Prescription
Main formula
Qiang huo sheng shi tang
Alternative formulas
Ma huang jia zhu tang
Juan bi tang
Du huo ji sheng tang
Modifications
Patent remedies
Main points
Explanations
Alternative points
Modifications
Diagnosis
Principle of treatment
Acupuncture treatment
Explanations
Invasion of Wind-Damp-Heat
Symptoms and signs
Principle of treatment
Prescription
Main formula
Jia wei xuan bi tang
Alternative formulas
Xiao feng san
Bai hu jia gui zhi tang
Modifications
Patent remedy
Main points
Explanations
Alternative points
Modifications
Accumulation of Cold-Damp
Symptoms and signs
Principle of treatment
Prescription
Main formula
Ling gui zhu gan tang
Alternative formulas
Shi pi yin
Du huo ji sheng tang
Wu ling san
Modifications
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Lower back pain
Notopterygium Dispelling Dampness Decoction. This formula dispels Wind, warms the channels and collaterals, eliminates Damp and relieves the pain. It is often used to treat acute lower back pain due invasion of Wind, Cold and Damp, or chronic lower back pain, which is related to weather changes. Xi Xin Herba Asari 5g, Chuan Xiong Radix Ligustici Wallichii 10g, Yu Jin Tuber Curcumae 10g, Gui Zhi Ramulus Cinnamomi Cassiae 10g and Ji Xue Teng Caulis Milletiae Reticulatae 10g, etc., could be added into this formula to strengthen the pain-relieving effects.
Ephedra Decoction plus Atractylodes. This formula can be used to treat mild case of lower back pain due to invasion of Wind, Cold and Damp. Xi Xin Herba Asari 5g, Chuan Xiong Radix Ligustici Wallichii 10g, Yu Jin Tuber Curcumae 10g, and Ji Xue Teng Caulis Milletiae Reticulatae 10g, etc., could be added to this formula to relieve the pain.
Remove Painful Obstruction Decoction. This formula is indicated in both acute or chronic lower back pain and joint pain due to invasion of Wind, Cold and Damp with deficiency of Qi and Blood. Chuan Xiong Radix Ligustici Chuanxiong 10g should be added to relieve the body pain.
Angelica Pubescens and Sangjisheng Decoction. This formula is indicated in chronic lower back pain due to invasion of Wind, Cold and Damp with deficiency of Liver and Kidney.
1. If there is a nasal discharge and sneezing, add Huo Xiang Herba Agastachis 12g (decocted later) to dispel the Damp and relieve the sneezing
2. If there is an aversion to cold and cold limbs, add Gan Jiang Rhizoma Zingiberis 10g to warm the Interior and eliminate the Cold
3. If there is lower back pain with a cold sensation, add Fu Zi Radix Aconiti Lateralis Praeparata 10g and Gou Ji Rhizoma Cibotii Barometz 10g to dispel the Cold and relieve the pain
4. If there is lower back pain with a heavy sensation, add Han Fang Ji Radix Stephaniae Tetrandrae 10g to dry the Damp and relieve the pain
5. If there is a poor appetite and a feeling of fullness in the abdomen, add Sha Ren Fructus Amomi 5g to dry the Damp and regulate the circulation of Qi in the Middle Burner
6. If there is diarrhoea, add Fu Ling Poria 10g to relieve the diarrhoea.
Shang Shi Zhi Tong Gao Injury ‘from’ Damp Stop Pain Plaster
Da Huo Luo Dan Greater Invigorate the Collaterals Special Pill.
LI-4 Hegu, TE-5 Waiguan, TE-6 Zhigou, GB-20 Fengchi, BL-40 Weizhong, BL-60 Kunlun and some local Ah Shi points. Reducing method is used on these points. Moxibustion is applied on LI-4, TE-5 and BL-40.
▪ LI-4 and TE-5 dispel the Cold, eliminate the Damp and relieve the External symptoms.
