Wednesday, January 23, 2013

Oh my aching back...

Oh my aching back…

Back pain is one of the most common and costly conditions that motivates people to seek medical attention. Did you know that more than one million people in the USA are affected with back pain, costing an estimated 37 million dollars annually? This adds up to millions of hours of lost work and productivity, not to mention the pain and suffering of countless people.  

Half of all adults will experience some form of back pain in their lifetime, making this a significant source of inconvenience and suffering. This is also one of the most common reasons that many patients seek my help with acupuncture and herbal treatments. Back pain comes in many shapes and sizes, intensities, and durations, making the treatment of each patient an individualized one.

How Does Back Pain Present?

Common causes of back pain are sprains and strains that can occur from over-stretching or over-loading the muscles and ligaments. This can occur suddenly, as with a fall or accident, or over time through wear and tear from poor posture, improper use, or structural imbalances (like scoliosis, curative of the spine).

Other common ways back pains present are:
Disc herniation or subluxation -- when a disc that is the inner cushioning between the vertebrae bulges out causing compression of the nerve root in some cases. This can cause referred pain to other areas of the body.
Sciatica -- a nerve that begins at the spinal cord and goes to the hips, buttocks, and then branches down each leg. It is when the sciatica nerve is irritated or inflamed that one experiences pain, most often radiating into the buttocks or down the legs, causing pain, numbness, and muscle weakness. 
Osteoarthritis -- when wear and tear on the joints causes the breakdown of cartilage that surrounds, protects, and cushions the bones at the joints.  This can cause pain, swelling and stiffness throughout the spine. This condition is commonly seen in the elderly.

Types of Pain

There are two types of common back pain: acute and chronic. 

Acute back pain occurs suddenly, making it impossible to walk, bend, or even conduct daily activity. Acute back spasm can induce a pain cycle that leads to muscles that are distorted, which in turn pull on discs and joints and compress nerves.  This is a very painful situation and demands immediate attention, usually a multi-faceted approach: acupuncture, massage, heat therapy, and sometimes medication and spinal adjustments. 

Back pain can also be chronic in nature -- a dull ache that never really seems to go away. This condition takes a little more time to resolve and requires an understanding of how to correct muscular imbalances and weaknesses with restorative exercises and physical therapy, as well as all the other modalities already listed.

95% of back pain cases will resolve with therapeutic treatments without the need of invasive surgeries. 

How Can Acupuncture Help Back Pain?

Acupuncture can play a major role in the reduction or elimination of back pain by promoting blood flow, reducing inflammation, and helping restoring normal function of the muscles, joint, ligaments, tendons and nerves.



Research studies have shown that acupuncture treatments cause the body to produce natural steroids and promote the production of natural endorphins. These natural steroids reduce inflammation and swelling, while the endorphins reduce pain levels in the body. This in turn can break the pain cycle, help improve activity levels, increase range of motion, promote faster recovery time, improve function of the musculoskeletal system, and reduce the chances of reoccurring back pain.  

Acupuncture and herbal remedies can also reduce the need for painkillers or other medications that can cause unwanted side effects or delay the healing process.

Chinese Medicine Patterns of Back Pain

In Chinese Medicine the patterns of disharmony are divided into several different types of back pain and whether the condition is acute or chronic:
Deficiency type pain is usually dull, chronic and improves with rest. Back muscles are often weak and under conditioned.
Qi and blood stagnation is often acute with severe and stabbing pain. Back muscles are stiff and tight and the patient feels worse with rest. This pattern is often related to an acute sprain or strain.
Cold damp obstruction back pain is worse in cold and damp weather and there is often numbness, swelling, and a sense of heaviness in the muscles. This is often seen in arthritic conditions.

The treatment approach is different for each type of back pain. In the deficiency pattern the approach is to improve muscle function, promote blood flow and reduce pain. When there is stagnation of qi and blood, the approach is to move the blood and reduce pain and spasms of the muscles. In the cold damp obstruction, the approach is to move the fluid in the lymph system, improve circulation, and restore nerve function.

