Lumbar muscle strain is a common clinical disease and a frequent disease. Although there are many treatment methods, the efficacy is not ideal. I combined with long-term clinical practice, for the etiology of the disease mechanism to analyze in detail, and then put forward acupuncture countermeasures and a number of high points.
A. General understanding of lumbar strain injury
Lumbar muscle strain is a chronic injury disease of the lumbosacral soft group, including chronic injury of the lumbar muscles, fascia and ligaments, which causes diffuse pain on one or both sides of the waist and hip. This disease is a kind of aseptic inflammation in the lumbar and hip area, which is also called lumbar and hip myofasciitis or functional lumbago.
This disease belongs to the category of “lumbago” in Chinese medicine, among which kidney deficiency lumbago is the most common. It is one of the common clinical conditions of chronic lumbar and leg pain.
Lumbar muscle strain is a symptom of many diseases and can occur as an independent disease. Western medicine kidney disease, rheumatism, rheumatoid disease, lumbar strain spine and trauma, gynecology and other diseases. And more often than not, it is independent and the onset of disease.
Second, the twelve characteristics of lumbar strain injury symptoms
Generally speaking, the symptoms of lumbar muscle strain have some characteristics, which I summarize as twelve major characteristics.
(1) Irregularity of the severity of pain symptoms in the lumbar hip. The pain symptoms are sometimes mild and sometimes severe, and the lumbar spine is deformed, and in serious cases, the person must walk with crutches or even be bedridden.
(2) Irregularity of the range of the painful parts of the lumbar and hip areas. Muscle spasm is often manifested in one side of the sacrospinous muscle, gluteus muscle or both sides; there can be pressure pain points in the lumbar region, but it is not good to fix a certain part. Mostly at the sacrospinous muscle, the posterior iliac spine, the sacrospinous muscle stop after the sacrum or the transverse process of the lumbar spine. The shape and activity of the lumbar region are mostly not abnormal, and there is no obvious lumbar muscle spasm.
(3) Non-limiting nature of painful painful points of the lumbar hip on pressure. There may be extensive pressure pain in the lumbar region, and there is mostly no abnormality in spinal activities. Both sides of the spinous process, the transverse process of the lumbar spine and the posterior superior iliac crest are the most common.
(4) Relative fixity of the radiating site of lumbar and hip pain. Pain and numbness usually radiates to the knee and rarely to the calf and foot.
(5) Imaging of low back and hip pain is not positive. x-rays, electromyography and myelography are not diagnostic for this disease.
(6) A few patients with low back and hip pain are multisymptomatic. Concomitant symptoms of autonomic disorders (e.g., abdominal pain).
(7) Recurrent nature of low back and hip pain symptoms. It is aggravated by exertion, relieved by rest, relieved by proper activity and frequent change of position, and aggravated by excessive activity. Cannot insist on bending over for work. Often forced to stretch the waist from time to time or hit the waist with the fist to relieve the pain.
(8) The symptoms of low back and hip pain correlate with climate change. Pain may vary with climate change or the degree of exertion.
(9) The lingering nature of low back and hip pain symptoms does not heal. Because the human body is active all the time and all the time, its old strain is not restored and new strain is born again. Therefore, it is difficult to heal this disease.
(10) Acute onset of lumbar and hip pain symptoms; during acute attacks, all kinds of symptoms are significantly aggravated and there may be muscle spasm, scoliosis and limitation of functional activities. Some patients may have pulling pain in the lower extremities.
(11) Dull contusive nature of lumbar and hip pain; the pain of this disease is a dull contusive pain pain that may be confined to one area or spread throughout the back. Soreness or swelling of the lumbar region, with some stabbing or burning pains.
(12) Slight restriction of movement in the area of lumbar hip pain.
(3) Chinese medicine etiology and pathogenesis of lumbar muscle strain
Lumbar muscle strain, which is a chronic disease, generally takes longer to treat and is more effective. The main causes of this disease.
1, the shape of the body is thin and weak, the waist is not resistant to work. The waist is the house of the kidney, due to the weakness of the body, the weakness of the kidney qi, the essence of the kidney can not fill the tendons, bones and meridians, so the affected part is mostly poor qi and blood or blood stagnation in the meridians, blood does not glory tendons, tendons and veins do not Shu, resulting in the waist tendon contracture pain.
The lumbosacral region has congenital structural abnormalities, so that the starting and ending points of the muscles are abnormal or the activities of the region are unbalanced, which may cause chronic injury to the lumbar region.
