A, what is the lumbar soft tissue injury 1, lumbar soft tissue injury has acute and chronic lumbar muscles, ligaments, fascia, synovium once directly or indirectly by the sudden stimulation of external violence, impact, twisting flash or excessive pulling, resulting in some soft tissue injury of the waist, the normal physiological function of the waist is damaged, lumbar pain, lumbar motion uncoordinated and other symptoms that is called acute soft tissue injury of the waist. Chronic soft tissue injury in the lumbar region is mostly due to a long time in a forced posture or repetition of a movement caused by local soft tissue injury, resulting in muscle, tendon, tendon sheath and ligaments connecting the vertebrae and lumbar fascia, synovium, joint capsule and other tissue damage, which leads to a series of clinical symptoms. Acute soft tissue injury disorders through treatment, most of them can be cured, some of them without regular treatment into chronic. However, most chronic soft tissue injuries are chronic in origin. 2, about the lumbar soft tissue waist by the five lumbar vertebrae and the surrounding strong muscles, fascia, ligaments and other components, there is a wide range of motion, can withstand a significant amount of load, such as lifting, carrying, lifting, lifting, carrying and other heavy physical labor, are centered on the waist. Each lumbar vertebra is indirectly connected to each other through the intervertebral disc. The lumbar intervertebral disc is a ring of fibrocartilage, and the central part is filled with elastic gel-like material called “nucleus pulposus”, which can play a cushioning and stabilizing role. The anterior and posterior edges of each vertebral body are protected and connected by the anterior and posterior longitudinal ligaments, respectively. There are yellow ligaments on the upper and lower edges of the vertebral plate, interspinous ligaments between the spinous processes, and supraspinous ligaments on the spinous processes. The posterior sides of the lumbar vertebral body are sagittally articulated by the upper and lower articular processes to form the vertebral tubercle. The intrinsic stability and balance of the lumbar spine is dependent on these tissues to maintain. The external stability and balance of the lumbar region mainly depends on: (1) Sacrospinous muscle: It is the longest muscle in the back, thick and strong, located in the deep layer. It starts from the back of the sacrum and the inner edge of the posterior iliac crest, and the fibers are divided into three columns: the outer column is called the “iliac rib muscle” and ends at the back of the ribs; the middle column is called the “longest muscle” and ends at the transverse processes of the vertebrae straight up to the temporalis mastoid; the inner column is called the “spinous muscle “, “sacrospinous muscle”, “spinal erector spinae” ends at each vertebral spinous process. (2) transverse process muscle: it is a deep lumbar short muscle, located on the deep side of the sacrospinous muscle, composed of most oblique short muscles, starting from the posterior sacrum and transverse process, and ending at the spinous process in an upward oblique line. (3) abdominal muscles: rectus abdominis, transverse abdominis, external oblique abdominis, internal oblique abdominis. (4) Lumbar square muscle: located between the iliacus and the twelve ribs, in front of the sacrospinous muscle. The lumbar muscles are the main organs of movement and strength. The muscles, tendon sheaths and ligaments connecting the vertebral bodies and the lumbar dorsal fascia, synovium and joint capsule involved in and governing the movement of the spine in the lumbar region can be called the lumbar soft tissues. 3, the role of lumbar soft tissues We know that the lumbar spine is different from the thoracic spine with rib protection, the sacrum with pelvic protection, the lumbar spine around only the lumbar spine itself and its attached soft tissue protection, the waist is the hub of human activity, is the main organ of movement and strength, forward and backward, left and right lateral bending, turning are involved, regardless of movement or activity, the joints here than the whole body which joints withstand the force are large. The intensity of work or activity, joint activity will be more. The activities of the joints have muscle participation, so the stability, protection and movement of the lumbar spine depends greatly on the lumbar soft tissue, it can be said that the lumbar soft tissue for our lumbar spine is the faithful guardian and performer. 4, the common causes of lumbar soft tissue injury, type of acute soft tissue injury in the lumbar region due to picking, lifting, moving heavy objects and other reasons such as excessive force, flash sprain, and sprain soft tissue, causing muscle, fascia, ligament damage, or even tear. Muscle injuries are mostly at their starting and ending points, or myofascial strain areas. The pathological changes are injuries to muscles, fascia, ligaments, synovial processes and synovial membranes, producing aseptic inflammatory changes, such as congestion, edema, fibrous tissue proliferation and adhesions. The ligaments may tear or rupture, irritating and compressing the nerve endings and causing pain. According to the pathological development of the injury, acute soft tissue injury can be roughly divided into three periods: early, middle and late. Early period: refers to the acute inflammatory period within 24 or 48 hours after the injury, with tissue bleeding and local signs of redness, swelling, pain and heat, and functional impairment. Mid-term: refers to the injury 24 or 48 hours later, bleeding has stopped, acute inflammation gradually subsided, but there is still local bruising and swelling, granulation tissue formation, and began to absorb, the tissue is being repaired. Later stage: the injury is basically repaired, and local signs such as swelling and pressure pain have been eliminated. (1) Acute supraspinous or interspinous ligament injury: there are supraspinous and interspinous ligament connections between the lumbar vertebrae, and after external flash twisting, these ligaments are torn or strained, resulting in severe pinprick-like or knife-like pain in the lumbar interspinous. (2) Acute lumbar joint synovial impingement: this pain occurs mostly at 1.5 cm next to the spinous process and may have