Patient: I am a finance officer, last April the right lumbar eye began to vaguely pain, and then the pain is very strong, spread to the lumbosacral, hip, right hip, thigh front and knee stop, waking up at night pain can not sleep, are right, now the day and night pain, seems to have spread to the left side of the tendency, there is no obvious pressure point, and the pain is not limited by the position, how all pain,. The doctor said that this is not the reason for the mild expansion and protrusion of the lumbar spine 4-5, and the examination for ankylosing spondylitis was normal, the rheumatoid rheumatism was normal, the CT of sacroiliac joints and the MRI of both hips were normal, the blood tests and urine tests were normal, the ultrasound of all organs in the abdominal cavity was normal, and the bone scan of the whole body was normal. I have done microwave physiotherapy, medium frequency and short wave physiotherapy, but the effect is not good, acupuncture and cupping and tui na are also not good, I suspect that it is the third transverse process syndrome, under the ultrasound of the third transverse process closed two injections, the first injection is slightly better, the pain is not so strong at night, the second injection and not, back to the previous situation, the pain is very strong, eat back pain Ning eight boxes ineffective, eat Fenbid and Xilabao such painkillers effective. The doctor has not diagnosed what the problem is, there is no symptomatic treatment, but only said to try this way does not work to change a way, because the test results are not positive, but also ruled out the protrusion of nerve compression, I have not been traumatized, long-term sleep deprivation mental stress is also particularly high, I myself are desperate, especially at night when the pain woke up very painful, especially helpless. Please help me, Dr. Zhao, help me diagnose what is wrong with me and how to treat it. Please give me an answer in your busy schedule, okay? I am looking forward to it! Zhao Guoli: Based on the information you provided, it may be considered as “non-specific lower back pain”. Of course, specific tests have to be done to confirm the final diagnosis. The new concept of non-specific lower back pain is that most of the lower back pain comes from upper lumbar lesions, caused by physical or chemical stimulation of the posterior branch of the upper lumbar spinal nerve or its branches, which manifests as lower back pain, muscle spasm and restricted movement. If the location is accurate, anti-inflammatory and analgesic drugs can be injected into the posterior branch of the spinal nerve at the point of compression to provide local anti-inflammatory and analgesic effects. You can try local nerve block or radiofrequency treatment of the posterior branch of the spinal nerve, and may be able to achieve satisfactory results. I wish you a speedy recovery.