One of the most common things bringing someone into our office is lower back pain, often times radiating down into the hips or legs. In fact, according to the National Institute of Health, back pain is the second most common neurological ailment in our country today 1! Americans spend billions of dollars addressing this issue, and it often affects work productivity. Though there are a myriad of causes for back pain, some more treatable than others, let’s take a look at how acupuncture can help the situation.
When I’m evaluating a patient with back pain, I’m curious about the following: How long has it been going on? Did it start suddenly, or gradually over a long period of time? Where does it hurt and when? What does the pain feel like, and are there any other neurological symptoms such as numbness, tingling, burning, muscle weakness? All this information gives me a clue as to what structures – muscles, bones/joints, nerves – may be involved. As I tell my patients, acupuncture can be most helpful in the case of muscle strain or sprain, say, back pain after a long work out. In the case of damage or injury to a joint or vertebral disc, such as in a herniated disc, this is a much more challenging clinical scenario.
But, let’s just say you are having low back pain that is not related to any spine or disc damage. Being an acupuncturist very much so practicing in the intersection between western anatomy and physiology and Chinese theory, one of my favorite strategies clinically is to look at the muscle groups most likely affected. I often get great success addressing the quadratus lumborum – a muscle that attaches to your lower rib, vertebrae and rim of the pelvis – and helps you bend to one side. If you have one-sided back pain and have a hard time moving to one side or twisting, chances are, this muscle is acting up in a big way. By finding tight places on the edge of this muscle and along the pelvis, I can help release spasm with just a few needles.
Drawing of QL in bright red
Another key structure is the piriformis muscle – deep under the gluteal muscles of the buttock, and often known for its role in putting pressure on the sciatic nerve causes pain down the leg. Most commonly, the sciatic nerve lies underneath the piriformis, but some anatomical variations show the nerve running on top, or even through the muscle. When the piriformis is tense or in spasm it can place a lot of pressure on the sciatic nerve. The acupuncture point Gallbladder 30(GB30) lies right at the middle point of this muscle, and even a single needle here can significantly reduce tension and pain.
Diagram of piriformis muscle, sciatic nerve in yellow
While back pain can be quite complex, I find that these structures are often involved, and can offer immediate relief when successfully treated. My college dance mentor always used to say “use the power of the pelvis!”, and I find that even in addressing lower back pain, addressing tension and imbalance down through the pelvis and hips can affect the low back directly above. And, both these muscle groups can be easily stretched at home for continued relief!
1 “Low Back Pain Fact Sheet.” Low Back Pain Face Sheet: National Institute of Neurological Disorders and Stroke. National Institute of Health, July 2003. Web. June 24, 2014. < http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm>
2 “Quadratus Lumborum Muscle.” Wikipedia: Quadratus Lumborum. Wikipedia, May 18, 2014. Web. June 24, 2014. < http://en.wikipedia.org/wiki/Quadratus_lumborum_muscle>
3 Golob, Kelly. “Can the Piriformis muscle cause Sciatica?” Olympia Sports Chiropractor, March 21, 2011. Web. June 24, 2014. < http://www.olympiasportschiropractor.com/2011/03/21/piriformis-muscle-sciatica/>