Abstract： Objective： To observe the clinical effect of the therapy of external application of Xiaotong Prescription combined with Jianyao Huoluo Needling on residual low back pain after lumbar surgery. Methods： A total of 136 patients with residual low back pain after lumbar surgery were divided into the control group and the observation group according to the random number method，with 68 cases in each group. The control group was given Loxoprofen Sodium Tablets，and the observation group was additionally treated with Xiaotong Prescription combined with Jianyao Huoluo Needling based on the treatment of the control group. Both groups were treated for 2 treatment courses， 7 days being a course. The scores of Visual Analogue Scale (VAS) ，Oswestry Disability Index (ODI) of lumbar spine，lumbar extension，flexion activity，oxidative stress indexes [malondialdehyde (MDA)，glutathione peroxidase (GSH-PX)，superoxide dismutase (SOD)] and contents of serum pain mediators [nerve growth factor (NGF)，β-endorphin (β-EP)， substance P (SP)] were compared before and after treatment between the two groups，and the total clinical effective rates，adverse reactions，and recurrence rates were also compared. Results：The VAS scores in the two groups were gradually decreased after 7 and 14 days of treatment (P＜0.05)，and the VAS score in the observation group was lower than that in the control group at the same time point (P＜0.05). After treatment， the ODI indexes of lumbar spine in the two groups were decreased (P＜0.05)， and the ODI index in the observation group was lower than that in the control group (P＜0.05). After treatment， the lumbar extension and flexion activities in the two groups were increased (P＜0.05)， and the above two indexes in the observation group were greater than those in the control group (P＜0.05). After treatment， the serum MDA levels in the two groups were decreased (P＜0.05)，and the MDA level in the observation group was lower than that in the control group (P＜0.05)； the serum GSH-PX and SOD levels in the two groups were increased (P＜0.05)，and the above two levels in the observation group were higher than those in the control group (P＜0.05). After treatment，the NGF and SP levels in the two groups were decreased (P＜0.05)， and the above two levels in the observation group were lower than those in the control group (P＜0.05)； the β -EP levels in the two groups were increased (P＜0.05)， and the β -EP level in the observation group was higher than that in the control group (P＜0.05). After treatment，the total effective rate in the observation group was 95.59%，higher than that of 85.29% in the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). After 3 months of follow-up，there was no significant difference in the recurrence rate between the two groups (P＞0.05). After 6 months of follow-up， the recurrence rate in the observation group was 3.08%， lower than that of 15.52% in the control group (P＜0.05). Conclusion： The therapy of external application of Xiaotong Prescription combined with Jianyao Huoluo Needling has a definite curative effect on residual low back pain after lumbar surgery， which is conducive to relieving pain， improving lumbar function， enhancing lumbar activity， lessening oxidative stress injury， inhibiting the expression of pain-inducing mediators in serum，and has fewer adverse reactions and a significantly lower recurrence rate.