Lumbar Myalgia (Lumbago)

Our grandmother, who had experience with this, often warned us: “Children, get dressed in your warm clothes, don’t run barefoot on the cold floor, because all that will come back to you when you are old and the whole body will hurt”. She was right, as always. After all, in ancient China there is nothing new under the sun – the cold HAN and the wind FENG have always been the cause of thousands of diseases! According to Western medicine, sciatica, or lumbago, occurs mainly in middle age, especially in men. There is a sudden pain in the lumbar spine, aggravated by movement and improved at rest, preceded by sudden, uncoordinated movement (rapid turning, lifting a load, putting on socks without bending knees, or tying shoelaces, etc.). This condition is often preceded by catching a chill or sweating. All these factors lead to persistent stabbing pain in the lumbar muscles, which sometimes shoots into the buttocks. The pain is caused by the pressure of the contracted muscles on the nerve endings coming from the spine. This condition can be compared to the opening of scissors – the more they open on one side (muscles), the more they contract on the other side (muscles) and push on the nerves…

On St Martin’s Day a goose is better than a gander

It usually starts in autumn or spring, when it is cold and windy outside. A person affected in this way is already in a certain way predisposedly weakened by work, sports, one-sided workload, etc. If you catch a chill in addition – for example, you sweat during sports and let your clothes dry on you or catch a chill after a hot shower, or you are insufficiently clothed when the temperature changes (air conditioning, fans, etc.). The potential patient will first feel a sudden electrifying pain in the lumbar region during some (inappropriate) movement, which will paralyse them for a second and seem to “cut them in the waist”. At first it seems that it is caused, as they say, by “stale blood” and everything will return to normal during the day. However, the opposite is true. The “back blockage” gradually worsens, and the next day it is usually the worst – the patient cannot even move, turn around in bed, or perform the most basic human needs (literally all of them, including sneezing or breaking wind), because every slight push into the sacral region causes a sharp cutting pain, as if somebody stabs a knife in your back. If you have ever experienced it, there is no need to describe it. For those who may (maybe) face it, it is useful to give a bit of a better idea of these hardships. The pain can be compared to the stabbing of a knife during any movement and leads to one being confined to bed. If the symptoms do not improve within a week, a professional examination by imaging methods is necessary, as it may be a prolapse of the intervertebral disc, because the herniation of the disc sometimes begins as a lumbago. Later, symptoms of radicular irritation appear in the back, such as numbness of the lower limbs, usually unilaterally, restriction of mobility, muscle weakness, and impaired sensation of the area.

How does TCM see it?

According to Chinese medicine, this disease is most often a combination of 3 different factors:

The predisposing factor is the insufficient yang essence of the kidneys SHEN YANG XU – weak yang does not sufficiently heat the body to the “operating temperature”, it does not strengthen the liver GAN, whose insufficient blood XUE XU does not nourish tendons and ligaments, especially in the lumbar spine. Such an organism is then already “pre-prepared” for the external cold wind FENG HAN to penetrate the weakened body, especially the muscle layer, and to literally “freeze” there and thus give rise to energy qi and blood QI ZHI/YU XUE blockage. According to Chinese medicine, every pain is the “tissue’s hunger for energy”, and in our case the pain is caused by “freezing of the tubes”. As you can see, sciatica is a complex disease and therefore the treatment, according to Chinese medicine, must be complete!

TCM recommends:

The advantage of Chinese medicine is that when the true cause of the disease (according to TCM) is known, and in this case it is usually one and the same, then the treatment is easy, fast, and, what is most important, effective, because the patient is most interested in quick relief from troubles and especially pain!

