Diagnostic points of low back pain treatment
The main clinical symptom is pain on one or both sides of the waist. Low back pain can often radiate to the legs, often accompanied by symptoms of exogenous or internal injuries. Lumbar X-rays and other examinations often show abnormalities.
Dialectical analysis of low back pain treatment
There are five kinds of lumbago: one is yin deficiency, and the other is yin deficiency and kidney deficiency. Everything is sunny in October because of low back pain. Second, wind and spleen, cold waist, is low back pain. Third, kidney deficiency, service injury to the kidney, is low back pain. Four times, waist-deep, fall and hurt your waist, which is low back pain. Fifth, take a cold place to sleep, and it is low back pain that is injured by local qi. The pain has stopped and it hurts to pull back. "
Low back pain can be caused by cold and dampness, damp-heat, or injury caused by falling servants, qi stagnation and blood stasis, or kidney deficiency and physical weakness. Its pathological changes are often characterized by kidney deficiency, exogenous pathogens and falling.
First of all, it is advisable to distinguish between exterior deficiency and cold and heat. Generally speaking, exogenous pathogens are mostly true in the exterior and interior, and the onset is sudden, so the treatment should be based on eliminating evil and dredging collaterals, according to the difference of cold, dampness and dampness. Due to deficiency of kidney essence, syndromes are mostly internal deficiency, and chronic recurrent attacks are common. Treatment should be based on tonifying kidney and benefiting qi.
Differential diagnosis and treatment of low back pain
Cold-dampness syndrome is characterized by severe cold pain in the waist, unfavorable turning over, unrelenting recumbent, and aggravated rainy days. The tongue coating is white and greasy and the pulse is heavy.
Treating cold and warming channels.
Herbs on the prescription
1. Jiawei Ganjiang Lingshu Decoction (Zhang Zhongjing's Synopsis of the Golden Chamber)
Prescription: Zingiberis Rhizoma 12g, Radix Glycyrrhizae Preparata 9g, Atractylodis Rhizoma 15g, Poria 20g, Eucommia ulmoides Oliv. 12g. Radix Angelicae Pubescentis, Rhizoma Cibotii 20g, Achyranthis Radix15g. Decoct with water.
2. Chinese patent medicine
(1) Low back pain, 2 capsules each time, 3 times a day.
(2) Jin Shu Huoluo Pills, each time 1-2 capsules, twice a day.
(3) Yaobitong Pills, each time 1 capsule, three times a day.
3. One-sided prescription
(1) Ershuyiren Decoction (Liu Guopu Syndrome)
Prescription: Atractylodis Rhizoma 30g, Coicis Semen 20g, Atractylodis Rhizoma 15g. Decoct with water.
(2) Rhizoma Atractylodis dry powder (Li Zhenqiong's secret recipe)
Prescription: 50 g of dried ginger, 0/0 g of atractylodes rhizome/kloc, 0/5 g of angelica sinensis/kloc, and 95% alcohol. Grinding the above medicines into fine powder, sieving, applying to the affected part, and hot compressing. Every day 1 time.
(3) Yao Qiang powder (Zhang Jianming's prescription)
Prescription: 30g of Radix Aconiti, 30g of Cinnamomum cassia, 30g of dried ginger, 20g of Radix Angelicae Dahuricae, 20g of Arisaema cum bile, 20g of Radix Paeoniae Rubra and 30g of camphor. Grind the medicine * * * into very fine powder, 30-50g each time, mix it with boiling water into paste, spread it on gauze, and apply it to the sore spot while it is hot. 1 Change it every other day.
Damp-heat syndrome is characterized by low back pain with heat sensation, which is aggravated in hot days or rainy days, and can be relieved after exercise, resulting in red urine. The tongue coating is yellow and greasy and the pulse is slippery.
The treatment is to clear away heat and promote diuresis, relax muscles and collaterals.
Herbs on the prescription
1. addition and subtraction of the main prescription Simiao powder (Zhang Bingcheng's easy to read)
Prescription: Rhizoma Atractylodis, Cortex Phellodendri each 12g, Coicis Semen 30g, Caulis Lonicerae, Rhizoma Dioscoreae Septemlobae 20g, Fructus Chaenomelis, Radix Stephaniae Tetrandrae, Cortex Erythrinae, Radix Achyranthis Bidentatae 15g, and Radix Glycyrrhizae 6g. Decoct with water.
2. Chinese patent medicine
(1) Huoluo Zhitong Pill, L Pill each time, 3 times a day.
(2) Xiaohuoluo Pills, each time 1 capsule, twice a day.
