Low Back

Common Causes and Conditions of Lower Back Pain

1. Muscle & Soft Tissue Issues

  • Lumbar Strain – Overstretched muscles/ligaments
  • Piriformis Syndrome – Tight piriformis muscle irritating sciatic nerve
  • Myofascial Pain – Trigger points in quadratus lumborum

2. Disc & Nerve Related

  • Lumbar Herniated Disc – Nerve root compression (sciatica)
  • Degenerative Disc Disease – Disc dehydration with age
  • Spinal Stenosis – Narrowed spinal canal causing leg pain when walking

3. Joint & Structural Problems

  • Facet Joint Arthritis – Stiff, painful spinal joints
  • Spondylolisthesis – Vertebral slippage (often L4-L5)
  • Sacroiliac Joint Dysfunction – Inflammatory pain radiating to buttock

4. Systemic & Referred Pain

  • Kidney Stones/Infection – Flank pain with urinary symptoms
  • Endometriosis – Cyclic pain in women
  • Ankylosing Spondylitis – Inflammatory arthritis with morning stiffness

Rehab Exercises at Home After and Between TCM Treatments

1. Mobility & Decompression Exercises

A. Pelvic Clock

  • Lie on back, knees bent
  • Gently rock pelvis forward/backward/side-to-side
  • Reps: 10 circles each direction
  • Benefits: Restores lumbar-pelvic rhythm

B. Nerve Flossing (Sciatic)

  • Seated, extend one leg with flexed ankle
  • Nod head forward while straightening leg
  • Reps: 8-10 gentle oscillations
  • Benefits: Reduces nerve adhesions

C. Supported Bridge

  • Lie with calves on chair, knees at 90°
  • Lift hips slightly, hold 20 seconds
  • Reps: 3-5x
  • Benefits: Decompresses lumbar discs

2. Core Stabilization Exercises

A. Dead Bug

  • On back, arms/knees at 90°
  • Slowly extend opposite arm/leg while bracing core
  • Reps: 8-10 per side
  • Benefits: Trains anti-extension stability

B. Side Plank (Modified)

  • Knees bent, lift hips to align shoulders-knees
  • Hold 15-20 seconds
  • Reps: 3x per side
  • Benefits: Strengthens obliques/QL muscles

C. McGill Curl-Up

  • One knee bent, hands under lumbar arch
  • Lift head/shoulders only 2 inches
  • Hold 8-10 seconds
  • Reps: 5-8x
  • Benefits: Safe core activation without disc compression

3. TCM-Inspired Therapies

A. Moxibustion on BL-23/25

  • Warm “Shenshu” (BL-23) and “Dachangshu” (BL-25) points
  • Duration: 5-10 minutes
  • Benefits: Warms Kidney Yang for chronic cold-type pain

B. Gua Sha Along Bladder Meridian

  • Use jade tool with oil from sacrum to mid-back
  • Direction: Always downward strokes
  • Benefits: Releases muscle stagnation

C. Herbal Hot Pack

  • Apply cloth pouch with steamed Duhuo (Angelica root) + Mugwort
  • Duration: 15 minutes pre-exercise
  • Benefits: Relaxes tendons, dispels cold-damp

Precautions & Recommendations

✔ First movement of day: Roll to side before sitting up
✔ Sitting posture: Use lumbar roll support
✔ Acute phase: Prioritize decompression over strengthening
✖ Avoid: Toe touches, sit-ups, prolonged standing

TCM Dietary Support:

  • Black beans + Walnuts for Kidney essence
  • Turmeric + Ginger tea for inflammation

When to Seek Professional Help:

  • Progressive leg weakness/numbness
  • Bowel/bladder dysfunction
  • Night pain unrelieved by position changes

Note: These protocols combine modern rehab principles with TCM meridian theory. For personalized herbal formulas or acupuncture point selection, consult your licensed TCM practitioner.

