Acute lumbar sprain is a common and multi-injury, generally caused by improper lumbosacral posture such as carrying heavy objects, but also many patients can be caused by sudden twisting, bending and jerking the waist and other sudden postural changes, once the onset of lumbar pain (or with interlocking sensation), the waist is forced forward position, painful expression and walking difficulties. The more severe cases even have severe pain in the lumbar stiffness, and the slightest activity or even talking and breathing can be unbearable. If not treated properly, the pain will not heal for a long time and turn into chronic lumbago. In contrast, the treatment of acute lumbar sprains by Chinese medicine techniques is not only less painful, but also has an immediate effect. Many patients feel amazing, and many doctors also exaggerate it and say it is fantastic. What is it all about? The clinical manifestations of the so-called acute lumbar sprain are injuries to the lumbosacral muscles, fascia, interspinous ligaments, posterior lumbar joints, sacroiliac joints and so on. The onset of the disease can be in the lumbar muscles, ligaments and other soft tissues, but also in the posterior lumbar joints often lead to soft tissue and joint injury at the same time. Some scholars believe that acute lumbar sprain is mainly an acute laceration (or sprain and contusion) of the soft tissues of the lumbar region; some scholars believe that it is an acute injury to the soft tissues of the lumbosacral region accompanied by acute injury to the posterior lumbar joints; some scholars believe that it is an acute injury to the soft tissues of the lumbosacral region, the posterior lumbar joints and the sacroiliac joints. Generally, it mainly includes two categories of lumbosacral soft tissue injury and small joint disorder of lumbar spine, but in general, they often exist together. 1.Pathogenesis First, there is an obvious history of trauma. It is often caused by improper posture of lumbosacral body position such as carrying heavy objects, poor cooperation when two people lift heavy objects together, fall and fall in life, etc. The second is no obvious history of trauma. It is often caused by sudden twisting, bending and jerking of the waist and other sudden position changes. Third, there is a history of lumbar fatigue, which is often caused by poor posture, prolonged bending work or concussion of the lumbar region. Fourth, the posterior lumbar joint degeneration. Intervertebral disc and posterior lumbar joint degeneration and ligament, joint capsule and other supporting structures relaxation to increase the mobility of the intervertebral joint, often caused by the occurrence of lumbar joint instability and subluxation during a certain movement. Fifth, anatomical and physiological variation. Caused by anomalies in the anatomy of the lumbosacral region (asymmetry of the posterior lumbar joints) or endocrine changes in women (systemic hormonal factors causing ligament and joint capsule relaxation in menstruating, pregnant, postpartum or lactating women). Acute lumbar sprain is usually seen in young and strong physical workers, sportsmen, sedentary and long-distance transport or taxi drivers and computer operators who suffer from prolonged lumbar shock. It is not uncommon in middle-aged women, women who are menstruating, pregnant, postpartum or breastfeeding, dancers and Peking Opera performers. It is also seen in overweight, obesity, post-consumptive disease, lumbosacral angle abnormalities, etc. When lumbar sprain occurs, soft tissues such as lumbosacral muscles tear and produce inflammatory reaction, on the other hand, the joint surface is slightly misshapen due to the pull of muscle tension on the joint protrusions of the posterior joints on both sides of the spine, so that the anatomical position of the posterior joints of the lumbar spine is changed and the synovial membrane of the posterior joint capsule is overstretched, which causes lumbago. Some scholars believe that the lumbosacral region is located at the junction of the trunk and pelvis and has the largest range of activities and many deformities, so the lumbosacral muscles and lumbar. The posterior sacral joint is prone to injury as a common clinical condition. The injury is related to the degree of external force at the time of sprain, or to the position of the lumbar region and the magnitude of stress at the time of sprain. According to the common causes, the degree of vulnerability and susceptible population, acute lumbar sprain is clinically most common as acute lumbar muscle sprain and/or posterior lumbar joint disorder. 