Lower Back Muscle Pain - The TCM Perspective

In Chinese Medicine, pain occurs when there is obstruction in the flow of Qi and Blood through the channels, organs and tissues. Pain is most often a subjective ailment involving physiological, emotional and psychological issues and can thus be quite difficult to treat, especially more so in the Western medical paradigm, as western science has only in very recent times, understood and acknowledged the importance of the emotional and psychological factors in causing diseased states.

Where Western Medical Science has failed dismally in treating and controlling pain, especially when it is of a chronic nature, Chinese Medicine and especially acupuncture, has filled the void quite admirably. In fact, the first forays of genuine interest in Chinese Medicine and Acupuncture were established in the 1950's, when the first reports of operations under acupuncture analgesia were reported from China. Since then, many studies into the efficacy of acupuncture analgesia have been conducted both in the Western and Chinese arenas. Today, although Acupuncture has achieved world fame, the general community as a whole, is more familiar and comfortable with the pain relieving effectiveness of acupuncture than with the therapy as a complete form of medicine, equal to if not more powerful than the Western model.

In China, acupuncture has been used for thousands of years as a treatment for pain relief. In TCM, pain is seen as a symptom which manifests when there is a disharmony in the free flow of Qi and Blood ie.when Qi/Blood is blocked or obstructed, pain occurs.

In order to accurately interpret pain and to facilitate appropriate treatment strategies,
the symptom of pain (Qi and Blood stagnation in TCM) has to be analyzed according to the 8 Patterns of Differentiation -

-Interior (li)/Exterior (biao)
This parameter defines the location of pain whether it is relatively superficial or deep. It can reside in any of the anatomical positions - superficially along the pathways of the channels and collaterals or deeper in the bones and Zang fu.

Superficial Pain (Luo and Meridians)-
This type of pain will generally reflect an invasion by an external pathogenic factor and the disorder does not last for very long. Changes in environmental conditions can affect symptoms, for better or worse. By locating which area of the body is painful by palpation, the exact channel involved can be located.

Deeper Pain-
The pain is experienced at a deeper level, with a wider range of symptoms, associated with one or two organs. Usually, there is no recent history of pathogenic invasion and the illness can be chronic. Pain is usually in the proximity of the Organ or in an area that corresponds to that Organ. Organ theory (Zang fu Theory) is used as differential diagnosis.

-Cold (han)/Heat (re)
This parameter establishes the nature of pain. Cold pain is accompanied by a cold sensation and reduced local temperature. Pain aggravated by cold and alleviated by heat, indicates either deficiency of yang Qi or Cold pathogen. Cold slows the circulation of Qi and Blood and promotes the emergence of pain.
Heat pain is accompanied by a hot, burning sensation. There may be local redness and swelling. This type of pain which is aggravated by heat and alleviated by cold, indicates either yin Deficiency or an attack of pathogenic Heat.

-Deficiency/Excess
This parameter reflects the state of Qi and the presence of pathogenic Qi
Pain from deficiency which improves with pressure or local support, means that Qi is deficient.
Pain from excess, which is aggravated with pressure, indicates that pathogenic Qi
is present.

The pain associated with Qi disorders is usually generally deeper than that associated with channels and collaterals. There is usually no history of invasion by an external pathogen but the aggravation or relief of symptoms can frequently be associated with an emotional/psychological disturbance.

-Yin/Yang
This parameter qualifies the type of pain.
A yin type pain is dull, throbbing, and constant, of moderate intensity, chronic, deep, aggravated at night.
A yang pain is sharp, violent, paroxysmal, stabbing, burning intense, superficial.
The Yin/Yang parameter incorporates the 6 others and allows the practitioner to pinpoint the origin of the symptom.

These 8 parameters must be studied in relation to one another in order to distinguish Deficiency and Excess in relation to Heat and Cold, to Interior and Exterior, to Yin and Yang. Once the patient's symptoms have been collated with the findings of all the above parameters, the site of the disease and the nature of the disease will be able to be determined.

CONCLUSION

TCM can be a very effective method of recognizing and treating different types of pain and can be particulry useful in the diagnosis of back pain and lower back pain.
Different patterns of lower back muscle pain can be treated with acupuncture and traditional Chinese medicine.

In saying that other methods including hypnotherapy and naturathopy can also be employed to help manage back pain. Yoga can certainly be beneficial in the management of back pain.