Predisposing factors: trauma, strain injury, poor working posture and habits, physical defects, age, etc. Symptoms: (1) the main characteristic of the complaint of pain in the lower lumbar region, the lesion site in the upper lumbar region; (2) can be due to the lifting and placing of objects, improper posture, forced position operation and the onset of the disease; (3) pain in the lumbosacral, sacroiliac joints, buttocks, paravertebral, iliac crest, etc., and localized pressure pain, and occasional lateral femoral and posterior femoral pain; (4) acute lumbar pain pain when the pain is so severe that you can not get up, turn over and get up and get out of bed difficulties, slow gait, chronic mainly manifested in back pain, limitation of flexion and extension activities, can not sustain bending, or can not straighten the back. Slow gait, chronic mainly manifested as lumbago, flexion and extension activities are limited, can not sustain bending, or straight up, walking is not affected; 【Physical Examination】 1, general examination: temperature, pulse, respiration, blood pressure, sanity, body position, color, systemic examination. (2) Acute lumbar pain, stiffness and forward leaning, lumbar muscle spasms, limited activities, lumbar scoliosis, one side of the sacrospinal muscle, broad fascia tensor muscle spasm, standing hip and knee joints, bending, toeing the ground, the foot can not be stepped on the level of the straight leg raising, passive bending of the hip and knee joints are aggravated by lumbar pain, but there is no lower extremity radiating pain and sensation, muscle, reflexes, and other neurological signs; (3) chronic physical examination: body temperature, pulse, respiration, blood pressure, mental, body position, color, general systemic examination. (3) Chronic signs are few, the pain site is limited, active and passive bending can aggravate the pain; 【Assistant examination】 1. Laboratory examination: blood, urine routine, blood lipids, blood glucose, liver and kidney function, electrolytes. 2, plain film of lumbar spine: rotational displacement of the spine, rotation of the articular processes of the pedicles together with the vertebral body, the outer edge of the pedicles and the vertebral body edge no longer overlap on one side, part of the vertebral body edge is exposed, and the intervertebral space is asymmetric, narrowing or disappearing on one side, with the articular surface of the lower articular process facing the opposite side and the articular surfaces exposed, and the transverse processes becoming shorter on one side after rotation, and the side film of rotated vertebral body changing from a single posterior edge to a bilateral double overlap, with the lower and upper edge of the pedicles of both sides no longer overlapping, exposing the opposite side lower edge, with a heavy weight on both sides. The lower edge of the contralateral side is exposed with double shadowing. Old compression fracture, vertebral cuneiform change, localized posterior convexity may be caused by the posterior branch in the transverse process compression 3, CT and MRI: can obtain the three-dimensional structure of the lumbar spine, so not only from the sagittal plane, the coronal plane and the transverse plane observation of the lumbar spine vertebral canal inside and outside of the anatomical state of the variations. Diagnosis】 1. History: some occur after lifting heavy objects, sudden twisting of the waist and other actions, some have no clear history of injury, and some are secondary to lumbar spine surgery or cone compression fracture. Symptoms: acute and chronic low back pain. Acute lumbago is characterized by severe symptoms, difficulty in sitting up, turning over, walking, aggravated by change of position, and limited or widely unclear pain area. It may be accompanied by pain in the buttocks or the posterior lateral thigh, but it does not exceed the knee joint. 3. Signs: limitation of lumbar movement, sometimes when the lumbar movement in one or two directions, the pain can be aggravated. There are no neurologic signs. On the same side of the complaining pain area, there is a pressure point on one of the cones three segments up from the course of the posterior branch of the spinal nerve. There is tenderness at the spinous processes of the cone, the affected calcaneus, and the affected transverse process, radiating to the area of complaint. Among them, the root of the lateral transverse process of the articular eminence is the most obvious. 4, X signs: often see pressure pain cone rotation signs. Differential diagnosis: 1. Lumbar disc herniation: sciatica is the main cause of lumbago. Generally there is lumbago first, followed by sciatica. The lower limbs show pain and numbness, mostly radiating to the calves or soles of the feet. The leg pain of posterior spinal nerve syndrome will never exceed the knee joint. 2. Vertebral stenosis: the range of low back pain is more extensive, often with heavy symptoms and few signs. Typical symptoms are intermittent claudication, aggravation of leg pain when stretching backward and reduction of symptoms when bending forward. 3, lumbar spondylolisthesis: arch fracture: X-ray can confirm the diagnosis. [Treatment principle] 1, bed rest: the purpose of relaxing the muscles, get up and turn over difficult patients, bed can reduce pain, but long lying so that the lumbar back muscle atrophy, general bed 3d pain relief, can insist on early ground activities, in order to shorten the recovery period. 2.Drugs: acute pain is severe, such as visible analgesic adjuvant therapy to reduce the patient’s pain. 3, traction: thoracic belt fixed for pelvic traction, pull open the intervertebral space and accessories, is conducive to the recovery of osteoarticular anatomical relationships; 4, massage, massage: manipulation to relieve muscle spasm, improve osteoarticular relationships. 5, posterior spinal nerve branch block: first in the lumbar pain localization point to do pichu (2% lidocaine 0.1-0.2ml intradermal injection), in the C-arm X-ray fluoroscopy to change the No. 9 intracardiac injection needle, puncture to the upper edge of the transverse process or transverse process root, no C-arm equipment can be based on the posterior branch of the body surface projections, puncture point in the localization level quite superior to the sphenoid process outside the lower edge of the 2cm, vertical puncture of 3-4cm to the upper edge of the transverse process, the patient has a feeling of electric shock or The patient has a feeling of electric shock or numbness to the complaint pain area, injection of local anesthetic 3-4ml (2% lidocaine), can make the pain immediately lifted, lumbar activities back to normal. Acute lumbar pain more than once cured, some patients with chronic lumbar pain after the effect of drugs are still painful, can be frozen or radiofrequency electrocoagulation treatment. 6, the posterior branch of the spinal nerve radiofrequency thermo-coagulation therapy: patients take the prone position, according to the anatomical characteristics of the posterior branch of the spinal nerve to determine the site of injury to the posterior branch of the spinal nerve, in the plane of the injury with a 1% methyl violet marking. Routinely disinfect the skin and spread the towel. Use 2% lidocaine as local anesthesia at the puncture point. The radiofrequency lancing needle was inserted vertically into the upper edge of the transverse process (2-4 mm from the root of the transverse process) along the nail violet marking. The base of the transverse process is reached by the bone. The needle is slightly oblique to the cephalic end, and there is a sensation of falling, proving that the needle is at the upper edge of the transverse process, and the needle is slightly oblique to the inside, encountering the bone, that is, the lateral edge of the superior articular eminence. Slightly lift and insert the puncture needle, when there is numbness, pain dispersion and the site of the complaint of pain is consistent, proving that the needle has touched the posterior branch of the spinal nerve, i.e., for the treatment of the desired point of action. To determine the accuracy of the puncture, it can be performed under X-ray fluoroscopy. Once the puncture is completed, the core of the puncture needle cannula is withdrawn and the temperature-controlled RF needle is inserted into the insulated puncture needle for radiofrequency thermocoagulation. Give 90 ℃, 120 seconds, four consecutive cycles of radiofrequency treatment, after the operation an return to the ward, give anti-inflammatory and symptomatic supportive treatment. 7.Physical therapy: Early activities after the acute phase, including walking, exercising the back muscles, cycling and so on, can help to shorten the recovery time.