Western Differentiation
Lower backache can be treated perfectly adequately and successfully according to the Chinese
diagnosis and treatment outlined above without any reference to Western medicine. However, it
is important for acupuncture practitioners to understand at least the basics of the Western
pathology of back pain, if only to be able to communicate with patients and their doctors.
Western medical doctors are increasingly referring patients to us.
From a Western medical perspective, the pathology of back pain is not well understood. There
are many cases when the pathogenesis of back pain is not clear. Back pain may be caused by
very many conditions, the most common of which are:
- Chronic lower lumbar ligamentous strain (ligaments)
- Spondylosis (synovial joints of vertebrae)
- Spinal osteoarthritis (vertebrae)
- Prolapsed lumbar disc (disc).
These four conditions affect each of the main structures of the lumbar spine as indicated above in
parentheses, i.e. the ligaments, the zygo-apophysial joints (synovial joints) between vertebrae,
the vertebrae themselves, and the discs in between the vertebrae. Figure 24.14(497) shows the
anatomy of two lumbar vertebrae, while Figure 24.15(498) shows the zygo-apophysial joints
between two lumbar vertebrae.
Chronic Lower Lumbar Ligamentous Strain
This is a very general term which applies to an ill-defined group of conditions characterized by
persistent and recurrent back pain without a recognizable pathology.
It is due to the back muscles failing to protect the ligaments in maintaining posture. The pain is
usually better with rest and worse on exercise.
From a Chinese medical perspective, as the problem lies within the muscles and ligaments, it is
necessary to treat the Spleen and Liver with points such as SP-3 Taibai and G.B.-34
Yanglingquan. It is interesting to note that the "Simple Questions" says that Spleen diseases
influence the spine as mentioned above. This is obviously in the sense that it influences the
muscles alongside the spine.
Spondylosis
This consists in disease (usually ankylosis) of the zygo-apophysial joints between vertebrae (see