Back Pain

Jonathan Clogstoun-Willmott

July 11, 2023

Q. Can back pain be cured by acupuncture, if used correctly?

A. If the underlying Chinese medicine ‘syndrome‘ (as in TCM Theory) is dealt with properly, and/or the acupuncture c hannels can be cleared, then the pain goes or improves greatly.

Conversely, if the treatment fails to address the real reason, any improvement will be temporary.

Just sticking some needles in where it hurts won’t necessarily make any difference. Treating a sore back the right way, ie as Chinese medicine works, very often makes improvements, but that comes down to the initial diagnosis.

So it’s important to get the diagnosis right.

What does an acupuncturist think about when you say you have pain in your back?

Well – for instance:

What the pain is like
What makes it better or worse
The times or circumstances when it happens
How – if known – it originated
Are any strong emotions connected with it?
What happens elsewhere when you have it
How it affects you
On which acupuncture channel(s) the pain is felt
Where on those channels the pain is felt, and why.
The syndrome causing or accompanying the pain.
The ‘Western’ diagnosis will be considered.

The Back-Shu points

Pain may also be felt, or a reaction discovered on examination, at any of the Back-Shu points. To save you clicking on that link, which takes you to a page about them, the Back-Shu’s are acupuncture points which are often important for both diagnosing and treating problems related to individual energy organs or Zang-fu.

Location of Back Pain

When examining someone with back pain, an acupuncturist thinks of the anatomy and physiology in Western Medicine, but also of the energy (Qi) moving along the acupuncture channels in the back.

Which acupuncture channels traverse the back?

Acupuncture Channels on the Back

The main acupuncture channels on the back are:

Governor Channel (in your spine)
Bladder channel (two vertical lines parallel to your spine)
Gall-bladder channel
Small intestine channel (especially upper back and shoulders)
Three-heater (San Jiao) channel (upper back and shoulders)
Large Intestine channel (upper back, neck and shoulders)
Kidney channel (spine)
Conception vessel (spine)
Chongmo (Penetrating) channel (spine)

That’s not all! Perhaps of lesser frequency:

Stomach tendon (or ‘sinew’) channel
Spleen tendon (or ‘sinew’) channel

(So what’s left out, you wonder? Just the Lung, Heart, Pericardium and Liver channels. But each of these can indirectly produce back pain through its paired Zang-fu. For instance, the Liver channel works on the back through the channel of its paired organ, the Gall-bladder.)

If you are using acupuncture or one of the many therapies that, in effect, use the theory of acupuncture (whether knowingly or not), it may help to find the place where the pain starts, finishes or goes to.

Why? Because then you’ll use the correct acupuncture channel.

Q. What happens if you don’t use the right channel?

A. Often, not a lot. The patient may or may not return for more treatment, depending on how much they like and respect you! Sometimes there is an improvement, probably more from luck than good judgement. (Even for this there is an explanation – Chinese medicine is very sophisticated!)

Of course, pain can occur over a wide area, taking in a number of channels. In that case all of them may need treatment but even here usually one takes precedence. Discovering which that is can take skill.

In fact, there are many acupuncture methods (eg Dr Tan or the Balance method, Dr Tung, Japanese acupuncture) which are amazingly good at reducing pain. These use points found on other meridians to clear blockages causing pain in the affected meridians.

Where you, the patient, feel the pain, may not be where the best acupuncture treatment is done. If the underlying condition isn’t treated, the back pain will return and relief will be temporary.

Q. Why?

A. Suppose the condition is caused by Cold and/or Damp(there’s more about these below).

To understand this, take an analogy:

There’s a village in Somerset, England, called Munchelney. It lies inland, about 18 miles (around 29 kilometres) from the sea.

At the time of writing this (2014), after heavy rain for weeks, it is surrounded by water, like an island.

rock island on sea - not Munchelney! — Island, by definition surrounded by water – Photo by Nathan Boadle

Being cut off, they need food, not to mention rescuing. Power supplies are affected so no doubt some of them will be suffering from cold and damp. (By the way, the image is not of Munchelney, unless things have seriously deteriorated.)

Those susceptible will have back pain, amongst other problems.

Of course food, warmth and rescue will help. But until the floods drain and the land dries out, their problems will remain or return.

So, what is the correct treatment? Obviously, drain the floods; dry out; warm up.

Then consider (1) flood defences, (2) a raised causeway (!) and (3) whether, in the absence of effective flood defences and the expectation of future flooding from heavy rain, living in Muchelney continues to be a good idea.

A somewhat bleak prospect!

Diagnosis in Chinese medicine

Here are some of the syndromes that in Chinese medicine often lead to back pain. (By the way, these syndromes can produce problems elsewhere too. If they do, those other symptoms help to confirm the diagnosis of the syndrome in question.)

