Low Back Pain

Low back pain ( pain in the lumbar region ) is closely associated with disorders of the kidney for the lumbus is the seat of the kidney .

Clinically , low back pain can be found in various diseases . This section only deals with the following etiological factors :

• Invasion of exogenous pathogenic cold and damp ;
• Deficiency of qi of the kidney ; and
• Sprain or contusion .

Etiology and Pathogenesis

Invasion by pathogenic cold and damp :

In this case low back pain is due to obstruction of circulation of qi in 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 .

Deficiency of the kidney qi :

In this case low back pain is generally due to excessive sexual activity that consumes essence and qi , resulting in poor nourishment of the meridians in the lumbar region .

Trauma due to sprain or contusion :

Trauma may cause injury of qi and blood in the meridians and collaterals , leading to stagnation of qi and blood , thus producing low back pain .

Differentiation

Cold damp :

Main manifestations : Low back pain usually occurring after exposure to cold and damp and aggravated on rainy days , heavy sensation and stiffness of the muscles in the dorsolumbar region , limitation of extension and flexion of the back , pain radiating downwards to the buttocks and lower limbs , cold feeling of the affected area , white and sticky tongue coating , deep and weak , or deep and slow pulse .

Analysis : Pathogenic cold and damp characterized by viscosity and stagnation block the meridians and collaterals , causing retarded circulation of qi and blood . This produces heaviness , cold sensation and pain in the lumbar region and limitation of extension and flexion of the back . Stagnation of qi and blood becomes worse on cloudy and rainy days , and so does the pain . Accumulation of cold and damp gives rise to the white sticky tongue coating and the deep , weak or deep , slow pulse .

Kidney deficiency :

Main manifestations : Insidious onset of protracted pain and soreness , accompanied by lassitude and weakness of the loins and knees , aggravated by fatigue and alleviated by bed rest . In case of deficiency of kidney yang , cramp - like sensation in the lower abdomen , pallor , normal taste in the mouth , cold limbs , pale tongue , deep thready or deep slow pulse . In case of deficiency of kidney yin , irritability , insomnia , dry mouth and throat , flushed face , feverish sensation in the chest , palms and soles , reddened tongue proper with scanty coating , thready weak or thready rapid pulse .

Analysis : The lumbar region is said to be the dwelling house of the kidney . The kidney dominates the bones , produces marrow and stores essence . When the kidney has insufficient essence , the bone is lacking of marrow , and the result is soreness and pain in the lumbar region accompanied by weakness of the knees . Over strain and stress consume essence and qi , and make the pain worse . Pain is lessened by bed rest , which makes qi quiescent . In case of deficiency of kidney yang , the kidney fails to warm the lower abdomen and the limbs . This gives rise to cramp - like sensation in the lower abdomen and cold limbs . Deficiency of yang causes pallor , pale tongue , deep thready or deep slow pulse . When yin is deficient , kidney water is unable to ascend to reduce the heart fire . This results in irritability and insomnia . Deficiency of yin causes excessive internal heat , which gives rise to the following symptoms : flushed face , feverish sensation in the chest , palms and soles , dryness of the mouth and throat , reddened tongue with little coating , thready weak or thready rapid pulse .

Trauma :

Main manifestations : History of sprain of the lumbar region , rigidity and pain of the lower back which is generally fixed in a certain area , and is aggravated by pressure and by turning the body , pink or dark purplish tongue proper , string - taut hesitant pulse .

Analysis : Muscular strain in the lumbar region causes retardation of qi and blood and further leads to stagnation of blood in the meridians and collaterals . The result is the fixed severe pain which can be aggravated by pressure . String - taut pulse is associated with pain , dark purplish tongue proper and hesitant pulse are signs of blood stasis .

Treatment

Method : Points are mainly selected from the Du and the Foot - Taiyang Meridians to promote the circulation of qi and blood , to relieve pain , to relax the muscles and to activate the blood circulation in the collaterals . Acupuncture and moxibustion are applied together for cold - damp type . in case of deficiency of the kidney yang , apply needling with reinforcing method and moxibustion . For deficiency of the kidney yin , puncture with reinforcing method . For traumatic low back pain , apply reducing method or pricking to cause bleeding .

Prescription : Shenshu ( B 23 ) , Yaoyang - guan ( Du 3 ) , Weizhong ( B 40 ) . Supplementary points : Cold damp : Dachangshu ( B 25 ) , Guanyuanshu ( B 26 ) .

Deficiency of the kidney yang : Mingmen ( Du 4 ) , Yaoyan ( Extra ) .

Deficiency of the kidney yin : Zhishi ( B 52 ) , Taixi ( K 3 ) .

Traumatic injury : Renzhong ( Du 26 ) , Yaotongxue ( Extra ) , Ahshi point .

Explanation ; The low back is the dwelling house of the kidney . Shenshu ( B 23 ) can be selected to tonify the qi of the kidney . Moxibustion may also be applied to this point to eliminate cold and damp . Yaoyangguan ( Du 3 ) is a local point . Weizhong ( B 40 ) is one of Four Key Points , and an important distal point for the treatment of low back pain . Dachangshu ( B 25 ) and Guanyuanshu ( B 26 ) can dispel wind and cold , remove obstruction in meridians , and relieve pain . Combination of acupuncture and moxibustion applied to Mingmen ( Du 4 ) and Yaoyan ( Extra ) can tonify the kidney yang and strengthen the kidney essence as well . Zhishi ( B 52 ) and Taixi ( K 3 ) are selected for the purpose of nourishing the kidney yin . As the Du Meridian travels along the spine , Renzhong ( Du 26 ) is a distal point effective for treating rigidity and pain of the lumbar region . Yaotongxue ( Extra ) is an empirical point used in treating sprain of the lumbar region .

Remarks

Low back pain may be seen in renal diseases , rheumatism , rheumatoid arthritis , hyperplastic spondilitis , muscle strain or traumatic injury of the lumbar region .

When the lumbar vertebrae are diseased , the corresponding Huatuojiaji points may be punctured perpendicularly 1 . 0 - 1 . 5 inches . Needles are retained . Here , acupuncture therapy is only a supplementary method of treatment .