Causes and TCM Treatment for Low Back Pain

Lumbar pain is a common symptom in traditional Chinese medicine, which belongs to the categories of "lumbar pain" and "arthralgia". The causes are mostly related to kidney deficiency, invasion of cold and dampness, blood stasis, insufficient qi and blood, or strain and trauma. The specific causes need to be analyzed by syndrome differentiation. The following are common causes and treatment methods:

First, Analysis of etiology and pathogenesis of traditional Chinese medicine:

1. Kidney deficiency

Manifestation:

Kidney yin deficiency: dull lumbago, dizziness, tinnitus, dry mouth and throat, and fever in the five hearts.

Kidney yang deficiency: continuous lumbago, likes to be pressed and warm, accompanied by fear of cold, cold limbs, and frequent urination at night.

Pathogenesis: The kidney governs the bones, and the waist is home to the kidney. Kidney deficiency causes pain in the waist due to a lack of nourishment.

More common in: elderly people with physical weakness and chronic diseases.

2. Invasion of cold and dampness

Manifestation: heavy lumbago, aggravated by cold or humid weather, accompanied by stiffness and heaviness in the waist.

Pathogenesis: Cold and dampness invade the waist, meridians are blocked, and qi and blood flow is not smooth.

Causes: Long-term residence in wetlands, wind and cold invasion.

3. Blood stasis

Manifestation: Low back pain like needle prick, fixed, aggravated after activity, especially at night.

Pathogenesis: Trauma or long-term strain leads to qi and blood stasis, blocking the meridians.

More common in: lumbar lesions or sequelae of trauma.

4. Qi and blood deficiency

Manifestation: Low back pain is dull, aggravated after fatigue, accompanied by fatigue, pale complexion, dizziness and palpitations.

Pathogenesis: Qi and blood deficiency, unable to nourish muscles and bones, leading to low back pain.

More common in: postpartum weakness, long-term illness or overwork.

5. Strain and trauma

Manifestation: Recurrent low back pain, often aggravated by fatigue, long-term sitting or improper posture.

Pathogenesis: damage to waist muscles and fascia, obstruction of qi and blood circulation.

Causes: physical labor or long-term sitting.

Second, treatment methods:

1. Acupuncture

Commonly used acupoints: Shenshu (BL23), Mingmen (DU4), Yaoyangguan (DU3), Weizhong (BL40), Ashi point, etc.

Efficacy: dredge meridians and relieve pain.

2. Moxibustion

Acupoints: Shenshu, Mingmen, Guanyuan (CV4), etc.

Efficacy: warming the kidney, dispelling cold and relieving pain.

3. Massage/Tui Na

Key areas: waist, sacrum and bladder meridian.

Method: massage, rub, tap, relax muscles and improve blood circulation.

4. Cupping

Location: Ashi points on the waist and along the bladder meridian.

Efficacy: dispel dampness and cold, activate blood circulation and dredge collaterals.

Third, Chinese medicine treatment:

1. Treatment principles

Kidney deficiency type: tonify the kidney and strengthen the waist.

Cold and dampness type: dispel cold and dampness, warm the meridians and dredge the collaterals.

Blood stasis type: activate blood circulation and remove blood stasis, dredge the collaterals and relieve pain.

Qi and blood deficiency type: replenish qi and blood, nourish tendons and strengthen bones.

Strain type: relax tendons and activate collaterals, replenish qi and promote blood circulation.

2. Commonly used prescriptions

   1)  Kidney deficiency type

Prescriptions:

Kidney Yin deficiency: Liuwei Dihuang Pills with modifications (cooked rehmannia, yam, cornus officinalis, oriental water chestnuts, poria, moutan bark).

Kidney Yang deficiency: Yougui Pills with modifications (cooked rehmannia, cornus officinalis, eucommia bark, cinnamon bark, aconite).

Additions and subtractions:

For those with obvious soreness and weakness in the waist and knees, add Dipsacus asper and Viscum album. For patients with chills and cold limbs, add dried ginger and Morinda officinalis.

   2) Cold-dampness type

Prescription: Ling Gui Zhu Gan Tang or Du Huo Ji Sheng Tang with modifications.

Composition: Poria, cinnamon twig, white atractylodes, licorice, notopterygium, duhuo, mistletoe, eucommia bark.

Modifications:

For patients with severe cold, add asarum and Chuanwu. For patients with severe dampness, add Atractylodes macrocephala and coix seed.

   3) Blood stasis type

Prescription: Shen Tong Zhu Yu Tang or Tao Hong Si Wu Tang with modifications.

Composition: peach kernel, safflower, Chuanxiong, angelica, Achyranthes bidentata, Corydalis yanhusuo, Cyperus rotundus.

Modifications:

For patients with severe pain, add frankincense and myrrh. For patients with obvious local stiffness, add Pueraria root and mulberry twig.

   4) Qi and blood deficiency type

Prescription: Bu Zhong Yi Qi Tang or Gui Pi Tang with modifications.

Composition: Astragalus, Codonopsis, Angelica, Atractylodes, Poria, Licorice.

Additions and subtractions:

For patients with low back pain accompanied by fatigue, add Eucommia and Cibotium barometz. For patients with obvious dizziness and palpitations, add Longan meat and Rehmannia glutinosa.

   5) Strain type

Prescription: Shujin Huoxue Decoction with additions and subtractions.

Composition: Angelica dahurica, Chuanxiong, Cinnamon twig, Morus alba, Millettia reticulata, Achyranthes bidentata.

Additions and subtractions:

For patients with severe fatigue, add Ginseng and Astragalus. For patients with muscle stiffness, add Pueraria root and papaya.

Fourth, daily care suggestions:

1. Avoid fatigue:

Avoid lifting heavy objects or sitting for a long time, and maintain the correct waist posture.

2. Keep warm:

Especially the waist, avoid cold or moisture.

3. Moderate exercise:

Exercises suitable for the waist, such as Tai Chi, yoga, and walking, can improve waist muscle strength.

4. Diet conditioning:

Eat more foods that nourish the kidney and spleen, such as black sesame, walnuts, yam, wolfberry, and beef bone soup.

5. Mattress selection:

Use a hard bed or medium-hard mattress suitable for the lumbar spine to maintain the normal curvature of the lumbar spine.

Fifth, precautions:

If low back pain is accompanied by radiating pain, numbness or other serious symptoms, you need to seek medical attention in time and combine modern medical examinations (such as CT, MRI) to clarify the cause. TCM treatment requires long-term conditioning. Patients need to see a professional doctor for prescription diagnosis, adhere to treatment, and combine daily health care to achieve better results.