Low Back Pain

Low back pain is a very common symptom experienced by most people at some point in life. This pain may be located anywhere on the back below the ribcage; in some cases it will extend over the buttocks and into the legs, often referred to as sciatic pain, or sciatica. The pain presentation ranges widely in differing patients from severe, even disabling pain, which usually lasts less than one month, to an annoying dull ache, which may persist for many years. This pain may feel hot, cold, stabbing, throbbing, dull, indistinct, fixed or varying in location. The chronic form of low back pain becomes increasingly common as one advances in age. For a minority of unfortunate patients, the disabling acute episode of back pain persists long-term, greatly reducing quality of life and restricting work and leisure activities for these patients. Common treatments, such as long-term use of opiods and surgery, prove unsatisfactory for many. Acupuncture and herbal therapies give excellent results in reducing pain and preventing recurrence of acute episodes. Specific treatments in Oriental medicine differ depending on the specific qualities of pain reported by the patient.

In Oriental medicine, the low back is considered the “residence of the Kidneys”. In part this refers to the fact that the Kidney organs are located in the lower back and that a problem in the organ, such as a Kidney infection, frequently presents with severe back pain. However, the Kidneys have a broader function in Chinese medicine than the Western anatomical Kidney organ. They represent the basic constitution and essence of a patient, which has ramifications for bodily strength, resistance to disease, and overall health as one ages. Maintaining Kidney system health and vigor is the primary focus in Chinese medicine for anti-aging treatments and for treatments focused on restoring health after long-term illness. All types of low back pain relate to the Kidneys in some way, either reflecting a weakness in Kidney function, or contributing to a weakening of the Kidney system. For this reason, appropriate treatment for back pain is very important in preventing a decline in overall health.

There are three conditions frequently found to be a cause of low back pain; often all three are seen mixed in a single patient, with one condition predominating. The symptoms differ in each condition.

  • Invasion of Cold and Damp – The pain is worse in the morning and better with light exercise and movement. The condition improves over the course of the day. If cold predominates, the patient feels more severe pain, feels worse with rest and better with the application of heat. Cold causes stiffness and contraction of the muscles and joints, which produces a more severe pain. If dampness predominates, the patient feels more numbness, and may feel that the low back is heavy and swollen. Symptoms may be worse on cold or rainy days. Invasion of Damp and Cold is a condition called Bi syndrome, or Painful Obstruction Syndrome in Chinese Medicine; it is also found in the various forms of arthritis.

  • Deficiency of the Kidneys – The pain is dull and recurs; it is better with rest and worse when the patient becomes tired or overexerts. The pain may become worse after sex, especially in men, and is usually worse at end of the day. The patient may have a cold sensation in the low back, with the low back area actually feeling cold to the touch. A feeling of weakness in the knees and a generalized sense of low energy may accompany the back pain. Kidney energy naturally declines with age; so, this form of back pain becomes more common as one ages.

  • Stagnation of qi and blood – The pain is severe and stabbing in quality, and usually fixed in a specific location. The patient feels worse with rest and better with movement. The condition is not affected by the weather, and does not improve with the application of heat. This is the form of low back pain seen after trauma or injury. However, low back pain primarily due to invasion of cold and damp or to deficiency of the Kidneys will lead to stagnation of qi and blood even without specific trauma to the back.

Factors that increase the likelihood or severity of low back pain include:

  • Excessive physical activity – This can cause strain to the muscles, producing local stagnation. Over time excessive physical activity, especially repetitive bending and lifting, will weaken the Kidneys. Many patients do not realize that sports and leisure activities when aggressively pursued may cause such damage.

  • Excessive sexual activity – This weakens the Kidneys, resulting in a chronic, dull pain in the low back. This occurs more easily in those with an inherited constitution for weakness in the kidney system.

  • Pregnancy and childbirth – The physical strain of carrying a child and of labor may weaken the low back and kidneys, especially if the mother is in poor health, stressed, has a weak constitution, receives inadequate rest after the birth, or has several children in rapid succession.

  • Cold and Damp exposure – This includes exposing the low back area to the elements through insufficient or inappropriate clothing, wearing damp clothing in cold, windy conditions, or lying on cold, damp ground.

  • Overwork – Working long hours with inadequate rest for many years debilitates Kidney energy, especially when working under the stressful conditions common for many office workers.

  • Inadequate exercise – This weakens the spinal ligaments and joints, contributes to poor posture and disc problems. Gentle exercise such as Tai Chi may be very helpful in restoring back health and function.

Treatment for acute low back pain focuses on acupuncture. Needle treatments frequently prove effective in remedying even long-term back problems in only a few sessions. However, conditions that include sciatic pain usually require longer treatment to clear the problem. In addition, if there is a significant underlying deficiency in the Kidneys, this must be addressed, often through herbal medicine taken often a period of one to three months, to prevent recurrence of the back pain. Conditions that involve acute disk herniation should be treated every day for at least one week. Patients who have been diagnosed with severe spinal osteoarthritis should note that many people with this condition do not experience chronic pain; so, treatment of pain is recommended even in this condition. Those who have been diagnosed with a prolapsed lumbar disc, or bulging disk, may not be aware that recovery is possible, that disk fluids may be reabsorbed into the disc. Again, acupuncture treatment for the pain is highly effective.

One unusual feature of acupuncture treatments for low back pain is that treatment may be done with the patient standing. Points on the legs or arms are needled while the patient gently rotates the lower back. After ten to fifteen minutes of this, the patient is asked to lie down and points in the low back area are needled and then the patient rests for about twenty minutes.