Overview: The third lumbar spine syndrome is particularly prone to injury due to excessive length, greater curvature, and extensive motion. Severe cases can produce fractures of the transverse process. It is also generally susceptible to avulsion injuries of the muscles, fascia, and tendon membranes, resulting in hemorrhage and plasma exudate. The injury can produce a mild or severe inflammatory response depending on the causative factor. In mild cases, laceration, hemorrhage, and hematoma of the transverse process and muscle attachment, followed by myotonia and myospasm, will also result in irritation or compression of the lateral branch of the posterior spinal nerve. The pathological and physiological changes that occur at the same time cause the nerve bundles between the bound muscles and fascia to become edematous and thickened due to insufficient blood supply or suspension, thus causing pain in the superior gluteal nerve. Zheng Lin, Department of Traditional Chinese Medicine and Orthopedics, Gucheng County People’s Hospital Diagnostic points: 1. History of lumbar trauma. 2, pain in the lumbar region, with radiating pain down the thigh in severe cases, pain unrelated to increased abdominal pressure. 3. There is obvious pressure pain at the tip of the lumbar 3 transverse process and the site is fixed. 4.X-ray film shows that the lumbar 3 transverse process is too long. Sometimes the left and right transverse processes are asymmetrical. Differential diagnosis: It must be differentiated from lumbar disc herniation, acute sacroiliac joint sprain, and pear-shaped muscle syndrome. In this case, the pressure point is at the tip of the lumbar 3 transverse process, and the sciatic nerve does not show the same obvious nerve root distribution as in lumbar disc herniation, and the straight leg raise test may be positive and the straight leg raise strengthening test negative. The site of pressure pain is different from that of the pear-shaped muscle syndrome, which is at the sciatic nerve notch, often with intermittent claudication, and a positive Freibeg test and a positive Thiele test. In sacroiliac joint sprain, the affected sacroiliac joint is painful and the pain often radiates to the hip and lateral femur, and there is usually spasm of the affected sacrospinous muscle, tilt of the trunk to the affected side, inability of the affected limb to bear weight, and walking claudication. Diagnostic hints: The diagnosis of the third lumbar transverse synovial syndrome is not very difficult and can usually be correctly diagnosed through history, signs and symptoms, combined with X-rays. However, attention should be paid to differentiate it from lumbar disc herniation, pear-shaped muscle syndrome and sacroiliac joint injury when it is seriously accompanied by sciatic nerve symptoms. Treatment: I. Non-surgical treatment 1. local closure 2. physiotherapy: heat therapy, electrotherapy can relieve symptoms. Second, surgical treatment For severe symptoms, frequent attacks, conservative treatment is ineffective to affect the work life, surgery can be done for the third lumbar transverse process stripping or excision. Third, manual therapy Commonly used plucking technique and pushing and pressing sacrospinous muscle, can relieve pain and release spasm. Treatment tips: For the treatment of the third lumbar transverse process syndrome, local closure is more effective, and the pain disappears immediately after local closure. For those with more severe symptoms, frequent attacks, and those who do not recover from conservative treatment, surgery can be performed to remove or excise the transverse processes of the third lumbar vertebra.