resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
October, 2001, Vol. 01, Issue 10
Unraveling the Lower Back Pain Puzzle
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
If you've practiced bodywork for more than a day, you've probably encountered a client with lower back pain! It is the single most common complaint from people who walk into my office, no doubt for you as well.Helping patients with lower back pain can greatly increase your skill in accurately assessing this condition, according to Chinese medical theories.
In Chinese medicine, there is never a direct correlation to Western assessment. For back pain or any other ailment, there isn't a silver bullet/magic acupressure point that will fix the problem. As I mentioned in previous articles, if someone has depression, you have to look at the Five Element correlation to effectively treat it. To treat a headache, we have to know where it is located to select meridians that will bring relief, based on the Six Divisions theory.
So, are there different elements that relate to the various types of back pain, or different types of back pain based on location? Nope, sorry! Knowledge of the Five Elements and Six Divisions will help you in treating lower back pain, but they are not the key. The Four Examinations and Eight Principles will give you the clues you need to solve your client's back pain puzzle once and for all. (To confirm your suspicion, just about all Chinese medical paradigms begin with a number, and there are a lot of them!)
The Four Examinations start with listening, as you get an idea of their condition based on the client's voice on the phone. Next is observing ,as you note posture and affect as the client walks in the door and you look at the tongue, face and any abnormalities along the meridian pathways. By now, you are asking questions and touching the client's pulses and meridians. The fun part is taking all of that information and making sense of it all.
Sorting it out is where the Eight Principles come in. Is the client's condition acute or chronic, superficial or deep, hot or cold, excess or deficient? Let's look at the main individual types of back pain to figure it all out.
This type of back pain is chronic, deep, usually cold and of course, deficient. We know that if the client has had the problem for a long time, there is definitely something depleted. Chronic conditions have moved deep into the body, and the pain has a more diffuse, dull nature. The pain is worse at the end of the day when the person is tired; back pain will take the form of a dull ache, rather than a sharp pain. Sexual activity will aggravate it. Kidney energy is something that gradually decreases with age; but too much sex, overwork, stress, drugs and alcohol will deplete it faster.
You will notice general Kidney symptoms, such as a pale face and tongue, frequent urination and fatigue. In addition, if it is a Kidney Yang Deficiency, there will be cold symptoms such as cold feet, and there will be some relief from the pain with the application of heat. If there are general Kidney deficiency symptoms plus a thin and rapid pulse, a red tongue with no coating and a vague, low-level anxiety, there is probably a Kidney Yin deficiency.
This is the type of back pain that gets worse when it is cold and rainy outside. You'll find that heat gives considerable relief. With dampness, there is a heavy feeling. It is excess in that it is caused by a pathogenic factor; you may be able to trace onset of the pain to a specific event, such as the client sitting in front of an air conditioner while covered with sweat. For example, I had one client that said his back pain started from when he was at his son's soccer game, sitting in the cold rain.
Stagnation of Qi and Blood
This is the type of back pain that improves with light exercise. You will find clients who say that when they get up in the morning, their back is sore, but after they move around and stretch for a bit, it feels better. This is a clear indication that there is stagnation blocking the free flow of Qi, causing pain. They usually have a history of a traumatic injury which never was treated properly, so it keeps reoccurring.
You may find that with the latter two excess types of back pain, there is an underlying Kidney Deficiency. Since the Kidneys rule the lower back area, there is an initial weakness that exposed them to injury, or that let in an external pathogenic factor, such as cold-damp. Even if the client didn't start off with much of a Kidney Deficiency, one will be created by long-term problems in the lower back. In any lower back pain treatment, make sure to include techniques that will tonify the Kidneys. Hold the Kidney shu points bilaterally with a tiger's mouth (thumb and index finger apart, like they are chomping the points) as you work up the Kidney meridian with your other hand, starting on the sole of the foot. Use deep, penetrating pressure, but not to the point that it is at all painful. You are trying to encourage qi into that area and sharp pain will make it want to go away. You can think of it like you are attempting to entice a reluctant cat: "Good qi, come on qi, here you go qi..." Use any technique that is going to have that vibe to it. Also, hold the area that is painful and work down the Bladder meridian.
If you are trained in using moxa, that is really one of the best techniques that you can do to add qi to an area. Make sure of course that the client is not showing any Heat symptoms such as a rapid pulse, red tongue/ face, feeling warm or inflammation. Choose points such as the Kidney shu, mu and ashiqi. Think of that little kitty that just likes gentle chin scratches. (Editor's note: For a more detailed explanation of shu and mu points and ashi points (painful points that make that make the client say, "Ah-sh...!") You want to use tonifying circles clockwise with a moxa pole in your right hand as you place the point between a V made by your index and third finger. When you feel your fingers getting warm, you know the point is also warm. You don't want the feeling to be painful to your client, as it will disperse, please read Barbra's columns from the July and September issues of Massage Today.
If the client has either of the later two excess types of back pain, you will need to use techniques that disperse the cold-damp or move the qi and Blood stagnation. For cold-damp, fire cupping is great to use with a TDP lamp. This is a pretty dramatic technique as you take a flaming meatball looking thing on a stick, insert it into a glass cup to take out the air, and quickly place a cup each over Du4 and the ashi/ painful points. This creates a suction and pulls apart the meridians (and fascia), allowing the pathogenic factors to be released. A TDP lamp is specifically designed to warm yang and expel cold. It can be placed over the area for the 10 minutes that you are using the cups. (Note: Do not try either of these techniques without training, as there is as much potential for causing harm as good!)
Another technique that you'll want to learn is gua sha. This is what I use if there is any qi and/or Blood stagnation; I follow this technique with stretching. Put an ointment on the area, such as Tiger Balm or Vicks Vapor Rub, depending on whether the client has cold or heat symptoms. Scrape it with a Chinese soupspoon or a smooth jar lid, just to the point where your client starts to feel uncomfortable. There is quite a contrast to how it feels and how it looks. It has a wonderful opening, freeing effect on the area that had stagnation, although it looks as if you have dragged your client along the road. You can see why caution is advisable!
You may be starting to see how your initial assessment is going to affect how you treat your client. You always will be successful treating points local to the problem, and distal on the affected meridian, but to affect long-term changes, you need to find and treat the underlying pattern of disharmony that is the cause of the problem.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.