Lumbar sprain is characterized by lumbar soft tissue injury, such as muscle, tendon, ligament, without bone fracture, dislocation, or open wounds. In Chinese medicine, strenuous exercise, lifting heavy objects, falling down, or a forceful straightening from a crouched position causes qi and blood stagnation and blockage which manifests as local swelling and pain, even limited joint movement.
Upon clinical examination if the sprained location is swollen and painful, the skin may appear to be red, purple, or blue. If it is a more recent injury, the local area is slightly swollen, indicating that the injury is not severe. If the injured area is red, swollen, painful, unable to flex, then the injury is more severe. Older injuries often do not exhibit any swelling. Because of external pathogenic factors such as wind and cold dampness, these injuries will become inflamed.
Pair-point Treatment Combinations
(1) Shousanli (LI10), Taixi (KI3) (Fig 63)
Shousanli (LI10) regulates qi and blood, reduces swelling and stops pain. Taixi (KI3) disperses and opens qi in the channel, tonifies kidney and strengthens bone. This pair point combination, one tonifying and one reducing, work to tonify kidney, strengthen tendon and bone, open channels, invigorate luo-connecting channels, reduce swelling and stop pain. This treatment is appropriate for acute lumbar sprain accompanied by inferior lumbar pain.
Needling techniques:
Shousanli (LI10) perpendicular insertion to a depth of 1 cun.
Taixi (KI3) perpendicular insertion to a depth of 1 cun.
(2) Weizhong (BL40), Chengshan (BL57) (Fig 131)
Weizhong (BL40) is the lower he-sea point of the foot-taiyang channel. It disperses and opens qi and blood in the lumbar and back region. Chengshan (BL57) soothes tendons, activates luo-connecting channels and regulates qi and blood. This pair point combination, connecting channels and qi within the channels, disperses and opens lumbar back qi and blood and stops pain. This treatment is appropriate for acute lumbar sprain.
Needling techniques:
Weizhong (BL40) perpendicular insertion to a depth of 1 cun.
Chengshan (BL57) perpendicular insertion to a depth of 1 cun.
Or prick blood.
(3) Shenshu (BL23), Weizhong (BL40) (Fig 139)
Shenshu (BL23): on the lower back, below the spinous process of the second lumbar vertebra (L2), 1.5 cun lateral to the posterior midline.
Weizhong (BL40): at the back of the knee, on the midpoint of the popliteal crease, between the tendons of biceps femoris and semitendinosus.
Shenshu (BL23) tonifies kidney and strengthens lumbar and back region. Weizhong (BL40) disperses and opens lumbar back qi and blood. This pair point combination, one zang organ and one fu organ, one exterior and one interior, one tonifying and one reducing, works to tonify both liver and kidney, strengthen tendon and bone and stop pain in the lumbar region. This treatment is appropriate for regular attacks of lumbar sprain caused by kidney deficiency.
Needling techniques:
Shenshu (BL23) towards spine oblique insertion to a depth of 1 cun.
Weizhong (BL40) perpendicular insertion to a depth of 1 cun, or prick blood.
(4) Houxi (SI3), Kunlun (BL60) (Fig 140)
Houxi (SI3): on the ulnar side of the hand, when the fist is formed, it is located at the end of the transverse crease proximal to the fifth metacarpo-phalangeal joint, on the junction of the red and white skin.
Kunlun (BL60): posterior to the lateral malleolus, in the depression between the prominences of the lateral malleolus.
Houxi (SI3) connects to the Du channel, elevates yang, opens the luo-connecting channels and stops pain. Kunlun (BL60) promotes qi of the taiyang channel, soothes tendons and activates luo connecting channels. These points in this combination, one superior and one inferior, both located on the same channel, reinforce the effects of one another. Together they have greater effects on the qi of that channel, disperse and open taiyang qi, opens the luo-connecting channels and stop pain. This treatment is appropriate for lumbar sprain accompanied by tender, painful points along the taiyang channel.
Needling techniques:
Houxi (SI3) perpendicular insertion to a depth of 1 cun.
Kunlun (BL60) perpendicular insertion to a depth of 1 cun.
Commentaries
Acupuncture treatment has excellent results in treating soft tissue injuries.
Activities of the injured area should be restricted after injury. Any exercises should be performed under a physician's supervision in order to hasten the recovery process. In the early stage of sprain, a cold compress should be used to stop internal bleeding, and then a warm compress should be applied to help disperse the blood. If the course of the disease is longer it is important to avoid further injury. Keep the injured area warm, avoid exposure to wind and cold and avoid attacks of external pathogenic wind cold and dampness.