Most Americans have some back discomfort in their lifetime. Most often back pain is caused by a muscle or ligament strain or spasm, a disk problem, spondylosis, or stenosis. Stress can also be a factor. Prolapsed disc also known as herniated disk can produce severe back pain. Most prolapsed discs will repair themselves with adequate time and rest. In addition to medications and surgery, physicians sometimes inject Chymopapain, an enzyme derived from the papaya tree to shrink the disc. (Herbalists often use proteolytic enzymes in oral form for this purpose).
Spondylosis sometimes referred to as degenerative joint disease, or osteoarthritis of the spine, produces back pain and tenderness caused by overuse, injury or aging. Lumbar stenosis, a constriction or narrowing of the spine caused by arthritic changes or genetics, results in pain in the buttock, thigh, and calf associated with movement. Sciatica, nerve inflammation or compression of a nerve root in the lower back, leads to radiating sensation from the back through the buttock and leg. Tingling, numbness, or muscle weakness may be present.
Good posture while sitting, lying, lifting or exercising is often the best way to prevent back problems. Exercise, stretching, and strength training can make your arms, legs, and back stronger, thus relieving back pain. Weight loss is important as extra pounds stored in the abdomen puts stress on your lower back. Physicians typically recommend medications such as aspirin, acetaminophen, ibuphrophen, steroids, physical therapy, and surgery.
It is thought in Traditional Chinese Medicine (TCM) that trauma, overwork, and exposure to wind, cold, heat and dampness cause back pain. Weak kidney energetic function and impaired circulation result. To get the best results using Chinese herbs, one must assess how much the problem is caused by weakness and how much by stagnation. The most useful formulas for long-term use often contain herbs that will have both tonifying and circulating properties. For this reason one of the most valuable herbs is dipsacus (xu duan). Dipsacus is traditionally used for painful lower back, stiffness, and weakness in the lower body due to deficient kidneys. Dipsacus also increases blood circulation, and reduces pain; it can be used topically and internally. It is often combined with eucommia (du zhong), which is traditionally used to treat backache. Laboratory experiments have shown Eucommia has anti-inflammatory, and diuretic effects.
In a study conducted at Chongqing Hospital, a pill made of eucommia and psoralea was administered to forty patients with low back pain, fatigue, and weakness of the extremities. Symptomatic improvement was seen in most cases. Psoralea (bu gu zhi) tonifies the kidneys, and treats painful and cold lower back, impotence and premature ejaculation. Cibotium (gou ji) is traditionally used for weakness in the low back and extremities, and expels wind and dampness. The next step to treat the lower back pain in TCM is to use blood circulating herbs. Myrrh (mo yao) is one of the premier pain relieving plants in many parts of the world. Ancient Greek and Roman used this resinous plant to treat wounds. Today it is employed in clinics in the U.S. and China to treat pain associated with trauma. Achyranthes (niu xi) is said to strengthen the sinews and lower back. It belongs to the invigorate blood section of the materia medica. Laboratory experiments have shown analgesic effects. Sichuan Achyranthes (chuan niu xi) is considered stronger than the standard variety for relieving low back pain. Carthamus (hong hua) also known as safflower, is a bright red flower used topically as well as internally for traumatic injury.
In 775 cases; sprain, bleeding and swelling were reduced in almost all cases of those applying carthamus tincture. It is also commonly administered in tea and capsule form. Acanthopanax (wu jian pi), a relative of the widely used eleuthero ginseng, is traditionally used to strengthen the sinews and bones. Experienced herbalist will often add herbs to enrich the blood such as rehmannia (shu di huang) and tang kuei (dang gui). I have combined many of these herbs into a formula called Backbone, which is indicated for low back pain, weakness of the back and knees due to kidney yang deficiency. It is not indicated for acute sprain or strain. For acute injury, formulas such as Resinall E and Resinall K, based on the ancient formula Qi Li San can be applied.
For patients who have frequent sprains and strains, Backbone can be employed after short-term administration of Resinall K or Resinall E. Backbone is also not indicated for those with digestive weakness. For low back, and weak digestion, consider AC-Q formula (clematis wei ling xian, ginseng ren shen, siler fang feng, saussurea mu xiang, ho-shou-wu he shou wu, rehmannia shu di huang, lindera wu yao, chiang-huo qiang huo, tang-kuei dang gui, gastrodia tian ma, cinnamon bark rou gui, aquilaria chen xiang, frankincense ru xiang, coptis huang lian, blue citrus qing pi, cloves ding xiang, gentiana qin jiao, achyranthes niu xi, loranthus sang ji sheng, borneol bing pian), which has a larger percentage of blood circulating ingredients and less tonifying herbs.
For sciatica, I usually employ Mobility 2, Shu Jing Huo Xue Tang, (red peony chi shao, tang kuei, dang gui, ligusticum chuan xiong, rehmannia shu di huang, persica tao ren, atractylodes bai zhu, poria fu ling, citrus chen pi, siler fang feng, vitex man jing zi, gentiana qin jiao, achyranthes niu xi, chinag huo qiang huo, clematis wei ling xian, ginger gan jiang, angelica bai zhi, licorice gan cao).
CASE 1
Jake, a 42-year old chiropractor and runner who was having lower back pain and fatigue. His pulse was weak in the kidney position, and normal in the other positions. His tongue was normal. I recommended Backbone, three capsules TID, on an empty stomach with ginger tea. Within one week he saw a substantial reduction in back pain. I recommended he continue on the formula for another month, and then use it on an as needed basis.
CASE 2
Aaron, a 33-year old professional mover and weight lifter. When I saw him he was having chronic low back pain and was talking ibuprofen every four hours as well as drinking alcohol every night for the pain. His pulse was weak and slightly irregular. His tongue was purple. Initially we recommended AC-Q (2 capsules QID) to move Qi and blood, Backbone (2 capsules QID) to strengthen his kidneys and increase blood circulation. We also recommended Po Sum On Oil applied topically twice per day, massaged into his lower back by his wife. After two weeks Aaron saw a reduction in pain; his pulse was slightly stronger. After one month he eliminated the AC-Q, and was able to reduce his ibuprofen and alcohol usage. He continued on Backbone for three months with a total resolution of pain.