ACUPUNCTURE FOR LOW BACK PAIN AND SCIATICA
- CAUSE, PREVENTION AND TREATMENT
by Joanna Zhang, L.Ac, Ph.D.
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Low back pain affects people from all aspects of life. The pain can arise from a small region as well as spread to a much larger area of the low back. As common as it is, low back pain can however be difficult to treat and easy to relapse. I have written this article to encourage patients and to offer a comprehensive treatment to release neuropathy, back pain, heal and live a better quality of life.
GET TO KNOW YOUR LOW BACK
The back encompasses a very large area, including neck, thoracic, lumbar and lumbosacral region. The low back, i.e., lumbar and sacral area, is the most important because it supports the weakest part of the whole back. Accordingly, the low back pain is one of the most common pain syndromes, and often associated other complications.
The main structure of the back is the spine column. The human spine is made up of 33 small bones: 7 cervical vertebrae, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal vertebrae. The side view of the spine is a big soothing S form with four physiological curvatures. The vertebrae protect the spinal cord within, while being surrounded by the ligaments, muscles, tendons and fascia. Its structure is very sophisticated and complex, while fairly vulnerable to damage.
Our low back carries a lot of weight from upper body simply by standing or sitting. A much more significant mechanical stress applied to our low back when turning, bending, extension, through our daily life.
WHAT CAUSES LOW BACK PAIN?
Low back pain can be categorized as mechanical pain or neurogenic pain in terms of cause and pain characteristic, as summarized in table below.
Table 1. Mechanical Causes vs. Neuropathic Causes
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Mechanical Pain
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Neurogenic Pain
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%
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80-90% of low back pain
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5-15% of low back pain
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Cause
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Mechanical stress to the spine and its supporting structure
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Nerve root involvement
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What kind of pain
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Throbbing or aching
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Shooting or stabbing
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What make it worse
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Aggravated with movement and relieved with rest
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Aggravated with prolonged sitting or forward flexion
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Pain below knee
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No
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Yes
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Typical causes
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Muscle strain
ligamentous injury
degenerative disc or joint disease
vertebral fracture
congenital deformity (scoliosis, kyphosis, transitional
vertebrae)
spondylolysis and instability
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Lumbar spinal stenosis
herniated disk
osteophytic nerve root compression
annular fissure with chemical nerve root irritation
failed back surgery (arachnoiditis, epidural
adhesions, recurrent herniation)
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Cervical spondylosis
Cervical spondylosis occurred in cervical spine, how can it cause back pain? The posterior ramus of spinal nerve from the 4th, 5th, 6th cervical vertebra, extend along the back and control the back muscle and fascia.
Any cervical vertebra degeneration affecting the 4th, 5th, 6th cervical vertebra can also lead to low back pain. Therefore, low back pain can be one of the symptoms of cervical spondylosis. Other symptoms include neck and shoulder pain, upper limb weakness, finger numbness, dizziness, nausea, blurred vision, swallowing difficulty etc.
Frozen shoulder
“Frozen shoulder,?also called "adhesive capsulitis" or "periarthritis of the shoulder", is a chronic, inflammatory disorder of the shoulder and surrounding soft tissues. This pain can even extend to the low back for some patients.
Ankylosing spondylitis
Ankylosing spondylitis is an inflammatory disease that can cause some of the vertebrae in your spine to fuse together. Most patients have clinical manifestations such as limited activity of lower back and lumbar, lumbar spine crest tenderness and paravertebral muscle spasms, muscle atrophy at late stage, it could even lead to kyphosis deformity and a hunched-forward posture.
Patients with ankylosing spondylitis can have chronic constant low back pain. The low back often feels stiff in the morning, and the low back pain aggravates with back extension and eases with increasing mobility.
Lumbar Spinal Stenosis
In lumbar stenosis, the spinal nerve roots in the lower back become compressed and this can produce symptoms of sciatica—tingling, weakness or numbness that radiates from the low back and into the buttocks and legs—especially with activity. It most often occurs at the L4-L5 and L3-L4 levels, but can occur any level in the spine. It is usually relieved by forward flexion, such as when walking while leaning forward on a shopping cart, and aggravated by lumbar extension. Stenosis patients can often ride a bicycle and walk up hills. The degenerative cascade may eventually affect most of the vertebral segments of the lumbar spine.
Herniated Disk
If a patient complains of a specific abrupt-onset event causing neuropathic pain, a herniated disc is usually the cuase rathen than a lumbar stenosis. A herniated disc in the lower back can put pressure on the nerve that extends down the spinal column. This commonly causes pain to radiate to the buttocks and all the way down the leg. This condition is called sciatica. Sometimes, bulging causes the material from inside the disc to press on the sensitive nerves that carry messages to the brain. The result can be the excruciating pain.
Other visceral disease
Low back pain can also be caused by other visceral disease,
. Respiratory diseases, inclduing pleural adhesions, lung cancer and tuberculosis,
. Pelvic inflammation disease,
. prostate disease,
. Kidney disease including kidney stone, nephroptosis and pyelonephritis,
. Retroperitoneal diseases including abscesses and hematoma,
. Liver and heart disease.
SEVEN WAYS TO RELIEVE/PREVENT BACK PAIN
The purpose of pain management is to reduce pain to the level patient can tolerate and eanble them to start low intensity exercise to strengthen their core and low back to return to a healthier active life.
1. Strengthen your back through proper exercise
Muscle extension or contraction through exercise can help not only joint movement but plays an important role in protecting the spine. Low intensity exercise such as walking, swimming, stretching, can help strengthen low back strength. There are certain activities to avoid if you have low back pain. For example, butterfly swimming style can intensify the pressure to back muscles and thus not suitable for patients with back pain. Other activities such as weightlift can also complicate low back pain. We can help you customize the best exercise regimen to support your back.
