Acupuncture for Back Pain

How Chinese medicine understands back pain

In Chinese medicine, back pain is usually described as a type of Bi syndrome: pain from Qi and Blood that are not moving freely through the channels of the back. The lower back is also linked with the Kidney system, so pain that comes and goes over years is read differently from a strain you got lifting a box last week.

The common patterns are:

• Qi and Blood stagnation. Sharp pain fixed in one spot, often after lifting, twisting or a fall. It hurts to press on and is worse after sitting still. Treatment focuses on moving circulation through the area.
• Cold and Damp. A heavy, stiff ache that is worse in cold, wet weather and first thing in the morning, and better with heat and gentle movement. Treatment warms the area.
• Kidney deficiency. A dull, weak ache in the low back, often with tired knees, that is worse when you are run down and better with rest. In Chinese medicine this is seen as the back not being supported well enough, so treatment also builds you up.
• Liver Qi stagnation. Tight upper and middle back muscles that flare with stress and long days at a desk.

Many people have a mix: an old weakness underneath and a recent strain on top. The pattern decides where the needles go and what else is added.

This page is about pain that stays mostly in the back. If your main problem is pain that travels down one leg, the sciatica page is a better fit.

What treatment involves

Your first visit at the clinic in Keswick starts with questions: how the pain began, what makes it better or worse, how you sleep and sit, and your general health. I look at your tongue and take your pulse. An assessment for back pain usually also checks which movements hurt, which gives a baseline to compare against at later visits.

In Chinese medicine, acupuncture is usually the main treatment for back pain. Points are commonly chosen in the back itself and further away, such as behind the knee and in the hands and feet, which in Chinese medicine connect to the back through the channels. I treat the whole body at every treatment, not only the area that hurts. The needles are very fine, 0.14 to 0.30 mm. The aim is to ease pain and let the muscles guarding your spine relax, so you can move more normally.

Depending on the pattern, other treatments may be added. Cupping can be used over the large muscles on either side of the spine. Moxibustion adds warmth for a Cold pattern. Tuina massage works on tight muscles directly. When an ongoing weakness is part of the picture, Chinese herbal medicine is a formula written for your pattern.

A recent strain usually settles faster than pain you have had for years. Plan on 5–10 treatments to judge progress; after that we decide together whether more is useful.

Between visits

• Keep moving. Gentle walking is usually better than bed rest. Several short walks a day are easier on the back than one long one.
• Break up sitting. If you work at a desk or drive for long stretches, stand up and move every 30 to 45 minutes.
• Use heat for stiffness. A heat pack for 15 to 20 minutes can ease a stiff back, especially one that feels worse in the cold.
• Lift close to your body. Bend your knees, keep the load near you, and avoid twisting while you lift.
• Keep up your exercises. If a physiotherapist or doctor gave you exercises, keep doing them and tell me what they are.

When to see your doctor first

See your doctor before starting treatment, or promptly if you are already coming in, if:

• You have numbness in the groin or inner thighs, or new trouble controlling your bladder or bowels. Go to emergency.
• Weakness in a leg or foot is getting worse.
• The pain started after a fall, car accident or other injury.
• You have a fever, feel generally unwell, or have lost weight without trying.
• You have a history of cancer, osteoporosis or long-term steroid use.
• The pain is severe at night and does not ease with rest or changing position.