LOWER BACK

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Chapter 67

LOWER BACK

Chapter contents

LOWER BACKACHE

Interrogation, Chapter 37

SCIATICA

Apart from identifying the pattern, the affected channel must be identified. The channels affected are the Bladder, Gall-Bladder or Stomach; often more than one channel is involved.

Cold-Dampness in the lower back and legs

Dull pain in the leg that is worse in the morning, numbness/tingling of the leg, a feeling of heaviness of the leg, pain aggravated by exposure to cold and dampness and ameliorated by the application of heat.

Damp-Heat in the lower back and legs

Severe pain in the leg that is worse in the afternoon or evening, numbness/tingling of the leg, a feeling of heaviness and heat of the leg.

Stagnation of Qi and stasis of Blood

Severe stabbing pain in the leg that is slightly better with movement and worse with rest or sitting and during the night, pain slightly ameliorated by the application of heat.

Kidney-Yang deficiency with Dampness

Dull ache in the leg that is better with rest and worse with overexertion, lower backache, cold and weak knees, a feeling of heaviness of the legs, a feeling of cold, bright-white complexion, tiredness, lassitude, abundant clear urination, urination at night, impotence, decreased libido, Pale and wet tongue with sticky coating, Deep-Weak and slightly Slippery pulse.

Clinical note

• In my experience, in sciatica if the pulse is Rapid and Slippery and the tongue is Red with a sticky yellow coating, it is more difficult to treat.

FEELING OF COLD AND HEAVINESS OF THE LOWER BACK

Kidney-Yang deficiency

A chronic feeling of cold and heaviness of the lower back, a desire to apply warmth to the lower back, worse for exposure to cold and dampness, weak and cold knees, a feeling as if sitting in cold water, cold feet, lower backache, a feeling of cold, bright-white complexion, tiredness, lassitude, abundant clear urination, urination at night, impotence, decreased libido, Pale and wet tongue, Deep-Weak pulse.

Cold-Dampness in the back

A feeling of cold and heaviness of the lower back, a feeling of heaviness in general, chronic backache, cold legs, sticky white tongue coating, Slippery-Slow pulse.

Invasion of Wind-Water

A sudden feeling of cold and heaviness of the lower back, oedema of the ankles, aversion to cold, Floating pulse.

WEAKNESS OF THE LOWER BACK AND KNEES

Kidney-Yang deficiency

Weak back and knees, lower backache, cold knees, better with rest and worse with exercise, a feeling of cold, cold feet, bright-white complexion, tiredness, lassitude, abundant clear urination, urination at night, impotence, decreased libido, Pale and wet tongue, Deep-Weak pulse.

Kidney-Yin deficiency

Weak back and knees, lower backache, a feeling of heat, hot feet in bed at night, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, dry mouth and throat at night, lower backache, constipation, scanty dark urine, tiredness, normal-coloured tongue without coating, Floating-Empty pulse.

Cold-Dampness in the lower back

Weak back and knees, a feeling of heaviness and cold of the lower back, lower backache, swollen feet, worse with exposure to damp and cold and better with application of warmth.

Damp-Heat in the lower back

Weak back and knees, a feeling of heaviness and burning of the lower back, lower backache, swollen and hot feet, worse with exposure to damp and heat and better in dry weather.

STIFFNESS OF THE LOWER BACK

Stagnation of Qi and stasis of Blood

Severe stiffness of the lower back, inability or difficulty in bending forward or turning the waist, backache, stiffness alleviated by moderate exercise and aggravated by inactivity, Wiry pulse.

Cold-Dampness in the lower back

Stiffness of the lower back, a feeling of heaviness of the back, numbness/tingling of the legs, stiffness worse in the morning and better as the day progresses.

Kidney-Yang deficiency

Slight stiffness of the lower back, dull backache, weak and cold knees, lower backache, a feeling of cold, bright-white complexion, tiredness, lassitude, abundant clear urination, urination at night, impotence, decreased libido, Pale and wet tongue, Deep-Weak pulse.

COCCYX PAIN

Traumatic injury

Coccyx pain with history of traumatic injury, difficulty in walking, lying down or turning, pain aggravated by coughing and sneezing.

Kidney deficiency

Dull ache in the coccyx not related to movement numbness, with no history of traumatic injury, lower backache, dizziness, tinnitus, Weak pulse.

Other symptoms and signs depend on whether there is Kidney-Yin or Kidney-Yang deficiency.

Cold-Dampness in the Bladder channel

Coccyx pain, a feeling of heaviness of the legs, numbness/tingling of the legs, pain aggravated by exposure to cold or dampness and ameliorated by the application of heat.

Damp-Heat in the Bladder channel

Severe coccyx pain, a feeling of heaviness of the legs, numbness/tingling of the legs, a feeling of heat in the lower back.