2, long-term sedentary rest, lumbar qi and blood is not smooth. Long-term sedentary, or sedentary less mobile, lumbar movement and excessive load in a position; or long-term standing, can make the lumbar muscle in a long-term high-tension state, which can lead to chronic lumbar muscle strain.
3, long-term improper posture or bending work, or often lumbar continuous weight, can cause chronic accumulative injury of the lumbar muscles. Or bending position holding heavy objects, lifting objects can make the lumbar muscle in a long-term high tension state, which can lead to chronic lumbar muscle strain injury.
4, sudden excessive force, acute lumbar strain injury. Because of excessive force suddenly and excessive lumbar, it is easy to cause acute lumbar injury, improper treatment or delayed treatment, prolonged for a long time, can cause chronic injury of the lumbar.
5, flash setback day long unhealed, the waist qi and blood is not restored. Acute lumbar sprain and long-term repeated lumbar muscle strain. Treatment is not timely treatment method is not appropriate, can cause this disease.
6, the environment and climate is bad, the waist feel cold and wet. Chronic lumbar muscle strain and climate and environmental conditions also have a certain relationship, the temperature is too low or humidity is too large can promote or aggravate the lumbar muscle strain.
Fourth, the overall treatment principles of lumbar muscle strain
The treatment of this disease, the scientific method should be five combinations: rest and maintenance, exercise and rest, treatment and health care, exercise and rehabilitation, Chinese medicine and Western medicine combination.
Among them, Chinese medicine must be applied to treat the root cause in order to cure lumbar muscle strain.
The overall treatment and health care principles for this disease are mainly fourfold.
First, proper rest and recovery from strain
After the symptoms of lumbar muscle strain appear, after sufficient rest or treatment, the strained lumbar muscles and ligaments can be restored to some extent and the symptoms can be relieved.
Secondly, western medicine method, medication
Oral western medicine, such as pain relief and antispasmodic drugs, aspirin, anti-inflammatory pain, etc., can be used when the pain is heavy.
However, it is not suitable for long-term use or external use of Western medicine. Long-term application of Western drugs, the liver, kidneys, gastrointestinal damage, but also after a long time will produce drug dependence, low utility, or even ineffective.
Third, physical means, functional forging
1, appropriate traction, local fixation. It is recommended that patients with lumbar muscle strain pay more attention to some medical devices commonly used in China during daily home treatment, all of which belong to the common methods of multifunctional treatment in China.
2, backward walking exercise, flat heel forward.
Backward walking exercise, this is a proven method, backward walking when the body’s center of gravity moves backward, which is conducive to reducing the pelvic tilt and lumbar spine curvature. The same when standing.
Barefoot or feet with flat shoes, small steps slowly backwards or forward, the amount of exercise to the waist does not feel tired as appropriate.
The negative heel standing exercise also has a good effect on lumbar strain lesions. You can wear a pair of high front and low back negative heel shoes, high front and low back to force the body’s center of gravity backward to the heel, reduce the waist curvature and pelvic tilt, correct unreasonable posture, exercise the muscles of the low back, relieve pain, consolidate the effect of backward walking exercise, the role of rehabilitation of lumbar muscle strain. As long as the body’s center of gravity backward, you can correct the posture is conducive to the uprightness of the spine to reduce the lumbar curvature, slow down the symptoms, beneficial and harmless.
3, dump the high heel, nursing waist and feet. Lumbar strain patients in daily life it is best not to wear any shoes with heels, high heels can aggravate lumbar pain or even directly lead to lumbar pain.
4, waist movement practice, appropriate into the exercise.
Lumbar movement exercise exercises to strengthen the lumbar back muscle exercise for lumbar strain injury, promote the circulation of Qi and blood, and enhance the strength of the lumbar muscles is greatly beneficial. Large body exercises can be as follows.
(1) the sky up and down
(2) open bow side flexion
(3) wind swing lotus leaf
(4) supine stirrups
(5) Flying swallow pointing water
(6) Turning side paddle
(7) Golden chicken independence
(8) Single Whip with Cloud Hand
(9) High leaping and exploring horse
(10) Radio Exercise
Such dynamic practice, and so on and so forth.
Fourth, Chinese medicine treatment, from the root to seek treatment
(A) Etiology and treatment rules
Lumbar muscle strain in Chinese medicine, the main causes and mechanisms of the following aspects, and make the corresponding evidence treatment.
1, feeling cold, the meridians and veins coagulation, qi and blood is not smooth. Treatment should be cold and warming the meridians, draining the meridians.
