|
Oh, My Aching Lower Back!
Who is most likely to suffer from
lower back pain?
It is incredible to believe that 4 out of 5 Americans will experience
low back pain at some point in their lifetime.
An estimated 6 million seek professional treatment for this ailment.
The average age requiring this treatment is 45. Lower back pain is the
second leading cause of absenteeism followed by the common cold.
Nurses rank second to heavy industrial workers for the number of people
who suffer from low back pain.
What causes lower back pain?
-
Low back strain and sprain can occur with poor conditioning and
overuse. A sprain is caused by a
sudden forceful movement that injures a ligament.
This is the most common cause of lower back pain.
Other causes include:
-
Obesity causes undue stress on the joints,
tendons, ligaments and muscles of the lower back.
-
Congenital problems such as scoliosis can
result in lower back pain.
-
Poor body mechanics such as bending at the
waist instead of down on one knee to pick something up, pulling instead of
pushing objects, using stools to reach, making several trips when carrying
and lumbar supports on chairs.
-
Age decreases elasticity and strength of
muscles and ligaments
-
Arthritis which can be seen as early as
the second decade of life can cause spurring and inflamed joints that result
in pain and stiffness.
-
Osteoporosis and compression fracture
caused by decreased bone density and strength due to the aging process and
menopause. Sometimes even a
sneeze can cause a compression fracture.
-
Muscle strain and sprain from heavy
lifting, excessive exercise and overwork.
-
Injury and trauma
-
Bulging or herniated disc can develop from
cracks and fissures in the vertebrae. Disk
material may protrude or rupture causing severe pain and pressure on the
nerve root. This pressure can
cause foot pain and/or lower back pain.
-
Spinal stenosis
-
Sciatica or pinched nerve results from
nerve irritation with radiating leg pain.
-
Sacroiliac joint inflammation
How does Western medicine diagnose
and treat lower back pain?
A history and physical is done to determine possible causes of the lower
back pain. Posture and gait
are noted. History of injury or
trauma is considered. Family history
of skeletal problems is explored. The
extent of exercise and physical work is assessed.
Musculoskeletal and neurological physical exams are given looking for
differences in shoulder, hip, knee and ankle heights, as well as discrepancies
in leg length. Scoliosis and other
spinal deformities are assessed.
X-rays and CT scans are
done. Myelograms, MRI, EMG, and
nerve conduction tests and discography are done.
All of these tests are to ascertain the condition of the bones, joints,
and nerves and to investigate for degeneration in the spine and bony
abnormalities.
Initial treatment is to
rest the back. Ice is used for a new
injury to reduce swelling, inflammation and pain. Nonsteroidal Anti-inflammatory
Drugs are used to reduce inflammation and pain.
Physical Therapy and exercise are recommended.
How does Eastern medicine diagnose
and treat lower back pain?
Lower back pain and sciatica can be discussed together
with common etiology, pathology and treatment.
50% of the western industrialized world will suffer from back pain at
some point in their lives. Excessive
physical work such as heavy lifting strains muscles in the back and the Kidney
channel. A weakened back weakens
Kidney Qi. Stagnation of this Qi and
blood causes intense pain in the lower back.
This can be acute or chronic. Many
situations can cause this result. Occupations
that require heavy physical work such as furniture movers, excessive sports or
exercise and excessive sexual activity can cause back sprain, strain and injury.
Excessive sexual activity weakens the back in an energetic sense and
depletes Kidney Qi and this deficient Qi leads to a chronic weak back.
Pregnancies and childbirth puts physical and energetic strain on the back
muscles. Kidney Qi is depleted with
each pregnancy. Weak constitution
and poor diet after childbirth can deplete energy.
Supplementation can improve Kidney Qi.
Traditional
Chinese Medicine explains this as an invasion of cold and dampness.
It is necessary to warm and protect from the invasions of cold damp.
Cold and wet weather can invade the muscles, sinews and channels.
Climatic factors, insufficient clothing, sweating or swimming and staying
in the wet clothing afterwards can affect the channels.