▪ GB-20 dispels the Wind and relieves the External invasion
▪ TE-6 dispels the External Wind and promotes the Water discharge so as to eliminate the Damp
▪ BL-40, a distal point, dispels the Damp, warms the limbs and promotes the free flow of Qi in the channels in order to treat the lower back pain
▪ BL-60 dispels the Cold and Damp in the superficial parts of the body, harmonises the collateral and relieves the lower back pain.
Local Ah Shi points promote the circulation in the channels and collaterals and relieve the lower back pain. Moxibustion warms the channels and collaterals and dispels the External pathogenic factors.
BL-37 Yinmen, BL-39 Weiyang, BL-54 Zhibian, BL56 Chengjin, BL-63 Jinmen and BL-64 Jinggu, etc.
Lower back pain may also be caused by blockage in different channels, such as the Gallbladder, Bladder, Liver or Stomach channels or the Governing or Girdle Vessels. Therefore different points may need to be combined with those above, as follows:
1. If there is also pain in the middle of the back, add SI-3, the Confluence points for the Governing Vessel, and BL-62, together with GV-1, the Connecting point, to promote the circulation of Qi and relieve pain in the middle of the back
2. If there is lower back pain due to blockage of the Girdle Vessel, manifesting as heaviness in the lower back, a feeling as if a belt is tightening the lower back, a cold sensation in the upper body with warmth in the lower body, or vice versa, a feeling as if sitting in the bath, or pain radiating to the sides of the abdomen, add GB-26, GB-27 and GB-41 to harmonise the Girdle Vessel, eliminate the Damp and relieve the pain
3. If there is lower back pain radiating to the leg along the Bladder channel, add BL-36, the local point, BL-58 and BL-63, the Connecting point and the Accumulation point of the Bladder channel, respectively, to harmonise the collateral and sedate the pain
4. If there is lower back pain radiating to the leg along the Gallbladder channel, add GB-29, GB-30, GB-36 and GB-40 to eliminate the Damp, harmonise the collateral and sedate the pain
5. If there is lower back pain radiating to the leg along the Stomach channel, add ST-30, ST-34, ST-40 and ST-42 to promote the circulation of Qi in the Stomach channel and relieve the pain
6. If there is lower back pain radiating to the leg along the Liver channel, add LR-3, LR-5, LR-6 and LR-12 to regulate the Liver channel, promote the circulation of Qi and relieve the pain
7. If there is sacral pain, add BL-32 and BL-53, the local points, to harmonise the collateral and arrest the pain
8. If there is a severe aversion to cold in the lower back, add a moxa box over the lower back to warm the lower back, dispel the Cold and relieve the pain
9. If there is a feeling of heaviness in the body, add ST-40 to resolve the Damp and eliminate the Phlegm
10. If the appetite is poor, add SP-4 and ST-36 to promote the circulation of Qi in the Middle Burner to improve the appetite
11. If there is diarrhoea, add BL-20, the Back Transporting point of the Spleen, to activate the Spleen, eliminate the Damp and relieve the diarrhoea
12. If there is scanty urination, add SP-6 to promote the urination and relieve the Damp accumulation
13. If there is abdominal pain, add BL-25, the Back Transporting point of the Large Intestine, to ease the pain.
A 44-year-old male worker had been suffering from lower back pain for 3 days. He had lived in a cold and damp room for a few years. His main symptoms were lower back pain, usually occurring after exposure to cold and damp and worsening on rainy days, together with a heavy sensation and stiff muscles in the dorsolumbar region, limitation of extension and flexion of the back, heavy sensation in the lumbar area, pain radiating downwards to the buttocks and legs, a poor appetite, loose stools, a white and sticky tongue coating and a deep and slow pulse.
Lower back pain due to invasion of Wind-Cold-Damp.
Dispel Cold, dry Damp and relieve the pain.
LI-4, TE-5, TE-6, GB-20, BL-20, BL-23 and BL-40. Reducing method is used on all these points. One treatment was given every other day.