2. Bend your knees not your back
When you lift heavy objects, bend the knees not the back. By doing so, you transfer the stress to the legs, not the back. In addition, it is better to separate your legs, with the back up straight, and keep the heavy object as close as possible to the body to minimize back stress. When carrying a heavy object, you should alternate shoulders.
When you sleep with low back pain, it is recommended to sleep sideways with knee bent, one best way to ease the pressure of intervertebral disc. Lying on stomach for sleeping is not recommended as it relaxes the abdominal muscles and promotes the lordosis. If you have to lie on your back, put a pillow between the knees. In addition, the mattress should not be too soft.
3. Wear properly
Avoid wears that could add stress on your joints from decreasing shock absorptions. Those wears includes but not limited to
. High-heeled shoes that change your natural postures
. Flip-flops that doesnot have an arch support and doesnot get shock absorptions
. Skinny jeans or pencil skirts that are so tight and restrict your knees, hips, and thighs.
4. Maintain body weight
Being overweight can stress back muscles. Clinic study shows that overweight people often have chronic back pain. In addition, a sudden weight gain may also increase the burden of the back muscles and ligaments. For instance, low back pain often occurs during the late pregnancy. Generally speaking, a BMI over 30 would be an indicator of weight loss necessity. Check out our Detox and Weight Loss program to make a positive life change and start breaking the viscous cycle.
5. Practice good postures
Wrong posture is one of the major causes of low back lesions, and often leads to spinal joints degeneration, muscle spasms, and ligament adhesions. A good posture should be the one reducing the pressure of the low back, such as
. Chin up
. Neck and chest straight,
. Pelvis forward,
. Tuck up the belly as well as the pelvic bone
. Keep low back up and straight
6. Quite smoking
Acupuncture and herb is one of natural approach to kick the habit via rebalancing your lung and kidney meridian.
7. Fight the viscous cycle.
It is vicious cycle that the more pain your body feels, the less active patient tends to be, the more pain it is! Whenever your lower back acts up, stop crawling into bed. See your doctor and get treated for low back pain early on, so you can stay moving and active!
LOW BACK PAIN TREATMENT
You might want to seek treatment with low back pain if
. after accident or falling
. pain continue after 4 to 6 weeks
. severe pain without improvement after a few days
. Numbness or altered sensations in the upper inner thighs, groin area, buttock or genital area
Drug Treatment
There are various pain medications such as acetaminophen, NSAIDs, oral steroids, narcotic drugs, muscle relaxants, and anti-depressants. In terms of its pathogenesis, most of the pain medication helps relieving the pain, without treating underlying cause. Each medication comes with multiple unique risks and possible side effects and drug interactions, which need to be evaluated by a physician.
Injection of drug, such as lidocaine anesthetic and steroid, on peripheral nerve trunk, plexus, spinal nerve root, sympathetic ganglion nerve or its surroundings, can provide low back pain relief by blocking the function of nerve conduction and decreasing inflammation of the painful area.
Accordingly, epidural steroid injections have become the standard treatment for nerve-related back pain, as it temporarily stops irritated nerves from sending pain signals and reduces inflammation.
However, similar as other drug healing method, the steroid injection offers no remedy for the actual cause of the pain. It is also not effective on mechanical-related back pain, which accounts for 80-90% of back pain. Continued steroid use can also weaken your immune system with associated conditions such as ulcers, bruising, weight gain, acne, hypertension, cataract, and even further pain.
The side effects of long-term steroid use and the desire for long-term relief lead patients to look for a more holistic drugless approach for pain treatment.
Drugless Treatment - Holistic Approach
Drugless healing method aims for causation rather than symptomatic relief, and is an alternative treatment when drug healing is ineffective and side effects become major concerns. The holistic approach is initiated by a series of treatments such as manual therapy, acupuncture, infrared therapy, micro-current stimulation, herb/essential oil. It is intended to treat acute or chronic low back pain and intervertebral disc herniation, lumbar joint disorder, cervical spondylosis, and spinal deformation.
1. Anti-inflammatory effects. Acupuncture needling increases the natural secretion of monoamines, serotonin, norepinephrine and pituitary ?endorphins. As a result, acupuncture has been used to treat a wide range of painful conditions. This produces anti-inflammatory effects for acute or chronic inflammation of muscles, joints, ligaments, nerve, or internal organs, without any side effect.
2. Analgesic effect. Acupuncture increases spinal cord enkephalin and dynorphin secretion and consequently modifies pain perception.
3. Remove blood stagnation. This can be done via manual therapy, Cupping therapy, along with herb and essential oil.
4. Reduce adhesion. Manual therapy such as GuaSha, can help release the conglutination and adhesion.
5. Promotes blood circulation. Acupuncture promotes blood circulation and expedites the elimination of the pain-producing substances.
6. Stimulate stem cell generation. Micro-current stimulation along infrared/heating therapy helps expediting stem cell generation for self-healing. In the case of reversible peripheral sensor/nerve injury and muscle atrophy, it can stimulate the nerve and muscle, promote the repair and regeneration, aid sensation recovery.
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WHAT PROPLE ARE SAYING ...
I recommend her treatment for the family which has kids ...
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Immediate relief of pain and swelling
Since I started my treatment with Dr. Zhang, I have noticed a significant improvement on my legs and back. Before, I had no feeling when I'd step or put any pressure on my feet. Now the swelling has gone down a lot and my feet have sensations once again!
- Rhodora A., Los Angeles*
I can sleep sound again after so many years
I had diabetes for 20 years. I need get up urination 2-3x every night and can't sleep well. After 2 treatments with Dr. Zhang, I only get up once during one night. After 4 treatments, I can sleep through the night!
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Disclaimer
*Results may vary from individual to individual
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