2, clinical manifestations of acute lumbar sprain clinical manifestations are mostly sacrospinous muscle or lumbar dorsal fascia from the starting point of the tear, rupture lumbar posterior joint disorder joint synapse jump interlock, synovial joint subluxation or synovial joint imbrication, some scholars believe that the lumbar posterior joint disorder accounts for about in more common. The clinical characteristics of patients are lumbar pain (or with interlocking sensation), lumbar tilted forward forced position, painful expression and walking difficulties. The more severe cases are characterized by severe pain in the lumbar stiffness, and the pain is unbearable even with slight activities such as talking and breathing, and the expression is extremely painful, and the activities and walking are limited. In severe cases, it can be accompanied by tearing of the posterior lumbar joint capsule, or tearing and rupture of the supraspinous and spinal ligaments, or even fracture of the articular process and spinal process. If acute lumbar sprain is not treated properly, the pain can not be healed for a long time and turn into chronic lumbar pain. 3, diagnosis based on medical history, symptoms and signs, combined with x-ray examination, the diagnosis is not difficult. In addition to the history of trauma such as lumbar sprain, the history of sudden change of position, lumbar fatigue and other medical history should be inquired, which is characterized by lumbar pain and restricted movement, inability to turn over, difficulty in bending or holding the waist, often maintaining a certain forced position, lumbar pain increases when changing position, and generally no lower limb pain or numbness. During the examination, attention should be paid to the stiffness and muscle spasm of the lumbar region, and the focus should be on checking whether there is pressure pain in the paraspinous process, supraspinous process, interspinous process and lumbosacral joint, and whether there is pressure pain in the skewed spinous process. 4, the indications and contraindications of manipulative treatment is generally considered suitable for acute lumbar muscle sprain and or lumbar spine posterior joint disorder and sacroiliac joint injury (subluxation). Some scholars also believe that acute injuries of the supraspinous and spinal ligaments should not be treated with acupressure, while their chronic injuries should be treated with gentle manipulation. The combined vertebral and accessory fractures, rib fractures, severe ligament tears or ruptures, subcutaneous hematomas, skin injuries, skin ulcers and other injuries, or tuberculosis, tumors, severe osteoporosis, lumbar arch rupture, lumbar spondylolisthesis (degree I or above) and other diseases, is not suitable for massage. 5, the mechanism of action of manipulation Manipulation can strengthen local tissue circulation, improve the pain threshold of local tissues, elongate the tense and spastic muscles, promote the repair of injured tissues and absorption of hematoma and edema, loosen adhesions (eliminate traumatic sterile inflammation), so manipulation can directly relax the muscles and release muscle tension, spasm, in order to achieve the effect of relaxation of tendons and blood, remove blood stasis. 6, the choice of techniques The main techniques are shaking leg kneading waist method, side lying shaking press method, directional pounding method, hold shaking stamping method, knee rolling method, according to the waist moving leg method, sitting rotating shaking moving method, girdle waist method, before the stoop pulling palm (finger) pressure method, knee top method, supine trigger over extension method, lifting leg pressure waist method, snap pressure method, etc.. However, in clinical practice, it can probably be summarized as relaxation of muscle spasticity (with pressing, flicking, tucking, etc.) and adjustment of joint misalignment (oblique wrenching method, etc.). Generally speaking, they can improve the symptoms significantly, but attention should be paid to the safety of the manipulation process. In conclusion, acute lumbar sprain involves different tissues such as muscles, fascia and ligament joints. It occurs in different parts of the lumbar region, lumbosacral sacroiliac region, etc. There are different etiologies such as trauma, sudden position change, degeneration, strain, anatomy and physiology, and different degrees of injury and populations affected. To achieve satisfactory results in the treatment of acute lumbar sprains, we must pay attention to the diagnosis, indications, techniques and operations in order to achieve a well-informed and safe treatment. However, it is certain that the effect of acutely sprained lumbar muscles and/or posterior lumbar joint disorders is satisfactory. Of course. The reactions to manipulation and adverse prognosis also need to be noted.