Back Pain, Lumbago
Crooke, Mikrokosmographia, 1618Back pain or Lumbago refers to pain int he back, most specifically lower back. Lower back pain may be acute or chronic. Acute back pain can be from muscle or tendon spasm, acute strain, spinal misalignment following stress such as carrying a heavy weight or bending is an unusual position. In most cases, rest with some massage, stretching, exercise, application or warmth etc. is enough to relieve and it will spontaneously resolve. Acute Back Pain that doesn’t resolve in a couple of days, or that is more severe (painful, limited movement etc) can be classified as follows:
Acute Back Pain
- Heat–Inflammatory pain (worse with movement), feels better with cold applied, area may be red, hot and swollen, pulse will be fast or strong.
- Cold–duller pain, worse in cold, feels better with movement, heat or massage. Area feels cold and clammy, pulse is deep and weak or slow.
- Wind–spasmodic and moving pain, may come and go suddenly
- Blood Stasis–fixed pain associated with Trauma, bruising, may have dark veins or capillaries in the area, and the nailbeds or lips maybe slightly cyanotic (blue).
Chronic Back pain
Usually more severe and especially in the elderly often occurs due to degeneration or chronic inflammation. These cases will require longer and stronger treatment, and often may need long-term use of tonic medicines once pain has been relieved.
In general, chronic back pain can be differentiated into:
- Yin Deficient–lower back pain, nocturnal urination, dry mouth and throat, maybe insomnia and night sweats
- Yang Deficient–lower back pain, clear urine, feels the cold, cold hands and feet, pain worse with cold, better with warmth
Structural Damage
Acute Severe or Chronic Back pain can be associated with serious structual damage such as degeneration, rupturing of a disc, or chronic destructive inflammation. These can sometimes be helped with long-term treatment. Herbs such as Comfrey, Soloman’s Seal, Asparagus root and Eucommia Du Zhong are examples of Kidney strengthening medicines that are used for chronic Lower Back pain such as is seen in the old and weak. The various Rehmannia formulas of TCM (Liu Wei Di Huang Wan, Shen Qui Wan, Zuo Gui Wan, Zuo Gui Yin etc.) are useful for these types of chronic back pain too.
Special mention should be made of Velvet Deer Horn (Lu Rong). This is a special type of horn as it grows quickly within one season before ossifying (turning to bone), then falling. During the growth phase it is blood-rich with growth factors to promote bone growth. It is also rich in collagen and calcium. Because of this, it is regarded as a special medicine to restore damaged and degenerated spine and discs in TCM.
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Western Tradition Simples: Acute Muscular Back Strain:
2. Indian Spikenard, Frankincense, Asparagus root 3. Safflower, Tabasheer, Pearl, Scorpion (Tibetan) 3. Henbane seed, Valerian, Saffron 4. Myrrh, Frankincense, Nux Vomica prepared Chronic Back Pain:
1. Cyperus rotundus and Frankincense 2. Comfrey and St. Johns wort (spine and nerve involvement) 3. Asparagus root, Comfrey root, Soloman’s Seal 4. Asparagus seed, Cumin (1 dram each), powder and take with white wine. (The Secrets of Alexis, 1615) 5. Elecampane in powder (2 drams) taken in wine. 6. Walnut, Cinnamon, Saffron, Mastic 7. Tormentil root (6 parts), Galangal, Mint (1 parts each). Powder and take with every meal. 8. Withania, Asparagus root, Cyperus rotundus, Zinc Bhasma 9. Withania, Asparagus root, Frankincense, Shilajit Cold Back Pain
Formulas Special Formulas to Take Note of The following are formulas that may be easily prepared today: Antidote for Back Pain (Galen) Pills for Scoliosis Special Medicine to Strengthen the Back Chelsea Pensioner Dorsi doloribus – Back Pain Decoction for Back Pain and Kidney Stones (Galen) Special Medicine to Strengthen the Back Syrup of Polypody Gelatin of Deer Horn Pulp of Comfrey root Bishops Electuary (Electuarium Elescop) (Mesue) Electuary of Dodder and Fumitory (Mesue) Electuary for Back Pain (Galen) Antidote Proven for Hip Pain Antidote for Lumbar Pain (Galen) Antidote for Hip Pain and Arthritis Antidote for Cold Lumbar, Venery, & Defect of Semen Confection for Cold Kidneys Powder of Nutmeg Compound Powder of Cinnamon Compound (Diacinnamonum) Powder of Galangal Compound (Diagalanga) (Mesue) Powder for Edema (Nicholas) Pills of Opopanax Pills for Scoliosis Foetid Pills Major Oil of Fir tree Oil of Pepper Oil of Foxes Oil of Wax Oil of the Philosophers Oil of Scorpions Ointment Martiatum Ointment for