The prevalence of low back issues comes in large part from our overly-sedentary lifestyles. These dynamic bodies of ours were not designed to sit at a computer all day, sit in our cars, sit on the couch. They were designed to move in a full range of motion on a daily basis. Few of us achieve that and many of us simply live with achy and stiff muscles or, even worse, pain.

All pain, regardless of the origins, is a result of poor circulation. In Chinese Medicine, we say where there is poor circulation there is disease. And when we restore good circulation of qi, or energy, and blood, to the body, it can then rebalance itself leading to a decrease in pain. What then impedes circulation?

Acute Low Back Pain & Sciatica

Let’s first look at acute trauma to the lower back. Perhaps you have never had any lower back pain. Yet after a stagnating and stressful week at your desk at work you helped a friend move last weekend. And all of a sudden, you threw your back out doubling over in pain! This often occurs with a lifting and twisting motion, i.e. poor lifting mechanics. Your back just went into spasm. This 10 out of 10 pain is sharp, electric and if and when you are able to stand up, you may notice that you are “stuck” to one side. Why did this occur? Sitting for prolonged periods of time creates imbalances in muscles—some tight and short with others elongated and weak—and a general weakening of the ligaments supporting the spine due to a lack of exercise. With such an internal environment, a sudden movement of lifting and twisting can very easily bring on a back spasm or even worse, sciatic pain.

Sciatic pain can be due to two causes. The first is from a disc bulge in one or more of your lumbar vertebrae. The discs in between your vertebrae act like small shock absorbers and look much like jelly donuts. With overexertion and a weakened structure, that jelly can be forced out of the donut, irritating the local nerves causing pain and inflammation. You might experience that as a spasm. This is the time when your body begins the inflammatory process, splinting the area with blood, allowing the tissues time to fix themselves. The message here is "Do Not Move! Repairs being done!" Sometimes though the inflammation may be mild and you may think that you are just stiff. And if you proceed to stretch it out, you will find that after a few minutes of relief, your back will tighten up even more. In either case, this is a good time to immediately ice your back for 5-10 minutes at least 3 times a day, come in for treatments ASAP, and rest. If the injury is severe enough those nerves can get so irritated that they refer pain into the buttock and down your leg all the way to your foot with a dull somewhat electric achy sensation. This is true sciatica.

Sometimes, however, perhaps in the absence of low back pain, tight gluteal muscles can clamp down on the sciatic nerve going through them, causing that same pain referring down your leg. We call this Piriformis Syndrome, named for the overly tight gluteal muscle in question.

Acupuncture and herbs are incredibly effective in dealing with acute low back pain and sciatica. The acute pain can shift quickly and dramatically and the sooner after the injury I see you the better. If you actually have a bulged disc, that jelly will never get back into the donut. But I can help you decrease the local inflammation and pain and maintain a state of comfort, and, over time, support and strengthen your lower back with the proper daily exercises.

Chronic Low Back Pain & Sciatica

You may be out of the acute stage of pain, but you still feel stiff and tight. And how do you keep that awful, ruin your week kind of pain from returning? Here, we need to determine what is causing your qi & blood to stagnate. Are there muscle imbalances? Poor posture? Too much sitting and not enough movement and exercise? Or perhaps there are internal imbalances that need to be addressed. Are you better or worse with heat? How about cold? How do you feel with rest versus activity? Is your pain worse at the end of the day or upon rising in the morning? The answers to these questions plus local palpation and having a look at your tongue and feeling your wrist pulse can lead us to a very clear understanding of what type of internal environment is supporting your recurrent or stubborn pain. Once we determine your underlying imbalance, we can construct our acupuncture and herbal treatments accordingly.

Treatment Goals

When you are in pain, let’s treat you quickly and often until you get more comfortable. Sometimes that may mean twice a week for one or two weeks. Once we get you out of the acute stage of pain, then we scale down to once a week and then every other week and get you to the point where you may only come in once a month for a tune-up. They key factor in this progression is whether or not you are able to recognize the causes of your pain, adjust your lifestyle accordingly, stick to our treatment protocols, and do the daily back exercises I give you.

Is it time?

It is very easy to live with pain. Do you often hear yourself saying “I have a bad back?” “Maybe the pain will just go away.” Are you stiff when you get out of a seat and just need “to walk it off?” Nothing a couple of Advil couldn’t fix, right?

Does any of this sound familiar? Perhaps now is the time to finally experience your back differently. Perhaps it is time to finally do something about it. Acupuncture and herbs have helped me and my back tremendously, so I speak from personal experience here. With chronic pain, it is about first acknowledging that you are in pain and then making the clear decision that you do not “have a bad back.” You are not defined by that pain. And it is time to no longer let it limit your enjoyment of your life. Pain is a messenger. And as they say, “Don’t kill the messenger!” Hear what it has to say, and make the wellness-affirming choice: it is time to do something about it!