ATROPHY OF THE MUSCLES ALONG THE SPINE

Observation, Chapter 11

Spleen-Qi deficiency

Atrophy of the muscles along the spine, weak muscles, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, slight depression, tendency to obesity, Pale tongue, Empty pulse.

RIGIDITY OF THE LOWER BACK

Observation, Chapter 11

Retention of Damp-Cold

Rigidity of the lower back, swelling of the muscles of the lower back, backache that is worse with rest and better with moderate activity, a feeling of cold of the back, a feeling of heaviness of the back.

Blood stasis

Rigidity of the lower back, backache that may be worse at night, stabbing pain of the lower back that is worse with rest and better with movement, Wiry pulse.

SKIN SIGNS

Spots on the back

Observation, Chapter 11

Wind-Heat with Toxic Heat

Red papules on the upper back with acute onset, aversion to cold, fever, tongue with red points and thick, sticky yellow coating, Floating-Overflowing-Rapid.

Damp-Heat

Red papules or pustules on the back, lower backache, a feeling of heaviness of the back, sticky yellow tongue coating, Slippery-Rapid pulse.

Other symptoms and signs depend on the organ involved, which may be the Stomach, Spleen or Liver.

Stagnant Liver-Qi turned into Heat

Red papules on the back which may be itchy and painful, hypochondrial or epigastric distension, a slight feeling of oppression of the chest, irritability, premenstrual tension, irregular periods, premenstrual breast distension, a feeling of a lump in the throat, a feeling of heat, red face, thirst, propensity to outbursts of anger, heavy periods, tongue Red on the sides, Wiry and slightly Rapid pulse.

Vesicles on the lower back

Observation, Chapter 11

Retention of Damp-Heat

Vesicles filled with clear fluid on the lower back which look like a string of pearls, backache, a feeling of heaviness of the back, sticky yellow tongue coating, Slippery-Rapid pulse.

Dryness and redness of the skin of the lower back

Observation, Chapter 11

Liver-Fire

Red and dry macular rash on the skin of the lower back that is itchy and hot, headache, red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Heart-Fire

Red and dry macular rash on the skin of the lower and upper back that is itchy and hot, dark urine, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Yellow colour of the lower back

Observation, Chapter 11

Damp-Heat in the Spleen and Kidneys

Yellow colour of the lower back, small vesicles on the lower back, backache, a feeling of heaviness of the back, turbid urine, sticky yellow tongue coating, Slippery-Rapid pulse.

Skin marks on the lower back

Observation, Chapter 11

Girdle Vessel pathology with Kidney deficiency

A discoloration of the skin of the lower back like long skin marks often distributed like a belt, not itchy, not painful, lower backache, dizziness, tinnitus, a feeling of heaviness of the lower abdomen and back, urinary discomfort, excessive vaginal discomfort, a feeling of bearing down.

Boils on BL-23 Shenshu

Observation, Chapter 11

Phlegm with Kidney deficiency

Boils on BL-23 Shenshu, a feeling of heaviness of the back, swelling of the muscles of the back, lower backache that is alleviated by rest, weak knees, dizziness, tinnitus, a feeling of oppression of the chest, Swollen tongue, Weak pulse.

Ulcers on the buttocks

Toxic Heat

Unilateral ulcers on the buttock, red, swollen and painful in the centre with a red edge around, indistinct margins, oozing a sticky yellow fluid and festering, thirst, a feeling of heat, Red tongue with red points and a thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

External Toxic Heat

Ulcers on the buttocks, red, swollen and painful with sudden onset, Floating-Rapid pulse.

Papules or pustules on the buttocks

Observation, Chapter 11

Damp-Heat in the Bladder

Papules or pustules on buttocks, frequent and urgent urination, burning on urination, difficult urination, dark-yellow/turbid urine, thirst with no desire to drink, hypogastric fullness and pain, a feeling of heat, thick, sticky yellow coating on the tongue root with red spots, Slippery-Rapid pulse.

SPINAL CURVATURE

Scoliosis

Observation, Chapter 11

Kidney-Essence deficiency

Congenital scoliosis, lower backache, weakness of the knees and legs, poor bone development in children, softening of bones in adults, deafness, poor memory, loose teeth, falling hair or premature greying of the hair, weakness of sexual activity, infertility, sterility, dizziness, tinnitus, normal-coloured tongue and Floating-Empty or Leather pulse if Kidney-Essence deficiency occurs against a background of Kidney-Yin deficiency, or Pale tongue and Deep-Weak pulse if against a background of Kidney-Yang deficiency.

Kidney deficiency with Blood stasis

Scoliosis, severe lower backache, stiff back, dizziness, tinnitus.

Other symptoms and signs, including tongue and pulse, depend on whether there is Kidney-Yin or Kidney-Yang deficiency.