3. One-sided prescription
(1) Eupolyphaga Seu Steleophaga powder: 7 Eupolyphaga Seu Steleophaga, baked and ground into coarse powder, soaked in 30 ml of Chinese liquor 1 day and night, deslagging, and taken separately, daily 1 dose.
(2) Bushen Huoxue Decoction (Lai et al. "Clinical Miraculous New Prescription")
Prescription: Radix Angelicae Sinensis, Radix Paeoniae Rubra, Fructus Chaenomelis, Rhizoma Alismatis each 10g, Radix Rehmanniae 15g, Semen Persicae, Flos Carthami, Rhizoma Chuanxiong, Ramulus Cinnamomi, Honeycomb each 6g, Radix Salviae Miltiorrhizae 9g, Poria 12g. Decoct with water.
Kidney deficiency syndrome is characterized by backache and backache, like pressing and rubbing, weakness of feet and knees, which is even worse when you are tired. It is relieved when you lie down, and often occurs repeatedly. Heavy or thin pulse.
Treatment of kidney essence.
Herbs on the prescription
1. Add and subtract the main prescription Zuogui Pill (Zhang Jiebin's Complete Works of Jingyue)
Prescription: 20 g of Radix Rehmanniae Preparata, 0/5 g of Rhizoma Dioscoreae, Fructus Lycii/kloc-,0/2 g of Cornus officinalis, Semen Cuscutae, Poria, Cortex Moutan/kloc-,30 g of Herba Taxilli and Carapax et Plastrum Testudinis (fried first), 0/5 g of Achyranthes bidentata, 0/0 g of Cortex Moutan and Alismatis Rhizoma. Decoct with water.
For patients with kidney-yang deficiency, remove Cortex Moutan, Rhizoma Alismatis and Carapax et Plastrum Testudinis, and add Radix Aconiti Lateralis Preparata 12g, Cortex Eucommiae 15g, Cortex Cinnamomi 5g and Herba Epimedii 12g.
2. Chinese patent medicine
(1) Jin Shu Huoluo Jian Yao Pill, 5g each time, 3 times a day.
(2) ancient fairy tablets, 4 tablets each time. Six tablets, three times a day.
(3) Zhuangyao Bushen Pill, each time10g, three times a day.
3. One-sided prescription
(1) Psoralea corylifolia powder: Psoralea corylifolia 10g, decocted and ground into powder, and taken with yellow wine, once a day 1 time.
(2) Wenshen Zhitong Pill (Lai et al. "Clinical Miraculous New Prescription")
Prescription: Radix Aconiti Lateralis Preparata 12g, Herba Epimedii, Radix Morindae Officinalis, Cortex Eucommiae, Herba Taxilli, Radix Astragali, Radix Rehmanniae Preparata, Radix Angelicae Sinensis, Radix Paeoniae Rubra, Radix Paeoniae Alba, Achyranthis Radix 15g, Rhizoma Chuanxiong 9g and Caulis Spatholobi 30g. Decoct with water.
(3) Wenshen Tongluo Decoction (Lai et al. "Clinical Miraculous New Prescription")
Prescription: Radix Aconiti Lateralis Preparata 18g, Ramulus Cinnamomi 9g, Herba Epimedii 18g, Radix Morindae Officinalis 15g, Radix Paeoniae Alba 15g, Radix Salviae Miltiorrhizae 15g, Radix Achyranthis Bidentatae 15g and Radix Angelicae Sinensis15g. Decoct in water twice and take it twice, daily 1 dose.
(4) Bushen Zhuangyao Decoction (syndrome of Li Zhenchao)
Prescription: 20g of Radix Rehmanniae Preparata, 0/5g of Fructus Corni/kloc, 0/5g of Rhizoma Dioscoreae, 0/2g of Eucommiae Cortex, 0/5g of Herba Epimedii, 0/2g of Rhizoma Cibotii/kloc, 0/2g of Radix Paeoniae Rubra/kloc, and 0/5g of Radix Salviae Miltiorrhizae. Decoct in water twice and take it twice, daily 1 dose.
Other therapies for low back pain
1. Application method
(1) Radix Aconiti Kusnezoffii Preparata 15g, Rhizoma Zingiberis Recens 10g, a little salt, * * * mashed into fine powder, stir-fried with a little wine, wrapped in cloth and applied externally. It is suitable for low back pain caused by cold and dampness.
(2) Mash 30g scallion and rhubarb 10g, fry until cooked, and apply externally to the sore spot. Suitable for damp-heat lumbago.
