Template

Condition Treated / Pain Conditions

Back Pain (Lower Back Pain)

Low back pain, also called lumbar vertebra pain, is a condition mainly characterized by unilateral
or bilateral pain of the lumbus. It may result from external contraction of pathogenic factors,
internal injuries or traumas from sprain or contusion. The above conditions may either obstruct the
flow of qi and blood in the lumbar area or fail to nourish the lumbar area, leading to low back
pain.
The treatment of low back pain based on syndrome differentiation also applies to some Western
diseases that present with low back pain such as fibrositis of lumbar muscle, ankylosing
spondylitis, hyperosteogeny of lumbar vertebrae, lumbar intervertebral disc disorder, and lumbar
muscle strain as well as diseases of internal organs.

Etiology and pathogenesis of lower back pain

1. External contraction of pathogenic factors: Living in humid places, direct wind attack after
sweating, inadequate clothes, wading in the water, or air-conditioning in hot summer may attack the lumbar area and obstruct the flow of qi and blood, leading to low back pain.
2. Weak constitution due to aging process: Congenital deficiency, overstrain, aging process, or sexual indulgence may consume kidney-essence and kidney-qi, leading to low back pain.
3. Traumatic injuries: Lifting up heavy objects, sudden contusion, inappropriate body postures or sudden sprain may cause stagnant blood and obstruct the flow of qi and blood in the lumbar area, leading to low back pain.

Low back pain is located in the lumbus and closely related to the kidney, liver and spleen. Its
pathological nature can be excess or deficiency. But deficient conditions are more common than
excessive conditions. The main pathogenesis for low back pain due to exogenous pathogenic factors is obstruction of the flow of qi and blood of the meridians.The main pathogenesis for low back pain due to internal injuries is kidney deficiency.

Treatment based on the syndrome differentiation

Before low back pain is treated, excess and deficiency must be distinguished first. Excessive
conditions are caused by exogenous pathogenic factors. Deficient conditions are caused by internal injuries. A mixed excess and deficiency syndrome may also be possible.

The treatment principle for excessive conditions is to remove pathogenic factors (dissipate cold, resolve dampness, and clear heat) and clear the meridians.

The treatment principle for deficient conditions is to tonify the kidney. The treatment principle for traumatic low back pain is to regulate qi, circulate the blood, resolve stasis and stop pain.

1. Low back pain due to cold-dampness

Symptoms: Low back pain with a heavy and cold sensation, difficulty in turning the bodies over, the
pain cannot be relieved by bed rest and the pain becomes worse in cold, cloudy and rainy days, a
pale tongue with a white and greasy coating and a deep, slow and moderate pulse.
Keys in differentiation: Low back pain with a heavy and cold sensation, the pain
becomes worse in cold, cloudy and rainy days, a white and greasy coating and a deep, slow and
moderate pulse.
General pathogenesis: Cold-dampness obstructing the meridians
Treatment principle: To dissipate cold, resolve dampness, and warm the meridians.
Major formula: Gan Jiang Ling Zhu Tang

2. Low back pain due to damp-heat

Symptoms: Low back pain with a heavy and hot sensation, the pain becomes worse in hot and damp summer days and becomes better after movement, heaviness sensation in the limbs, a bitter taste in the mouth, scanty and dark-yellow urine, a yellow and greasy tongue coating and a soft and rapid or slippery and rapid pulse.
Keys in differentiation: Low back pain with a heavy and hot sensation, a bitter taste in the mouth, dark-yellow urine, a yellow and greasy tongue coating and a soft and rapid or slippery and rapid pulse.
General pathogenesis: Damp-heat obstructing the flow of meridian-qi
Treatment principle: To clear heat, resolve dampness, relaxes tendons and stop pain.
Major formula: Si Miao Wan

3. Low back pain due to stagnant blood

Symptoms: Stabbing low back pain with a fixed position and tenderness, the pain · becomes better
during day time and becomes worse at night, those with mild conditions only have difficult bending
and those with severe conditions may not tur:n their bodies over, a dark-purple tongue or a tongue
with ecchymosis and a hesitant pulse.
Keys in differentiation: Stabbing low back pain with a fixed position and tenderness, a
dark-purple tongue or a tongue with ecchymosis and a hesitant pulse.
General pathogenesis: Qi and blood stagnation blocks the meridians
Treatment principle: To circulate the blood, resolve stasis, clear the meridians and stop pain.
Major formula: Shen Tong Zhu Yu Tang