Overwork for long hours and little rest can deplete Kidney Yin and fails
to nourish the back and leads to chronic backache.
Inadequate exercise weakens the spine ligaments and joints.
Poor posture, heavy weightlifting and excessive aerobic exercise can
result in lower back pain. Tai chi
and yoga keeps ligaments and muscles supple and calms the mind.
This damp-cold pain is
worse in the a.m., better with light exercise, application of heat and worse
when the weather is cold and damp. Stiffness
and contraction of back muscles with more severe pain aggravated by rest
indicates cold predominance. Movement
and the application of heat will improve the situation.
Dampness symptoms include swelling, numbness and a heaviness feeling
similar to Painful Obstruction Syndrome (See a Story
of Lizzie).
The stagnation of Qi and
blood presents with a severe stabbing pain.
The pain will be worse with rest and better with movement or light
exercise. The area will be tender to
touch and does not really respond to heat or climatic changes.
The pain is worse on standing or sitting.
Rigidity and stiffness prevail.
Kidney Deficiency causes
chronic backache. The pain is dull
and comes and goes. It will be
aggravated by overtiredness or sexual activity.
There will be a cold sensation and only a small improvement with occur
with heat application. Sprains and
cold damp can contribute to pain. Middle-aged
or elderly people usually suffer from this.
Excessive physical work or exercise as in ballet during the time of
puberty can cause Kidney weakness.
In Kidney Yang Deficiency
the face is pale. When the area of the lower back is stiff, hard and rigid on
palpation, stasis from sprain can be suspected.
Coldness indicates Kidney Yang Deficiency.
If the vertebrae are widely spaced Kidney Deficiency may be the root
cause. The tongue is pale, swollen
and wet. The coating is white.
In Kidney Yin Deficiency
the face is dark like a beet. A blue
face indicates stasis of blood and chronic pain.
The tongue is red or dark, dry and peeled (no coating).
Congested venules at the
back of the leg is another indication of stasis of blood. A sunken inner ankle
muscle at the Ki3 point indicates Kidney Deficiency.
Stabbing pain at area will indicate stagnation of blood.
Dull pain will indicate deficiency. It
will improve with light exercise. Local
stagnation will improve with rest due to the deficiency.
If pain is worse in a.m.
and gets better as the day progresses, the pain is due to a cold invasion.
If the pain is better in the a.m. and worsens as the day progresses, the
pain is due to a Kidney deficiency pattern.
Pain will get worse in cold weather if it is due to cold.
Damp pain will be unrelated to the weather.
A throbbing pain will indicate a vascular problem.
If the area of pain covers
a large area Kidney Deficiency can be a result an invasion of cold and damp.
Small areas are sprains.
Swelling of the lumbosacral
area can be the result of stasis of blood and spider veins may be present.
Lower back pain can result
from misalignment of the scapula, hips and pelvis.
Leg lengths can be compared by comparing the levels of the medial malleoli.
Shorter leg means that the pelvis is posterior and the longer leg means
that the pelvis is anterior. The
psoas muscle flexes, adducts and rotates the thigh medially.
This muscle can be responsible for many L2-L3 problems.
The lower back area compensates when vertebrae are misaligned and/or
muscles are tightened or atrophied. This
results in pain.
Traditional Chinese
Medicine assesses the pulse. The
pulse in the left rear position will be wiry and floating or fine and deep
meaning that there is a chronic Kidney Deficiency present.
The pulse will be tight in damp-cold patterns.
Kidney problems would also manifest themselves with symptoms of fever,
edema, scanty dark urine, malaise or headache.
Stones would have colicky pain migrating from the low back into groin.
Protein would be present in the urine.
Kidney channel disturbance can be accompanied with tinnitus, dizziness
and pale frequent urination.
How does Amma
Therapy help the pain?
Amma Therapy like acupuncture circulates Qi to remove stagnations and
blockages that cause pain. Heat can
be applied to cold conditions and cold can be applied in heat situations.
