What is a lumbar strain? Lumbar strain is generally considered to be pain in the lower back caused by overexertion of the lumbar muscles, with no abnormalities on photographic examination. It is often painful after exertion, relieved after rest, and mostly recovers within 1 week. The few who have not recovered for more than 3 months are called chronic lumbar strain. Most of the chronic lumbar muscle strain that is not cured for a long time is misdiagnosed, and the real pathology may be the following: 1. discogenic lumbago, i.e. lumbago caused by intervertebral disc degeneration. It is manifested as pain in the middle of the lower back, with vague localization, aggravated by prolonged sitting and alleviated by bed rest. Magnetic resonance examination can confirm the diagnosis. Treatment methods include ozone ablation, radiofrequency ablation, discoscopic decompression, artificial disc replacement, etc. 2, posterior branch of spinal nerve syndrome The posterior branch of spinal nerve is caused by fiber and tendon tissue compression. It is aggravated when the lumbar area is moved in a certain direction, and there are pressure pain points next to the vertebrae. The lumbar pain may spread to the lower extremities, but does not exceed the knee joint. 3, lumbar isthmus crack The lumbar isthmus is not connected, the affected vertebral joint protrusion pressure pain. x-ray or three-dimensional CT can confirm the diagnosis. The treatment method is mainly posterior fusion internal fixation surgery. 4, osteoporosis lower back pain, aggravated by activity, extensive pressure pain in the lumbar spine, doctor’s examination and bone densitometry examination can confirm the diagnosis. Anti-osteoporosis drug treatment. 5.Lumbago of visceral origin Nephritis, hydronephrosis, pelvic inflammatory disease, adnexitis and other visceral lesions can cause lumbar involvement pain, mostly not related to body position, often accompanied by abnormal performance of related organs, visceral ultrasound, MR, CT examination can confirm the diagnosis. 6.Ankylosing spondylitis and other autoimmune diseases Mostly nocturnal pain and morning pain. Blood tests for HLA-B27 antibody, blood sedimentation, C-reactive protein and other indicators are often elevated. At present, it is mainly treated by immunosuppressive drugs. 7. Malignant tumors Malignant tumors mostly have progressive aggravation, weight loss and other wasting manifestations. Nocturnal pain is obvious. MR, CT, PET can be found. In addition to chemoradiotherapy, interventional therapy is also gradually increasing in treatment. 8, spinal infections General bacterial infections are often accompanied by fever and chills and are aggressive, while atopic infections such as tuberculosis and brucellosis often have a chronic course. Laboratory tests, MR, CT, lesion biopsy, and culture can confirm the diagnosis. Surgical removal of the lesion and antibiotics are often required.