Overview
Acute lumbar sprain is an acute injury of soft tissues such as lumbar muscles, ligaments, fascia due to improper action during lumbar activities. It could be accompanied by dislocation of intervertebral small joints and incarceration of their articular capsules. Lumbago and limited activity which are aggravated by coughing and sneezing are caused. It is included in "tendon injury" in TCM. The main reason is injury of lumbar tendon and meridians, and qi and blood obstruction of local meridians due to sudden lumbar suffering from external power, or intensive wrench. The main principle of acupuncture therapy is relaxing tendons, activating blood circulation, removing qi stagnation and alleviating pain.

Treatment
1. Shuigou (DU 26)
Ask the patient to sit in flexion. A 30 gauge 1 cun filiform needle is used. Pinch the phihrum groove with the pressing hand and insert the needle quickly with the puncturing hand. The needle tip should be oblique upward 0.2-0.3 cun. When the sensation of distending pain or distending numbness is obtained on the local area, reducing method by twirling the needle is applied. Meanwhile ask the patient to move lumbar forwards, backwards, to the left and to the right. The needle is retained for 15-20 minutes. Manipulations are done 2-3 times during the needle retention. When the pain is alleviated obviously, ask the patient to stand up and move the lumbar. The treatment is applied once every day, 2-3 times might be needed.

2. Yaotongdian (EX-UE7)
When Yaotongdian EX-UE7 is punctured, select both bilateral points on the affected side. 30 gauge 1.5 cun needles are used. After quick insertion and arrival of qi, withdraw the needle a little bit, then puncture obliquely upward. Reducing method by twirling the needle or dragon-tiger fighting method is applied to make conduction of meridian-qi upward. And ask the patient to move lumbar around. Needles are retained for 10-15 minutes. Manipulations are done 2-3 times during the needle retention. The treatment is applied once every day, 2-3 times might be needed.

3. Houxi (SI 3)
The SI3 point is selected on the affected side. Ask the patient to make a fist. A 30 gauge 1.5-2 cun filiform needle is used to penetrate about 1.5 cun toward Hegu LI4. Reducing method by twirling the needle is applied after arrival of qi. Meanwhile, ask the patient to move the lumbar around. The needle is retained for 10-15 minutes. Manipulations are done 2-3 times during the needle retention. The treatment is applied once every day, 2-3 times might be needed.

4. Weizhong (BL 40)
For those having severe blood stasis in meridians and intensive pain, tap with dermal needle or prick with three-edged needle on the varicose veins around BL40 to cause bloodletting. After cupping, the jars are retained for 5-8 minutes to keep the local area bleeding for 3-5 ml. The treatment could be applied once every other day. Generally the effect is shown after 1-2 treatments.

Note
Acupuncture is considered to be one of the most effective therapies to treat acute lumbar sprain. Selection of distant points along the course of the corresponding meridians and reducing method by strong manipulation of twirling the needle, combined with lumbar activities are mainly applied in the acupuncture therapy for this disease to achieve the aim of unblocking meridians, relaxing muscles and alleviating pain.