Lumbago

lumbago is one of the commonly seen clinical symptoms,and a syndrome caused by various kinds of diseases. according~to modern medical science, the occurrence of is mostly due to injury of the lumbar muscles,ligaments fasciae, and joints, or congenital deformity of lumbosacral vertebrae, protrusion of the lumbar intervertebral-disc, or pathological changes of some internal such as the kidney and bladder.In the theory of TCM, in addition to the fact thatlumbogo is closely related to functional changes of the kidney invasion of exogenous pathogenic wind, cold, dampness etc. and injury of fall and sprain may all lead to blood qi sta~ation of the meridians in the lower back,which will cause obstruction resulting in the disorder.

DIAGNOSIS
 
 
Acute Lumbago, also called Shanyao ( lumbar sprain~). Lumbago usually occurs when people bend their wrist to work with improper posture or strength, or when they overload their waists, which cause intensive contraction of the muscles leading to rupture of soft tissues such as the muscle fibers and fascia and other injuries. Or it may also result from sprain of the waist, which brings on impaction and malposition of the lumbar vertebral joints as well as rupture of the ligaments and joint capsules around the joints, or even protrusion of the lumbar intervertebral disc. }

 

according to the diagnostic methods mentioned in the previous chapter, combined with experimental tests,tuina therapy has significant effects on lumbago excluding those caused by visceral diseases. Lumbago may clinically be divided the acute and the chronic types.

Chronic Lumbago: It refers to the intermittent sore and distending pain in the lumbus caused by delayed or uncured acute lumbago and chronic strain of the soft tissues, which is characteristic of extensive, but not sharp pain aggravated by fatigue and relieved by rest and also related to changes of weather. There is no marked disturbance, but a pulling sensation in waist movements .The diseased part is of preference for warmth and aversion to cold. Of special functional tests, the calcaneus-hip test and the lifting straightened leg test prove positive

This type of acute pain may have a sudden attack after trauma, injury of soft tissue is signed by marked tenderness, and tension of the muscles increases because of their protective contraction. When small joints are impaction or mallocated, local swelling is not evident, but there is severe pain. While in patients with protrusion of lumbar intervertebral disc, the pain may radiate to the lower limb. In the special lumbar functional tests of ordinary cases, positive results can  be seen in flexing test(Nrudzinski's sign) and straightening the abdomen test. In the patient with protrusion of lumbar intervertebraldisc, tests of lifting a straightening leg and increasing pressure on it and tests of dorsiflexion and plantar flexion of the great toe are both positive.
   
BASIC MANIPULATIONS 


 
The principle of tuina therapy: activating flow of qi~ blood circulation, restoring and reducing soft tissues he patient takes a supine position. The doctor applies one finger pushing or rolling manipulations to the painful area and its surroundings in the lumbar region (for those with redness, swelling and severe pain, pressing-kneading manipulation may be performed first), combined with pressing  Shenshu (BL 23), Dachangshu (BL 25), JuLiao(GB 29) and pressure pain points. According to different
dysfunction, passive movements can be made properly and co-operatively for 3 - 5 minute
(2)Press-knead Weizhong (BL 40), Zusanli (ST36)Juegu (GB 39) with strong stimulation for one minutes respectively to relieve pain in the lumbus.

The patient takes a supine position. The doctor scrubs the lumbosacral region along the direction of the fibers of sacrospinalis until a hot sensation is achieved.