In recent years, more and more people disenchanted with western bio-medicine have turned to physicians of Oriental medicine and their holistic and naturalistic philosophy for help with all types of health concerns, including back pain. Back pain is the single largest cause of lost working days in the U.S. In 1991, low back disability claims were increasing at 14 times the rate of the population growth, and continues to rise. Today, back pain is a major health crisis, and while sufferers used to only receive high potency (and high toxicity) pain killers from their M.D., or undergo risky surgery, people are becoming more aware of the benefits of acupuncture and Oriental medicine and are finding relief from chronic and acute back pain.
The reality is that most low back pain is poorly understood by biomedicine. Research has shown that "pathologic" changes in the structure of the back (which would be the foundation for an M.D.’s diagnosis) are found in people without any back pain at all. 30-60% of people under 35 have some degree of disc degeneration, 20% under 60 have herniated discs, and 24% between 18-76 have abnormal lumbar discs, although none of these people are complaining of low back pain. Moreover, 80% of back pain sufferers who undergo a complete exam by an M.D. are told they have no evidence of physical damage. As a result of the limitations of the biomedical paradigm, only 10-15% of patients who seek treatment from an M.D. receive a specific diagnosis of their back pain. This means that 85-90% of back pain sufferers will not receive any meaningful treatment, and are usually just given pain medication to mask the symptoms, or worse yet, they are recommended for surgery. Every year 25,000 -50,000 cases of back surgery fail, resulting in unrelenting back pain and significant functional impairment. It has been said that "No operation in any field leaves more human wreckage than surgery of the spine." (Waddell, G., 1992)
The most common types of jobs that place people at high risk for back injury and pain are any job requiring heavy lifting and carrying, which obviously puts people at risk of strain injuries, and any job requiring long periods of sitting or standing in one position, which basically includes everybody else. Other factors that increase one’s risk are poor muscle tone, which means being out of shape from too little exercise. Also being overweight, as this usually involves a combination of poor muscle tone as well as the extra weight putting a strain on the back. The abdominal (stomach) muscles, which includes the rectus abdominis muscles which are what give some people their "bricks", as well as the obliques which wrap around the sides of the body from the spine to the front, are especially important in supporting the trunk of the body, and we should all work on strengthening these muscles as both a treatment for, and prevention of, back pain.
The structures involved in back pain include the muscles, tendons, ligaments, nerves, the vertebrae (the bones of the spinal column), and the intervertebral discs (composed of the nucleus pulposus and the annulus fibrosus, they provide a cushion between the vertebrae). In Oriental medicine, these structures correspond to certain Organ-Channel complexes, and often it is an imbalance in these systems that predisposes one to back pain. Specifically, the Kidney relates to the bones, and therefore the vertebrae and intervertebral discs, as well as having a strong effect on the low back due to their anatomical location. The Liver is responsible for nourishing the tendons and ligaments and is often involved in disorders of these tissues, as well as having an effect upon the nervous system. The Spleen is in charge of nourishing the muscles, as well as transforming the nutrients from food and transporting them to whole body. As a result, a person whose Kidney Qi is Deficient, for example, is more likely to have a disc prolapse, while a person whose Spleen Qi is weak is prone to muscle strains.
Chinese medicine states that wherever the Qi does not flow smoothly there is pain, and wherever there is pain there is Qi Stagnation. One reason that Qi does not flow freely is Qi Deficiency or weakness, which doesn’t have the strength to move through the channels. Dampness & Phlegm in the body, from a poor diet, obstruct the flow of Qi. Our emotions affect the flow of Qi. Trauma will disrupt the Qi flow. As previously mentioned, imbalances in a given Organ-Channel system predispose us to all types of health problems by affecting the Qi of those systems.
AN OUNCE OF PREVENTION…
Back pain doesn’t just happen, it is the result of something that we have done, and therefore the only way to prevent back pain is to take care of ourselves. Especially destructive to our health are the excess’ of modern living. The following is partial list of some of the biggest offenders;
1. Too much work & not enough rest and relaxation.
2. Emotional stress and imbalances.
3. Abuse of alcohol, caffeine, nicotine, and other drugs, both legal & illegal.
4. Excess sexual activity.
5. Dietary imbalances: too much sugar, salt, grease & fat. Not enough vegetables.
6. Not enough (or any) exercise, including a complete stretching routine.
We must remember that we can only take care of our health, and our backs, in the HERE & NOW. Planning on starting an exercise routine or a change in diet next month, or telling yourself you will do some stretches or relaxation techniques (such as meditation) when you get home after work are not going to help. Every moment you should try to be aware of your body, your movements, your health, and do something to improve them.
Besides healthy living, there are some simple body mechanics that should be practiced all the time. Most important is your posture. The ancient Chinese doctors describe the spine as a "string of pearls", capturing both the value and the mechanics of the spine. When we stand or sit upright, we allow are spine to fall into its natural alignment, like we were holding the "string of pearls" from the top of our head. Whenever we slouch we put a kink into our spinal "string", and it at this location that an injury is most likely to occur.
Good balance is essential to all body movements. The image of someone over-reaching while standing on one foot suggests an accident waiting to happen. When doing anything that requires exertion, such as lifting, be sure to have both feet firmly planted on the ground, and the object should be easily within arms reach. When you move, especially when carrying heavy objects, try to move from you center of gravity, which is an area just below the belly-button (the Chinese call this the Dan Tien). Hold objects close to your body, allowing the weight to hang off your shoulders. Finally, and this cannot be overemphasized, BEND YOUR KNEES and KEEP YOUR BACK STRAIGHT when lifting.
A POUND OF CURE…
Once you have back pain, what should you do? For acute pain of recent onset, a couple of days of bedrest is advised. You should not, however, continue to just rest after a couple of days because this will only encourage the Stagnation of your Qi. Gentle movements and stretches are essential to restoring the free flow of Qi and relieve the pain. Acupuncture is very effective in removing Qi Stagnation and relaxing muscles in spasm. It will increase the blood flow to the damaged tissues and thus speed healing. Chinese herbal teas are great at nourishing the various Organ-Channel systems and aiding in the flow of Qi. Topical herbal liniments are also very helpful in the healing process. Massage techniques, such as the Chinese system of Tui Na, are an important part of therapy when muscles and tendons have become knotted up. Don’t despair, most back pain improves over time, and with the right therapy, that time can be shortened.