▪ LI-4 and TE-5 dispel Wind-Cold, eliminate Damp and relieve External symptoms
▪ GB-20 dispels Wind and relieves external invasion as well as relieving the upper back pain
▪ TE-6 dispels External Wind and promotes water discharge so as to eliminate Damp
▪ BL-20, the Back Transporting point of the Spleen, and BL-23, the Back Transporting point of the Kidney, eliminate Damp
▪ BL-40 eliminates Damp and strengthens the lower back as well as harmonising the collateral in the back so as to relieve the lower back pain.
After 10 days of treatment, his lower back pain was obviously relieved. He was given a further month of treatment, after which his lower back pain had disappeared completely. A year later he was followed up, and he stated there had been no more lower back pain since the acupuncture treatment.
Lower back pain with a feeling of burning and heaviness, a hot sensation to the touch and limitation of movement, which is worsened on exposure to warmth and warm compressions, and is alleviated by cold compressions, together with local redness and swelling, and a dislike of pressure, accompanied by fever, thirst but disinclination to drink, loose stools or diarrhoea, a greasy feeling in the mouth, a red tongue with a yellow and greasy coating and a superficial, slippery and rapid pulse are all symptoms and signs of this condition.
Dispel the Wind, clear the Heat, eliminate the Damp and relieve the pain.
Disband Painful Obstruction Decoction. This formula can clear the Heat, eliminate the Damp and relieve the pain. Jiang Huang Rhizoma Curcumae Longae 15g, Hai Tong Pi Cortex Erythrinae 15g and Sang Zhi Ramulus Mori 15g, etc., could be added into the prescription to relieve the pain.
Eliminate Wind Powder from True Lineage. This formula, which can clear the Heat, eliminate the Damp and stop the itching, is often used to treat itching. However, it can also be used to treat scapular pain by adding Jiang Huang Rhizoma Curcumae Longae 15g, Hai Tong Pi Cortex Erythrinae 15g and Sang Zhi Ramulus Mori 15g, etc.
White Tiger Ramulus Cinnamomi Decoction. This formula is good for clearing the Heat in the joint and relieving the pain; however, its effect on Wind and Damp is not very strong, so Jiang Huang Rhizoma Curcumae Longae 15g, Hai Tong Pi Cortex Erythrinae 15g and Sang Zhi Ramulus Mori 15g, etc., could be added to the prescription to relieve the pain.
1. If there is extreme lower back pain, add Huai Niu Xi and Chuan Niu Xi Radix Achyranthis Bidentatae et Radix Cyathulae 6g to induce the herbal treatment to enter the lower back region directly and relieve the pain
2. If there is lower back pain with a burning sensation, add Huang Bai Cortex Phellodendri 12g to clear the Heat and eliminate the Damp
3. If there is a thirst, scanty urine and a red tongue, add Mu Tong Caulis Aristolochiae 3g to clear the Damp-Heat and promote urination
4. If there is urethral calculus, add Jin Qian Cao Herba Lysimachiae 10g and Hai Jin Sha Spora Lygodii 9g to dissolve the stone and promote urination
5. If there is diarrhoea, add Fu Ling Poria 15g and Cang Zhu Rhizoma Atractylodis 10g to activate the Spleen and relieve the diarrhoea
6. If there is urinary bleeding, add Xiao Ji Herba Cephalanoploris 15g to cool the Blood and stop the bleeding
7. If there is generalised body pain, add Luo Shi Teng Caulis Trachelospermi 10g to dispel External Wind, Damp and Heat and harmonise the collateral so as to relieve the pain.
Shi Re Bi Chong Ji Damp-Heat Bi Infusion.
LI-2 Erjian, LI-4 Hegu, TE-5 Waiguan, TE-6 Zhigou, GB-20 Fengchi, BL-40 Weizhong, BL-60 Kunlun and BL-66 Zutonggu. Reducing method is used on these points.
▪ LI-4 and TE-5 dispel the Cold, eliminate the Damp and relieve the External symptoms.