(3) Angelica sinensis, Ligusticum Chuanxiong, Olibanum and Myrrha, each 30g, and vinegar 300 ml, are soaked in vinegar for 4 hours, then moved into a pot and heated to 10. Then soak the gauze in vinegar. Apply it to the low back pain while it is hot, and then change it when it is cold. Apply continuously for 4-6 hours each time, one day 1 time. Is suitable for lumbago due to blood stasis.
2. Scald cinnamon 30g, Evodia rutaecarpa 90g, ginger 120g, onion 30g and pepper 60g, stir-fry, wrap with silk handkerchief, burn the sore spot, and stir-fry after cooling. Suitable for lumbago due to kidney deficiency.
3. Acupuncture generally takes Shenshu point, Weizhong point, local point or Ashi point. Fengfu and Yaoyangguan are added to those suffering from cold and dampness, Shu Ge and secondary epistaxis are added to those suffering from strain, and Mingmen, Fructus Aurantii Immaturus and Taixi are added to those suffering from kidney deficiency. According to the deficiency and excess of syndromes, reinforcing and reducing or flat reinforcing and reducing or acupuncture can be used as appropriate. For those with severe low back pain, blood can be bled at Weizhong point and cupping at waist point.
4. Diet therapy
(1) Eucommia pot pork loin: Eucommia 30g, pork loin 1-2, add appropriate amount of water to make soup. Suitable for lumbago due to kidney deficiency.
(2) Pepper root snake meat pot: 50 grams of pepper root, 250 grams of snake meat, soup, seasoning. It is suitable for low back pain caused by cold and dampness.
5. Massage therapy begins with rolling or pushing at and around the waist pain, with pressing Shenshu point, Dachangshu point, megacolon point and tender point, and adding relevant points according to syndrome differentiation or appropriately cooperating with corresponding actions. Then use the method of pressing, rubbing and wiping.
6. Prevention and care
To prevent low back pain, you should avoid sitting and lying in the wetland. If you wade in the water, get wet in the rain or sweat, you should change your clothes and wipe your body. When steaming in hot and humid summer, you should avoid staying outdoors at night or drinking cold water. Don't try to lift weights, and don't do strenuous exercise without preparation. This syndrome is due to kidney deficiency, so we should avoid excessive sexual intercourse and labor. Nursing care of low back pain can be self-massage, waist exercise, Tai Ji Chuan, frequent bathing or hot water bathing.
Low back pain refers to the symptoms of pain on one side or both sides of the waist connected with the spine, which is common in both men and women, mostly in women. According to statistics, patients with low back pain in gynecological clinics account for about 10% of the total number of patients. Common reasons mainly include the following:
1. Women who have been engaged in standing operations such as spinning, printing and dyeing, hairdressing and selling goods for a long time. Due to continuous standing, the stretching ability of lumbar tendons and ligaments is weakened, and excessive lactic acid can be accumulated locally, which inhibits the normal metabolism of lumbar muscles and can also lead to low back pain caused by lumbar muscle strain. Often carrying heavy objects, the waist burden is too heavy, prone to scoliosis, causing lumbar muscle strain and low back pain.
Second, urinary system infection Because the female urethra is short and straight, and the external urethra is close to the anus, Escherichia coli is often parasitic. In addition, due to the physiological characteristics of women, there are more opportunities for urethral orifice pollution. If hygiene is neglected, urinary system infection is easy to occur. Low back pain is mostly caused by acute and chronic pyelonephritis, manifested as swelling and pain in the waist, and severe cases radiate along the ureter to the perineum. Besides urinary system infection, diseases such as urinary calculi and tuberculosis can also cause low back pain.
Third, women with reproductive diseases have to go through about 400 reproductive organs in their lifetime, and they are also burdened with pregnancy, childbirth and other missions; Some women also have abortions and birth control operations. Therefore, the incidence of reproductive organ inflammation is high, such as salpingitis and pelvic inflammatory disease. These inflammations are easy to be complicated with low back pain, uterine retroversion and retroflexion, which is also one of the reasons for low back pain in women. Serious reproductive organ diseases such as hysteromyoma, cervical cancer and ovarian cyst can cause oppressive low back pain.
Fourth, women suffering from rheumatism and rheumatoid arthritis due to cold and trauma are often attacked by wind, dampness and cold during menstruation, childbirth and postpartum, leading to long bone spurs in the spine and inducing low back pain. If the waist has been sprained, it may develop into disc herniation, causing severe low back pain and even affecting the flexion, extension and rotation of the spine.
