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Expert Advice-Treatment of Low Back Pain in Traditional Chinese Medicine(TCM):
Low Back Pain
Acupuncture for Low Back Pain
Low back pain is probably the commonest health
problem in the United States, and it is also one of the most common reasons
for a medical doctor to refer a patient to an acupuncture clinic.
Because acupuncture is relatively new in this country, there have not been
many scientific studies done here on the general effectiveness of acupuncture.
Studies sponsored by the National Institutes of Health (NIH) have been
done in the areas of pain control, drug detoxification, and nausea reduction,
and have shown acupuncture to be a safe and effective treatment modality
for those problems. There are many more studies from Asia and Europe
that support the use of acupuncture and Chinese medicine for a variety
of health conditions. The reason American doctors are more and more
willing to refer their patients to acupuncturists for pain-related and
neurological problems is because of the NIH studies, and because their
patients report that acupuncture has a high success rate.
In my experience, acupuncture not only reduces
pain, it also promotes the healing process by bringing a stronger flow
of blood and energy (Chi) to the affected area. Because acupuncture
can affect the release of endorphins in the brain, people often find that
acupuncture treatments reduce stress and produce a feeling of well-being,
in addition to controlling their pain.
Most people probably think that back pain
is back pain, but it is important to distinguish between acute low back
pain and chronic low back pain. Type of treatment, length of treatment,
and treatment outcomes will vary, depending on which kind of back pain
you have.
Acute low back pain: If you have just
injured yourself, and come in to have an acupuncture treatment right away,
you will usually see immediate results. Recently I saw a young man
who had injured himself two days before when he tried to lift a heavy couch.
He had never experienced back trouble previously. His pain was so bad that
he could hardly get out of bed, or even go to the bathroom. He needed
assistance to get up on the treatment table and to take his shoes off.
After the acupuncture treatment he immediately felt much better, got off
the treatment table by himself, and could bend over to put his shoes back
on. Within the week he had two more treatments, and totally recovered.
Patients are quite often amazed at how quickly they improve with treatment,
and tell me, “It’s like a miracle.” The good news about acute low
back pain is that you really do not need many treatments in order to have
a satisfactory result. The bad news is that we hardly ever see acute
cases. Generally, by the time people decide to try acupuncture they
have already tried everything else they could think of, and acupuncture
is the last resort.
Chronic low back pain is a different story
because it takes more time and more intensive treatment to alleviate pain
and promote healing. Last week I saw a gentleman who was very optimistic
when he came in. He had been referred to the clinic by a friend who
had totally recovered from acute back pain after only one acupuncture treatment,
and he was expecting the same kind of results. When I asked him how
long he had been having back trouble, he told me fifteen years. I
was sorry to have to tell him that he was not going to have the same miracle
cure as his friend. When a health problem has become entrenched over
time, it takes more time to bring it under control. Generally, the
longer you have had something, or the more serious it is, the longer it
will take to fix it. With chronic conditions, acupuncture treatments
have a cumulative effect, building on each other over time. The good
part is that you can usually see positive change after several weeks of
treatment. I’m not saying that the condition is cured in a few weeks,
but you can tell that you are responding to treatment, and that your symptoms
are improving. Some people feel better after 4-5 acupuncture treatments,
and some of them need 7-8 treatments before they feel better.
Let’s say that you have severe back pain.
Your doctor says you have at least two herniated discs, and you are scheduled
for surgery in a month. At this stage, is there any point in trying
acupuncture? I had a case several months ago that shows how helpful
acupuncture can be. A woman was referred to my clinic by her doctor
for pain control while she was waiting for surgery, which was scheduled
in twenty days. Her husband brought her in, because she was in too
much pain to drive. After having about eight acupuncture treatments,
she returned to her doctor for a pre-operative check-up. Her pain
had been reduced considerably, and her mobility and range of motion were
much improved. The doctor was surprised to see how much better she
was. After a thorough examination, he decided to cancel the surgery
and let her continue with acupuncture treatments for another month.
She continued to improve, even flying to England to deliver a lecture.
I am not saying that acupuncture is a substitute for surgery. Some
people will need to have an operation to relieve severe back conditions.
But most people who try acupuncture will experience improvement in pain
levels and mobility, and some of them may be able to avoid surgery.
Traditional Chinese medicine (TCM) has several
effective modalities for treating low back pain. The most common
modality is acupuncture, which is highly effective for both acute and chronic
low back pain. Acupuncture is often combined with electro-stimulation,
where a machine that produces a mild electric current is attached to the
acupuncture needles with clips. The frequency and intensity of the
electric current depend on the condition of the patient. Moxibustion
is a TCM practice that goes back hundreds of years. A particular
plant of the artemesia family is processed into a concentrated form, and
then it is burned, something like a stick of incense. It can be applied
to the handle of an acupuncture needle, or just held above the surface
of the skin, and it has a deeply warming effect.
Chinese herbs and herbal formulas are also
a very important TCM modality. In China, all of the chronic low back
patients are treated with herbal formulas and acupuncture, and even the
acute low back patients will often get an herbal prescription. Herbs
are important because they have a very strong effect to correct internal
imbalances. The reason herbs are given to chronic low back pain patients
is because this kind of pain is seen as a symptom of a deeper internal
imbalance. A number of TCM patterns such as Kidney deficiency, Chi
or Yang deficiency, Cold Accumulation, meridian obstruction, and others
will have chronic low back pain as a symptom. Ideally, acupuncture,
herbs, moxibustion, and dietary modifications would be used in combination,
as needed, to open blocked meridians, promote the flow of Chi and blood,
and tonify the deficiencies and degeneration that can come with age and
stress.
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