The waist feels sore and uncomfortable, with a persistent dull ache, accompanied by grade I pain in the waist, also known as aching pain. However, since the predominant sensation is soreness and discomfort, it is referred to as waist soreness. Zhang Lu said: "Lumbago can also be caused by cold-dampness injury, while waist soreness is entirely due to overexertion and kidney deficiency" (Zhangshi Yitong Volume 5). Waist soreness and lumbago are closely related yet distinctly different. If the waist feels sore and uncomfortable due to temporary fatigue, it is not a symptom of disease.

bubble_chart Pattern Analysis

1. Kidney Deficiency︰In mild cases, there is persistent soreness and discomfort in the lower back, which worsens with fatigue and slightly alleviates after bed rest. In severe cases, it may also be accompanied by soreness, pain, weakness in the lower back and knees, cold limbs, heel pain, and even {|###|}alopecia areata{|###|}, loose teeth, impotence, {|###|}seminal emission{|###|}, a pale {|###|}tongue texture{|###|}, and a deep, thin pulse. The cause may be insufficient {|###|}kidney qi{|###|} due to aging or excessive sexual activity damaging {|###|}kidney qi{|###|}, which can temporarily improve after bed rest. {|###|}Kidney deficiency{|###|} with lower back soreness is accompanied by varying degrees of pain—milder in less severe cases and more intense in severe cases. The relationship between {|###|}kidney deficiency{|###|} lower back soreness and {|###|}kidney-deficiency lumbago{|###|} is close; the former may be the initial stage of the latter, and the latter is the result of the former progressing further. Jingyue Quanshu states in "Miscellaneous Syndromes": "For lumbago, if it lingers and recurs frequently, it is due to kidney deficiency." Both conditions arise from insufficient {|###|}kidney qi{|###|}. Lower back soreness is one of the main manifestations of insufficient {|###|}kidney qi{|###|}, along with limb weakness, {|###|}alopecia areata{|###|}, loose teeth, and weak pulses at the chi positions. Treatment should focus on warming and nourishing the kidneys, using formulas such as Young Maid Pill, Two-Solstice Pill, and Seven-Jewel Beard-Blackening Pill. If accompanied by {|###|}kidney yang deficiency{|###|} (symptoms include fear of cold, edema, pale {|###|}complexion{|###|}, {|###|}diarrhea before dawn{|###|}, clear and copious urine, {|###|}shortness of breath{|###|}, impotence, a pale and swollen moist tongue, and a deep, slow pulse) or {|###|}kidney yin deficiency{|###|} (symptoms include vexing heat in the chest, palms, and soles, a red tongue with scant coating, dry mouth, dizziness, {|###|}tinnitus{|###|}, {|###|}night sweat{|###|}, {|###|}seminal emission{|###|}, dark urine, and a thin, rapid pulse), the treatment can be referenced under the section on {|###|}kidney-deficiency lumbago{|###|} in the lumbar spine entry.
2. Strain︰Low back soreness is often localized to a specific area of the lower back. The discomfort worsens with fatigue and does not significantly improve with bed rest. Symptoms are more pronounced upon waking in the morning but alleviate slightly after grade I activity. In addition to soreness, grade I lumbago may also be present, though no other systemic abnormalities are observed. This condition is not accompanied by kidney deficiency manifestations. Instead, it results from prolonged static posture and excessive strain on the lower back muscles during labor, with symptoms easing after grade I activity. Mild cases can resolve by eliminating the cause and engaging in appropriate conduction exercises, tuina, acupuncture, or tai chi. Persistent and severe cases often involve insufficient kidney qi and are treated similarly to kidney deficiency-related low back soreness.

bubble_chart Documentation

1. Zhangshi YitongVolume 5: "Lumbago can also be caused by cold-dampness or injury, while soreness in the waist is entirely due to sexual overindulgence and kidney deficiency. Only drastic tonification is effective. For men, use Young Maid Pill or Eight Flavor Pill with Psoralea and Eucommia Bark. If there is heat, remove Aconite Lateral Root and add five flavors... If the stool is not solid, add Nutmeg and Psoralea, and use Chinese Yam powder paste instead of honey."