5. During pregnancy and postpartum fatigue, as the fetus grows up, the ligaments of the lumbosacral and pelvic joints of pregnant women relax, and the weight of the uterus increases with the growth of gestational age, so that the center of gravity of the body moves forward. In order to keep your body balanced, your waist should lean forward. If you don't pay attention to rest, it is easy to cause low back pain. During pregnancy, fetal development needs enough nutrients such as calcium and phosphorus. If the intake in the diet is insufficient, it will cause osteomalacia and decalcification of pregnant women, and it will also cause low back pain. Excessive bleeding during puerperium, or premature delivery, fatigue and cold. It can also cause low back pain.
Sixth, lumbar lesions are more common in elderly women. With the increase of age, the symptoms of lumbar nerve compression will also increase. Pseudospondylolisthesis caused by degenerative diseases is a common disease, which easily leads to lumbar spinal stenosis, compression of spinal cord and nerve roots, low back pain and radiation pain of lower limbs, and is often a collapsed fracture of vertebral body caused by osteoporosis. The formation of osteophyte in the elderly can cause spinal stiffness and persistent low back pain.
In addition, menopausal women may also suffer from low back pain due to autonomic nervous dysfunction, which is manifested as getting up in the morning and relieving after exercise. There are also factors such as irregular menstruation, dysmenorrhea or emotional crisis, which are also prone to low back pain.
Low back pain, don't think it's all "strain"
There are dozens of reasons for low back pain. The common diseases are lumbar hyperosteogeny, bone spur, disc herniation, lumbar hypertrophy, spinal canal stenosis, lumbar fracture, spinal tumor, acute and chronic lumbar trauma or strain, lumbar muscle strain, ankylosing spondylitis and so on. In the traditional concept, chronic low back pain is often considered as "lumbar muscle strain" after systemic examination excludes disease factors. In fact, 40% patients with low back pain suffer from chronic osteofascial compartment syndrome, but they have been troubled by low back pain for a long time because they cannot get symptomatic treatment. Many patients have had low back pain for a long time, and some people even have been hurting for 50 years and still don't know what is going on. The trend of low back pain is also obvious, and some people suffer from this disease at the age of 18.
The back is the most powerful part of the human body, providing support and protecting the spine. For people who are sedentary in the office for a long time and lack exercise, or who need to stand for a long time because of work, it is easy to cause low back pain, leading to chronic osteofascial compartment syndrome in lumbosacral region, and some of them accumulate after repeated injuries. Many patients with chronic low back pain are related to chronic osteofascial compartment syndrome, which may be caused by the increase of pressure in the osteofascial compartment, which leads to the disappearance of the subfascial space of the lower back, the decrease of muscle blood flow and the degeneration of loose adipose tissue. Because of this kind of injury, patients will have low back pain whether they walk more, sit more or lie more, that is, it is easy to have low back pain if they keep a posture for a long time. This is an important clinical feature of chronic osteofascial compartment syndrome.
Related links massage techniques for chronic low back pain
Kneading: Take a seat, put your hands and fingers together, put them on the left and right back lumbar vertebrae, and knead them slowly up and down until you get hot.
Rolling: Make a fist with both hands and massage around the waist, from bottom to top, from top to bottom, repeatedly. The head can be tilted back and forth.
Push: After hands rub against each other and get hot, put them in the middle of lumbar spine and push them from top to bottom for 30-50 times until they get hot locally.
Press: press your hands on your hips, press your thumb on your waist and eyes respectively, squeeze hard, and rotate and rub, first clockwise and then counterclockwise, a total of 36 times.
Pinch: Sit with your feet stretched forward, or bend your knees, or sit up straight. Lift the waist muscles with both hands 15-20 times respectively.
Knock: Make a fist with both hands, with both fists outward. It is advisable to tap the waist lightly without causing pain, and tap at the same time, 30 times each time.
Grasping method: Hands akimbo, thumb in front, press on the waist side, the other four fingers grasp the skin from both sides of the lumbar spine with fingertips, and grasp the tail from the waist eye, with both hands at the same time, 36 times each.
Shake: put your hands on your waist, press the root of your palm on the waist eye, and shake your palm up and down quickly 15-20 times.
Pressing: Sit still, and press the fingertip of the left or right middle finger on Renzhong point 1-2 minutes.
Point: Take a sitting position, point the Weizhong point (behind the knee joint) on both legs with the fingertips of both hands, and press 1-2 minutes until the pressed part feels sour, numb and swollen.
