腰骶部疼痛（LBP）发病率高，是45岁以下青年人群活动受限的首要原因，其病因涵盖肌肉功能异常、韧带损伤等多种因素，传统影像学检查存在辐射、成本高或静态评估等局限，肌骨超声因动态观察、便携无辐射等优势逐渐成为诊疗关键技术。本文系统梳理超声技术在腰骶部疼痛诊疗中的应用进展，结果如下：在病因诊断方面，超声可通过多模态技术评估软组织（多裂肌、竖脊肌等肌肉功能，胸腰筋膜等筋膜病变）、骨骼结构（腰椎小关节、骶髂关节）及神经压迫（神经根病、腰椎间盘突出症相关神经异常），为病因识别提供理论依据；在治疗领域，超声引导可精准定位，应用于肌肉韧带筋膜（药物注射、针灸等）、关节椎体（关节腔注射、神经射频治疗等）及神经根（药物注射、臭氧治疗等）治疗，减少并发症并提升疗效。超声技术具备无创动态评估、提高治疗精准性、操作简便成本低等优势，但存在依赖操作者经验、深部组织显像不足、需更多高质量的研究验证等局限。未来可结合剪切波弹性成像（SWE）与剪切波频散成像（SWD）技术，评估腰骶部肌肉筋膜的弹性与黏性以完善疾病评估。综上，超声技术为腰骶部疼痛诊疗提供重要工具，随技术发展与证据积累，有望成为该领域核心诊疗手段之一。

Low back pain (LBP) has a high incidence rate and is the leading cause of activity limitation among people under 45 years old. Its causes include abnormal muscle function, ligament injury, and other factors. Traditional imaging examinations have limitations such as radiation exposure, high cost, or static assessment. Musculoskeletal ultrasound, with advantages such as dynamic observation, portability, and no radiation, has gradually become a key technology in diagnosis and treatment. This article systematically reviews the progress in applications of ultrasound technology in the diagnosis and treatment of lumbosacral pain. In terms of etiological diagnosis, ultrasound can assess soft tissues (multifidus muscle, erector spinae muscle function, and fascia lesions such as thoracolumbar fascia), bone structures (lumbar facet joints and sacroiliac joints), and nerve compression (radeiculopathy and nerve abnormalities related to lumbar disc herniation) through multimodal techniqus, providing a basis for etiological identification. Regarding therapeutic applications, ultrasound-guided techniques enable precise localization and are utilized across a range of interventions targeting muscles, ligaments, and fascia (drug injection and acupuncture); joints and spinal structures (intra-articular injection and radiofrequency neurotomy); and nerve roots (drug delivery and ozone therapy). This approach contributes to reduced complication rates and improved clinical outcomes. Ultrasound technology has advantages such as non-invasive dynamic assessment, improved treatment accuracy, simple operation, and low cost. However, it has limitations such as reliance on the operator's experience, insufficient imaging of deep tissues, and the need for more high-quality research verification. In the future, it can be combined with shear wave elastography and shear wave dispersion imaging technologies to assess the elasticity and viscosity of the lumbosacral muscle fascia to improve disease assessment. In conclusion, ultrasound technology provides an important tool for the diagnosis and treatment of lumbosacral pain. With the development of technology and the accumulation of evidence, it is expected to become one of the core diagnostic and therapeutic methods in this field.