1. Acupuncture Treatment of Diseases Orthopedics 1: Lumbago 腰痛

2. Definition: Is a frequently encountered symptom in the lumbar region in various diseases such as muscle strain or traumatic injury of the lumbar region, rheumatism, spondylitis or disorder of some of the internal organs in the pelvic cavity.

3. Causes and Pathogenesis : External factors 1.Exposure to wind and cold, long term living in cold and damp places which leads to accumulation of external wind, cold and damp in the channels and collaterals resulting in impairing the circulation of qi and blood in the lumbar region. 2.Over exertion, trauma and sprain can lead to stagnation of qi and blood in the local channels and collaterals resulting in lumbago. Internal factors 1.Exhaustion of the kidney essence due to either congenital deficiency or over indulgence in sexual activity leading to malnutrition of the local tendons and muscles resulting in lumbago.

4. Clinical Manifestations: Chief symptoms: i.Aches and pains on the lower back.

5. Clinical Manifestations: 1.Cold and dampness type Stated manifestations with: i.Cold pain and heaviness in the lumbar area. ii.Muscle stiffness in the loins with limited movements. iii.Pain may radiate to the buttocks and lower limbs. iv.Symptoms usually occurs after exposure to cold and dampness. v.Can be worsen during rainy days or drastic climate change. vi.Usually light coloured tongue with thin coating. vii.Thready, tight pulse.

6. Clinical Manifestations: 2.Qi and Blood stagnation type Stated manifestations with: i.Fixed pain and rigidity in the lower back. ii.Usually occurs with a history of trauma or over exertion. iii.Worsen by sitting for extended periods or first thing in the morning. iv.Usually dark red tongue. v.Thin white tongue coating. vi.Thready pulse.

7. Clinical Manifestations: 3.Kidney deficiency type Stated manifestations with: i.Chronic dull pain and soreness in the lumbar region. ii.Lassitude and fatigue. iii.Pale tongue. iv.Thin white tongue coating. v.Thready pulse.

8. Treatment : General principle Promote qi and blood circulation of the affected channels and muscles to relieve pain. Principle channels: 1.Bladder channel. 2.Ashi acupoints.

9. Principle acupoints : 1.BL 25 Dachangshu 大肠俞. 2.BL 40 Weizhong 委中. 3.Ashi acupoint 阿是穴.

10. Prescription explanation (Principle acupoint): 1.BL 25 Dachangshu 大肠俞， Ashi acupoint 阿是穴 Channel acupoint of the BL channel and Back-Shu acupoint of the large intestine; Both acupoints are chosen to promote qi and blood circulation of the affected channels and muscles to relieve pain. 2.BL 40 Weizhong 委中 He-Sea and Lower He-Sea acupoint of the BL channel where qi of the channel congregates, chosen to adjust qi and blood circulation of the BL channel in the back.

11. Principle of treatment 1. Cold and dampness type Promote qi and blood circulation of the affected channels and muscles to relieve pain. Disperse cold Principle acupoints: as stated Supplementary acupoints: NIL. May combine acupuncture with moxibustion.

12. Principle of treatment 2.Qi and Blood stagnation type Promote qi and blood circulation of the affected channels and muscles to relieve pain. Regulate qi and remove stagnation of the channels and collaterals. Supplementary acupoints: NIL.

13. Principle of treatment 3.Kidney deficiency type Promote qi and blood circulation of the affected channels and muscles to relieve pain. Tonify kidney. Supplementary acupoints: 1.BL 23 Shenshu 肾俞. 2.BL 52 Zhishi 志室. 3.GV 4 Mingmen 命门.

14. TCM medical advises: 1.Best responds for lumbar strain or muscular rheumatism. 2.Can also respond for cases of lumbar joint abnormality. 3.Poor respond for tearing of lumbar tendon type. 4.Not suitable for TB spinal and tumor type. 5.Can be relieve using palm kneading every morning and evening. 6.Avoid cold and raw food. 7.Limiting sexual activity.