Low Back Pain

People with chronic low back pain find that acupuncture treatment will help not only break the pain cycle, but allow them to reduce pain medications and participate more vigorously in physical daily activities. Lower Back pain in Chinese medicine includes any pain, aching, discomfort or weakness in one or both sides of the lower thoracic, lumbar, sacral or buttock areas. Lower back ache effects up to 80% of the population at one or more times of their lives. The Chinese noticed that many disorders affecting the kidneys can easily give rise to low back pain thus calling the lower back the “palace of the kidney”.

History of Chinese Medicine Treatment Of Low Back Pain – Lower Back Pain

Traditional Chinese Medicine has been used to successfully treat low back pain for thousands and thousands of years with the use of acupuncture and herbal medicine. When looking at the entire time line of Chinese medicine acupuncture has only been exposed to other areas of medicine for a very short period of time.

Sir William Osler, often considered the father of modern medicine said: “For lumbago (lower back pain) acupuncture is, in acute cases, the most efficient treatment.” (Lumbago is an old-fashioned term for low back pain.) This is what Sir William Osler counseled a century ago in his classic medical text.

Acupuncture for Lower Back Pain
Low Back Pain
How Acupuncture works for low back pain:
Ancient Chinese believe that there is an inner energy or vital force that is more than synapsing neurotransmittors and vibrating molecules. This vital force or inner energy, in Traditional Chinese Medicine, is called “QI” (pronounced chee). Low Back Pain, or any physical dysfunction, is considered in Traditional Chinese Medicine to be due to stagnant Qi in that area. Back Pain can also be related to Kidney, Liver or Spleen Dysfunction and stagnation. When using acupuncture, the inserted needles will break up this stagnation allowing Qi to move freely within the channels alleviating low back pain.

Acupuncture is very effective for low back pain and generally is the treatment of choice in acute cases.

Acute Cases Of Low Back Pain – the principle of treatment is to invigorate Qi and blood to remove stagnation and unblock the channels to stop pain. The main focus in acute cases is to use distal points with strong stimulation
Chronic Cases Of Low Back Pain – the principle of treatment is to expel any pathogens invading the body, invigorate the circulation of Qi and Blood and tonify any underlying deficiencies. Generally in Chronic cases points local to the area of pain and distal points would be used in conjunction with each other.

Herbs / Formulas for Lower back Pain
Low Back Pain
The most successful herbs for treating low back pain are those which increase qi and blood movement in that area. The herbs will have to act not only on the lower back pain are but also on the organ which may be involved in chronic cases.

PATTERNS AND TREATMENT
Of Low Back Pain

Cold Damp – Low Back Pain
Low back pain starts after exposure to cold and damp environmental factors. Low back feels cold when touched, achy and heavy feeling, pain feels deep and unremitting. This pattern of pain generally gets worse and is aggravated by cloudy, wet or cold days and does not improve with rest or laying down.
Treatment Principle
expel cold and damp, warm and open the channels and support the kidneys
Formulas
Gan Jiang Ling Zhu Tang With Du Huo Ji Sheng Tang
Acupuncture:
Use Moxa and warm needle technique

Damp Heat – Low Back Pain
Low back pain starts with the invasion of damp heat through the tai yang channel or chronic cold damp which stagnation and turns into heat. The lower back pain will feel sore and hot when touched. The effected are will be red and swollen and the pain is aggravated during hot, humid or rainy weather. General symptoms of the patient may also include feverishness, irritability and thirst
Treatment Principle
Clear heat and dry dampness, ease the tendons and stop lower back pain
Formulas – Jia Wei Er Miao San
Acupuncture:
Add points kidney 7 and GB 34 to mentioned points.

Wind Damp – Low Back Pain
Acute lower back pain with heaviness, achiness, stiffness and pain is unrelieved by changing position or stretching. The general symptoms of the patient will be heaviness, headaches, mild fever, chills, possible superficial oedema and a floating pulse.
Treatment Principle
Expel wind and dry dampness to stop lower back pain
Formulas – Qiang Huo Sheng Shi Tang
Acupuncture
Add Points – Lu 6, Li 4, Sp 9, Ren 12, St 36

Wind Cold – Low Back Pain
Acute low back pain not relieved by changing position or stretching with general patient symptoms of a high fever, chills, shivering, myalgia, stiff neck, occipital headache, no sweating, slight cough, nasal obstruction or runny nose, sneezing with a floating and soggy pulse.
Treatment Principle
Disperse wind cold and alleviate low back pain
Formulas – Jing Fang Bai Du San
Acupuncture
Add points – Li 4, Lu 7, GB 20, BL 12 ,BL 13, use copping on ah shi points on lower back.

