The main problems of online consultation are summarized as diagnostic and treatment problems. Often, they put the information on the Internet to ask the doctor to confirm, or they are not sure about the local diagnosis and repeatedly consult with other doctors hoping to get a confirmation or denial. I feel that the patient’s mind is in turmoil, probably due to concerns about the side effects and efficacy of the Western medicine used. Another problem is that I don’t know if Chinese medicine can treat it. From the information on the internet, many people think that TCM cannot treat the disease. So it is necessary to talk about it, and it can also solve similar consultation problems in the future. The first is the issue of Western medical diagnosis. I always advocate that patients must go to the hospital in person to see the doctor to confirm the diagnosis, because there is no substitute for the doctor’s feeling of seeing the patient and the doctor’s active access to information about the disease. Also because the understanding of the disease is constantly deepening and the diagnosis is relative. So try to choose a reliable and regular western medicine rheumatology to determine the diagnosis according to your condition is the first step. Let me briefly explain what I know about it. The diagnosis of “strong spine” must have unilateral or bilateral manifestations of sacroiliac arthritis, and must be more than grade 2 bilaterally or grade 3-5 unilaterally. At the same time, there must be low back pain, morning stiffness, limitation of lumbar spine movement, and limitation of thoracic spine movement. This diagnostic criterion seems to be very simple, but in fact it is not, and clinical misdiagnosis or wrong diagnosis is very common. Many “small hospitals” diagnosed to “big hospitals” will give a negative. What is the reason? It is the level problem. First of all, there is a difference in the reading of the pelvic x-ray film, and the normal film is read as an abnormal film. Secondly, the definition of degree of back pain, morning stiffness, and limitation of thoracolumbar movement is wrong. Thirdly, because the test is positive for HLA-B27, it is considered to be “strong spine”, when in fact a normal population can be 6 to 8 percent positive. In fact, even in patients who are diagnosed clinically, the clinical manifestations are different, and the test results and severity are also different. Only a specialist can make a diagnosis as accurate as possible by differentiating it from other diseases (such as rheumatoid arthritis, dense osteitis, diffuse idiopathic bone hypertrophy, and lumbar disc herniation), so patients should not take the wrong first step in diagnosis to save time. Treatment is mostly with western drugs, mainly non-steroidal anti-inflammatory drugs (such as fentanyl, fotarine, indomethacin suppositories, etc.), hormones and drugs to control the activity of the disease (such as salazosulfapyridine, methotrexate, raglan polysaccharide), and in recent years also in the application of biological agents. Surgery can be considered in cases of advanced scoliosis and deformity of the spinal joints with severe functional impairment. These treatments seem to be justified in Western medicine. However, the clinical view can only be controlled. In fact, the effect of Chinese medicine is very good, I do not use Western medicine in the clinic, the patient will be divided into several types, according to age, gender, performance, general condition, or kidney tonification, or blood circulation, or wind dispersal, or a combination of legislation, patients responded better than the effect of Western medicine. Of course, we are also in the process of continuous discussion and research, and clinical evidence shows that the earlier the treatment, the better the long-term effect of pure Chinese medicine treatment. You can take a look at my article about medical cases. In conclusion, I hope that if you suspect “strong spine”, you must go to the regular rheumatology department to determine the western diagnosis. After listening to the treatment advice of western doctors, then find an experienced Chinese medicine doctor to ask whether it can be treated, and finally determine one of three treatment methods: western medicine, Chinese medicine, or a combination of Chinese and Western medicine. I wish you a speedy recovery.