Lumbar muscular strain
A lumbar muscular strain is defined as a stretch injury or tear involving the paraspinal muscles and their associated tendons in the lower back. This condition occurs when the muscle is subjected to excessive tensile force, resulting in overstretching of the myofibers and potential rupture near the myotendinous junction.
Mechanism of Injury:
Acute mechanical lumbar strains may occur during both physical and non-physical activities. Lifting is the most commonly reported precipitating event; however, approximately one-third of patients do not recall a specific inciting incident. Muscle strains and tears most often result from a sudden, forceful muscular contraction during an excessively forceful stretch, such as lifting heavy objects or performing abrupt twisting movements.
Anatomical Considerations:
Any posterior spinal muscle and its corresponding tendon may be affected. Muscles that cross multiple spinal segments are particularly susceptible to strain injuries.
Clinical Presentation:

• Acute Lumbar Strain: Pain typically reaches maximum intensity within 24 to 48 hours following injury.
  
• Chronic Lumbar Strain: Characterized by persistent or recurrent pain attributed to residual or ongoing muscle injury.
  
  什么是腰部肌肉拉伤？

腰部肌肉拉伤是指下背部的椎旁肌或它们的肌腱被拉伸过度或发生轻微撕裂。当肌肉受到超过它能承受的牵拉力量时，就会造成肌纤维过度拉伸，甚至在肌腱与肌肉连接处出现损伤。
为什么会发生腰部拉伤？腰部肌肉拉伤可以发生在日常生活、工作或运动中。常见原因包括：

• 提举重物（最常见）
  
• 突然的扭转动作
  
• 用力不当或姿势不良
  
• 剧烈运动或突然发力
  大约有三分之一的患者想不起明确的诱因，这也是正常的。
  

哪些部位容易受伤？后方脊柱周围的任何肌肉和肌腱都有可能拉伤。尤其是那些跨越多个脊椎节段、负责稳定与协调动作的深层肌肉，更容易发生损伤。
症状表现

• 急性腰部肌肉拉伤：
  
  • 痛感在受伤后的 24–48小时 达到最严重
    
  • 活动受限、僵硬、转身或弯腰时疼痛明显
    
• 慢性腰部肌肉拉伤：
  
  • 疼痛持续或反复发作
    ​常因未完全恢复或反复使用受伤肌肉引起

(为保护患者隐私，此录像做了变音处理。)
​视频为一个70岁的男性患者，他记忆里没有明显的外伤史。在三天前，往前弯腰拾东西的时候，突然感到腰部疼痛，活动受限。卧床休息，待第二天症状反而变得更严重。做腰椎前弯后伸测试时，主要表现腰前弯下后，再试图把身腰伸直时，表现疼痛加剧。治疗的过程，是首先通过特殊的肌筋膜触诊方法，摸到高张力点，用skin marker 画上记号后，再行针灸手法，治疗完毕后，立即让患者起来，重新再测试腰椎的前往后仰活动，已经明显改善。
(To protect the patient’s privacy, the audio in this video has been modified)
The video features a 70-year-old male patient who does not recall any significant history of trauma. Three days ago, while bending forward to pick something up, he suddenly experienced low back pain with restricted movement. After resting in bed, his symptoms actually became worse the following day. During lumbar flexion–extension testing, his main symptom occurred when bending forward; when he attempted to straighten his back from the flexed position, the pain intensified.
In the treatment process, we first used a specialized myofascial palpation technique to locate areas of high tension. After marking these points with a skin marker, acupuncture techniques were applied. Once the treatment was completed, the patient was asked to stand up and repeat the lumbar flexion–extension test, which showed significant improvement.

(为保护患者隐私，此录像做了变音处理。)
​视频为57岁患者男性，三天前搬完重物后，腰椎肌肉扭伤，行走时不能直腰，跨大步时疼痛加重，弯腰活动严重受限。治疗的过程，是首先通过特殊的肌筋膜触诊方法，摸到高张力点，用skin marker 画上记号后，再行针灸手法，治疗完毕后，再测试患者的行走步态，一起往前弯腰，症状明显改善，三天后回诊，症状完全消失。
​(To protect the patient’s privacy, the audio in this video has been modified)
The video features a 57-year-old male patient who strained his lumbar muscles three days ago after lifting heavy objects. He was unable to straighten his back while walking, experienced increased pain when taking large steps, and had severely limited forward bending.
During the treatment, a specialized myofascial palpation technique was first used to identify areas of high tension. These points were marked with a skin marker, followed by acupuncture treatment. After completing the procedure, the patient’s walking gait and forward-bending movement were reassessed, showing significant improvement. When he returned for a follow-up visit three days later, his symptoms had completely resolved.