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Chronic Low Back Pain

Key Symptoms:

  1. Low back pain sustained for a long time.
  2. A marked tenderness on the local area.

Differential Diagnosis:

1) Cold/Damp syndrome

Coldness, severe pain, heavy sensation and stiffness of the lower back, gradually aggravated by turning the body. Not relieved, but aggravated by lying down quietly and aggravated by rainy days or damp weather.

Tongue: Normal body with greasy white coating.
Pulse: Deep and slow.

2) Blood stasis

Severe pain in the lower back, which is generally fixed in a certain area, and is aggravated by pressure and impaired movement by bending forward or backward and turning the body.

Tongue: Dark or purplish body with purple spots.
Pulse: Uneven

3) Kidney Deficiencies

Sustained pain and soreness in the lower back, aggravated by fatigue and alleviated by bed rest.

Kidney Yang Xu: Cramp-like sensations in the lower abdomen. Pale face, hypofunction of taste sense, cold limbs.

Tongue: Pale body
Pulse: Deep and thready, or deep and slow.

Kidney Yin Xu: Irritability, insomnia, dry mouth and throat, malar flush, five center heat.

Tongue: Red body with scanty coating.
Pulse: Thready and weak, or thready and rapid.

Etiology:

1) Invasion by pathogenic cold and damp.
In this case, low back pain is due to obstruction of circulation of Qi in the meridians and collaterals. The precipitating factors may be living in cold and damp places, exposure to the rain, or wading in water, or being drenched with sweat.

2) Blood Stasis obstructing the channels and collaterals.
The patient has a long history of acute lumbar muscle sprain which has not been treated correctly. It has lingered for a long time and become a chronic condition. Or, the patient has a history of strain to the lower back on the job. Longshoreman and other workers who must carry heavy loads, or who have their back bent for a long time can easily overstrain their backs.

3) Deficiencies of the Kidney
In this case, the low back pain is generally due to congenital deficiency or weakness of the Kidneys in old age. The weakness of the Kidneys could also be due to overwork or excessive sexual activity resulting in poor nourishment of the meridians in the lumbar region.

Treatment Principle:

1) Dredging the meridian passages (reduce XS)
2) Tonifying Kidney Qi

Point and Technique Prescription:

Points are mainly selected from the Du and Foot Tai Yin (UB) channels.

UB 23 Kidney-shu
UB 40 One of four key points, distal usage
Du 3 Local point and "Kidney Yang Door"
GB 34 Influential point of the tendon
Ashi Points in the Lumbar Region

For Cold-Damp type, add:

Sp 9 He-sea point of Spleen channel, can dispel damp
UB 26 For dispelling cold
Use needles, moxibustion or cupping.

For Blood Stasis type, add:

UB 17 Influential point of blood.
UB 32 Combined with above, promotes circulation of Qi and Xue.
Prick and bleed UB 40.

For Kidney Yang Xu type, add:

Du 4 Ming Men point
UB 26 Guan Yuan-Shu
Moxibustion is applicable here.

For Kidney Yin Xu type, add:

Kid 3 "Tai Xi" (Great River) Stream (Earth) Point for Kidney
UB 52 "Jing Palace" Nourishes Kidney Yin

Explanation:

The Lower back is the seat of the Kidney. UB 23 can be selected to tonify the Kidney. UB 40 is one of the four key points and an important distal point for the treatment of low back pain. Du 3 is a local point. GB 34 is one of the eight influential point, for the tendons.

Spleen 9 is the He-sea point of Spleen channel, can dispel the damp. UB 26 can dispel the cold. UB 17 is one of the eight influential points, in this case, for blood. This point combined with UB 32 can promote circulation of Qi and Xue, as well as relieve pain.

Du 4 is the Ming Men the gate that opens fire of life. UB 26 is the Sea of Qi Back-shu which can tonify Kidney Yang.

Kidney 3 and UB 52 both nourish Kidney Yin.

More from Dr. Ma at: Acuherbsonline.com

For more information about back health: http://www.spine-health.com


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