radiating pain to the ipsilateral hip or behind the thigh, which is easily confused with lumbar intervertebral disc herniation. The radiating pain usually does not exceed the knee joint, and is not accompanied by signs of nerve root damage such as sensation, muscle weakness and loss of reflexes. (3) Acute third lumbar herniation syndrome: The lumbar third vertebral body transverse process is violently subjected to external force during improper posture activities, resulting in unilateral or bilateral pain in the middle part of the lumbar region, stiffness of the lumbar region and inability to bend, and pain aggravated by prolonged sitting and standing. (4) Lumbar muscle disorder: the lumbar muscles are disordered under certain reasons, which stimulates or embeds the nerves in the muscles and produces pain, commonly known as fork or flashback. (5) iliolumbar ligament injury: the ligament at the connection between the waist and the iliac bone is called the iliolumbar ligament, and its injury will produce deep pain on both sides or one side of the lumbar 5 vertebrae, and generally cannot point out the specific pain point, and the lumbar forward flexion and lateral flexion activities are limited. It is easy to cause severe pain when lifting heavy objects. Chronic soft tissue injury in the lumbar region is mostly due to local soft tissue injury caused by prolonged work in a forced posture or repetition of a movement, causing damage to muscles, tendons, tendon sheaths and ligaments connecting the vertebrae and lumbar dorsal fascia, synovium, joint capsule and other tissues, which leads to a series of clinical symptoms. Acute soft tissue injury disorders through treatment, most of them can be cured, and some of them without regular treatment into chronic. However, most chronic soft tissue injuries are chronic in origin. Such as accountants, drivers, typists and other long-term in a certain position, muscle contraction, even if you stop working, the muscle still can not restore the diastolic state, some hours, and some even adult months. Chronic soft tissue injury is a long period of gradual formation, not easily observed in the short term, when the symptoms are obvious, there has been an organic change. Chronic lumbar soft tissue injury etiology are: (1) cumulative injury: refers to the human body by a relatively minor persistent repeated pulling, squeezing and injury, this injury through a long period of accumulation, more than the body’s self-recovery compensatory capacity, it becomes an accumulative injury disease. (2) hidden injury: most of this injury is not perceived by the patient, such as in some recreational activities or accidental minor falls, hits, bumps, collisions, caused by the injury, at the time there is pain, but did not care, after a period of time found pain, patients tend to ignore the injury history, and easy to be misdiagnosed as other diseases. (3) fatigue injury: refers to the human limbs, trunk injury caused by prolonged overload work. Such as prolonged intense sports activities, limbs, trunk overload caused by the work of the injury, barely lifting heavy objects caused by the injury, etc., all belong to fatigue injury. Features: the role of low intensity, long periods of time, latent strong. Common types are: (4) lumbar muscle strain: lumbar muscle strain is a chronic injury to the lumbosacral muscles, fascia and ligaments and other soft tissues, resulting in local sterile inflammation, which causes diffuse pain on one or both sides of the lumbar hip. The disease is also known as lumbar gluteal myofasciitis or functional lumbago, which is called kidney deficiency lumbago in ancestral medicine. It is one of the common diseases in chronic low back pain. The main clinical symptoms: long-term recurrent episodes of lumbar back pain and discomfort, or dull swelling pain, lumbar weight on the board tight, such as a heavy load, sometimes light and sometimes heavy, lingering. Adequate rest, warmth, proper activity or change of posture can reduce the symptoms, but exertion or rainy weather, wind, cold and dampness will aggravate the symptoms. The lumbar activities are basically normal, generally no obvious obstacles, but sometimes there is a pulling discomfort. The patient is unable to sit and stand for a long time, and is unable to do stooped work. If he bends over for a long time, he has difficulty in straightening his back and often pounds his hands on his lower back. In acute attacks, the symptoms are obviously aggravated, there may be obvious muscle spasms, and even scoliosis of the lumbar spine, lower limbs pulling for pain and other symptoms. Lumbar dorsal myofasciitis: Mostly manifested as widespread vague pain in the lumbar region, or weight-bearing and anthraxic sensation in the lumbar region, which is heavier with exertion and cold, and relieved by rest and heat. It is mostly seen in women, with a history of cold, especially after abortion or childbirth, poor rest or cold wind. 5, from what to determine whether the lumbar soft tissue injury II, acute lumbar soft tissue injury Injury patients often feel the injury site with a loud sound or tissue suddenly “tearing” feeling. Local pain, activity impairment. When injured, patients often feel a loud sound or sudden tissue “tearing” sensation at the injury site. Localized pain, impaired movement. Can be divided into three stages: 1, early: refers to the injury within 24 or 48 hours, tissue bleeding and local redness, swelling, pain, heat, dysfunction and other signs of acute inflammation period. 2, the middle: refers to the injury 24 or 48 hours later, bleeding has stopped, the acute inflammation gradually subsided, but there is still local bruising and swelling, granulation tissue formation, and began to absorb, the tissue is being repaired. 3.Later stage: the injury is basically repaired, swelling, pressure pain and other local signs have been eliminated, but the function has not been fully restored, still feel pain when exercising, soreness and weakness. Some serious cases, due to adhesions or scar contraction, the injury stiffness, limited activity and other situations. Simple judgment: 1, acute soft tissue injury patients have tugging or tearing-like pain. 2, local swelling. 3, activity is significantly limited. 4, the presence of pain and muscle tension, pressure points are clear. 5.X-ray examination without fracture and small joint dislocation.