Lumbar Injuries: Insights from Traditional Chinese Medicine

Lumbar spine injury type 2?

I would like to ask about a situation I've been experiencing.
Previously, I felt pain in my lower back when riding as a passenger on a motorcycle, but I didn't pay much attention to it.
In September, I started to experience lumbar pain at work, so I consulted traditional Chinese medicine and alternative therapies, but they were ineffective.
I then went to an orthopedic specialist and was diagnosed with sciatica affecting the lumbar vertebrae L3 to L5 and the vertebra below them.
I underwent physical therapy three times, but the results were not satisfactory.
I returned to a traditional Chinese medicine clinic for treatment; during the first week, I received ten acupuncture sessions, which provided some relief, although I still felt pain when riding on the motorcycle.
In the second week, I had six acupuncture sessions and felt significantly better.
Recently, when lying down, I experience severe soreness in my lower back and must lie on my side with my knees bent to feel more comfortable.
I also experience numbness in my legs.
Additionally, during middle school, I had several instances of weakness in my hands, and while climbing stairs, my knees would suddenly buckle.
The first time I visited a nearby traditional Chinese medicine clinic for cupping therapy, I developed deep purple marks.
Yesterday, I went to a combined traditional Chinese medicine clinic for cupping, and the marks appeared light purple-red.
Is this a manifestation of sciatica?

Ying, 10~19 year old female. Ask Date: 2013/10/16

Dr. He Yujun reply Traditional Chinese Medicine

Is the numbness in your foot unilateral or bilateral? Is there any pain extending to the posterior thigh, popliteal fossa, lateral calf, and dorsum of the foot? Sciatica is merely a symptom.
The sciatic nerve is present on both sides and originates from the nerve roots in the lumbar region of the spinal cord.
It exits beneath the piriformis muscle in the buttock and innervates the posterior thigh, calf, and foot.
The causes of sciatica can include: 1.
Pathology within the spinal canal: the most common is lumbar disc herniation, followed by intradural tumors, lumbar tuberculosis, and radiculitis.
2.
Pathology in the distribution area of the sciatic nerve outside the spinal canal: such as sacroiliac joint arthritis, pelvic tumors, compression from a pregnant uterus, buttock trauma, piriformis syndrome, improper gluteal injections, and diabetes, among others.
Since the individual has undergone an orthopedic examination but the description does not clarify whether there is a herniated disc compressing the L3-L5 nerve roots, it can only be said that there may be symptoms of sciatica without knowing the underlying cause.
Regarding the appearance of light purple marks from cupping therapy, it is necessary to know the cupping location to determine whether the circulation of qi and blood is smooth.
Using this as a basis for diagnosing sciatica seems inaccurate and should be complemented with other symptoms and physical examinations for a proper diagnosis.

Reply Date: 2013/10/16

More Info

Understanding lumbar injuries, particularly in the context of Traditional Chinese Medicine (TCM), involves a multifaceted approach that considers both the physical and energetic aspects of the body. Your experience with lumbar pain and subsequent treatments highlights the complexity of diagnosing and managing such conditions.

Lumbar Pain and Its Causes
Lumbar pain can arise from various causes, including muscle strain, ligament sprain, herniated discs, or even issues related to the sciatic nerve, as you mentioned experiencing sciatica. In TCM, these conditions are often viewed through the lens of "Qi" (energy) and "Blood" circulation, as well as the balance of Yin and Yang within the body. When there is an obstruction or deficiency in these areas, pain and discomfort can manifest.

Diagnosis in TCM
In TCM, diagnosis is typically made through a combination of patient history, physical examination, and observation of symptoms. Practitioners may look for signs such as tenderness, swelling, or changes in skin color (like the purplish hue you observed after cupping therapy). The color and quality of the tongue, as well as the pulse, are also critical diagnostic tools. Your description of experiencing pain while sitting on a motorcycle and the need to lie in a specific position to alleviate discomfort indicates a potential imbalance that TCM practitioners would seek to address.

Treatment Approaches
1. Acupuncture: As you have experienced, acupuncture can be effective in alleviating pain and promoting healing. The needles stimulate specific points on the body to enhance the flow of Qi and Blood, which can help reduce inflammation and pain. The reduction in pain after your treatments suggests that acupuncture is positively influencing your condition.

2. Cupping Therapy: The appearance of deep purple and lighter red marks after cupping indicates that there was stagnation in the area, which the therapy aimed to release. Cupping can improve circulation and alleviate muscle tension, which may contribute to your overall recovery.

3. Herbal Medicine: TCM often employs herbal remedies to support recovery. These can be tailored to your specific condition, focusing on nourishing the kidneys (which are believed to govern the lower back) and promoting circulation.

4. Lifestyle and Dietary Adjustments: TCM emphasizes the importance of lifestyle and diet in recovery. Avoiding overly cold foods and ensuring a balanced diet can support your healing process.

Recovery and Prognosis
Regarding your concerns about recovery, it is essential to understand that healing from lumbar injuries can take time, especially if there is underlying nerve involvement, as with sciatica. The fact that you have experienced some improvement with acupuncture is promising. However, it is crucial to continue monitoring your symptoms and maintain open communication with your healthcare providers.

Conclusion
In summary, your experience with lumbar pain and the treatments you have pursued reflect the intricate nature of managing such conditions. TCM offers valuable insights and therapeutic options that can complement conventional medical approaches. It is advisable to continue with your acupuncture sessions, consider integrating herbal treatments, and maintain a dialogue with your healthcare providers to ensure a holistic approach to your recovery. Remember that patience is key, as healing, particularly from complex conditions like lumbar injuries, often requires time and consistent care.

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