In the first phase of pain, complete rest in bed and dry heat (e.g. in the form of a thermophore) is recommended, which is applied to the painful area in order to relax the muscles and thus relieve the pain. A warm bath is absolutely unsuitable, as it only worsens the pain, because it increases the stagnation of moisture and blood in the affected area. It is also possible to use a horseradish compress (grated homemade, i.e hot horseradish mixed with grated potato in a ratio of 1:1 and applied to the area of the pain previously lubricated with oil to prevent skin burns from pungent horseradish, for 15 minutes). This horseradish compress makes the YU XUE blood blockage going. It is also possible to apply a boiled onion compress, which in turn eliminates the cold FENG HAN wind Shaolin Oil (code 700) and makes the YU XUE blood blockage and stagnant qi energy QI ZHI going and eliminates the cold FENG HAN wind from the body surface; it is good to spread it on the affected area, even every hour in case of acute pain. Here again, “the more the better” applies, that is, it is recommended to apply more than less. The ice or cold compress is definitely not suitable, it “freezes” the pain, so the patient seems relieved for a while, but in the future it “freezes” and thus prevents the supply of QI energy and XUE blood to nourish and internally warm the affected area and also to remove accumulated metabolites caused by this stagnation and blockade. Chemical drugs such as analgesics (painkillers), myorelaxants (muscle relaxants), antirheumatic drugs (drugs for rheumatism), antiphlogistics (anti-inflammatory drugs), antibiotics and chemotherapeutics (drugs that kill microorganisms), infusions with antispasmodics (drugs that relieve cramps) work similarly – according to Western medicine, all these drugs are most often administered in these cases. After their use, the pain is temporarily alleviated, but the convalescence lasts considerably longer and does not always lead to a complete cure – usually such problems return to these patients, or they suffer more or less from chronic pain in the lumbar region. Therefore, according to Chinese medicine, it is good to endure this pain for a few days and then this load will fall off your mind and body, mostly without consequences! It depends on everyone which path to choose, even if it is true more or less that the bird who has eaten (or is healthy in other words) cannot fly with the bird that is hungry (or sick)…

According to Chinese medicine, the highpoint of treatment (and definitely the nail in the imaginary coffin) in this acute case is acupuncture. If you do not believe in acupuncture and are affected by painful lumbago, you will usually become an enthusiastic promoter of this method after several acupuncture treatments – in this case, acupuncture is the most effective method and it is the first choice of treatment. It is always necessary to insert needles into distant points that keep the YU XUE blood blockage going, relieve muscle tension and relieve pain, all in the lumbar region: such points include, in particular, the 40th and 60th points of the bladder and the 34th point of the gallbladder, where the needles are inserted using the distraction (dispersion) technique. Other local points are selected according to the affected painful area, here it is recommended to insert needles by the so-called hot needle method (warming the needles with a moxa stick from wormwood) or just warming up the painful areas on the back with moxa itself, because in this case it helps eliminate harmful cold wind FENG HAN from the affected areas and alleviates the pain.

The second highpoint is the indispensable herbal therapy. The herbal tablets (Stability of the palace pillar code 201) nourish the renal yang SHEN YANG XU and strengthen insufficient liver blood GAN XUE XU, which nourishes tendons and ligaments, eliminates external harmful cold HAN, wind FENG and moisture SHI and soothe pain. To these, other herbal tablets (Smooth ivory bone code 206) are added, which strengthen the insufficient essence of the kidneys SHEN JING XU and liver blood GAN XUE XU, induce the blood blockage YU XUE, nourish tendons and bones and relieve pain. Both of these herbal mixtures are used in the acute stage of problems in high doses – in China, up to 5×8 tablets a day from each type are taken, and, according to the decrease of the intensity of problems, the dose decreases gradually to a maintenance dose of 3×4 tablets from each mixture, but for at least 3 months, otherwise the problems often return.

Physiotherapy or chiropractic is also suitable, where various manipulative techniques are performed only after the acute phase of the disease has disappeared, e.g. In the recommended diet turmeric, saffron, horseradish, chilli, ginger, cloves and cinnamon are recommended in the acute phase.

Prevention is (as always) the best!

Those are the most important prevention principles: avoiding cold FENG HAN wind (see the beginning of the article), strengthening your SHEN JING kidney essence with a proper lifestyle and not exhausting it by overworking, overload, unilateral movement or excessive sports or physical work, moving and exercising regularly (harmoniously maintain and keep qi energy and blood QI/XUE going) and not suppressing anger, which then blocks the lumbar region (from the pathway of the gallbladder and liver, which feeds tendons and ligaments…). All this together causes these problems. Also, preventive use of the combination of the above-mentioned herbal tablets, which can be used for virtually all types of back pain, is recommended in this case preferably for 3 months in spring and 3 months in autumn to strengthen the essence of the kidneys and nourish ligaments, tendons and bones, at a dose of 3×4 tablets from each mixture (Stability of the palace pillar (code 201) + Smooth ivory bone (code 206)).  In the recommended diet, lamb and game, shrimp and cravfish, liver, kidneys, legumes, especially kidney beans, ginger, star anise, cinnamon and cloves are suitable. From the point of view of Chinese medicine, daily regular practising of slow Chinese gymnastics, such as Eight Pieces of Brocade (BA DUAN JIN), QI GONG or TAI QI QUAN is optimal to prevent these problems.