There are many different therapies within the specialty of Traditional Chinese Medicine (TCM) for the treatment of low back pain. As explained in the previous article, TCM has been practiced for thousands of years in Asia. TCM encompasses many modalities, including acupuncture, herbal medicine, moxabustion, Tui Na or medical massage, and may include nutritional therapy and breathing therapy, known as Qi Gong.

Some of the body's meridians or acupuncture channels

Acupuncture
The use of thin, pre-sterilized, disposable needles to re-establish the proper flow of Qi and blood through the channel(s) of the back. This flow increases circulation allowing for oxygen, blood and lymph to support the bodies healing process. If the channels have been blocked for a long period of time, or if there is pronounced deficiency of Qi and blood, it is necessary to have acupuncture for a longer period of time to assist the body in regaining it’s normal function.

Research has shown acupuncture to cause the release of neurochemicals such as: endorphins, enkephalins, serotonin and corticosteroids—all of which contribute to the reduction of pain and inflammation.

What to Expect During Acupuncture
Acupuncture is strictly regulated via individual state medical licensing boards as well as the National committee. Practitioners are typically qualified and trained to provide you with a successful experience. Acupuncture doesn’t “hurt” but you may feel sensations that are “different” (like tingling, dull, achy), these sensations are Qi.

The thin needles are inserted according to your individual diagnosis and are left in for approximately 20-40 minutes. During this time, most people experience a deep sense of relaxation, in part because of the endorphins that are released during acupuncture.

Depending on whether your pain is acute or chronic guides the number of treatments you may need. Your pain may be resolved in a few treatments or it may take several courses, in some cases acupuncture, serves primarily as pain management. In any case, your whole body benefits from the affects of acupuncture.

Moxabustion
Concentrated herbs that are sprayed or burned above the skin to open and warm the channels.

Herbal Medicine
The use of herbs from the Chinese herbal pharmacopia also dates back several thousand years. Typically, individual herbs are put together synergistically to create a formula with a specific function (ie, open the channels or strengthen the Kidneys). Herbs go to specific channels and have specific properties (ie, sweet, bitter, cold, warm).

Tui Na or Chinese Massage
Working on the meridians with the hands, using techniques specific to Tui Na. Care must be taken not to exacerbate inflammation if it is present.

Proper Diet
If we put vinegar in our finely tuned automobile it won’t run, it needs good clean gas. Our bodies “gas tank” needs good clean nutrients. This means a balance of quality protein, good/essential fats, and carbohydrates (5-9 servings of vegetables and fruit with a moderate of whole grains).

• This means no overeating, as our body has a hard time managing the overload.
• Eat meals at regular times, do not eat late at night, minimize or eliminate sugar, processed foods/drinks, alcohol, and don’t eat any one thing in excess (ie, dairy products or bread).
• Drink plenty of water.
• Contemplate the fact that our body can only be as healthy as the fuel we give it.

Qi Gong Breathing
Qi Gong is the art of therapeutic breathing. Breath is Qi, Qi is life. The two substances that fill our Qi tank up are air and nutrients (breathing and healthy foods). To take in a full breath of air into our abdomen is health promoting, yet poor breathing habits have left most of us breathing on the shallow side.

To begin with, make an effort to remember to breathe deeper. Post little notes if necessary that say, “breathe deep”. Be aware of inhaling fresh air/Qi in through your nostrils all the way down into your abdomen and exhaling through your mouth. Your abdomen should visibly push outward on the exhale and contract back in on the inhale.

As well, there are specific breathing exercises to open the spine, which in turn, supports the flow of cerebral spinal fluid. You may want to get a book or video on breathing exercises to support your health. Deep breathing has far reaching affects in our body by balancing our nervous system, increasing oxygen delivery and keeping the Qi moving. Do not underestimate the value of this simple, yet powerful practice; we have to breathe anyway, why not do it right?

Proper Exercise
Exercise promotes the normal flow of Qi and blood. Our bodies were designed to move. I don’t believe it’s a coincidence that back pain is on the rise in proportion to an increasingly sedentary lifestyle. Regular aerobic activity, regular stretching, keeping the abdominal muscles strong and proper body mechanics when bending and lifting are some of the necessities in back maintenance.

Stress Management
Well, this could be an article in and of itself. It has been proven that prolonged stress creates disharmony on many levels: physically, emotionally and spiritually. Explore avenues to keep stress at a minimum in your life. There is an interesting book written by Robert Sapolsky (a professor of science at Stanford) entitled, “Why Zebras Don’t Get Ulcers”. He depicts with detail and humor, the effects of stress on our body. I recommend it to anyone interested in understanding and successfully managing stress. Learning to meditate is another recommended way of managing stress, as well as pain.

Proper Rest
Our physiology needs regular sleep and rest balanced with the activity we perform. Rest is Yin, activity is Yang, and attention to both is required to maintain balance. When we push ourselves too hard for too long and ignore the need for rest our Yang consumes our Yin and imbalance ensues. A healthy body can recover from a temporary period of hard work or emotional strain; the imbalance only begins when it goes beyond temporary.

I encourage you, if you haven’t already, to consider including Chinese medicine as you journey towards a more pain-free and healthier life.

Spine Expert Commentary

More than 1 million Americans are treated with acupuncture annually for musculoskeletal disorders, including back pain and fibromyalgia. Surveys report 57% of rheumatologists and 69% of pain specialists had made referrals to practitioners of acupuncture.

Traditional Chinese Medicine (TCM), including acupuncture is based on centuries-old East Asian concepts. As the author points out, there is some evidence acupuncture and other needling techniques may affect endorphin levels, potentially offering a "scientific" explanation for relief of pain. Clinical studies of TCM in back pain have focused primarily on acupuncture and have produced inconclusive findings.

A recent comparison of massage therapy with traditional Chinese acupuncture and self-care education in persons with chronic low back pain found massage was superior to acupuncture, which was no better than self-care. As the author points out, the use of TCM does not preclude traditional medical treatment.—Daniel J. Mazanec, MD