bubble_chart Concept

Back pain refers to a self-perceived symptom of pain in the back caused by some reason.

This condition is classified as "wind reversal" in Suwen. Yinyang Bie Lun, and as "chest impediment" in Jingui Yaolue.

Although chest impediment also includes symptoms of back pain, it is primarily characterized by chest pain and is discussed in a separate section.

bubble_chart Pattern Analysis

1. External Contractionwind-cold︰Back pain with stiffness, involving the neck, rigidity and pain in the nape and back, discomfort in the scapula, or heaviness and stagnation in the shoulders and back accompanied by {|###|}aversion to cold{|###|}, {|###|}tongue coating thin and white{|###|}, and {|###|}floating and tight pulse{|###|}, or wiry, thin, and rapid. This is often due to constitutional weakness, with {|###|}wind-cold{|###|} invading the {|###|}taiyang{|###|} channel. Cold leads to stagnation, obstructing the meridians and collaterals, causing poor circulation of qi and blood. Blockage results in pain, hence the stiffness in the back, rigidity and pain in the neck, and discomfort in the scapula. The key points for clinical differentiation are: {|###|}wind-cold{|###|} invasion causing back pain, stiffness in the back, accompanied by {|###|}aversion to cold{|###|}, and a {|###|}floating and tight pulse{|###|}. If the shoulder and back pain is so severe that the patient cannot turn their head, this indicates the hand {|###|}taiyang{|###|} channel is affected by pathogens. If there is back pain with neck rigidity, a sensation of the waist being broken, and the neck being pulled, this indicates obstruction of the foot {|###|}taiyang{|###|} channel. The treatment primarily focuses on dispelling wind and dispersing cold, often using Notopterygium Overcoming Dampness Decoction with modifications.
2. Qi and Blood Stagnation and Coagulation︰Back pain after sleeping, often accompanied by numbness, which alleviates after getting up and moving. The tongue appears bluish with a white coating, and the pulse is deep and thin or thin and choppy. This condition commonly occurs in the elderly or those with prolonged illness and weak constitution, due to qi deficiency and insufficient blood. When qi lacks the strength to propel blood circulation, blood flow becomes sluggish, leading to qi stagnation and blood stasis. As a result, the meridians are malnourished, causing back pain, as mentioned in Linzheng Zhinan Yi'an. It is said in "Various Pains": "Prolonged illness inevitably affects the collaterals, leading to stagnation of qi and blood," and also: "Deficiency of the collaterals causes pain." The clinical features include back pain after sleeping, worsening at night, and relief after activity, with a deep and choppy or deep and thin pulse. The treatment focuses on tonifying qi and nourishing blood, supplemented by harmonizing the collaterals. The recommended prescription is Juanbi Tang, combined with Xiao Huoluo Dan, or paired with tuina therapy.

Back pain has both internal and external causes, with differences between deficiency and excess. As recorded in Yixue Rumen, the symptoms of shoulder and back pain are briefly described: "Sudden pain is due to external contraction, while prolonged pain is due to deficiency and stagnation." In clinical treatment, selecting appropriate meridian-guiding herbs, such as Saposhnikovia Root and Notopterygium, can yield better therapeutic effects.

bubble_chart Documentation

1. Zabing Guangyao. Shoulder and Back Pain, citing "Six Essentials of Medicine": "Back pain, obese people often have phlegm. The elderly must use someone to pound for relief, which is due to deficiency, eliminate dampness transformation phlegm and also tonify the spleen and kidneys. Pain after overeating and drinking, wanting to be pounded, is due to the spleen not transporting and dampness-heat causing discomfort, must moderate drinking. Thin people often have blood deficiency and yin deficiency, also due to not abstaining from alcohol and rich flavors, nourish blood and clear fire, use Siwu Tang, wine-processed Scutellaria, Coptis, and Moutan. For back pain, add Notopterygium and Saposhnikovia Root as guiding herbs, obese people should add a small amount of Aconite Lateral Root."