Wind Heat – Low Back Pain
Acute lower back ache accompanied by lower back heat sensations unrelieved by changing positions or stretching. General patient symptoms include fever, mild sweat, dry mouth, thirsty, sore throat, red tongue tip and a floating rapid pulse.
Treatment Principle
Expel wind heat and alleviate low back pain
Formulas – Xiao Chai Hu Tang
Acupuncture
Du 14, BL 12, LI 11, LI 4, SJ 5, copping on ah shi points on lower back

Blood Stagnation – Low Back Pain
Common type of low back pain post traumatic injury such as lifting a heavy object or twisting and bending improperly. The pain is usually sharp in quality and quite severe which is aggravated by pressure or palpation.
Treatment Principle
Invigorate blood circulation and regulate qi to stop lower back pain
Formulas – Huo Luo Xiao Ling Dan
Acupuncture
Add points – BL 17, LI 4, SP 10, SP 6

Liver Qi Stagnation – Low Back Pain
This pattern usually has hypertonicity of the muscles (tense, spasm) and usually occours in individuals under high stress or emotional patients. The lower back pain tends to be aggravated by stress and emotional upsets and often radiates from the lower back to the lower abdomen or hypochondriac regions. The pain may have a distending quality which may move from place to place or come and go. General symptoms include irritability, headaches, digestive upset, chest fullness and possible menstrual disorders. The pulse will generally be wiry and thready while the tongue will be darkish in color with red edges and a thin coat.
Treatment Principle
Regulate liver qi and stop lower back pain
Formulas – Tian Tai Wu Yao San
Acupuncture
Add points Liv 3, LI 4, GB 34, PC 6

Spleen Deficiency with Dampness – Low Back Pain
This pattern usually has hypotonicity of the muscles (weak, emaciated) with a loss of mechanical support and hypermobility of the lumbar spine. This pattern generally gives rise to aching and heaviness of the lower back region which may be flabby while the patients will be commonly overweight. They may also have some degree of digestive weakness or fluid retention with a pale, swollen tongue and a slippery soft pulse.
Treatment Principle
Strengthen spleen and eliminate dampness to alleviate lower back pain
Formulas
Bu Zhong Yi Qi Tang
Ping Wei San – excessive dampness
Fang Ji Huang Qi Tang – easily sweating, mild dampness, knee swelling and painful
Shi Pi Yin – spleen yang deficiency with pitting edema
Acupuncture
Add points – SP 3, ST 40, ST 36, BL 20

Kidney Deficiency – Kidney Qi – Kidney Yin – Kidney Yang
The kidneys have a powerful influence over the tissues of the lower back therefore if the kidneys are weak and qi and blood are sluggish then the lower back is easily effected. Kidney Deficiency will give rise to a chronic lower back ache or low back pain with soreness and weakness which is improved by massage and general rest. The pain will be recurring and is aggravated after exertion, prolonged standing or sexual activity. The knees and legs are commonly sore or weak as well in kidney patterns.
Acupuncture
Add points – BL 23, BL 25, Du 4, BL 52, REN 4, REN 6, KD 3, BL 60, Hua Tuo Jia Ji
Use moxa for kidney yang deficiency.

Kidney Qi Deficiency – Low Back Pain
Kidney Deficiency with – clear copious urination, nocturia, pale lustreless complexion, edema of lower extremities, sore knees, pale or pink tongue with a deep thready pulse
Treatment Principle
Tonify kidney qi and strengthen lower back
Formulas – You Gui Wan

Kidney Yang Deficiency – Low Back Pain
Kidney deficiency with – clear copious urination, nocturia, pale lustreless complexion, edema of lower extremities, sore knees, generally cold, dislike of cold, wet swollen tongue and a slow pulse.
Treatment Principle
Support and strengthen the lower back and tonify the kidneys and support the kidney yang.
Formula – You Gui Wan

Kidney Yin Deficiency – Low Back Pain
Kidney deficiency with – intolerance of heat, occasional urinary irritation, tinnitus, dizziness, facial flushing, nightsweats, sensation of heat in the palms and soles and chest, red tongue with no coat and a thready rapid pulse.
Treatment Principle
Tonify kidneys and nourish kidney yin to strengthen and support lower back
Formulas – Zuo Gui Wan

Compiled by: Hao Chen ( Harry )