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A case of lower back pain

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Post time: 2009-04-28 11:29:45
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This is my first post in this forum. I'm not good in English , but I'd like to share my experience and improve together.

♀ 49, 2006-09-13
Lower back pain for half day.
In the morning, just after she got up, when she banded the back, she suddenly felt the pain on the lower back. She can hardly move her back to any direction; she feels the radiation on both of her hips. There is no pain on any leg or foot. She had sciatica many years ago.
Exam: limited R.O.M. of the lumbar spine. SLR (-). The muscles on the left side of the lower back are spasm and rise up a little higher than the other side. Pressing pain and deep pressing pain (+) on L4~5 and L5~S1. Tender spots on FengFu (++), left TianZhu (++), and left WeiYang (++).

Treatment:
1) Gentle TuiNa massage 5’;
2) Acupuncture on left TianZhu, WeiYang, and FengFu (gentle reducing technique); both sides of L5 spinous process (0.5Cun, slowly puncture in 1.5Cun deep, reducing technique) 20’;
3) Cupping on lower back 5’;
4) Herbal electric stimulation with heating pad (mild) 20’.

Result:
Right after the treatment, she feels better and can move the lower back a little bit.
2 days later, called: the pain is completely gone, and can move free.

(To be continued, if anyone wants to discuss)
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Post time: 2009-04-28 11:29:57
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Diagnosis and Differentiations:
This case is an acute lower back pain due to wind-cold blocked the meridians (muscles). Or say myofibrositis.
The patient had no injury or big movement, no nerve pain signs. Although there was deep pressing pain on the lumbar spine (L4~5, L4~S1), but the pain feeling of the patient and touching feeling of mine was different from arthritis pain. The pressing pain is more likely coming from the deep tissues than the spinal joints. Also the time when the patient got the pain was during the weather change.
Didn’t check the tongue, because it is a meridian disorder, the tongue won’t show anything about it, and may confuse the diagnosis. Same thing happened on pulse check (unless the high pulse check skill may tell this kind of body situation).

Needle technique:
Although this is an excessive case, and the reducing technique was used, but I didn’t give strong stimulations. This is the point I’d like to discuss: [color=red:0891983cde] REDUCING DOES NOT MEAN STRONG STIMULATION. [/color:0891983cde]
Reducing or tonifying, is the result of the patient’s reaction of the needle techniques. Gentle or strong stimulation is the practitioner’s choice of the needle techniques. As a practitioner, to choose to give strong or gentle stimulation is not only depending on excess or deficiency, but also on the shape (Xing) and Qi of the certain patient.
Back to this case, the lady is quite skinny, she was quite sensitive to the needles too, and the pathogen was not deep. So I decided to use gentle way, and the result proved it was right.
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Post time: 2009-04-28 11:30:10
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"Although this is an excessive case, and the reducing technique was used, but I didn’t give strong stimulations."





[color=red:c0005c5cbd][size=18:c0005c5cbd]Could you please tell about how to decide if the case (any case) is an excessive or the oppesit (Deficiency).[/size:c0005c5cbd][/color:c0005c5cbd]

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Post time: 2009-04-28 11:30:22
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generally, excess means the pathogen is strong and the vital qi is not weak. in this case, i was not talking the patient's whole body condition, only the lower back. threasons are: the pain has no deficient signs, the touching feeling is excessive, and the reason of the pain also excessive. after all, when i used needles on her back, i could feel it was not empty.
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