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Z: Y2S2 - External I > Low Back Pain > Flashcards

Low Back Pain Flashcards

0
Q

5 Sources of Pain

A
  1. Spinal
  2. Discogenic
  3. Nerve root
  4. Multiple lumbar spinal stenosis
  5. Referred visceral
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1
Q

Def

A

Also called Lumbago, is a subjective symptom with pain on one or both sides in the area between the 12th rib and the Illiac crest on the back of the body

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2
Q

Spinal Pain

A

Distribution: Sclerotomal
Nature: Sharp, dull
Aggravating Factors: Motion
Neurological Changes: None

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3
Q

Discogenic Pain

A

Distribution: Sclerotomal
Nature: Deep, Aching
Aggravating Factors: Increased intradiscal pressure ie. Bending, sitting
Valsalva Maneuver
Neurological Changes: None

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4
Q

Nerve Root Pain

A

Distribution: Radicular
Nature: Paresthesias, numbness
Aggravating Factors: Root Stretching
Neurological Changes: Present

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5
Q

Multiple Lumbar Spinal Stenosis Pain

A

Distribution: Radicular Sclerotomal
Nature: Paresthesias, spinal claudication pattern
Aggravating Factors: Lumbar Extension, walking
Neurological Changes: Present

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6
Q

Referred Visceral Pain

A

Distribution: Dermatomal
Nature: Deep, Aching
Aggravating Factors: Related to affected organ
Neurological Changes: None

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7
Q

Corresponding Western Diseases

A 
Kidney Disease
Rheumatism
Rheumatoid Disease
Lumbar Muscle Strain
Diseases of vertebrae and spinal cord
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8
Q

Etiology

A

Cold Damp Invasion - EPF block lumbar channel, qi/blood Stag.

Qi and Blood Stagnation - Block Lumbar channel

Retention of Damp Heat - Block lumbar channel/kidney/UB

Kidney Deficiency: Lack of nourishment to kidneys and lumbar area

Prolonged combination of excess and Deficency

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9
Q

Lumbar Pain Causes

A

Organ
Bone
Mm./Tendon
Nerve

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10
Q

4 Patterns

A

Cold Damp
Damp Heat
Qi and Blood Stagnation
Kidney Def. (Qi,Jing, Yin, Yang)

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11
Q

Lumbar pain with a burning or hot sensation at the affected area which is aggrevated by pressure

A

Damp Heat

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12
Q

Protracted pain, soreness and weakness at the lumbar region with an empty feeling which is alleviated with pressure and bed rest and aggravated by overwork

A

Kidney Def

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13
Q

Fixed lumbar pain with rigidity of movement that is aggravated by pressure or movement

A

Qi and blood Stag

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14
Q

Lumbar pain, soreness, heaviness with a cold feeling thats alleviated by warmth at the affected area, stiffness of mm in the dorsal lumbar region, limitation of movement especially in extension and flexion, aggravated by rainy days, pain radiating downwards to the buttock and lower limbs