Exercise is recommended for moving Qi and improving flexibility and
strength of the muscles. Tai Chi Chuan and Yoga are excellent methods to achieve
this purpose without stress on joints. I
recommend a personalized exercise program containing a combination of yoga and
conventional exercise. Swimming is a
wonderful way to expend calories, strengthen and improve the flexibility of
muscles without stress on the joints of the body.
A diet that consists of
foods that supplement the Kidney is recommended.
When Kidney Yang Deficiency is diagnosed, warming foods that nourish the
Kidney Qi and Essence are indicated. These
foods include:
Fenuagreek seeds, fennel,
anise seeds, black pepper, ginger (dried), cinnamon, walnuts, black beans,
onion, garlic, chives, scallions, leeks, quinoa, chicken, lamb, trout and
salmon.
When Kidney Yin Deficiency
is diagnosed, tonifying and nurturing foods are recommended.
These foods include:
Millet, barley, tofu,
string bean, black bean, black soybean, black sesame seed, kuzu root, mung bean,
Kidney bean, blackberry, blueberry, mulberry, huckleberry, water chestnut,
seaweed, wheat germ, spirulina, chlorella, sardines, crab, clam, egg and cheese.
Some herbal remedies can be prescribed by a herbalist such as
Rehmannia-Six or Six Flavor Tea Pills which contain Rehmannia Glutinosa and
Asparagus Root to tonify Kidney Yin.
Amma Therapy and Massage
Techniques stimulate the release of endorphins which are the body’s natural
pain killers. It calms the nervous
system resulting in improved sleep, muscular tension, mental and physical
stress. It increases the flow of oxygen and nutrients to cells and tissues by
increasing the circulation of blood and lymph.
It aids in the removal of toxins from the body.
Bodywork can improve joint flexibility and motion.
It enhances overall performance and feeling of well-being.
Acupuncture
has gained support from the World Health Organization for the treatment of back
pain.
Biomagnetic
Therapy has been useful in treating back pain.
Magnetic Mattresses and Back Magnets have provided relief for many
clients and are popular among the golf professionals.
Amma Therapy focuses on
eliminating blockages allowing the free flow of Qi in the channels.
Posture is noted and corrected.
-
The area at GV14 is where all of the yang
channels converge. When
Dowager’s hump is present the channels get congested.
Special attention is given to this area.
-
BL23 is the yu point of the Kidney and
tonifies the Kidney, strengthens the lower back and benefits the bones.
-
BL25 is the yu point of the colon.
It is used for chronic problems like constipation and lower back
pain.
-
BL36 is used in combination with GB30 to
circulate Qi in lower back pain and sciatica. GB30 strengthens the lower
back, circulates Qi and blood to lower leg and strengthens sciatic sinews.
-
Distal points are useful.
-
BL40 is in the center of the popiteal
crease. BL39 is to the left of it.
-
BL57 relaxes the sinews and teats chronic
lower back pain and the upper back.
-
BL58 treats sciatica and strengthens lower
back
-
BL60 strengthens lower back
-
BL61 strengthens lower back, relaxes
sinews and removes obstructions
-
BL62 on the right with Si3 on the left
strengthens the spine.
-
Sp 6 regulates the smooth flow of liver
Qi, calms and promotes the flow of blood and Qi to muscles.
-
Ki3 is the organ point for the Kidney and
alleviates lumbar pain.
-
Liv5 regulates the smooth flow of liver Qi
and treats the lower back.
-
Tunzhong is an extra point that relieves
leg pain to the buttock.
The key is to prevent back pain by proper
posture, exercise, and good body mechanics.
For individuals whose occupations require them to sit long hours,
frequent stretching breaks are indicated. Good
comfortable but supportive chairs are essential.
Get rest, drink plenty of water! Shoes
should be comfortable and supportive too!
If you would like to read more about neck
or back pain, I recommend the following books
and websites:
[ Back ] [ Up ] [ Next ] |