Lumbar muscle strain refers to the chronic injury of lumbosacral muscles, fascia and ligaments, which leads to local aseptic inflammation, thus causing diffuse pain on one or both sides of the waist and buttocks. This disease is also called lumbago and gluteal myofascitis or functional lumbago, which is called lumbago due to kidney deficiency in traditional Chinese medicine. It is one of the common diseases of chronic low back pain. The muscles of the back, especially the extensor muscles of the back, have dual functions of isotonic contraction and isometric contraction. The former produces or controls the motion of the spine, while the latter maintains the posture of the trunk and the normal flexion of the defying gravity tension of the spine at any position (except for comfortable standing and motion limit). Due to excessive fatigue of the waist, such as bending over for a long time, the muscles, fascia and ligaments are constantly stretched, the pressure in the muscles rises, the blood supply is affected, and the muscles are in an ischemic state, muscle spasms and produce a lot of lactic acid, as well as metabolites (free radicals, serotonin, etc.). ) can not be eliminated in time, leading to edema and adhesion, which can lead to tissue degeneration and chronic strain. Or due to acute injury of lumbar soft tissue, the damaged lumbar myofascia can not be completely repaired, and chronic aseptic inflammation, muscle fibrosis or scar formation are formed locally, which stimulates nerve endings and produces low back pain. In addition, due to congenital diseases such as sacralization of lumbar spine and spina bifida, the structure is unstable, and some muscles and ligaments lose their attachment points, thus inducing strain and producing low back pain. [Diagnosis] (1) Long-term recurrent back pain and discomfort, or dull pain and swelling, and the waist is tightly attached to the board. If there is a heavy object, it will be light and heavy, and it will not go away. Adequate rest, strengthening warmth, proper activities or changing posture can relieve symptoms, and fatigue or rainy weather will aggravate symptoms due to cold and dampness. The waist movement is basically normal, generally without obvious obstacles, but sometimes there is discomfort in pulling. I can't stand for a long time and I can't bend over. If I bend over for a long time, it is difficult to straighten my waist. I often like to slap my back with my hands. The symptoms of acute attack are obviously aggravated, and obvious muscle spasm may occur, and even symptoms such as scoliosis and lower limb pain may occur. (2) Check 1. The range of tenderness in the back is wide, and the tenderness points are mostly in sacrospinous muscle, transverse process of lumbar vertebrae and posterior margin of iliac crest. 2, muscle spasm: when palpation, the waist muscles are tense, cramped, or have induration and hypertrophy. 3.x-ray examination: a few patients may have congenital malformation, and elderly patients may have hyperosteogeny, and no abnormality is found. [Treatment] Massage has a certain effect on chronic lumbar muscle strain, but the key is to eliminate the pathogenic factors, that is, to change bad posture and overwork, in order to achieve satisfactory therapeutic effect. Treatment principle: relax muscles and collaterals, promote blood circulation to remove blood stasis, relieve spasm and relieve pain. Location and acupoints: Shenshu, Yaoyangguan, Dachangshu, Bajiao, Zhibian, Weizhong, Chengshan, Yaobuttock. Main techniques: rolling, pressing, kneading, clicking, poking, kneading and passive movement. Operation method: 1. Massage along meridian: the patient is prone and the doctor is standing on one side. First, the bladder meridian on both sides should be operated from top to bottom by rolling massage for 3~5 times, and the intensity should be light to heavy. Then press and rub Shenshu, Yaoyangguan, Dachangshu, Bajiao and other acupoints with both thumbs, and take the pain as the degree, and cooperate with stretching and passive exercise for several times. 2. Spasmolysis and analgesia: The doctor applies point pressure and plucking to the pain points and muscle spasms, which is repeated for 3~5 times to achieve the purpose of improving pain threshold, releasing adhesion, relieving spasm and relieving pain. 3. Adjustment of joint disorder: The patient lies on his side, and the doctor stands facing the patient, and applies the waist oblique pulling method 1 time to the left and right, and then takes the supine position, knees and hips of both lower limbs are bent, and the doctor holds the patient's knees for lumbosacral rotation, clockwise and counterclockwise for 8~ 10 times respectively, and then rolls the knees 16~20 times to adjust the waist. 4. Closing technique: The patient is prone. First, the doctor massaged it for 3-5 times, and then operated on the waist, buttocks, back and outside of thighs in turn, and then clicked the acupoints of Rank Edge, Weizhong and Chengshan. Then he directly rubbed the bladder meridian on both sides of his back with thenar, and rubbed the lumbosacral part horizontally, with heat penetration as the degree. Finally, he put his fingers together, relaxed his wrist and beat the bladder meridian of his waist and lower limbs rhythmically. 5, adjuvant therapy: functional exercise, strengthen back extensor exercise, such as supine arch bridge exercise, prone position flying swallow exercise, morning and evening 1 time, 20~30 times each time. Conducive to the recovery of back muscle strength. 【 Prognosis 】 Massage can obviously improve the symptoms of chronic lumbar muscle strain, especially in the early stage, but the disease is often prone to relapse, so we should pay attention to the usual working posture. If you can cooperate with functional exercise and persevere, it will help to improve the curative effect. [Note] 1. In daily life and work, correct bad posture, change posture frequently and avoid excessive fatigue. 2. Pay attention to rest and local warmth, and control sexual intercourse. 3. Strengthen back muscle exercise and participate in outdoor activities or physical exercise as appropriate. [Related research] Chronic lumbar muscle strain is a stubborn strain disease. Massage therapy has a certain effect, but it is difficult to recover. The key is to eliminate the causes of tension and strengthen preventive measures. At the same time of massage treatment, good results can be achieved if it can be combined with oral Chinese medicine that nourishes liver and kidney, promotes blood circulation and removes blood stasis, and warms meridians and unblocks collaterals.