Traditional acupuncture for back pain
2008
What traditional acupuncture can offer to people with back pain
Back pain is common, but the degree of problem and pain, and the causes are perhaps as varied as the individuals who suffer. From niggling low backache to conditions so exceedingly painful you hardly know how to get from one moment to the next. Sometimes, I have been faced with a patient in excruciating pain and have felt dubious as to whether I can help, but after treatment their perception of the pain – on a scale from 1 – 10 (1 being the least pain and 10 the worst it has been for them) has, in 95% of cases lowered at least a notch or two and often much more. Affirming again and again to them and me what a wonderful system of medicine this is – its results are often marvellously swift and clear.
Acupuncture is an ancient system of medicine the theoretical basis of which links us with the natural world. Man stands between earth and heaven and as such is a conduit for those energies. We are connected to everything. I believe that it is this connection that brings us health and ease and disconnection that starts a process of ill health and disease.
There are two main schools under the traditional acupuncture heading. Traditional Chinese Medicine (TCM) encompassing herbal medicine as well as acupuncture is the system currently practiced in China. It has a language for dealing with particular symptoms and clusters of symptoms known as Syndromes.
Five element (or five phases) acupuncture looks at the individual’s constitution and the balance of these elements within them. The elements which inform all acupuncture are a creative cycle like the seasons: fire – summer; earth – late summer, metal – autumn, water – winter and wood – spring and there are many correspondences from the physical level through to the emotional.
For a traditional acupuncturist these energies are carried through a network flowing over the surface of the body and connecting with every part – tissues, muscles, bones, organs and vessels from superficial skin level to deep within the body. These conduits are known as channels or meridians. The energy is known as Qi or Chi and can be understood as life energy. The free flow of Qi keeps us healthy and hearty and without discomfort or pain.
How do sessions work?
All acupuncturists look at the balance and quality of energy within these elements. The tools used for this include; reading the pulse at the wrist; taking in the quality of voice and skin colour and looking at the tongue. Palpation of the area of pain and along the channels related to it will also show the relative strength or weakness in a particular area.
A thorough case history will be taken including medical history, childhood history, preferences in food and climate, and the perception of their general health – sleep, energy, appetite and emotional state.
Sometimes people say “I have a pain in my knee why do you want to know all this?” It is because acupuncture at its best is a truly holistic treatment – I think we all know that we can sometimes have an accident, a trip or fall, and know that it was because we were not totally present to ourselves in that moment. And why was that – why were you preoccupied? Were you stressed or anxious, or angry or sad?
The person in pain may also not be sleeping well (either because of the pain or have a history of poor sleep) and have a generally sluggish system, being constipated and possibly ‘tired all the time’. This is important information and I know that systemically acupuncture can help all these symptoms if I can reach the root of their cause, and by including strategies they can adopt to help them ensure their symptoms do not return.
So with all the information, a diagnosis is made and treatment begins. Treatment with acupuncture is basically the 
manipulation of the Qi energy through the use of fine needles inserted into points on these channels or meridians. The needles used nowadays are single use and disposed after each treatment. Acupuncturists may also use a technique called moxibustion. This is burning a herb (mugwart) in a variety of ways, not burning the patient; its use is for warming the area not causing more pain! Needling is also not usually painful. But a sensation of warmth or tingling may be noticed as the Qi is contacted.
The points chosen in relation to back pain will probably include points on meridians flowing through the area and some far from the pain. “I have a headache why are you needling my foot?”, because the meridian concerned begins there and so will have a strong effect on the Qi.
The bladder meridian is the longest in the body and flows from the corner of the eye, up over the top of the head and down the back through the lumbar and sacral areas, down the back of the thigh through the calf and ends on the outside of the little toe. The points here are essential in the treatment of most back problems. These points will increase flow to nourish the area and strengthen it.
Prevention of back pain may be covered in other areas of this magazine: strengthening exercises, the importance of learning safe ways to lift; the importance of warming up and cooling down after strenuous exercise. As a traditional acupuncturist I would also emphasise paying attention to relaxation and general balance in life. Being stressed, burning the candle at both ends and being careless with ourselves, perhaps not following the above advice, is a recipe for many illnesses including back problems.
Andrea came to me when she was in extreme pain in her lower back. She is in her thirties, a hard working and conscientious nanny, often required to lift children in her care. At her first session it became clear that her conscientiousness meant that she found it hard to take time for herself often working to the point of exhaustion. After addressing the immediate problem with a short series of treatments that alleviated it, Andrea chose to have regular monthly treatment to deal with underlying deficiencies and bring about greater ability to relax. What had been a recurrent problem has not returned three years later. I see her now at the change of the seasons.
Sciatica is one of the most common conditions that people bring to my treatment room. Depending on the underlying physical cause, improvement comes with several treatments or with just one or two.
As with most painful conditions we would begin with a specific treatment to relax the muscles and tendons then the main symptom will be addressed. The patient may be asked to lie on the couch on the opposite side from the pain, with the upper knee slightly bent and supported by a pillow. Needles will be inserted in points at the hip and on the meridian or meridians concerned, more often than not in points at the knee and ankle on the affected side. Sometimes the area will also be warmed with moxa. The patient may be asked to move gently and to let me know what they feel, hopefully a reduction in pain. Treatment will usually be completed with points specific for the individual that will increase the amount of energy available and hasten healing. Again follow up is important – once balance is restored and the person feels well – a change of habits may be necessary to ensure it doesn’t recur.
Obviously there are cases where all the pain is not going to disappear. The general sense of well being and relaxation gained through treatment can give a sense of space from the pain. The mind is very important in pain management. If we concentrate all our attention on the pain, fighting it, it can take over and seem to increase, until it seems to be all we are. Whatever stress or discomfort, physical or psychological is with us. It is important that we know it is not all we are. That perhaps is the balance we aim for, the harmony we seek.
Please note the term acupuncture is used for a range of different treatments and what Julia describes in this article may be different from what other acupuncturists, such as medical acupuncturists, practise.
Julia is a Member of the British Acupuncture Council.