Chinese Medicine for Back Pain

My first anatomy teacher had a doctorate in neuroanatomy. He was a chiropractor as well. It seems reasonable to assume that he understood back pain better than most. He said that a practitioner could always do well treating back pain for two reasons. One is that there is so much of it going around and the other reason was that 80% of back pain resolves on its own with or without medical intervention. This article is for the 20% whose pain has not gone away all on its own.

Back pain is commonly considered a nerve impingement syndrome. The way it works is that there's some kind of structural problem that prevents the nerves from exiting the spinal cord through the spinal vertebrae and out into the body. When there is something pinching one of these nerves as it exits the spine it causes pain. The common term for this problem is a "pinched nerve."

One way in which doctors determine if there is a nerve impingement is by having the patient lean to the right, and then to the left in order to see if that movement has any effect on the pain. If it does, then a nerve is being pinched. If that pinching can be relieved, then, presumably, the pain will go away along with it. It is important to note that this is just one way of testing for a nerve impingement syndrome. This test isn't always an end-all diagnostic tool.

While removing the obstruction to the nerve should remove the nerve pain, it doesn't always work. Surgery, which is expensive at best and dangerous at worst, may be required. Chinese medicine sees these pains as having several possible etiologies. An examination of these causes and some suggested treatments to alleviate the pain are discussed below. Perhaps you'll recognize your own situation and be able to see an acupuncturist/herbalist to help treat it.

Qi stagnation

Qi is pronounced "Chee" and is sometimes spelled Chi. This is basically the energy that circulates throughout your body. This Qi flows through a network of channels and meridians. This sounds much like our neurological system. If push came to shove, we could say that Qi stagnation is the pinched nerve syndrome. But this is not entirely accurate because acupuncture is very adept at treating this frequent cause of back pain without having any effect on the mechanics of the situation. We simply insert needles near the location of the pain and at a few other strategic locations to stimulate the movement of qi in the desired area and the pain goes away. We don't do any manipulation of the spine, perform surgery to remove a herniated disc, or perform any other invasive procedure and, yet, the pain is relieved. This begs the question - Is the nerve impingement theory the correct explanation for back pain?

While debating the cause is interesting for theorists, it does little for the sufferer. Left untreated, Qi stagnation can lead to blood stagnation, and what was a dull ache that radiates outward from the central location can become a very sharp fixed pain. Qi stagnation lower back pain is sometimes found in women who have painful periods. Again, in this case,  acupuncture is the treatment of choice.

Another cause of Qi stagnation is the invasion of cold or dampness into the acupuncture channels that go up and down the spine. In Western culture we talk about catching a cold. In Chinese medicine we can also catch a damp. This damp and cold can end up in the meridians and slow the flow of Qi and cause pain. For instance, if cold or damp weather aggravates the condition, then it is likely that you've got some cold or dampness stuck in the channels of the back impeding the flow of Qi. This is actually a typical form of arthritis. A great herbal formula for this is called Du Huo Ji Sheng Tang. However, this is only appropriate if the problem is aggravated by cold or damp weather. If your diagnosis is incorrect it won't help, and may even hamper your healing. That is why it is recommended that you see a qualified acupuncturist/herbalist who can give you an accurate diagnosis.

Blood Stagnation

There are two main causes of blood stagnation; one is that there was some local trauma. This could be caused by heavy lifting, a sport's injury, or perhaps even an automobile accident. Any specific trauma to the back will give rise to what we call blood stagnation. The treatment principle is the same as the Qi stagnation. We just get the blood moving and the pain goes away. We may also choose to use some herbs to dispel the blood stasis. Blood stasis is the local inflammation, bruising, and purple thick blood that is found at the site of the trauma.

Yun Nan Bai Yao is a commonly used herbal formula that is used to heal bruising. It is sold in capsule form and powdered form. You'll want to take the capsule form if the skin isn't broken, and the powdered form sprinkled right on to the wound if there is bleeding present. For the form that comes in capsules, you'll want to be sure that is says "in capsules" on the package. The spelling on that package is slightly different. It's called "Yunnan Paiyao". Same thing inside. Its 100% San Qi or Radix pseudoginseng, an herb that has proven to be remarkably effective for bleeding and blood stagnation conditions.

The other cause of blood stagnation is a long history of Qi stagnation. The Qi is said to move the blood. Should the Qi remain stagnant for long enough, then the local body fluids that are supposed to be flowing begin to stagnate as well.  We might also see some emotional component in this particular pathology - for instance, a long history of frustration, resentment or some other really bitter emotional pathology. We all get frustrated once in a while and that can give rise to the Qi stagnation type of back pain, but if it goes on for long enough it becomes more tight, compacted. In this case, the body begins to really manifest that stagnation in the form of lumps, tumors, sharp pains or other blood circulation problems. Other formulas might be better to treat this particular issue and once again, it is recommended that you consult a trained Chinese medicine herbalist who would be able to direct you to the appropriate formula.

Damp Heat

This pathology can cause radiating pain that actually circles the lower back down into the groin area. This kind of symptom may suggest some problems that would be better addressed by Western medical attention. Check with your MD and if you don't have any serious pancreas or liver pathologies, then go visit your practitioner of Chinese medicine, we have some great answers for you.

Basically; this is a back pain, normally in the lower back,  that is associated with a kind of infection in the urinary tract or other area in the lower abdomen. This might be kidney stones, or this could be a bladder infection. In any case, it is often some uro-genital disorder that may include a local infection of some sort. Herbal medicine is often times employed to dry the damp and clear the heat. Herbal medicines again would be used to treat this condition, though the formula itself would be chosen based on other signs and symptoms.

Kidney Pathology

Like the damp heat problem listed above, this is not a nerve impingement syndrome but an issue that deals with the organs found beneath the skin in the lower back. Those are the kidneys. Kidney pathologies run the gambit from stones, to a deficiency of Yin or Yang in the body. Yin deficiency tends to include lower backache that is a long-term problem, six months minimum with no history of trauma. It just started hurting one day and never went away. Other symptoms of Yin deficiency include hot flashes, night sweats, tinnitus, irritability, restlessness and the feeling that your hands and feet are too hot. Acupuncture treatments would be consistent with stimulating the kidney functions and herbal medicines such as Liu Wei Di Huang Wan would be employed to treat the root cause of the pain.

A deficiency of Kidney Yang could also give rise to lower back pain. Other symptoms of Kidney Yang deficiency would be early morning diarrhea, cold hands and feet, lack of energy, pale face, hearing loss, feeling cold all the time, frequent urination, low libido.

In either case, we would seek to strengthen these most important organs to take away the lower back pain. This might take a little longer to achieve than the Qi or Blood stagnation problems. But it still responds well to treatment with acupuncture for the specific pains and herbal medicines that go a little deeper into the organs to strengthen what is weakened. Herbal medicines for this might include Jin Gui Shen Qi Wan or one of the other patent formulas designed specifically for lower back ache due to a deficiency of Kidney Yang.

Most of the herbal formulas mentioned in this article are available at pharmacies that carry pre-made Chinese medicines in pill form. Another way in which a trained Chinese medicine herbalist would use these formulas is as the base for a more complex formula. This prescription not only takes into account the things I've mentioned above, but also other signs and symptoms that you might not consider related to your back pain. An intelligently written formula will treat the root cause of the pain as well as all of its manifestations, not just the back pain alone.

Formulas written specifically for the patient tend to be a little more expensive than the pills you'll find in your local Chinatown, but they also tend to be more focused to your specific needs and often times can work better. Once a formula is written, the prescription can be filled at a Chinese herb pharmacy in the form of raw, or bulk herbs that would need to be taken home and brewed into a tea for consumption. Some of us use powdered extracts instead of raw herbs and put these extracts into capsules for easier consumption. Both are effective.

Backaches are a common pathology among people everywhere and thanks to the Westward expansion of traditional Chinese medicine, people are coming to appreciate the age old medical wisdom of the Orient. This is especially true with regard to the alleviation of back pain.