What are Neck and Back Pain?
Your spine is a column of more than 30 bones (vertebrae) held together by muscles, tendons and ligaments and cushioned by shock-absorbing disks. A problem in any part of your spine can cause neck, back, and sciatic pain. For some people, these pains are simply an annoyance. For others, they can be both excruciating and disabling.
A common cause of neck and back pain is injury to a muscle (strain) or ligament (sprain). Strains and sprains can occur for many reasons, including improper lifting, poor posture, stress, and lack of regular exercise. Being overweight may also increase your risk of strains and sprains affecting your neck and back. Overuse, such as too many hours hunched over a computer, often triggers muscle strains.
Herniated disks or bone spurs in the vertebrae can also press on the nerves branching out from the spinal cord, causing pain and sometimes numbness in limbs. Furthermore, injuries to the neck and back, like whiplash or vertebral fractures, can stretch the soft tissues beyond their limits and cause severe pain. Diseases, like arthritis, meningitis, cancer, fibromyalgia, osteoporosis, kidney infections, and scoliosis, can all cause neck and back pain.
What is Sciatic Pain?
Sciatica refers to pain that radiates along the path of the sciatic nerve. This nerve is the biggest nerve in the body and consists of a large bundle of smaller nerves that begin in the lower back, travel down the buttocks, and move through each leg. Typically, sciatica affects only one side of your body.
Sciatica most commonly occurs when a herniated disk or a bone spur on the spine compresses part of the nerve. This causes inflammation, pain, and often some numbness in the affected leg. A spastic or very tight pelvic muscle can also put pressure on the sciatic nerve and cause uncomfortable pain. Other conditions that may contribute to sciatic pain include: obesity, sedentary lifestyles or prolonged periods of sitting (like driving an automobile), age-related changes in the spine, and diabetes.
Most all neck, back, and sciatic pain goes away on its own, or with proper rest and home care, like using hot/cold packs, stretching, breathing deep to oxygenate the muscles, or using common over-the-counter medications for pain relief. Surgery is rarely needed and is generally considered only as a last resort.
If someone does suffer pain severely, or for very extended periods of time or following an accident, proper diagnosis from a doctor is advised. X-rays, CT scans (computerized tomography), and MRI scans (magnetic resonance imaging), as well as blood tests, nerve tests, and a lumber puncture, may be used to determine more serious reasons for the pain.
How Chinese Medicine and Acupuncture Treat Neck, Back, and Sciatic Pain
Chinese medicine states that the body is interconnected; no one part can be separated from another. The diagnosis and treatment is based upon identifying specific imbalances in the muscles and the body as a whole. Correcting the imbalance does not just treat the symptoms or mask the condition, but rather corrects the root of the problem by encouraging self-healing of the body.
Pain, in Chinese medicine, is due to an obstruction in the flow of energy (Qi), blood, lymph or other fluids. With neck, back, or sciatic pain, as with other forms of pain, Chinese medical practitioners use acupuncture, herbal formulas, and physical therapy to increase the circulation of Qi, blood and fluids, especially in the area of discomfort. When circulation in the tissue increases, Qi, blood and fluids are allowed to flow more freely, the muscles in the area become more relaxed, and pain reduction follows in most cases. Occasionally the pain in the effected area may initially intensify, followed by the muscle relaxation, tissue repair, and then the diminishing of the pain.
Chinese Medicine’s vocabulary for pain is very different from that of Western medicine’s, and identifies the patterns of back pain as:
- Deficiency type pain
- Energy (Qi) and Blood stagnation pain
- Cold Damp Obstruction pain
Pain that results from deficiency is usually dull, chronic, and improves with rest. It is more common in middle-aged and elderly people.
Pain from stagnation is more severe and stabbing in nature. There is stiffness and tightness in the muscles and it worsens with rest. Often this type is seen in occurrences of acute sprains and strains. It can reoccur chronically, thereby indicating an underlying deficiency.
Pain from cold damp obstruction is worse in the morning, and exacerbated by cold and damp weather. It improves with heat and may be accompanied by numbness, swelling, and a sense of heaviness.
