Acupuncture for Low Back Pain - Treatment Protocols

General Approaches

Acupuncture For Low Back Pain - Treatment Protocols

Acupuncture treatment protocols are generally directed towards the deeper root of a persons set of health issues, not at each individual issue. In Traditional Chinese Medicine, treatment is generally directed towards the individuals diagnostic pattern(s) and their primary issue is only a part of the information required to approach the correct patterns to treat (see "treating the cause vs. the symptoms" for an introduction to this process.).

In designing an acupuncture protocol for back pain, one might find one or a combination of the following patterns: blood stagnation, kidney yang deficiency, kidney yin deficiency, liver qi stagnation among many other possibilities and possible combinations.

Below you will find some of the more common tcm diagnoses and acupuncture treatment protocols for low back pain and related issues. There are many ways to approach the treatment of this condition within TCM. Our presentation describes foundational approaches that would need to be further tailored in most cases to be effective for a given individual.

  • Etiology & Pathology:
    1. Stagnation of Qi and Blood in the lumbar region due to trauma (i.e. sprain or contusion)
    2. Invasion and retention of pathogenic cold/wind/damp in the corresponding channels and collaterals (i.e. the Urinary Bladder, Gall Bladder and Governing Vessel Channels) causing obstruction and retardation of the circulation of Qi, and resulting in pain.
    3. Xu of the Qi of the Kidney
  • Differentiation:
    1. Trauma (i.e. sprain or contusion) leading to Stagnation of Qi and Blood:
      • Signs & Symptoms:
        • History of Sprain
        • Pain and/or rigidity of lower back
        • Pain usually fixed and aggravated upon movement and/or pressure
      • Treatment Points:
        • First needle the empirical points and move the patient's body to a position where the pain begins to appear. Manipulate the needle with reducing method for 1-2 minutes. If the patient responds well, repeat this process a few times then insert auxillary/local points and retain for 15-20 minutes.
        • Empirical Points:
          • GV 26 - if pain is only on the midline of the back and patient has flexion/extension difficulty
          • SI 3 - if pain is on the posterior-midline and also lateral and/or patient has torso rotation difficulty
          • Yaotongxue - if pain is on either side of the posterior midline, pain above UB 23
          • UB 40 - acute back pain on the UB meridian, pain below UB 23
          • UB 37 - in lieu of UB 40 if there is pain and tenderness here and no congestion of blood vessels at UB 40
          • GV 8 - stiff and/or rigid spine
    2. Cold/Wind/Damp:
      • Signs & Symptoms:
        • Pain began after exposure to pathogenc cold/wind/damp
        • Heavy sensation and pain in the lumbar region
        • Stiffness of the muscles with possible limitation of movement
        • Pain usually involves a larger area and also be in the buttocks and/or down the leg
        • Area may feel cold to the touch and/or to the patient
        • Pain is often weather related
        • Pain is not alleviated by bed rest
      • Treatment Points:
        • GV 3 - expels cold damp
        • UB 23 - expels damp, tonifies the Kidney
        • UB 52 - chronic back pain above UB 23, direct needle towards pain
        • UB 32 - sacral pain
        • UB 54 - expels cold and damp
    3. Kidney Qi Deficiency:
      • Signs & Symptoms:
        • Pain is not severe - experience a sensation of soreness
        • Weakness in the lumbar area as well as in the knees
        • Fatigue and lassitude
        • Symptoms aggravated by exertion and alleviated by bed rest
        • Frequent urination, polyuria & other KD Qi Xu symptoms possible
      • Treatment Points:
  • Common Distal Points for all Differentiations:
    • Urinary Bladder Channel:
    • UB 37 - history of trauma and stagnation of Qi and Blood
    • UB 57 - spasm of gastrocnemius or pain radiates to area
    • UB 58 - function of movement is impaired and back/leg pain is not so severe - or when there are signs of retention of damp and stagnation of Qi and Blood
    • UB 59 - severe pain and limitation of movement
    • UB 60 - chronic back pain, both lumbo-sacral and posterior leg pain
    • UB 62 - dropped foot or back and leg pain w/difficult walking due to spasm in the channel
    • UB 63 - acute and severe pain along UB channel
    • Gall Bladder Channel:
    • GB 30 - sciatica and hip pain, bi syndrome of hip
    • GB 31 - dispels wind, dispels cold/damp, used for pain in lateral thigh
    • GB 34 - back and leg pain with GB channel involvement
    • GB 39 - pain that radiates to the lower leg, frequently used for neck sprains

The information on our site is drawn from our own lecture notes and clinical experience. The following lecture notes were consulted within this section:

  • St. John, Meredith: New England School of Acupuncture, Etiology and Pathology Lecture Notes
  • Valaskatgis, Peter: New England School of Acupuncture, Etiology and Pathology Lecture Notes

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