2, dampness stagnation, or from heat, congestion of the meridians. Treatment should be dampness and heat, smooth the development of the meridians.
3, fall and trauma, long-term slow damage, stagnation of Qi and blood stasis. Treatment should be to remove blood stasis and blood stagnation.
4. Insufficient bodily functions, deficiency of the kidney, and loss of nourishment of the lumbar region. Treatment should be to tonify the kidneys and nourish the lumbar region.
The first three of the above are real, and evil should be the main treatment; the last one is deficiency, and should be treated with tonification. If the disease occurs for a long time and the duration of the disease is long, the disease may affect the kidneys and lead to kidney deficiency and essence deficiency. Therefore, this disease is mostly internal and deficiency.
(B) Treatment methods and choices
1.Acupuncture treatment
Acupuncture treatment is mainly aimed at four.
First, for local symptoms, to sparing the treatment of the lumbar mansion.
Acupuncture to take the A is point: kidney Yu, Zhi chamber, Qi Hai Yu, Life Gate, lumbar Yang Guan, the second s point is the main, mostly with tonic method, or tonic diarrhea at the same time.
The second is to target the area to be treated in order to regulate the meridians.
If the disease involves the Governor’s meridian, add Fengfu, Dazhi, Lumbar Yu, Changqiang, etc.
If the disease involves the foot solar bladder meridian, add Chibian, Zhizhong, Chengshan, etc.
If the disease is identified as kidney deficiency, add Guan Yuan, Qi Hai, Zhao Hai and Tai Xi.
If the disease is identified with spleen and stomach weakness, add Spleen Yu, Stomach Yu, Zhang Men and Foot San Li.
Third, to address the cause of the disease in order to remove the evil Qi.
If the cold evil is heavy, add Guan Yuan and Kidney Yu, and treat with moxibustion.
for heavy dampness, add Yinlingquan and Shangqiu mainly, using the diarrhea method.
for heavy stasis of blood, add Diaphragmatic Yu, Blood Sea and painful or stagnant points, with puncture as the main treatment, together with cupping.
Fourth, for the disease period, treat both the symptoms and the root cause.
In acute attack, add local peri-prick or peri-moxibustion, and use fire acupuncture and electro-acupuncture.
The disease in the usual remission period, local and meridian acupuncture points, combined with the cause of treatment.
Acupuncture treatment for this disease, treatment 10-20 times a course.
Other methods of acupuncture can be combined with ear acupuncture, acupoint injection, etc.
2.External application treatment
Chinese herbal medicine that warms the meridians, tonifies the kidneys and strengthens the waist is selected and treated appropriately to be applied locally.
(1) External application of Chinese medicine package: the main herbal medicines are: Douhu, Fangfeng, Chuanxiong, Niubizi, Gentiana, Duzhong, Angelica, Hossein, Guizhi, Cinnamon,
Sichuan pepper and stretching herbs, etc. The herbs are fried in vinegar and applied externally, or heated in microwave oven as appropriate.
(2) Black dog skin ointment: baked and applied externally to the affected area.
(3) Musk rheumatism ointment, applied externally to the affected area.
3.Chinese herbal soup treatment
(1) Cold-damp type.
Formulas: Main formula Ganjiang Lingzhu Tang.
(2) Damp-heat type
Main formula: Si Miao San
(3) Kidney deficiency type
Main formula: Kidney Yang deficiency: Jin Kui Kidney Qi Pill; Kidney Yin deficiency: Liu Wei Di Huang Pill.
(4) Blood stasis type
Blood stasis: Blood Mansion and Blood Stasis Soup.
4.Chinese patent medicine treatment
Large Ligament Dan, Small Ligament Dan, etc.
5.Massage technique treatment
Necessary massage treatment can be carried out in hospital or at home.
Along the bladder meridian (both sides of the sacrospinous muscle area), to the painful points, etc., with a series of massage techniques:.
(1) point point
(2) plucking
(3) pinching
(4) Rolling
(5) kneading method
V. Basic methods of self-care
1.Prevent moisture, cold and cold.
2, active treatment, rest at ease.
3.Strenuous exercise, prepare first.
4, correct posture, avoid sedentary.
5, appropriate work, prevent overwork.
6.Hard-padded bed, ensure sleep
7, pay attention to weight, do not make obese.
8, strengthen exercise, increase physical fitness.
9, abstain from sexual intercourse, do not cause kidney deficiency.
10.Press and rub the waist, when making light tapping.
11, flat bottom walking, less wear high heels.