Back pain is the most common reason for going to see a doctor. Most of the people will suffer from lower back pain at some point in our lives and most of the time the pain will go away on its own.
For many people this pain is not transient, and therefore back pain is the most common reason for turning to Chinese medicine.
Acupuncture treatment has a lot to offer for this condition.
General:
Even in conventional medicine, back pain is perhaps the most common condition for which one goes to the doctor. 60-80% of the population will suffer from lower back pain at least once in their lives, though usually the pain will go away within four weeks.
For about 25% of those suffering from back pain the problem becomes a prolonged nuisance. In this article I will focus on lower back pain which is not due to damage of the spinal vertebrae. To go to the article about treatment for a herniated disc, click here.
Read UK’S National Institute of Health and Care Excellence (NICE) guideline, which recommend Acupuncture as an effective treatment in managing chronic pain.
Read the BBC news article about NICE guideline
Causes:
- Injury to muscles or tendons. This is the most common cause for back pain. Usually this injury occurs due to a sharp movement that creates muscle contraction or as a result of incorrect posture or wrong body positioning during sleep. In its normal condition a muscle should be flexible and relaxed, yet at the same time able to contract if necessary in order to create movement in the body. Due to having bad posture or body positioning, either in the daytime or during sleep, the muscle contracts and gets “caught”. Factors such as exposure to cold (for example, sleeping with an open window and waking up in the morning with a stiff neck) and mental stress also affect the muscle’s flexibility and increase the chances of injury. In these types of injuries, the pain will usually be localized, without radiating to other places in the body.
- Degenerative changes in the disc. Bulging or herniated disc that presses on spinal nerves (the nerves that come out from between the vertebrae) and as a result there is a radiating pain the location of which depends on which nerve is being pressed. Sometimes a bulging or herniated disc can cause only local pain without inflicting any pressure on the spinal cord.
- Abnormality in skeletal structure – back curvature. Anatomical changes of the spine can be congenital or as a result of incorrect posture or prolonged exertion. These changes create strain on the muscles and stress on the nerves. There are three types of abnormal back curvature: Kyphosis, also called Hunchback: an abnormally rounded upper back; Lordosis – Swayback: the spine curves significantly inward at the lower back; Scoliosis – a condition in which the spine curves to the side. All of these types of spinal abnormalities can lead to back pain!
- Idiopathic – without a clear cause – this is definitely common and occurs in many of cases! Mental and emotional factors, stress from work and the environment can lead to back pain.
Chinese medicine – back pain
Acupuncture treatment has been found to be very useful as an analgesic (pain relief) as well as highly effective in the treatment of back pain. Read the British National Institute for Health and Care Excellence (NICE) guideline [NG193], which recommend Acupuncture as an effective option in managing chronic pain.
According to Chinese medicine, the lower back region is associated with the kidneys which are located in this area of the back. Sometimes energetic weakness of the organ may cause lower back pain. Every organ in Chinese medicine has a meridian (a channel through which the body’s energy, blood and body fluids flow) on which the acupuncture points are located. The meridian connects to the internal organ in the body and actually constitutes another area of influence of the organ. In addition to the kidney meridian and kidney organ, the bladder meridian, which is designated as the partner of the kidneys, runs along the entire back and has the ability to influence the treatment of back problems. It is important to emphasize that damage either to the kidney organ or to the kidney meridian according to Chinese medicine is not the same as what is considered damage to the kidney organ (kidney functions) according to Western medicine.
Causes (according to Chinese Medicine):
- External factor: One of the functions of the bladder meridian is to form the first protective layer of the body (connection to the immune system). When there is an invasion of an external pathogen into the body, this meridian will usually be affected. External pathogens according to Chinese medicine are cold, heat, humidity or wind. For example, sleeping with a fan very often will lead to back soreness the morning after, or even to a “stuck “ or stiff back.
- Internal factors: According to Chinese medicine, the kidney organ is related to the essences which are inherited by us from our parents at birth (similar to the concept of genetics). These essences dwindle down as we age. In addition, the kidneys are associated with the bone tissue in the body. We know that there is a depletion of bone density as we grow older. In old age, or in certain conditions of weakness, when the kidney organ is not functioning properly, and due to the strong connection of the kidneys to the back through the association with the meridian of the bladder and the governing vessel, back pain can arise.
- Trauma that causes stagnation of qi and blood: a direct blow, an injury, a sharp or sudden movement – all these may impair the proper flow of qi and blood in the meridians in the area and can lead to back pain.
Treatment:
The treatment will be performed after a differential diagnosis is concluded, evaluating the various factors that can cause back pain, and by differentiating which meridians are involved in the condition. If it is an invasion of an external pathogen, treatment will focus on expelling the pathogen out of the body and regulating the movement of qi in the meridians involved. In the case of weakness or in older patients, treatment will focus on strengthening and support. Herbal remedies may be added to this type of treatment, depending on the condition itself.
At times the treatment will be given locally on the back itself, while at other times the treatment may be done on points which are distant (distal) from the problematic area. Acupuncture is a very effective treatment for back pain. Today, more and more doctors are referring their patients to acupuncture. Sometimes the pain will go away during the treatment session itself or after a short series of treatments.
Prevention:
Prevention and understanding of what causes us pain are both very important, during treatment as well as in general. It is important to maintain proper posture during prolonged sitting in the office, while walking and sleeping. In winter, it is advisable to wear suitable and warm clothing in order to avoid exposing your back to the cold. In summer, it is recommended to sleep without an air conditioner or fan that can contract the back muscles.
Attached is a nice video on proper posture while working on the computer: