Acupuncture and low back pain - a Chinese Medical Perspective

Recently, the Government Watchdog - The National Institute for Health and Clinical Excellence (NICE) recommended acupuncture as one of the first treatments of choice for non-specific lower back pain.

Clinically, low back pain can be found in various diseases. The cases most commonly seen in the clinic are caused by:

1. Trauma due to Sprain or Contusion
2. Invasion of External Wind /Cold / Damp and
3. Deficiency of Kidney Qi (energy)

1. Trauma due to Sprain or Contusion

Trauma may cause injury of Qi and Blood in the body's energy channels; this leads to stagnation of Blood and Qi and that stagnation causes pain.  There is often a history of back sprain in the lumbar area, rigidity and pain which is fixed in a certain area, is made worse by pressure or by turning the body. The patient's tongue is purple and their pulse is wiry, reflecting pain, and hesitant, reflecting stasis of Blood.

2. Invasion of External Wind/ Cold / Damp

In this case,low back pain is due to obstruction in the energy channels by damp and cold, disrupting the free flow of Qi. Stagnation of Qi and Blood becomes worse on cloudy and rainy days and so does the pain. It may be caused by living in cold, damp places, exposure to rain or wading in water or being drenched in sweat. This condition commonly appears up and down the coast amongst windsurfers, fishermen and the sailing fraternity. It is characterised by a heavy sensation and stiffness of the muscles in the area of the lower back, limitation of extension and flexion of the back, pain radiating downwards to the buttocks and lower limbs and a coldness over the area.  The patient’s tongue coat will be white and sticky, reflecting damp trapped in the system with a deep, weak or deep and slow pulse, reflecting cold.

3. Deficiency of Kidney Qi

In this case, low back pain is often caused by excessive sexual activity that consumes the Essence and Qi resulting in poor nourishment of the energy channels in the lumbar region. It can also be seen in the senior population, whose Qi and Essence naturally wanes with advancing years. This condition has an insidious onset of longstanding pain and soreness with lassitude and weakness of the loins and knees: it is aggravated by activity and alleviated by bedrest. If the patient is suffering from Kidney Yang Deficiency, typically they will show symptoms of pallor, feeling the cold, lack of strength and drive: their tongue will be pale and wet and their pulse deep and slow. If the patient is suffering from Kidney Yin Deficiency, they will have symptoms of insomnia, irritability, dry mouth and throat, flushed face, sometimes hot palms, chest and soles. Their tongue will be red, without the normal coat and their pulse will be thready and weak or thready and rapid.

Acupuncture treatment involves the insertion of hair-fine needles in appropriate acupoints once a differential diagnosis has been made. The action of the needles will move Qi and Blood to expel pathogenic factors where necessary and strengthen Qi. Sometimes electro-acupuncture is used, as well as other techniques such as magnets, cupping therapy or moxibustion (warming the channels by burning a herb on the needle). Pain is dispersed by removing obstructions in the channels, activating Qi and stimulating the release of endorphins, the body's natural pain killers.

Your GP can now recommend a course of up to 10 sessions of acupuncture over a period of up to 12 weeks.

Read more about our acupuncturist, Noelle Ayers-Morgan.