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You are here: Home / Acupuncture / A Chinese Medical Approach to Diagnosing Low Back Pain

A Chinese Medical Approach to Diagnosing Low Back Pain

November 30, 2021 in Filed Under: Acupuncture, Pain Management by Robert Keller

One of the most common complaints that brings people to my office is low back pain. Low back pain occurs in people of all ages, but is most common in men over the age of 40. How does Chinese medicine consider low back pain from a clinical perspective? Let’s look at symptoms, causes, and diagnosis from both a Western perspective and a Chinese medical perspective.

Low Back Pain Symptoms
Typically, patients complain of a sore, achy low back and/or hips. There may be pain that travels into the buttocks or down the legs, as well.

Western Biomedical Diagnosis
From the perspective of Western medicine, low back pain is caused by one of the following factors: soft tissue issues (muscular tightness); hard tissue damage (arthritis that causes narrowing of the spinal canal; spinal stenosis; facet arthropathy; degenerative disc disease); or neurological issues (nerve compression or impingement due to herniated or bulging disc).

Western Biomedical Causal Factors
Western medicine professionals typically identify causes that include: injury, age-related degeneration, obesity, or osteoporosis.

Chinese Medical Disease Diagnosis
There are numerous traditional diagnoses for low back pain in Chinese medicine. Primarily they fall under the category of bi syndrome, which means painful obstruction syndrome.

There are bone bi, tendon bi and muscle bi syndromes. Chinese medicine has its own system for naming disease, which is one of ten methods utilized for pattern discrimination. Let’s look at the patterns related to low back pain.

Chinese Medical Patterns
Low back pain can result from multiple and varied patterns of disharmony. While there are generalities for everyone that has a painful back, Chinese medicine also considers the specific and underlying factors that are unique for each individual. Common factors (following the order of patterns listed above) include: Qi and Blood Stasis; Kidney Yang Vacuity; Wind, Cold, Heat and Damp Obstruction; Water Imbalance; Bladder and Gall Bladder Tendino-Muscular Excess; Tai Yang and Shao Yang Impediment; Wei Level Impediment; Lower Burner Stagnation; and finally the disease category of Muscle, Tendon and Bone Bi Syndrome.

Chinese Medical Causal Factors
There are only three causes of disease in Chinese medicine. They are:

  • Nei Yin – The internal causes of disease, or the emotions (sadness, joy, worry, pensiveness, anger, fear and shock)
  • Wei Yin – The external causes of disease, or the weather (the external pernicious influences of Wind, Cold, Dampness, Dryness, Fire, and Summer Heat)
  • Bu Nei Bu Wei Yin – The neither internal nor external causes of disease (includes diet, lifestyle, and trauma)

The Picture of Low Back Pain in Chinese Medicine
Putting together all of the above information, Chinese medicine views low back pain in this way: each person has a constitutional tendency (physiological predisposition) towards particular imbalances, dysfunctions, illnesses, and injuries. Against this background, when we experience any of the three causes of disease, then pain or illness will present according to the patterns of disharmony that are described above. All of this leads to a unique presentation for each individual.

It is commonly noted in Chinese medicine that one disease can present as many patterns, and that one pattern can present as many diseases. 

That is why these issues of differential diagnosis are so vital to the practice of Chinese medicine. Chinese medicine addresses the unique and ever-changing landscape of a person’s health. Without this approach, there is only temporary and symptomatic treatment.

With the first step of proper and thorough diagnosis, low back pain can be successfully treated using the Chinese medical modalities of acupuncture, herbal medicine, dietary therapy and lifestyle changes. In many cases, Chinese Medicine can help patients avoid prolonged pain, repeated injuries, and in some cases even surgery. Stay tuned for part 2 of this article, which discusses more in depth treatment of low back pain with Chinese medicine. I’ll include particular case studies to give you a better idea of what diagnosis and treatment would be like for particular presentations.

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