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The causes of lumbago are various. The lumbago dis-cussed in the following is mainly caused by chronic sprain of the lumbar muscles and protrusion of lumbar interver-tebral disc. Lumbago can be caused by damage of the lum-bar muscles, adhesion of muscles and ligaments or joints; or by retrograde pathological changes of the spinal verte-brae complicated by lumbar impairment, rupture of the fibrous ring of the lumbar vertebrae and protrusion of pulpiform nucleus that press on the nerves, periost and ligaments. TCM holds that lumbago is mainly caused by retention of pathological wind, cold and dampness in the meridians; or by malnutrition of the meridians and ten-dons due to kidney asthenia; or by inhibited flow of qi and blood in the meridians due to overstrain and impairment.

[Syndrome differentiation]

1. Obstruction by pathogenic cold and damp-ness

Cold pain and heaviness sensation in the loins, or pain involving the buttocks and legs, inflexibility, aggra-vation with cold and rain, thin and white tongue fur and deep or slow pulse.

2. Stagnation of qi and blood

Pricking and fixed pain, stiffness of the waist, inflexi-bility, purplish tongue or with ecchymoses, taut or un-smooth pulse.

3. Deficiency of kidney essence

Slow onset, vague aching and lingering pain in the loins, aggravation with overstrain, weakness of loins and knees; pale complexion, dizziness, tinnitus, spiritual las-situde, cold limbs, frequent and clear urine, pale tongue, deep and thin pulse in the case of yang asthenia; flushed cheeks, dysphoria, insomnia, dry mouth and throat, fe-verish sensation over palms and soles, yellow urine and dry feces, red tongue, thin and rapid pulse in the case of yin asthenia.


Chinese Herbal Medicines and Acupoint Massage for Treating Chronic Lumbar Strain

1. Body acupuncture

Prescription: Shenshu (BL 23), Dachangshu (BL 25) and Ashi acupoints.

Modification: For the syndrome of obstruction due to cold-dampness, Yaoyangguan (GV 3). Huantiao (GB 30), Chengfu (BL 36), Weizhong (BL 40) and Kunlun (BL 60) are added; for the syndrome of stagnation of qi and blood, Geshu (BL 17), Ciliao (BL 32), Weizhong (BL 40), Yanglingquan (GB 34) and Feiyang (BL 58) are add-ed; for the syndrome of kidney asthenia and essence con-sumption, Mingmen (GV 4), Qihaishu (BL 24), Guanyuanshu (BL 26), Ciliao (BL 32), Zusanli (ST 36) and Dazhong (KI 4) are added.

Performance: Kidney asthenia syndrome is treated with reinforcing needling technique, other syndromes are treated with reducing needling techniques. All the acu-points on the waist can be moxibusted with the supplemen-tation of cupping. If there is blood stagnation, Weizhong (BL 40) is punctured to let blood.

2. Ear acupuncture

Prescription: Lumbosacral Vertebrae (AHg), Kidney (CO10), Ear Shenmen (TF4) and Subcortex (AT4).

Performance: Each time 2 - 3 acupoints are selected and needled with medium and strong stimulation. The needles are retained for 20 - 30 minutes. Or Wangbuliu-xingzi (Semen Vaccariae) is used for ear pressure.

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