In all types of back conditions the goal is to improve blood flow, reduce inflammation, alleviate pain, and increase the recovery time. Chinese Medicine has been shown to do just that, as well as provide long term benefits by addressing all the underlying health issues to prevent any reoccurrence of back pain.  

My patient Scotty is an example of how Chinese Medicine and lifestyle changes can keep back function at optimal levels.

Case Study

Scotty, a dapper, articulate man of 64 with a soft southern accent, came to me with the complaint of lower back pain that radiated down into his left leg.  His massage therapist had given him my name and encouraged him to try acupuncture along with his ongoing massage and physical therapy.

Scotty had been experiencing back pain for the past year.  His health profile revealed that he was diabetic, hypertensive (controlled with medication), overweight, undernourished, chronically dehydrated, and suffered from depression and seizures. His weighed 201 pounds and before his gastric bypass seven years ago he was weighing in at 355. This is a great accomplishment but he needed to learn better eating habits to help control his blood sugar, and to further reduce his weight. We would need to address his current unhealthy diet as well as his lower back pain.

The first order of business was to tackle his chronic back pain. His occupation as a hair- dresser required long periods of standing on his feet without rest. His spine from the upper cervical area down to his lumbar and sacral iliac joint suffered from the many years of standing and working with his arms elevated. The excess weight in is mid-section only exacerbated the situation. 

His back pain had been so acute six months prior to seeing me that he had been hospitalized for a week to determine what was causing all his discomfort. He was experiencing numbness, tingling, and a dull ache that had come on gradually, starting from his waist and running down to his toes and feet. He had extreme weakness in his left leg with a feeling that his leg could not support him at times when he was standing and walking. He had not had an accident or an injury that had caused this painful condition. 

While at the hospital he had been seen by three neurosurgeons, two neurologists, an osteopath, and a physiatrist all who could not determine why he was suffering with pain and numbness. The neurosurgeon recommended surgery, which was not something that Scotty was inclined to do at this point. He “gave up” on all the doctors and went to a massage therapist to “relax.” It was after taking the advice of his massage therapist that he came for acupuncture and herbal and nutritional advice. 

We started with acupuncture treatments that focused on reducing the numbness down his leg, while reducing swelling and nerve inflammation in his low back/sacral area.  His Chinese diagnosis was cold damp deficiency type low back pain. He felt better with rest and warmth and his low back and sacral area were swollen and cold to the touch.  The needles were placed from the cervical spine (neck) down to his ankles to increase circulation and help improve nerve and muscle function. The majority of needles were placed in the lumbar and sacral areas of the spine, while also using moxabustion to warm and improve blood flow, and electric stimulation to improve nerve function and to break the pain cycle.
In the last 5 months of every other week acupuncture and massage he is 95% symptom free.

The numbness in his left leg and foot are barley noticeable while the strength in his spine and legs have increased to the point that he is pain free and back to his daily activities without limitation. His energy is at a record high due to all the dietary changes that he has made. 

Due to the gastric bypass, it was very difficult for him to digest his foods, so I suggested that he puree and blend much of his foods. The morning anti-oxidant smoothie helped him get the nutrients in the morning to sustain him through his 12-hour workday, and his vegetable soup purees helped him get the vegetables that he so needed in his diet. He started eating on schedule and avoided sugary and fatty foods that he often ate while working. 

Scotty kept himself hydrated and avoided the diet sodas and coffee. He also started taking flax oil and herbal tonics, which helped in the healing of his muscular skeletal system.  He is always working at improving his diet and fitness level.

Scotty is always asking questions and has a renewed interest in learning about healthy living and it shows. His colleagues and clients notice the renewed bounce in his step and that his quick wit and joyous personality have returned. He has told me that I have saved his life!!  He saved his own life by taking the steps that he needed to take to change a lifetime not exercising and eating regularly and properly.  This has all changed as now he is in his “second spring” as they say in China.

We now are working together to cure his type two diabetes with diet, exercise and Chinese Medicine.

The journey continues…

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