4. Low back pain due to kidney deficiency

(1) Kidney-yin deficiency
Symptoms: Lingering dull pain, soreness and weakness in the lumbar region, restlessness, poor
sleep, a dry mouth and throat, a flushed face, feverish sensations in the palms, soles and chest, a
red tongue with a scanty coating and a thready and rapid pulse.
Keys in differentiation: Lingering dull pain, soreness and weakness in the lumbar region, feverish
sensations in the palms, soles and chest, a red tongue with a scanty coating and a thready
and rapid pulse.
General pathogenesis: Kidney-yin failing to nourish the meridians.
Treatment principle: To nourish kidney-yang and benefit the tendons and vessels.
Major formula: Zuo Gui Wan

(2) Kidney-yang deficiency
Symptoms: Persistent dull pain, soreness and weakness in the lumbar region, a cold sensation in the local area, the symptoms become worse with cold and become better with warmth, pressure and lying position, contracture in the lower abdomen, a bright pale complexion, cold limbs, cold intolerance, a pale tongue and a deep, thready and weak pulse.
Keys in differentiation: Dull pain, soreness and weakness in the lumbar region, cold tolerance,
preference for warmth, a pale tongue and a deep, thready and weak pulse.
General pathogenesis: Kidney-yang failing to warm the meridians. Treatment principle: To tonify
kidney-yang and warm the meridians.
Major formula: You Gui Wan

Common-used patent Chinese herbal products

1. Liu Wei Di Huang Wan Actions: Nourishes yin and tonifies the kidney. Indications: Low back
pain due to kidney-yin deficiency
2. Jin Kui Shen Qi Wan Actions: Warms and tonifies the kidney-yang. Indications: Low back pain
due to kidney-yang deficiency.
3. Da Huo Luo Wan Actions: Removes wind, resolves dampness, relaxes tendons and dredges the meridians. Indications: Low back pain due to wind-dampness.

Life style recommendations

1. Keep proper sitting, lying and walking postures in daily life, balance work and rest, avoid
carrying heavy objects, and prevent lumbar trauma or sprain; avoid sitting or lying in wet places,
and avoid sleep outdoors in hot summer; Changes clothes as quickly as possible after wading in
water or sweating or take tea containing ginger and brown sugar to dissipate wind-cold and resolve
dampness;
2. Get immediate treatment for acute low back pain and take rest after the treatment; keep warm in
the lumbar region for chronic low back pain, and prevent lumbar injuries by using abdominal belt;
3. Avoid overstrain and being attacked by pathogenic factors, move the low back
regularly or do self-massage or play Taiji to speed up the recovery.

Summary

Low back pain can be caused by external contraction of pathogenic factors, weak constitution due to aging process and traumatic injuries. It is located in the lumbus and closely related to the
kidney, liver and spleen. The pathological nature of low back pain can be deficiency or excess.
But deficient syndromes are more common than excessive syndromes. Excessive conditions are caused by exogenous pathogenic factors obstructing the meridians and circulation of qi and blood.
Deficient conditions are caused by essential-qi deficiency of the kidney and malnutrition of the
lumbus. Kidney deficiency is the key factor responsible for low back pain. Before low back pain is
treated, deficiency and excess should be distinguished first. The treatment principle for excessive syndromes is to remove pathogenic factors and clear the meridians. The treatment principle for deficient syndromes is to tonify the kidney.

Pain Care Acupuncture Clinic is your local acupuncture office in Torrance, CA . specializing in treating injuries and chronic pain. Dr. Ming Chen and Dr. Lu Yang, Both acupuncturists who also the oriental medical doctor ( O.M.D. ) can pinpoint the cause of the injury and suggest the best treatment methods for you. You need our doctor to listen to the whole story and examine you, so that you can get started treating on your injuries or chronic pain and get you on the track toward recovery.

Call now for a free health consultation !

310-316-5707

Visit out Pain Care Acupuncture Clinic in;

21320 Howthorne Blvd., Suite 203 Torrance, CA 90503