Back Pain Plaster of Marjoram Saffron Plaster Back Pain from Wind, Cold and Damp Powder of Cinnamon Compound (Mesue) Powder of Galangal Compound (Diagalanga) (Mesue) Antidote for Hip Pain and Arthritis (Nicholas) Arthritic Pills (Nicholas) Pil. Aggregative Majores (Mesue) Pills of Opopanax Pills of Colchicum (Mesue) (Habb E Suranjun) Pills of Colchicum Greater (Habb E Suranjun Kalan) Foetid Pills (Mesue) Pills for Scoliosis Bishops Electuary (Electuarium Elescop) (Mesue) Betel Nut 28 (Go yu nyer brgyad) Yogaraj Guggulu Pills of Three Tastes (Mongolian Medicine) Punarnavadi Guggulu (Boerhaavia and Bdellium Pills) Back Pain from Heat Kaisor Guggulu Ointment of Poppy Back Pain from Cold Kidneys (Yang Deficiency) Decoction for Back Pain and Kidney Stones (Galen) Powder of Nutmeg Compound Powder of Cinnamon Compound (Mesue) Powder of Galangal Compound (Diagalanga) (Mesue) Electuary of Calamus (Diacorum) (Mesue) Electuary of Steel (Unani) Antidote for Lumbar Pain (Galen) Antidote for Cold Lumbar, Venery & Defect of Semen Confection for Cold Kidneys Diathamaron Magna (Nichols) Betel Nut 28 (Go yu nyer brgyad) Back Pain from Deficiency Special Medicine to Strengthen the Back Antidote for Lumbar Pain (Galen) Antidote for Cold Lumbar, Venery & Defect of Semen Diathamaron Magna (Nichols) Electuary of Orchis (Diasatyrion) (Mesue) Betel Nut 28 (Go yu nyer brgyad) Back Pain from Blood Stagnation–Trauma Pills for Scoliosis Troches of Saffron Saffron Plaster Madder Pill (Tibetan Medicine) Antelope Horn 14 (Rgya ru bcu bzhi) (Tibetan) Chronic Back Pain from Obstruction (Damp with Blood Stagnation) Bishops Electuary (Electuarium Elescop) (Mesue) Madder Pill (Tibetan Medicine) Antelope Horn 14 (Rgya ru bcu bzhi) (Tibetan) To Purge in Back Pain Troches for Back and Sacral Pain (Nicholas) Bishops Electuary (Electuarium Elescop) (Mesue) Topically 1. Agrimony and Mugwort formed into a salve with (Deer) suet. 2. Comfrey as an oil, plaster or wash 3. Myrrh, Frankincense with Oil of St. John’s wort form a plaster. |
TCM Classification Simples:
Qi Stagnation acute or spasmodic lower back pain, worse when stress, irritable, emotional, headache, hypochondriac distention, irregular menstruation Shao Yao Gan Cao Tang Cold-Damp Pain cold lower back, stiffness, worse when still for too long, better after movement, pain aggravated when cold or on rainy day Huang Qi Gui Zhi Wu Wu Tang Shen Qi Wan (Jin Gui Shen Qi Wan) (Rehmannia 8) Heat-Damp Pain Inflammatory pain, worse with movement, relieved by cold, red tongue with yellow coat Shang Zhong Xia Tong Yong Tong Feng Wan Blood Stasis sharp piercing lower back pain, the pain is fixed in location, painful to move, aggravated by cold, feels better with warmth Shen Tong Zhu Yu Tang Huo Luo Xiao Ling Dan Injury & Trauma back pain with a recent history of Trauma; fixed pain, painful to touch Fu Yuan Huo Xue Tang Huo Luo Xiao Ling Dan Qi Li San Die Da Wan Jiu Fen San Shen Tong Zhu Yu Tang Yunnan Baiyao Kidney Deficiency chronic lower back pain with degeneration, aggravated when moves too much, very stiff when has been sitting, nocturnal enuresis, deep and weak pulse Qing E Wan Zuo Gui Wan You Gui Wan Shen Qi Wan (Jin Gui Shen Qi Wan) (Rehmannia 8) |
Special Formula
Xiao Sui Hua He Decoction–Ruptured Disc
Astragalus Huang Qi 20 grams
roasted Astragalus Huang Qi 20 grams
Stephania Han Fang Ji 10 grams
Dang Gui 10 grams
Ligusticum Chuan Xiong 10 grams
Atractylodes Bai Zhu 10 grams
Earthworm (Di Long) 10 grams
Leech (Shui Zhi) 6 grams
Clematis Wei Ling Xian 10 grams
Pawpaw 10 grams
Mustard seed (Brassica alba) 6 grams
Decocted in water and taken orally for 8–16 week. This was used as a conservative treatment of ruptured Disc in a group of patients in China, along with bed rest for 2–3 weeks, and certain exercises. It has good effect. (See here and here)
Yiqi Buxue Recipe–Ruptured Disc
Astragalus Huang Qi 20 grams
Dang Gui 10 grams
Ligusticum Chuan Xiong 15 grams
Earthworm (Di Long) 15 grams
Stephania Fang Ji 10 grams
Chaenomelas Mu Gua 10 grams
White Mustard seed (Bai Jie Zi) 6 grams
Clematis Wei Lin Xian 10 grams
This was studied and forund effective (see here).
Severe Acute Lower Back Pain
Centipede (Wu Gong)
Scorpion (Quan Xie) equal parts
These are powdered and taken in doses of 1500mg with wine, or they can be taken along another suitable formula such as Du Huo Ji Sheng Wan.
Research
1. Efficacy and Safety of Modified Duhuo Jisheng Decoction in the Treatment of Lumbar Disc Herniation: A Systematic Review and Meta-Analysis2. Yiqi Huoxue Recipe Delayed Intervertebral Disc Degeneration by Activating Autophagy