A

Cold DAmp

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15
Q

Cold Damp T and P

A

T: Normal or purple tongue with white or white slippery coat
P: Deep Tight

16
Q

Damp Heat T and P

A

T: Red tongue with yellowish sticky coat
P: Soft, rapid or slippery, wiry, rapid

17
Q

Qi and Blood Stag T and P

A

T: Purplish or purple spots with thin white coat
P: Wiry, choppy

18
Q

Kidney Def T and P

A

T: Pale or red tongue with thin coating
P: Deep, thin, weak or deep thin, rapid

19
Q

Cold Damp POT

A

Eliminate Cold damp

Warm the meridians and circulate the collaterals

20
Q

Damp Heat POT

A

Clear Damp heat
Relax the tendons
Relieve pain

21
Q

Qi and Blood Stag POT

A

Activate blood circulation to remove blood stasis
Regulate Qi
Relieve the pain

22
Q

Kidney Def POT

A

Tonify the kidneys to relieve pain

23
Q

Cold Damp Points

A

UB 23/24/25/40
Du 3
Sp 9

24
Q

Damp Heat Points

A 
UB 23/28/32/40
Du 3
Ren 3/9
Sp 6/9
GB 25
25
Q

Qi and Blood Stag Points

A

UB 23/40
Du 3/26
GB 25
Yao tong Xue

26
Q

Kidney Def Points

A

UB 23/40
Du 3

Yin & Jing: UB 52, Kid 3

Qi and Yang: Du 4, Kid 3

27
Q

Edu

A 
Get Acup tx's
Exercise to strengthen lumbar mm
Warm up and stretch before activity
Don't sit or lay in cold/damp areas for too long
Avoid excessive sexual activity
Avoid overwork
Wear a lumbar belt
28
Q

Tx:

A

Acute Low back pain:
Palpate around UB 23/52
Use YaoTong (UE 8) - manipulate for 1-2 min, leave needle in and
and get the patient to walk around and rotate side to side
Only do a 30 min local tx, distal points ok for longer

Pain on Extension:
Use SI 3, manipulate to get Qi, walk around and bend with needle in
If severe back pain use Du 26 to open Du meridian

Local Tx:
     Du, Kidney, UB merdian - Tonify Kidney/Circulate Qi and Blood
     UB 23/25/32/53/54
     GB 29/30
     Du 3/4
     Shixiquihia
     Ashi
     Jiaji L2-L5

Distal pts:
Sm Int 6
UB 2/40/60/62
GB 34/39

Tx Biao and Ben

Herbal Patch

Plumblossom: For acute pain and use cupping after to suction blood

Electro- One back point, one distal point - 2-4HZ for 15-20min
can use mixed wave for extreme pain

Scalp Acup: Sensory/motor line or leg motor/sensory line

Auricular Acup: To diseased side -lumbar, sciatica, kid, shenmen, sacral

29
Q

Things to rule out

A

Kidneys: ask about urine, UTI’s, kidney stones etc.

Bladder

Gyno: Before or after period

Mm/Tendon/Bone/Nerve problem

30
Q

Diagnosis Differentiation

A

Sciatica vs. Low Back Pain

Down to foot Stays in low back

31
Q

Disease Differentiation

A
  1. Ext vs. Int
  2. Def vs. Excess
  3. Cold vs. Heat

Zhi- Willpower (Kidney)
Yi- Thinking (Spleen)

~Swelling
~ Nature of pain: Dull vs. Stabbing
Pain when angry: Liver Qi Stag
Overthinking/worry: Spleen Qi Def.
Deep aching, needs support: Def.
Quick, severe, can’t move: Blood Stasis
Worse at night: Blood stag
Better with stretching and moving: Stag/Damp
Better laying down: Deficiency
Heavy pain, worse on rainy days: Damp
Better with rest: Liver or Kidney Def (Tendon and Bone)

32
Q

What meridian is it when you feel as if your back is broken?

A

Taiyang

33
Q

What vertebrae is involved with bottom of foot pain?

A

L4
L5
S1

34
Q

Protocol For Acute Low Back Pain

A
  1. Needle Ashi pts moderately for 20 min then withdraw needle. Then needle Du 26 or Yaotongxue or UB 40 with draining method and ask patient to turn, bend and stretch until pain relieved. If after 3 successive tx it doesn’t work add Sp 6 and LI 4 while subtracting DU 26/UB 40
  2. First needle SI 3, do draining manipulation and get patient to walk, rotate etc for 10 min. Repeat 3 times in one treatment. If acute pain persists withdraw SI 3 and add UB 40, Du 3/4 and ashi pts. Use draining method and moxa for 20 min. Massage low back around tension and ashi points
    * For Acute Central Low Back Pain!*
  3. Use same as #2 method but replace DU 3/4 with UB 23/24
    • For Acute Lateral Low Back Pain!*

Z: Y2S2 - External I (17 decks)

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