▪ GB-20 dispels Wind, relieves External invasion
▪ TE-6 dispels External Wind and promotes Water discharge so as to eliminate the Damp
▪ LI-2 and BL-66, the Spring point of the Large Intestine channel and Bladder channel respectively, clear the Heat, reduce the fever and relieve the lower back pain
▪ BL-40, a distal point, dispels the Damp and promotes the free flow of Qi in the channels in order to treat the lower back pain
▪ BL-60 dispels the Damp-Heat in the superficial parts of the body, harmonises the collateral and relieves the lower back pain.
BL-23 Shenshu, BL-25 Dachangsu, BL-28 Pangguangshu, BL-32 Ciliao and BL-67 Zhiyin, etc.
1. Since lower back pain may be caused by blockage in specific channels, various points may need to be added to the above depending on the specific symptoms (see above Wind-Cold-Damp invasion)
2. If there is fever, add GV-14 to clear the Heat and reduce the fever
3. If there is generalised body pain, an aversion to cold, a stiff neck and throat pain, add BL-10 and BL-12 to dispel Wind, Damp and Heat and relieve the External symptoms
4. If there is a cough with yellow phlegm, add LU-5 to clear the Heat in the Lung and relieve the cough
5. If there is sacral pain, add BL-32 and BL-53, the local points, to harmonise the collateral and arrest the pain
6. If there is a severe burning sensation in the lower back, add BL-67 with bleeding method to clear the Heat and relieve the burning sensation
7. If there is a feeling of heaviness in the body, add SP-6 to resolve the Damp and eliminate the Phlegm
8. If there is scanty and painful urination, add KI-4 and KI-5 to promote the urination and relieve the pain
9. If the appetite is poor, add CV-12, the Front Collecting point of the Stomach, to harmonise the Stomach and improve the appetite
10. If there is diarrhoea, add BL-20, the Back Transporting point of the Spleen, to activate the Spleen, eliminate the Damp and relieve the diarrhoea.
Symptoms and signs are chronic lower back pain with a heavy sensation, cold feeling and stiffness, which worsens on rainy days, together with limitation of movement in the lower back, cold hands and feet, an aversion to cold, nausea, loose stools, tiredness, a poor appetite, oedema on the legs or feet, scanty urination, a white and greasy tongue coating and a slippery and slow pulse.
Warm the body, eliminate the Cold, resolve the Damp and relieve the pain.
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Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction. This formula is originally designed to treat deficiency of Spleen-Yang with accumulation of Cold-Damp in the body. It is relatively effective at eliminating the Cold and resolving the Damp but is not sufficient to relieve the lower back pain. Some more herbs should be applied at the same time, such as Jiang Huang Rhizoma Curcumae Longae 15g, Hai Tong Pi Cortex Erythrinae 15g, Fang Ji Radix Stephaniae Tetrandrae 10g, Du Zhong Cortex Eucomiae 10g and Sang Ji Sheng Ramulus Loranthi 10g, etc.
Bolster the Spleen Decoction. This formula is designed to tonify the Yang of the Spleen and eliminate the Cold-Damp in the body, indicated in oedema and swollen abdomen due to deficiency of Spleen-Yang with accumulation of Cold-Damp. When there is lower back pain due to the same origin, this formula could then be applied. But the same modifications as the above formula should be taken to relieve the lower back pain.
Angelica Pubescens and Sangjisheng Decoction. Although this formula is originally designed to treat chronic lower back pain due to invasion of Wind, Cold and Damp with deficiency of Liver and Kidney, it could also be used to treat lower back pain due to accumulation of Cold-Damp in the channels and collaterals with deficiency of the Kidney.
Five-Ingredient Powder with Poria. The main function of this formula is to warm the Kidney-Yang, promote the Qi transformation and urination and eliminate Cold-Damp in the body, indicated in oedema and scanty urination due to weakness of the Kidney-Yang with accumulation of Cold-Damp in the body. When this formula is used to treat the lower back pain, the same modifications as Ling Gui Zhu Gan Tang as above should be taken.
1. If there is lower back pain with a cold sensation, clear urine, oedema, a pale and swollen tongue and slow pulse caused by deficiency of Kidney-Yang, add Zhi Fu Zi Radix Aconiti Lateralis Praeparata
