Chronic
lumbar muscle strain is caused when the lumbar muscles are intensely strained
in a continuous or repeated way within a short period of time, which exceeds the
physiological endurance and, therefore, results in a chronic aseptic inflammation
in the lumbar muscular fibers. The occurrence of the illness is closely related
with the damp room one lives in or damp ground one lies or sits on. It manifests
itself in a long-time pain in the lumbus of one side, which will e aggravated
when the patient is tired, but relieved when he has some gentle activity.
Main Points of Diagnosis
1. The patient has a history of acute lumbar
muscle strain which has not been well treated, lingered for a long time and become
chronic, or has a history of chronic labour strain which is often seen in doctors
or other workers whose backs bent for a long time and sportsmen whose lumbuses
have over fatigued.
2. The patient has aching pain, stabbing pain or dull
pain in the lumbus which can radiate to the buttocks and the posterior sides of
his lower limbs. The pain is obvious after the patient has got up in the morning
and relieved after he has done some activity and aggravated when he is fatigued.
The pain becomes severe in cold condition and alleviated in warm condition.
3.There
is a deep tenderness in one side or both sides along the lumbar region. The pain
is aggravated when the patient bends his back. There is a limit t the lumbar movement
of flexion, extension or bending sideward.
4. X-ray film helps the differential
diagnosis of the illness.
Differentiation and Treatment of Common Syndromes
1. Herbal Therapy according to Syndromes.
1) The Type of the Stasis of
Blood and Qi and the Obstruction in the Channels and Network-Channels.
Main
Symptoms and Signs: The illness has a long duration. The patient has stabbing
pain in the lumbus which occurs at a fixed location. Part of the lumbar muscles
feels hard and the lumbus becomes rigid and contracted. It will become better
after some gentle activity and aggravated when in fatigue. The tongue looked dark
with petechiae or ecchymoses on it. The pulse is taut and uneven.
Therapeutic
Principle: Relaxing muscles and tendons, activating collaterals and promoting
the flow of qi and blood.
Recipe: Decoction for Regulating and Activating
the Channels
tail part of Chinese angelica root
red peony root
peach
kernel
safflower
pubescent angelica root
achyranthes root
rhubarb
cinnamon twig
All the above herbs are to be decocted in water for oral
administration.
2) The Type of Chronic Strain Complicated with the Affection
due to Wind, Cold and Dampness
Main Symptoms and Signs: There is chronic lumbago
which is sometimes mild and sometimes sever and which is characterized by distending
pain, sensation of heaviness and discomfort due to muscular contracture. This
illness is relieved in warm weather and aggravated in cold weather.
Therapeutic
Principle: Relaxing muscles and tendons, removing obstruction in the collaterals,
expelling wind and cold and removing dampness.
Recipe: Pubescent Angelica
and Loranthus Decoction.
3)The Type of Chronic Strain Complicated with Deficiency
of the Liver and Kidneys.
Main Symptoms and Signs: The lumbago is lingering.
The patient feels soreness and weakness of lumbus and can't stand on his feet
for long. The illness becomes severe when the patient is fatigued. The patient
looks pale. He is in low spirit and has spermatorrhea and prospermia. The female
patient may have scanty menstruation. The tongue of the patient is pale with white
fur. The pulse is deep and feeble.
Therapeutic Principle: Relaxing muscles
and tendons, activating collaterals and tonifying and replenishing the liver and
kidneys.
Recipe: Decoction for Tonifying the Kidney and Strengthening the
Muscles and Tendons
prepared rehmannia root
dogwood fruit
eucommia
bark
Chinese angelica root
poria
white peony root
achyranthes root
carbonized Sichuan dipsacus root
acanthopanax bark
green tangerine
orange peel
All the above herbs are to be decocted in water for oral administration
2. Other Treatments
Acupuncture, massage, etc. can be employed as auxiliary
treatments.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing
Area,
Huaihua city, Hunan province
China