Eight out of 10 people will experience back pain at some point in their life.1 Lower back injuries are seen in patients who are sedentary or athletic or even those whose jobs require no sitting at all, including 37 percent of school-aged children.1 It almost seems like whatever we do, we're destined to feel lower back pain and this not only affects patients but also the economy and our health system. Statistically lower back pain is:
The numbers are alarming, to say the least, but with our medicine, we have the solution. We can reduce these trends and we can make a positive change in people's lives. A frustrating issue I faced before and immediately after acupuncture school (and I think many of you might agree regardless of which school you attended) is the lack of optimal training in such a common, debilitating problem like back pain.
In my experience, I was taught different treatment protocols from different professors and each had their own theory as to why their protocol was best. After experimenting in my school clinic and later in my practice, the results were never constant.
The Learning Curve
One protocol worked great with one patient and had zero results with another. Sometimes, the protocol I used on day one didn't work on the same patient during their follow-up treatments. This left me confused and I found myself hoping my treatment would work. As you can imagine, my confidence was extremely low and my patients could feel it. Once they have even a hint that you're not confident, your patients will begin to move on.
Over the ensuing years, I took as many continuing education courses as I could and read research and all the books I could get my hands on in the name of finding out what works and consistently gets great clinical results. This journey inspired me to come up with a systematic plan that can be applied very easily to any patient experiencing lower back pain. Ever since I found and fine tuned this system, I've noticed outstanding clinical outcomes that have made me the "go-to" acupuncturist in my community.
Assess & Treat the Dysfunction
The goal here is to detect what's contributing to the lower back pain and/or what's preventing it from fully healing. Dysfunction causes abnormal distribution of forces in the body, adding unnecessary pressure on areas (such as the lower back). This causes acute or chronic injuries. According to Dr. Anthony Lombardi, creator of the "Exstore MusculoSkeletal Assessment" system (something I use in my office), if we address the area of dysfunction, we'll get better results faster.
Specifically for lower back pain, we'd want to perform a manual muscle test of the hip girdle muscles and note if any muscles present with weakness. The weakness is the muscle not firing, thus causing abnormal movement and pressure to the site of injury and this could be the reason an injury occurs in the first place. Once we detect the muscle(s) that are weak, we can then perform electroacupuncture on that muscle(s) to restore proper movement. This will also help restore proper function and allow our "local" treatment to be more effective.5
Treating the Area of Pain
After addressing and correcting the area of dysfunction, it then makes sense to treat the area of injury/pain. Here we can apply our "typical" treatment that we learn briefly in school, such as BL10, BL40, BL60, BL23, BL25, BL52, DU4, etc. I like using electroacupuncture because I believe it amplifies the treatment and my patients get better results (of course, if it applicable and appropriate for the patient).
After performing acupuncture, I always integrate some type of secondary TCM modality to enhance results. I've found this approach truly sets me apart from other providers in my area who only perform acupuncture and nothing further. In the patient's eyes, I'm doing everything in my power and knowledge to help them recover (which I am) and they appreciate that even if they have to pay a little extra. Here's how I use secondary modalities:
By simply following a system that makes sense, you too can effectively treat lower back pain efficiently and effectively and make a dent in the statistics listed above.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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