Small knowledge of rehabilitation medicine can also see the problem through "walking"
Gait is a behavioral feature that people move their bodies through the alternating movements of their feet. Gait analysis reveals the causes and laws of abnormal gait through the study of walking laws, and evaluates the degree of injury and rehabilitation. Rehabilitation doctors have been able to let patients "walk" while seeing a doctor through special machines! Through gait analysis, doctors can provide objective diagnosis basis for patients' health, sub-health and diseases of bones, muscles and nervous system such as orthopedics, neurology and surgery. At the same time, it can provide objective and true basis for the formulation of surgical plan, the evaluation of postoperative effect and the evaluation of rehabilitation effect.
Four new concepts of orthopedic rehabilitation medicine
* Not only patients with late recovery or sequela should be rehabilitated, but also patients should be rehabilitated from the early clinical stage to strengthen their awareness of clinical rehabilitation.
* It is necessary to master not only the skills of rehabilitation specialty itself, but also the principles of clinical treatment of related diseases, such as related orthopedic injuries and diseases, in order to cooperate with rehabilitation.
* We should not only form an "intra-disciplinary team" with therapists in various treatment departments of rehabilitation medicine, but also closely contact doctors in orthopedics and other related clinical departments to form an "interdisciplinary team" to provide patients with the best rehabilitation treatment.
* Not only give full play to the role of non-surgical rehabilitation therapy in functional rehabilitation, but also fully understand the value and role of necessary orthopedic surgery in functional rehabilitation, and introduce patients who should undergo rehabilitation surgery into orthopedic surgery in time to correct deformity and improve function.
For a long time, people have always thought that it is best to sleep on a hard bed for those who always complain about low back pain. In order to verify the scientific rationality of this traditional statement, Spanish scientists recently conducted a related experiment. The experimental results show that for patients with low back pain, the type of mattress that can best relieve their low back pain is medium hardness, not the hard hardness that people often say.
The researchers explained that because hard mattresses can provide better support for the whole body, doctors generally recommend people with low back pain to use hard mattresses. But experiments have proved that the hardness of the mattress should be moderate, not too hard, so as to relieve the low back pain itself. Researchers say that the waist is one of the most prone to problems in all parts of the human body. Most people will leave back pain at some stage of their lives, either because of injury, careless use of their waist or accidents. At the same time, few people know that the cost of treating low back pain is amazing. Rehabilitation therapy: massage,
(1) Press the palms on the lumbosacral region: in prone position, press the palms on the painful part of the lumbar spine to avoid causing pain. Breathe in 1 time, and do 10~ 15 times.
(2) Back rubbing: After work, you can rub your back muscles with your hands in the morning or before going to bed at night, rubbing them up and down for 50~ 100 times, and twisting your waist at the same time, which has the functions of relaxing muscles and activating blood circulation, promoting local blood circulation and improving low back pain.
(3) Kneading tendons and knots: Carefully touch the waist and sacrum with your thumb. If there is tenderness induration, press it with the thumb, and knead each induration 1 min.
(4) Push the lower limb: with the help of others, fix the crotch on the stomach, starting from the sacrum with the palm root, passing through the hip along the outer thigh and the outer calf, and reaching the other limb.
4. Aerobics:
(1) leg exercises: lie on your back, hold one knee with both hands, bend your hips as much as possible, so that the front side of your thigh sticks to your abdomen for 5~ 10 times, and then do the other lower limb; Then hold your knees with both hands at the same time and do it 5~ 10 times at the same time. Every night 1 time or in the morning 1 time.
(2) sit-ups: supine, abdomen. Be careful not to use upper limbs to help, keep lower limbs straight, and the number of times is uncertain. This kind of exercise can also reduce abdominal fat.
(3) Waist rolling: Lie on your back, keep your legs flexed, curl up and roll back and forth 10~20 times. When lying on the back, put the hot water bag on the painful part of the waist and slightly below the sacrum, and the damp heat lasts for about 10 minute, and then lasts for about 10 minute on both sides of the waist respectively. Finally, lie on your back and do the same with your abdomen. Especially suitable for menstrual low back pain. Pay attention to the temperature to avoid scalding.
5. Diet:
(1) 1 pork or lamb loin,100g black beans, 3g fennel and 9g ginger. * * * cooked, eat kidney and beans, drink soup, can often eat. Used for cold-dampness lumbago.
(2) Turtle meat 250g, walnut kernel 100g. * * * Cooked clothes. Used for chronic physical weakness and low back pain.
(3) 20 grams of Taxilli and 250 grams of pig bones. Make soup together. Low back pain is generally edible.
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