



Back pain is a universal human experience, which is one of the most common ailments seen clinically.

Our lower back supports the weight of our upper body and provides movements such as bending and twisting. Our muscles in the lower back are responsible for flexing and rotating the hips while walking, as well as maintaining a proper posture of our body.





Acute back pain arises from injury of the muscles, ligaments, joints or discs. The body reacts to the injury by producing an inflammatory healing response, which causes us to feel pain around that region. This is commonly seen in a lower back strain or sprain, especially in middle-aged people, which happens after a sudden sneeze or bending over to take an object.

Chronic back pain often arises from a disc, joint or irritated nerve root problem, which can also be seen in acute back sprain not being treated properly and subsequently leading to complications of the disc or nerve.

Commonly seen musculoskeletal conditions of chronic back pain:

Lumbar herniated disc (腰椎间盘突出)

Spinal stenosis (椎管狭窄)

Sacroiliac joint dysfunction (骶髂关节紊乱)

Spondylolisthesis (腰椎滑脱)

Due to the sedentary lifestyle of many city dwellers, long hours of sitting during office hours or driving with a lack of exercise results in lower back stiffness, subsequently affecting the inter-vertebral discs of the spine and joints as seen above. If the condition worsens, it may even affect the quality of sleep or experience radiating pain to the lower limbs, causing a lack of agility and mobility in their daily lives, or even causing depression and anxiety disorders.





Acute back pain can be alleviated with acupuncture whereas chronic back pain can be relieved by acupuncture or integrating one or more of the treatments listed:

Acupuncture, whereby insertion and gentle manipulation of fine needles at the specific acupuncture points or acupoints. A possible mechanism of acupuncture is known as conditioning stimulation whereby there is a suppression of pain transmission in neurons of the spinal dorsal horn. This form of conditioning stimulation acts on opioid receptors to induce analgesic effects (1).

Back Acupuncture

Acupressure helps in alleviating tension and stress, as well as relieve tight muscles and tendons. It is believed that the stimulation of the meridian points can lead to the pain gates being overwhelmed by increasing the frequency of pain impulses, leading to the closure of pain gates hence reducing pain stimulation (2).

Cupping therapy create suctions from the cups onto the skin, which causes rupturing of blood capillaries under the skin. The mechanism of cupping is quite similar to acupressure.

Treatments for TCM helps to dispel stagnation (stagnant blood and lymph), thereby improving Qi flow. There is a saying in Traditional Chinese Medicine (TCM) “Smooth flow of Qi will relieve discomfort of the body, whereas stagnation and impeding Qi flow causes pain (通则不痛，不通则痛).”

In addition, the classical exercises of Chinese Medicine, such as Wu Qing Xi (五禽戏), help in body balance, re-train structure and restore the function of the lower back. However, we should be aware that chronic back pain might be more than just a musculoskeletal condition if pain persists.

Modern imaging and western diagnosis can help to differentiate for:

Tumour

Urinary disorders such as kidney or ureteral stones

Women’s health conditions

Autoimmune conditions

The treatment for these disorders differ from musculoskeletal back pain, and would require careful diagnosis before possible treatment with Traditional Chinese Medicine.





REFERENCES:

1. Kawakita K, Okada K. Acupuncture therapy: mechanism of action, efficacy, and safety: a potential intervention for psychogenic disorders? Biopsychosocial Medicine. 2014;8:4. doi:10.1186/1751-0759-8-4. 2. Internet Journal of Alternative Medicine 2007, Volume 4 No. 1

This article is written by Physician Chua Hui Zi





Graduated from the second batch of NTU Double Degree in Biomedical Sciences and TCM, Chua Hui Zi went on to further her studies in Tianjin University of TCM sponsored by the China Scholarship Council and graduated with a Masters in TCM (Internal Medicine).

Her passion in TCM continues to grow over the past 6 years in private and hospital practice as well as clinical attachments. As a member of NTU CMAA Executive Committee, she is also active in advocating and promoting TCM outside of Singapore, proposing to engage TCM alumni to do overseas volunteering in providing their healthcare expertise to the underprivileged. Chua Hui Zi is also an executive member of the World Federation of Chinese Medicine Societies (WFCMS) Council in Diabetes.





This article first appeared in Nanyang Technological University Chinese Medicine Alumni Association (NTUCMAA) website. Find out more about them here!





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