Traditional Therapeutics - Lumbago (Lower Back Pain)

Generally, lumbar pains are owe to the perverse Cold, or to the insufficiency of Kidney Energy:

1. Pain owed to the Perverse Cold: Extensive and enfeebling (impairing) pain; often radiating to the thighs and becoming worse with humid or overcast weather. The patient feels a cold sensation in the attacked region. The pains prevent the patients from stooping, from rising, and from turning themselves.
2. Pains owed to the insufficiency of the Kidney Energy: First light and latent, they become enfeebling in the long run; the patient is without strength and has a low morale.

Utilize the basic points GV-4 (Ming Men), UB-23 (Shen Shu), GV-2 (Yao Shu), UB-52 (Chih Shih), UB-31 (Shang Liao), GB-30 (Huan Tiao), UB-40 (Wei Chung), UB-57 (Cheng Shan), and UB-60 (Kun Lun).

In lumbar pains owing to insufficiency of Energy of the Kidneys, generally, one applies moxa at the points of the painful region. For pains owed to the Perverse Energy, one needles some of the painful points along the trajectory of the affected Tendino-muscular meridian, and one tonifies with moxa the Principal meridian that is along the pathway of the pain. For instance, if the pain is mainly localized along the pathway of the Bladder meridian on the back, one applies moxa to the Ting point UB-67 (Chih Yin), which is also this meridian's point of tonification.

The following is the therapy counseled by the Su Wen for the thirteen primary types of Lumbar Pain as described in Chapter 41 thereof:

1. Pains owed to attack of the Bladder meridian: They radiate along the vertebral column, up to the neck and down to the coccyx. Needle UB-40 (Wei Chung) and let it Bleed. Do not Bleed it in the spring.
2. Pains owed to attack of the Gall Bladder meridian: Patients have the impression that they are being pricked by needles, they cannot stoop, nor rise again, nor turn themselves. Needle the meridian at the head of the fibula GB-34 (Yang Ling Chuan) and make it Bleed. Do not Bleed it in the autumn.
3. Pains owed to attack of the Stomach meridian: It prevents the patients from turning themselves. If they make an effort to turn, they will become terrified as if they found themselves facing strange things, moreover, they moan often. Needle the three points of the Stomach meridian situated upon the front of the leg St-36 (Tsu San Li), St-37 (Shang Chu Hsu), and St-39 (Hsia Chu Hsu) in order to reestablish the "upper-lower" balance and make them Bleed. Do not Bleed them in the autumn.
4. Pains owed to attack of the Kidney meridian: They are localized in the interior, along the vertebral column and the neck. [It's a question of the dorsal aspect and the abdominal aspect (internal) of the vertebrae.] Needle the two points of this meridian located in the back of the internal malleolus K-2 (Jen-Ku) and K-3 (Tai Hsi). D no Bleed them the spring. If the Bleeding is too abundant, the patient will recover with much difficulty.
5. Pains owed to attack of the Liver meridian: They give the impression that the vertebral column is stretched like a bow (stiff). Needle the points located at the calf upon the artery Li-5 (Li Kou), Li-6 (Chung Tu), and Li-7 (Chi Kuan). In this disturbance the patient likes to talk, but does so in an ingenuous, artless, and simple manner (naiveté).
6. Pains owed to attack of the superficial meridians and the capillaries [here it's a question of the Tendino-muscular meridians and their ramifications]: They radiate toward the shoulder, accompanied by visual difficulties (blurred vision) and incontinence. Needle the superficial meridians at the level of the inter-articular space of the knee; needle also the large capillaries at this level and make them Bleed until the blood changes color.
   
   There exist some cases where the attack of the superficial meridians provokes lumbar pains which give the impression of one having on "a too tight belt" with rupture in the renal region, accompanied by uneasiness and fear.
   
   These meridians are vessels emanating from the point UB-40 (Wei Chung) [It's a question of the Distinct meridians of the Kidneys and Bladder]. At the level of this point, the Distinct meridians concentrate and emerge like a "grain of rice". The blood spurts out when it is punctured; let it flow until the blackness becomes red.
7. Pains owed to attack of the Yang Chiao: It manifests itself in the form of swellings which are very painful and project out of the renal region, like small pinched areas of flesh. It is necessary to needle the Yang Chiao at the level of the external malleolus at three points UB-59 (Fu Yang), UB-61 (Pu Shen), and UB-62 (Shen-Mai).
   
   NOTE: The Su-Wen designates the Yang Chiao by the name "Dong Am" which means "meridian common to the Yin". This description clarifies the situation of the two Chiao vessels; the Yang Chiao being only a continuation of the Yin Chiao. The latter, Yin, evolves into the Yang at the level of the point UB-1 (Ching Ming).
8. Pains owed to attack of the Yang Wei vessel: They are manifested by a swelling of the lumbar region, as in edema. This meridian meets with the Gall Bladder meridian at seven pouce from the external malleolus, at "one measure from the earth".
   
   NOTE: The reunion point is GB-35 (Yang-Chiao) and the point located at the level of the earth (one "measure" below the former) is UB-63 (Chin Men).
9. Pains owed to attack of the Chong Mo vessel: They impede forward and backward bending of the patient. If they lean forward, they have the impression of losing equilibrium. These difficulties happen after one has lifted a heavy weight. Needle the two points situated close to the space, which is the "exciter" of Yang.
   
   NOTE: The "exciter" space of Yang is the popliteal fossa, where UB-40 (Wei Chung) is found. The two neighboring points are: UB-38 (Fu Chieh) and UB-39 (Wei Yang).
10. Pains owed to attack of the Jen Mo (Conception) vessel: They are always accompanied by perspiration. When the sweating stops, the patient calls for drink; after having drunk, he wants to run. Needle three points of the vessel, which "awaits the Yang" situated within the Yang Chiao, and make them Bleed in the case of fullness.
    
    NOTE: "The vessel which awaits the Yang" is the Governor vessel. The Su-Wen gives it this name because it receives all the Yang of the body. The three points situated within the lumbar region are GV-3 (Yao Yang Kuan), GV-4 (Ming Men), and GV-5 (Hsuan Shu).
11. Pains owed to attack of the Yin Wei vessel: They are always painful and often accompanied by lamentations and fright. Needle the Yin Wei point situated at five distances above the internal malleolus at the place where the Yin Wei unites with the Kidneys (Shao Yin) [It's a question of the point K-9 (Chu-Pin)].
12. Pains owed to attack of the Yin Chiao vessel: They radiate toward the chest. In serious cases, the patient has the sensation of fracture at the renal region, blurred vision, stiff tongue, and difficult elocution. Needle the two points of the Yin Chiao, the one in front of the large muscle at two distances from the internal malleolus; the other, below the malleolus, behind the point of the Spleen meridian. The first point is K-8 (Chiao Hsin), the second K-6 (Chao Hai).
13. Pains owed to attack of the Tou Mo (Governor) vessel: It expresses itself always by fever. In the case of strong fever, the patient has some somber thoughts, the rena region is stiff like a piece of wood; one finds incontinence of the urine. Needle the three points situated between the tibia and the muscles St-36 (Tsu San Li), St-37 (Shang Chu Hsu), and St-39 (Hsia Chu Hsu).