Two years ago, 65-year-old Liu went to the local hospital for lumbar pain with left lower limb radiating pain. The local doctor considered that he had problems with his lumbar spine and hip joint, and after examination, he was diagnosed with lumbar disc herniation and left femoral head necrosis, which did not work well after traction, physiotherapy and massage treatment. The doctor suggested surgery, so he had a left femoral head replacement in a local hospital, but after the surgery, symptoms such as lumbar and leg pain not only did not improve, but became more serious. Luckily, the surgeon took a piece of bone for pathological examination during the operation, and the examination result suggested metastatic cancer. The doctor in charge immediately informed him to return to the hospital for a comprehensive examination, and finally found that it was left lower lung cancer, which was immediately surgically removed and followed by chemotherapy, and after treatment, his back and leg pain completely disappeared. In addition to lung cancer, breast cancer and pancreatic cancer in women, prostate cancer and multiple myeloma in men can easily metastasize to the lumbar spine. Therefore, it is advisable for people over 60 years old to have a comprehensive examination when they develop lumbar pain to avoid misdiagnosis or missed diagnosis. Lumbar pain is a common and frequent disease that seriously affects study, work and life. The common cause is the lesion of the lumbar spine, and because of this, in clinical work, under the influence of inertial thinking, once encountering low back pain, most people first think of lumbar disc herniation, lumbar strain and other diseases, but ignore some rare diseases that cause low back pain, which leads to misdiagnosis. However, if we analyze carefully, each kind of low back pain has its own characteristics: 1. Lumbar spondylosis The pain of lumbar disc herniation or degenerative joint degeneration (osteophytes) is persistent dull pain or soreness, aggravated by activity, reduced by lying down and aggravated by standing, the lumbar region may appear stiff, tolerable in general, and allows moderate lumbar activities and slow walking, mainly due to mechanical compression. The duration is as little as 2 weeks and as long as several months or even years. When the nerve roots are stimulated, radiating pain in the lower extremities may occur. The effect of early relief can be achieved by lying on a hard bed, closed therapy and various dehydrating agents. 2, ankylosing spondylitis Low back pain before the age of 30, especially in women, must be noted to exclude the possibility of ankylosing spondylitis (sacroiliac arthritis), this type of low back pain is insidious, difficult to locate, and feel pain deep in the hip. The pain is often unilateral and intermittent at the beginning of the disease, gradually becoming bilateral and persistent after a few months, and is also present in the lower lumbar region. Typical symptoms are prolonged fixation in a certain position or worsening upon awakening in the morning (“morning stiffness”), which can be improved by somatic activity or hot baths. Blood was drawn and tested positive for HLA-B27. Similar features are found in lumbosacral migrating spine lesions, but the pain is more intense and the treatment is less effective. 3, osteoporosis Among the common causes of low back pain, osteoporosis is more easily overlooked by everyone. After menopause in women and after the age of 60 in men, most people are likely to have osteoporosis, only that people usually do not pay attention to it and do not take it seriously, so many people have osteoporosis are not aware of it. Osteoporosis is a systemic disease, and the main lesions include fractures, and clinical manifestations related to the site of fracture occurrence. Vertebral fractures can manifest as back pain after bending, lifting heavy objects or coughing, or asymptomatic progressive loss of height or kyphosis. The nature and degree of pain varies and can present as discomfort, dull pain, and sharp pain, which increases with activity and sometimes radiates to the abdomen. Acute pain usually resolves after 4 to 6 weeks, and chronic pain is often present in patients with multiple fractures with kyphosis hump. It can be accompanied by weakness of the limbs, difficulty walking, and in severe cases, even inability to get up. The impact on the patient’s quality of life is very significant. In terms of treatment, there are no specific drugs for ankylosing spondylitis and it is mainly symptomatic. The treatment of lumbar spondylosis and osteoporosis is based on calcium and active vitamin D supplementation, along with attention to strengthening functional exercise, with more emphasis on the use of anti-osteoporotic drugs for osteoporosis. Chinese herbal medicine has a good effect in the treatment of low back pain, and there are various treatment methods, some of which are incomparable to Western medicine. If a combination of Chinese and Western medicine can be used, the effect will be even better. In addition to these diseases, common causes of low back pain include trauma, lumbar muscle strain, kidney stones, gynecological inflammation, etc. Some women may also experience low back pain after childbirth. Each kind of low back pain is treated differently, and it is best to go to the hospital and use medicine under the guidance of a doctor.