Retention of Wind-Dampness in the channels of the back

Scoliosis, backache that is aggravated by damp and cold weather, a feeling of heaviness in the back.

Lordosis

Observation, Chapter 11

Kidney-Essence deficiency

Congenital lordosis, lower backache, weak knees, poor bone development in children, softening of bones in adults, deafness, poor memory, loose teeth, falling hair or premature greying of the hair, weakness of sexual activity, infertility, sterility, dizziness, tinnitus, normal-coloured tongue and Floating-Empty or Leather pulse if Kidney-Essence deficiency occurs against a background of Kidney-Yin deficiency, or Pale tongue and Deep-Weak pulse if against a background of Kidney-Yang deficiency.

Deficiency of Liver- and Kidney-Yin

Lordosis, lower backache, weak knees, dizziness, tinnitus, hardness of hearing, dull occipital or vertical headache, insomnia, numbness/tingling of the limbs, dry eyes, blurred vision, dry throat in the evening, dry hair and skin, brittle nails, night sweating, dry stools, scanty menstruation or amenorrhoea, normal-coloured tongue without coating, Floating-Empty pulse.

Retention of Wind-Dampness in the channels of the back

Lordosis, backache that is aggravated by damp and cold weather, a feeling of heaviness in the back.

Deficiency of the Stomach and Spleen

Lordosis, weak limbs, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, an uncomfortable feeling in the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

Spine bent forward

Observation, Chapter 11

Kidney-Essence deficiency with weakness of the Governing Vessel

Spine bent forward, lower backache, weakness of the knees and legs, poor bone development in children, softening of bones in adults, deafness, poor memory, loose teeth, falling hair or premature greying of the hair, weakness of sexual activity, infertility, sterility, dizziness, tinnitus, normal-coloured tongue and Floating-Empty or Leather pulse if Kidney-Essence deficiency occurs against a background of Kidney-Yin deficiency, or Pale tongue and Deep-Weak pulse if against a background of Kidney-Yang deficiency.

If a person is born with such deformity of the spine, the condition is constitutional and there may not be any other symptoms.

Kyphosis

Observation, Chapter 11

Kidney-Essence deficiency in the elderly

Kyphosis, softening of bones, deafness, weakness of knees and legs, poor memory, loose teeth, falling hair or premature greying of the hair, weakness of sexual activity, lower backache, infertility, sterility, dizziness, tinnitus, normal-coloured tongue and Floating-Empty or Leather pulse if Kidney-Essence deficiency occurs against a background of Kidney-Yin deficiency, or Pale tongue and Deep-Weak pulse if against a background of Kidney-Yang deficiency.

Liver- and Kidney-Yin deficiency

Kyphosis, lower backache, dizziness, tinnitus, weak knees, hardness of hearing, dull occipital or vertical headache, insomnia, numbness/tingling of the limbs, dry eyes, blurred vision, dry throat in the evening, dry hair and skin, brittle nails, night sweating, dry stools, scanty menstruation or amenorrhoea, normal-coloured tongue without coating, Floating-Empty pulse.

Deficiency of the Governing Vessel

Kyphosis, lower backache, dizziness, tinnitus, poor memory, weak sexual function.

Other symptoms and signs depend on whether there is a Kidney-Yin or Kidney-Yang deficiency.

Kidney-Essence deficiency in children

Congenital kyphosis, poor bone development, weakness of knees and legs, poor memory, loose teeth, lower backache, dizziness, tinnitus, normal-coloured tongue and Floating-Empty or Leather pulse if Kidney-Essence deficiency occurs against a background of Kidney-Yin deficiency, or Pale tongue and Deep-Weak pulse if against a background of Kidney-Yang deficiency.

Flattening of lumbar spine

Observation, Chapter 11

Qi stagnation

Flattening of the lumbar spine, stiffness of the spinal muscles, backache that improves with gentle exercise, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, pre-menstrual tension, Wiry pulse.

Blood stasis

Flattening of the lumbar spine, stiffness of the spinal muscles, rigidity of the back, backache that improves with gentle exercise and is worse at night, Purple tongue, Wiry pulse.

Cold

Flattening of lumbar spine, backache that improves with the application of heat and is aggravated by exposure to cold and dampness, a feeling of cold, cold back and knees, Pale tongue, Tight-Slow pulse.

List of spine

Observation, Chapter 11

Qi stagnation

List of spine, stiffness of the spinal muscles, backache that improves with gentle exercise, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Blood stasis

List of spine, stiffness of the spinal muscles, rigidity of the back, backache that improves with gentle exercise and is worse at night, Purple tongue, Wiry pulse.

Cold

List of spine, backache that improves with the application of heat and is aggravated by exposure to cold and dampness, a feeling of cold, cold back and knees, Pale tongue, Tight-Slow pulse.

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