Overall, Chinese medical treatment can relax and stretch the tendons and fascia to help release the spastic muscles and strengthen them, thus allowing the neck, back, or sciatic nerve to naturally heal.
Acupuncture increases circulation to the muscles, allowing them to relax and heal. When your practitioner treats your neck, back, or sciatic pain with acupuncture, both local (at the site of pain) and distal (away from the area of pain) needles can be used to help resolve the problem. Distal points are very important, especially in acute pain. Often, needles can be placed in areas other than the back and you can get excellent and quick relief. There are many local points on the back and often a practitioner will feel to identify the most sensitive spots and needle those. Generally, it is advisable to have frequent treatment initially and taper off as the pain diminishes.
Chinese herbs can also be helpful in moving blood and reducing inflammation as well as strengthening a deficient condition. Many herbs use the same biochemical pathways as other pain relievers. In the short term, they are typically not as invasive but they have myriad positive effects.
If a patient approaches a Chinese Herbalist with back pains to sprain, strain, or injury, as with work and sports, the Herbalist may offer herbs to relieve blood stasis, dispel lactic acid buildup, and facilitate the natural recovery process. In this way the spot of acute injury can receive the nutrients it needs to heal more rapidly.
If a patient complains that cold weather makes their back stiff, the Herbalist may give a mixture of herbs to dispel cold or dry up damp from the meridians brought on by external influence.
If an individual complains of lower back pain, the Herbalist may attribute this pain to a depletion of Kidney energy or a urinary tract disorder, and offer herbs to strengthen or remove damp heat.
In Chinese herbal therapy, incidences of neck, back, or sciatic pain are hardly considered to be isolated events. Everything is a factor. The goal of Chinese herb therapy is to regain balance in all ways physical, chemical, and energetic.
Nutritional Guidance and Lifestyle Recommendations: According to Chinese medicine, the spleen is the organ in charge of digestion. It is the spleen energy (Qi) that transforms and transports the food and drink ingested. If, through overeating sweets and fatty foods, raw, chilled foods, and drinking excessive chilled beverages with meals, the spleen is damaged, it may fail to transform and transport liquids and these may accumulate to become internally generated dampness. Because dampness is yin, it tends to percolate downward in the body to lodge in the lower half of the body, causing damage to the liver and kidneys and thus creating lower back pain. Proper diet will be discussed with your Chinese medical practitioner, and an individualized plan will be prescribed to best address your pain and condition.
Proper exercise can also greatly aid in the treatment and prevention of neck, back, or sciatic pain. In Chinese Qi gong training, it is said that the shen leads the qi. That means that if you’re doing an exercise in which you are focusing your mind (shen) on your lower back, then the energy (qi) goes there, and healing takes place. This exercise can be very similar to Acupuncture’s function. When you have a needle stuck into your back, you think about it. You’re acutely aware of it. It forces the mind to become conscious of that area, and so the qi is led to that area. Qi gong exercises can have this same focus and are recommended in-between acupuncture treatments.
Tui Na Massage, a form of Chinese massage, can also increase blood flow to the tense muscles and relax them. This increased circulation can reduce lactic acid in the area, helping decrease inflammation and restore mobility.
How Western Medicine Treats Neck, Back, and Sciatic Pain
Neck, back, and sciatic pain are typically treated in similar fashion. First courses of action include rest, hot or cold compresses, physical therapy, and exercise, all of which can help reduce the pain and increase the flexibility and strength of the muscles. Over-the-counter medications for pain relief are usually recommended. If needed, prescription strength medications, like anti-inflammatories, muscle relaxants, and narcotics may be prescribed for severe cases under a doctor’s close supervision. Steroid injections and surgery may be used for extreme pain relief or for correcting nerve or spinal cord problems.
Research and Related Articles on Back Pain
Electroacupuncture treatment of acute low back pain: unlikely to be a placebo response
Acupuncture in Medicine. Published online May 15, 2014
Research and Related Articles on Sciatica
Effect of deep electroacupuncture stimulation of “Huantiao” (GB 30) on changes of function and nerve growth factor expression of the injured sciatic nerve in rats [Article in Chinese]
Zhen Ci Yan Jiu. 2014 Apr;39(2):93-9.