If the painful points are on the top of the lumbar muscles on both sides, it may be lumbar strain or 3rd lumbar transverse process syndrome. Lumbar muscle strain is a bilateral lumbar muscle with widespread pressure pain and many painful points, and in the case of 3rd lumbar transverse process syndrome, the painful points are mainly in the 3rd lumbar transverse process. If the painful point is in the interspinous intervertebral space of the lumbar region, this condition is most commonly associated with lesions of the lumbar spine, such as lumbar disc herniation, lumbar spinal stenosis or lumbar spondylolisthesis. To clarify the above diagnosis, you can go to the hospital to check the lumbar spine CT or MRI to confirm the diagnosis.