Overview
Chronic lumbar muscle strain is a series of symptoms such as lumbago and leg pain due to chronic pathological lesion of lumbar soft tissues. The clinical manifestation is recurrent lumbago. The pain sometimes drags downward the lower limbs, sometimes severe, sometimes mild with long time duration. It is included in "lower back pain", "lower back heaviness" in TCM. It is caused by qi and blood stagnation and obstruction of meridians due to exposure to wind when sweating or suffering from cold damp, or qi and blood stagnation due to traumatic injury hurting meridians, or qi and blood consumption due to long time sitting or standing straining tendons and bones, or deficiency of the liver and the kidney and insufficiency of essence and blood failing to nourish tendons and bones because of weak body constitution due to old age or congenital deficiency. The principle of acupuncture treatment is warming meridians, dispersing pathogenic cold, resolving pathogenic dampness, activating blood circulation, unblocking meridians and alleviating pain.

Treatment
1. Yaoyangguan (DU 3)
Ask the patient to lie in a prone position. After routine sterilization, puncture perpendicularly about 1-1.5 cun with a 2 cun filiform needle. Lifting and thrusting combined with twirling methods are mainly used. The needle is retained for 15-20 minutes during which manipulations are done 2-3 times. The treatment is applied every day or every other day, 10 times for one course.

2. Tianzhu (BL 10)
Ask the patient to sit in flexion with the head slightly bow. The doctor presses BL10 points bilaterally of the patient for a while with thumbs. After sterilization, 1 cun filiform needles are used to insert in 0.5-0.8 cun quickly, towards intervertebral foramen. Further manipulations are not applied because of the strong needling sensation on the points. Those having intensive lumbar pain would get relaxed feeling and alleviated pain in lumbar region in 3-5 minutes. Ask the patient to move the lumbar around at this moment. The needle is retained for 20-30 minutes. The treatment is applied once every day, 8 times for one course.

3. Yaoyan (EX-B6)
Point injection therapy is applicable. 10% glucose solution 5-10 ml mixed with Vitamin B1 solution 100 ml or compound angelica injection 2-4 ml is selected. Ask the patient to lie down in a prone position. After routine sterilization, insert the injector perpendicularly into the point. The injection is applied from the deep layer to the shallow one. Or use the method of one needle penetrating towards multiple directions with 5- 10 ml for each direction. The treatment is applied twice a week, 10 times for one course.

Note
Acupuncture therapy for chronic lumbar muscle strain is reliable and in common use. But the therapeutic cycle is a little bit long. For the patients having local tissue adhesion with long duration, needle knife therapy could be considered.