Chronic lumbar strain is most common in the middle-aged and elderly population, but it needs to be differentiated from other factors causing lumbago to prevent misdiagnosis. In comparison, disc herniation, lumbar tuberculosis and acute lumbar sprain are not very difficult to distinguish because they have characteristic lumbar pain, or are of acute course, or have obvious systemic symptoms. In contrast, exertional lumbago and chronic lumbar strain have relatively similar clinical manifestations, both of which are widespread lumbago and have the characteristic of aggravation after activity. Therefore, careful differentiation is needed in order to develop a scientific and reasonable prevention and treatment plan. The onset of exertional lumbago is a kind of widespread lumbar pain that occurs after a large number of activities in a relatively concentrated period of time in people who usually lack exercise and exercise. This is because the patient usually has less lumbar activity and poor adaptation of lumbar muscles, once too much activity will cause excessive production of metabolites, such as lactic acid, which will gather in large quantities in the lumbar area and stimulate the tissue to produce soreness and discomfort. Most of the chronic lumbar muscle strain has a history of acute lumbar sprain, which can be repeated due to improper treatment or improper conditioning, leading to the occurrence of lumbar muscle strain. It can also be caused by long-term bending labor or improper sitting posture, causing the lumbar muscles to be under tension for a long time, which eventually leads to the occurrence of lumbar muscle strain. The clinical characteristics of exertional lumbago are that there is no history of lumbago on weekdays, but if more or heavier physical activities are carried out within a concentrated period of time, such as excessive labor intensity and excessive exercise, the lumbar region suddenly feels pain and discomfort, and the pain increases after a night’s sleep, or even wakes up at night with pain, and there is also a tendency for the activity to increase during the day. Physical examination shows mild swelling on both sides of the lumbar region, and there are more extensive pressure points when palpating, and the pain can be aggravated when pounding. The clinical characteristics of chronic lumbar strain are insidious onset and slow progression. The lumbar pain is aggravated during exertion, relieved at rest, and reappears when the amount of activity increases again. There is no swelling in the lumbar region on physical examination. Although the patient feels a wide range of low back pain, there is no clear pressure point, and pounding on the low back does not aggravate the pain, but can make the low back feel comfortable. The main point of prevention and treatment is that exertional low back pain is not a real disease and injury, and generally no medication is needed. After a clear diagnosis, a hot bath and sufficient rest can be taken, and most of them can be relieved within 1-2 days. Individuals with significant back pain, bathing and rest can not be relieved or affect rest, 1-2 tablets of ibuprofen or painkillers can be taken to relieve pain. Preventive measures First, participate in regular exercise, pay attention to strengthening the strength of the lumbar muscles, such as doing sit-ups, push-ups, etc.; second, prevent excessive exercise and high-intensity labor, and do a combination of work and rest in daily life and travel to avoid the occurrence of exertional lumbago. Chronic lumbar muscle strain requires serious treatment, not only to rest properly during lumbar pain, but also to take comprehensive treatment measures to relieve pain, improve the condition and prevent the lumbar muscles from changing to fibrosis. Specific measures include rest, keeping the lumbar region braked, taking painkillers, and going to the hospital if the pain is severe. For those with widespread low back pain without obvious pain points, massage, physical therapy or acupuncture are feasible. After pain relief, one should pay attention to maintain good sitting and standing posture, i.e., head up and flat, abdomen, chest up, maintain the normal physiological curvature of the spine, and avoid excessive forward convexity of the cervical and lumbar vertebrae; second, strengthen physical exercise to enhance the strength of the lumbar region; third, avoid excessive bending and prolonged sitting still. In order to avoid recurrence of the disease caused by persistent pain and restricted activities in the lumbar region, then, it is more difficult to control. If the above situation cannot be relieved, minimally invasive treatment means such as minimally invasive soft tissue release and radiofrequency can be taken.