Invasion by Cold
Blood Stagnation
Invasion by Wind and Cold
Qi Stagnation
Kidney Deficiency – this usually shows up over time, with tiredness and the desire to lie down or rest.
Invasion by Damp
(If Damp invasion is a cause, then they should probably avoid ‘Damp Foods‘ ie foods that make them more susceptible to Damp invasion)

Often there is a combination of these syndromes.

For example, read below for descriptions of invasion by Cold and Damp, then invasion just by Cold.

Symptoms of Damp and Cold Invasion

Pain, is often accompanied by swelling and/or heaviness; like a sponge left out overnight, that has collected dew and is unexpectedly heavy.

The pain is often stabbing or sharp.
Pain improves in warm conditions, such as a warm bath or shower, or in a warm climate.
Pain is often better while you keep moving, but sore actually to start moving.
Like a mist settling overnight in low-lying areas, the swelling often occurs at the lowest areas. For example in the low back.

Like fog which clears when the sun comes up and burns it off or when the wind blows it away, warmth and movement help clear the syndrome. But unless the underlying tendency is addressed, the damp and cold symptoms will return.

Treatment of Damp and Cold invasion

There are acupuncture points that help to ‘drain’ damp. (Warmth can also be applied to help to ‘dry out’ the damp.)

The points that do this are often nowhere near the pain. Points local to where the pain is are often ineffective until the body’s tendency to let damp ‘collect’ is sorted out.

Of course, your acupuncturist would suggest ways to avoid exposure to damp and cold, (including avoiding foods that make you more susceptible to damp formation). He might suggest you stop living in a damp house. But if you don’t live in a damp house, it might be that your favourite sport or your work exposes you to damp conditions.

grayscale photography of man lying on floor

Some foods, medications and drugs also increase the incidence of damp in your body. Eating too much cold food also makes you susceptible to cold ‘invasion’.

So, for a syndrome like Damp, you may find there are plenty of things you can do yourself to reduce its likelihood and to improve your chances of getting rid of it.

Otherwise, just giving you the right food and warm clothing will be nice, but until the floods drain away, you’ll need continuing help. Visiting your acupuncturist may not cure you, even with the best treatment. You might as well take a painkiller!

So, although acupuncture can greatly help clear the above ‘syndromes’ that produce back pain, and in this case, ‘damp’, there may be changes you should make (in what you eat, for instance). If you don’t make these changes, cure may take longer.

Back Pain from ‘Invasion by Cold’

cold mountains - bad for large intestine luo channel symptoms — Mountains – cold and beautiful

Symptoms include:

You or your back feels cold: you like warmth where it aches
The whole area where it hurts feels sluggish and heavy
Pain may be stabbing
You feel better when you keep moving
It hurts more when you rest staying still
It’s bad when you haven’t moved for a while, for example when you wake in the morning

Back Pain Treatments

Treatment for back pain is seldom really successful unless both the channels in question are chosen carefully, and the underlying syndrome is addressed.

Otherwise, results will be like painting over rust: the paintwork will never look good and will soon deteriorate again.

The kinds of treatment that your painful back might be given by an acupuncturist include:

Acupuncture including electro-acupuncture
Ear acupuncture (auriculo-therapy)
Cupping
Tuina or other massage eg Shiatsu, including sometimes a form of gentle manipulation
Guasha – a special form of ‘scraping’ or ‘rubbing’ the skin
Release of stagnant Blood
Nutrition
Herbs
Moxibustion

Also, while not exactly treatment, you might receive advice about:

Exercises or moves you can do to increase or maintain your flexibility and strength. These might include simple movements to do, yoga asanas to try, or that you see an Alexander teacher, or learn from a Pilates instructor. In the long run, if you have a tendency to a bad back, you almost certainly should do some form of exercise.
Tai Qi, the ancient Chinese forms of movement

Tai Chi for Lung Phlegm fluids — Tai Qi – Photo by Mark Hang Fung So on Unsplash

Posture and sitting position at home and work
Not watching TV in your bed, and other such suggestions!
Your shoes and walking
How to lift and carry things safely or, at least, better
See also appendix 10 of my book below, where I describe a simple series of moves that lead to flexibility and, some of my patients tell me, ‘Everlasting Youth, Happiness and the End of the Universe’. (Well, we’ll see.)

Apologies

I’m not allowed by the ASA to tell you that acupuncture is good for back pain, so I haven’t – even though there is now some grudging acceptance of this.

For instance, both NICE, (the British National Institute for Clinical Excellence) and SIGN (the Scottish Intercollegiate Guidelines Network) now recommend or have recommended acupuncture for the treatment of low back pain. Also, click HERE for a major study from Southampton University, covering the benefits of acupuncture for a range of conditions that go beyond those ‘allowed’ by NICE.