Low back pain (or Yāo tòng) as seen by Chinese medicine.
The Chinese term yāo tòng refers to back pain, whether unilateral or bilateral. Low back pain is often encountered in clinical practice. It is not uncommon that behind this apparently simple complaint, other complications may be hidden such as :
- a herniated lumbar disc,
- lumbar disc protrusion (collapse of the vertebral discs),
- kidney stones,
- spinal osteoarthritis (degeneration of the intervertebral disc).
Sciatica or back pain (especially in the lumbar region) affects between 50 and 70% of the population. The origin is variable. It lasts from a few days in acute phase to several years. Traditional Chinese medicine links these pathologies to the Kidneys and the Bladder.
Low back pain is pain of the back that originates from the muscles located on both sides of the spine (the quadratus lumborum). The spasms of these muscles cause significant pain. This starts below the last dorsal vertebra (L1), to go down through the buttocks, extending behind the thigh, then behind the knees, and sometimes to the toes.
Less well known is cruralgia, a pain that focuses on the front part of the thighs and the outside of the buttocks and that can go down to the front of the knee, the shins and the toes.
Both types of pain are often only felt on one side of the body.
Etiology
These low back pains can have very diverse origins:
- Excess of physical activity
- Unsuitable physical activity
- Bad posture (or prolonged position)
- Sudden movement (without respect for joint physiology)
- Exaggerated repetition of a movement
- Heavy loads lifted
- Traumatic injuries
- Lack of physical activity
- Excessive sexual activity
- Pregnancy and childbirth
- Overwork
Clinical signs
Chinese medicine identifies through its diagnosis different syndromes at the origin of the pathology:
- A cold wet wind: this is a pervert that can invade the Bladder meridian. The cold contracts the muscles of the back. Moisture hinders the circulation of Qi and Blood, thus causing obstruction, which is a source of pain.
- Heat-humidity: when pathogenic factors (heat – humidity) penetrate and stagnate in the body, there is a feeling of heaviness.
- The stagnation of Qi and Blood: localized, it causes muscular contractures, and therefore pain.
- Emptiness of the kidneys: this reinforces the impact of the above-mentioned perversions, as the kidneys can no longer nourish and strengthen the back muscles.
Depending on the syndrome, the pain may have different characteristics:
- acute or chronic,
- sensation of cold or heat,
- heaviness,
- more intense during the day or night,
- at rest or in motion,
- tingling, numbness,
- fixed or erratic,
- dull or sharp,
- revived by emotions,
- more intense after effort…
The lumbar region, home of the Kidneys
Low back pain is pain in the lumbar region, an area that is connected to the Kidney, Bladder, Governing Vessel and sometimes the Belt Vessel meridians.
According to TCM, the lumbar area is connected to the Kidney. This organ is also coupled to the Bladder. The Bladder meridian is a long meridian that runs down the spine, continues behind the thigh, joins the calf and ends on the side of the foot at the little toe.
“The lumbar region is the home of the Kidneys and the root of the Qi.” Their deficiency promotes the penetration of perverts into the lumbar region. The Zu Tai Yang (Bladder) meridian as well as the Du Mai (Governor) meridian run through the lumbar region. If perverts invade and obstruct these meridians and the Kidneys fail to defend their home, lumbago occurs.
The invasion of external perverts
Sweating, living in a cold and damp environment, working in water or in a humid environment, etc. can all make the body prone to the attacks of external perverts such as Wind, Cold and Humidity. If we add other internal factors, such as the excessive consumption of hot, spicy and fatty foods, these perverts can, in a second stage, turn into Dampness-Heat.
When attacked by these external perverts, the meridians are obstructed. Wind is a Yang pervert which often starts with the Yang meridians when it invades the body.
Cold and Damp are Yin perverts, which often start by attacking the feet and then spread upwards.
The latter two do not necessarily cause low back pain, unless there is a Kidney Yang Emptiness.
If you sweat a lot or work in a cold, damp place, your body may be prone to these attacks. The Wind is mainly involved because it is a Yang pervert which attacks the Yang meridians, i.e. the Bladder and Biliary meridians.
However, the attack will remain superficial, affecting mainly the muscular tissues.
Mechanical trauma
Low back pain can develop gradually following a trauma to the lumbar vertebrae, for example, following an accident. It often occurs as a result of prolonged muscular tension related to: a state of tension, stress, poor posture, an accident or carrying an excessive load.
In case of sprain or tension, the local meridians are affected, which leads to a stagnation of Qi and blood stasis, and consequently to pain. The consequences can be more or less serious, for example, up to the displacement of a vertebra or the pelvis. Without rapid intervention, the body may quickly compensate by correcting its posture, thus generating new tensions and new pains.
It is then recommended to consult an osteopath or a physiotherapist to restore a correct posture.
Emotions and aging
Any intellectual overwork or sexual excess can affect the Kidney organ, draining its energy and therefore having an impact on the lower back.
Strong emotions related to the Kidney, such as fear and anxiety, can trigger delayed pain in the lower back.
Chronic illness will also consume the Qi and Blood, as will aging. The function of the Qi and Yang of the Kidneys is to warm and circulate the Blood so that it fills the meridians and nourishes the muscles, tendons, bones, tissues, etc.
If the Qi and Blood are weakened, they will not be able to fulfill this function, which will generate internal cold and an accumulation of mucus. As a result, the loins will receive less heat and nutrition. This will result in, among other things, low back pain.
The Kidneys also govern the bones. A weakness at this level can of course trigger lower back pain.
Therapeutic techniques
Acupuncture and moxibustion can give quick and satisfactory results. The work will consist in clarifying the heat, teasing the meridians and dispersing the cold to eliminate the perverts. It will also be necessary to regulate the Qi and Blood to nourish the Kidney.
It is important to use Chinese pharmacopoeia to reinforce the work of acupuncture. Qi gong is highly recommended to strengthen and nourish the Kidneys, and to promote the circulation of Qi throughout the body.
We also use cupping and Chinese Tuina massage. But the use of Chinese pharmacopoeia is essential.
Osteopathy and exercise
A certain number of tests are to be performed to identify muscular hyper or hypotonia, an osteoarticular imbalance, localized or distal.
Low back pain can therefore occur as a result of different body situations :
- badly treated ankle sprain,
- trauma to the knees (ligaments, menisci…),
- a locked shoulder,
- a hypertonic lumbar spine (it accentuates the lumbar lordosis),
- a hypotonic abdominal belt…
Osteoarticular normalizations are therefore to be performed in order to restore the balance allowing the free circulation of blood and energy, and to calm the pain.
Physical exercises are also recommended to strengthen the back and the abdominal muscles (static exercises in particular).
Duration of treatment
Finally, as in any pathology, it is important to adapt one’s lifestyle (work, leisure, rest, sports activities…) while limiting stress factors. This includes, of course, dietetics, but also activities such as yoga, qi gong or meditation that help build a more stable emotional state.
The duration of care will of course depend on the duration of your condition. An acute attack can be relieved in a few days. Chronic low back pain will take longer to treat. Results will be faster and more durable if the patient makes the appropriate changes in his or her life.
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