Lower Back Pain: TCM Pattern-Specific Modifications

1. Acute vs. Chronic Presentations

Acute (First 72 Hours – “Excess” Pattern)
▸ TCM Focus: Drain stagnation, reduce swelling
▸ Exercises:

  • Supported Bridge (Isometric) – 10-sec holds only
  • Prone Lying with Belly Breathing – Activates diaphragm without spinal load
  • Ankle Pumps – Promotes lymphatic drainage
    ▸ TCM Adjuncts:
  • Bleeding Cupping at BL-40 (Weizhong) for severe blood stasis
  • Cold Herbal Compress (Huangbai + Dahuang)

Chronic (>3 Months – “Deficiency” Pattern)
▸ TCM Focus: Tonify Kidney, nourish tendons
▸ Exercises:

  • Tai Chi “Wave Hands Like Clouds” – Weight shifting with spinal rotation
  • Wall Squats with Back Support – Builds endurance
  • Swiss Ball Cat-Cow – Enhances proprioception
    ▸ TCM Adjuncts:
  • Moxa on GV-4 (Mingmen) + BL-23 (Shenshu)
  • Deer Antler Gelatin (Lurong Jiao) for Kidney Yang deficiency

2. TCM Pattern Differentiation

A. Cold-Damp Obstruction
▶ Signs: Worse in damp weather, stiffness improves with heat
▶ Modifications:

  • Exercises: Add Qi Gong “Holding the Moon” (static standing with arm circle) to generate internal heat
  • Herbs: Topical Safflower (Honghua) Oil Massage before exercise
  • Diet: Ginger + Brown Sugar Tea pre-workout

B. Blood Stasis
▶ Signs: Stabbing pain, visible purple veins, dark tongue
▶ Modifications:

  • Exercises: Vibration Foam Rolling on glutes/hamstrings first
  • Acupressure: SP-10 (Xuehai) + BL-17 (Geshu) daily
  • Cupping: Purple/black marks indicate successful stasis removal

C. Kidney Deficiency
▶ Yang Deficiency: Cold limbs, fatigue, frequent urination

  • Moxa Sequence: GV-4 → BL-23 → KI-3 (Taixi)
  • Exercise: “Standing Like a Tree” 5 mins/day
    ▶ Yin Deficiency: Night pain, dry throat, red tongue
  • Hydration: Drink Ophiopogon (Maidong) Tea post-exercise
  • Movement: Water Tai Chi (slow pool exercises)

3. Pregnancy-Related Low Back Pain

TCM Diagnosis: “Kidney and Chong Mai weakness”
Safe Modifications:
▸ Exercises:

  • Pelvic Floor Activation with Kegels during cat-cow
  • Side-Lying Clamshells for gluteus medius
  • Birth Ball Circles for sacral mobility
    ▸ TCM Therapies:
  • Moxa on BL-67 (Zhiyin) – Only after 37 weeks for breech
  • Acupressure on SP-6 (Sanyinjiao) – Light stimulation only
    ▸ Contraindications:
  • Avoid deep forward folds after 2nd trimester
  • No gua sha on lower back during pregnancy

Progressive Rehabilitation Protocol

Phase 1 (Acute):

  • Days 1-3: Moxa + topical Dit Da Jow
  • Days 4-7: Begin nerve flossing + 10-sec dead bugs

Phase 2 (Subacute):

  • Weeks 2-4: Add McGill big 3 exercises
  • Week 5+: Introduce farmer’s carries with herbal wrist weights

Phase 3 (Maintenance):

  • Monthly: Tune-up acupuncture along Governing Vessel
  • Seasonal: Herbal patch (Eucommia + Cibotium) during weather changes

TCM Lifestyle Prescriptions

  1. Sleep: Place wormwood pillow under lumbar curve
  2. Work: Stand on acupressure mat during desk work
  3. Bathing: Add Achyranthes root (Niuxi) to foot soaks

Key Herbal Formulas:

  • Du Huo Ji Sheng Tang (Cold-Damp type)
  • Shao Yao Gan Cao Tang (Muscle spasms)
  • You Gui Wan (Kidney Yang deficiency)

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