Low back pain

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Textbook Prescriptions Pain — Low Back

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

BL23 Shenshu bilateral

Back-Shu of the Kidney; supports kidney qi
GV3 Yaoyangguan midline

Local point on the lumbar spine

Needle and moxa in the cold-damp type.
BL58 Feiyang bilateral

Luo point of the Bladder; key distal point for the low back

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

Treatment Principle

Move qi and blood, relax the muscles and open the collaterals of the low back.

Indications

Cold-damp: pain and heaviness of the lumbar and dorsal region after exposure to wind, cold and damp, stiff muscles limiting bending, pain possibly spreading to buttocks and legs, a cold feel in the area, worse in wet weather and not eased by restKidney qi deficiency: gradual onset, mild lingering pain, weak sore lower back and knees, worse with exertion and better with restSprain: history of lumbar injury, rigid painful back with fixed pain, worse on pressure and when turning

Method

Cold-damp: acupuncture with moxibustion at BL23 and GV3. Kidney deficiency: reinforcing method with moxibustion. Sprain: reducing method, or pricking to bleed.

⚠ Cautions

Exclude red-flag causes before treating: fracture, cauda equina signs (saddle numbness, bladder or bowel change), malignancy, infection, abdominal aortic aneurysm and renal disease. Bleeding at BL40 needs clean technique and is unsuitable for patients on anticoagulants or with bleeding disorders.

About

The colleges' prescription for low back pain, drawn from the Governor Vessel and Bladder channel, with additions for deficiency and sprain.

Rationale

BL23 supports the kidney, GV3 treats the lumbar area directly and BL58, the Bladder Luo point, acts from below; the three together relax the soft tissue and get blood moving. In the cold-damp pattern, needling and moxa at BL23 and GV3 warm the channels and drive out cold and damp.

Clinical Notes

Kidney qi deficiency: add GV4, BL52 and KI3 to replenish kidney essence. Lumbar sprain: add Renzhong (GV26, catalogued as Shuigou), chosen as an upper point for a lower disorder, and prick BL40 to bleed for the acute rigid back. The book relates low back pain to renal disease, rheumatic conditions and lumbar strain or injury, and gives an ear-acupuncture option.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Low back pain, p. 362–364.

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