, deformity or stiffness and deformity of the knee and ankle joints, resulting in back pain caused by body imbalance. 9. Due to neurological disorders (1) Nerve radiculitis. (2) Simple sciatica (unknown cause) sciatica, peripheral neuritis. (3) Various causes of lower limb paralysis (e.g. cerebral palsy, stroke, pediatric palsy). (4) Spinal cord cavitation. (5) Arachnoid adhesions. 10.Lumbago caused by other diseases (1)Certain surgical diseases: such as abscess of the posterior abdominal wall, skeletal fossa abscess, posterior appendicitis, etc. (2) Certain medical disorders: such as chronic gastritis, ulcer disease, gastroptosis, etc. (3) Certain urological disorders: such as urinary stones, pyelonephritis, chronic prostatitis. (4) Gynecological disorders; pelvic inflammatory disease, menstrual disorders, birth control ring, etc. (1) Straight leg elevation and sciatic nerve pulling test to determine whether there are signs of sciatica. (2) Unilateral hip flexion and knee flexion test to examine the ipsilateral sacral hip and the contralateral hip (positive for Tomas’ disease). (3) Bilateral hip flexion and knee flexion test to examine the lumbosacral joint, lumbar intertrochanteric joint and sacrospinous muscle pull test. (4) “4” test, to check the ipsilateral hip and sacro-hip disorders. (5) Abdominal jerk test to check the response to increased abdominal pressure and spinal hyperextension of the lumbar spine. (6) Knee Achilles tendon reflex to determine peripheral nerve, nerve root and central nerve disorders. (7) Examination of pathological reflexes to rule out central nervous disorders. (8) To measure the patient’s pain, touch, and temperature sensation, and whether there is any abnormality with the healthy side, and whether it is in accordance with the nerve distribution under the jurisdiction of which nerve. (9) To measure whether muscle strength and muscle tone are reduced or increased, whether the muscles are atrophied, and what nerves control them. (10) Bedside test, pelvic separation test, pelvic compression test to check the sacroiliac joint. (11) Look and palpate the lower extremity for deformity, inversion, valgus, K-type, and retroversion of the knee, whether the lower extremity is isometric, and whether the force line is centered. (12) Flexion and extension of lower limb joints, whether there is impedance or popping sound. (13) Push or percussion test of lower limb to exclude lumbar bone disease, osteomyelitis, bone tumor, bone tuberculosis, etc. (14) Pear-shaped muscle tension test. (15) Flexion neck test (jugular vein compression test to identify disorders related to pressure in the spinal canal). (16) Muscle impedance test of the lumbar and hip region, such as psoas major, psoas square, sacrospinous, internal and external oblique muscles, gluteus maximus, middle and minor muscles, quadriceps, iliopsoas, adductor group, biceps femoris, etc. (17) Whether there is percussion pain in the lumbosacral region, sacroiliac joint and hip joint to determine whether there is inflammation, misalignment or fracture of the bone and joint. (18) Sacroiliac joint squeeze, lumbar rebound pain test, prone position lift hip and iliac test. (19) Carefully search for touching painful points, tendon knots and striae, and use the index, middle and ring fingers along the spinous process, the posterior joint of each lumbar vertebra between the spines, the transverse process, the posterior superior iliac spine, the iliolumbar ligament, the sacrospinous muscle and other muscles. The sciatic nodes, the sacroiliac joints were identified with or without fat globules, and whether there was radiating pain on pressure to differentiate and diagnose true and false sciatica. (20) Combine with the application of laboratory tests, X-ray, CT, MRI and other imaging examinations to further clarify the diagnosis and avoid misdiagnosis and mistreatment.