Why You Have Back Pain: An Alternative Approach

Physical pain and specifically back pain is one of the most common conditions we see within the field of Chinese medicine. But very often we don't address the root of it or even understand where the root of back pain is. Now in this video I thought I would share some quotes from our medical ancestors about where pain comes from and how we treat it in Chinese medicine. Hey guys I'm Dr. Alex Hein, doctor of acupuncture and traditional Chinese medicine and author of the health book Master of the Day. So before we jump in, two important links right below the video. The first is if you'd like to become a patient of mine locally in Los Angeles or virtually via telemedicine, you can contact my private practice right below this video. And the second is for a free guide which is four daily rituals that could potentially help you add years to your life with traditional Chinese medicine. So let's first read from Su Wen chapter 39, one of our most ancient books, the Huangdi Neijing, about what causes pain within the body within the channels from a Chinese medicine point of view. So this is a translation from Henry Silu and he says, the yellow emperor asked what causes sudden pain in the five viscera of the human body, the organs. Qi Bo replied, the qi of the meridians flows without stop. It circulates in the meridians continually. When the cold qi penetrates into the channels, it will cause obstructions and slow down the circulation. If this pathological qi resides in the external region of the meridians, it will cause a scarcity of blood. If it resides in the internal region of the meridians, it will cause a stoppage of qi circulation which results in sudden pain. That is another passage that talks a lot about wandering body pains and where they come from. This is chapter 43, again a translation from Henry Lu and the yellow emperor asked, how does rheumatism come about? Qi Bo said, a mixture of three qis, he translates them as energies, will cause rheumatism which include wind, cold, and dampness. When rheumatism is caused by the predominant qi of wind, it is called wandering rheumatism, meaning the pains wander around the body. When it's caused by the predominant qi of cold, it is called painful rheumatism, meaning it's in a localized area in this physical pain. When it is caused by the predominant qi of dampness, it is called fixed rheumatism. These are translations, I believe, of bee syndrome, which are various kinds of pains in the body and various kinds of aches, wandering, localized, sharp, that kind of thing. Very often, physical pain in the body is what Chinese medicine considers cold. Now, if you just hear the idea or the term cold, it sounds very mystical and very pseudoscientific, but remember that these ancient people were observing symptoms and illnesses and trying to explain them in the absence of modern chemistry, modern imaging, and modern labs. For example, ancient people clearly observed that physical pain and menstrual pain got better with the application of warmth, which is still true to this day. Women that come into my office, they say they'll put a heating pad on their low abdomen during their menses because it helps the pain. Logical that an ancient person would assume that there's some cold there. Why would warmth make it better, right? Warmth is creating some quality that the body seems to like. Now, the same is true for pain. People putting a heating pad on their neck or a bengue, right? Those patches you put on that are heating and warming. All this kind of stuff is a modern example of how these ancient people observed physiological relationships that they did not really know the true explanation for, but developed these metaphorical ways of describing and treating them. And the treatments do really work, and they still work to this day. So, pain is often viewed as cold, one of the kinds of pain. Now, a very common scenario is, for example, this cold is often due to lack of circulation or is due to some kind of obstruction in the body. So, for example, I've spoken with many PTs that say that for a lot of people, one of the reasons why they have neck pain is that the thoracic vertebra, let's just say between the shoulder blades, is sort of a quote dead zone for people that are sitting at their computers all day. Because you may be typing, typing, typing away, and the neck is moving like this or like this, but this whole area is not moving at all. And very often, by applying massage or warmth or foam rolling or trigger point therapy in that area, it will improve circulation in that area and help some of the pain. You know, for example, when we talk about people who throw their back out, anecdotally, clinically, I see that the people who do this most often are not physically active athletes getting injured. It's most often the sedentary desk worker that goes down to pick up their newspaper in the morning, and they get that locked up sensation in the low back. It's not someone deadlifting a thousand pounds off the floor. It's an inactive person who's doing a very minor movement that then tweaks their back or that puts them in bed for three days, for example. So one of the ways we can view cold is circulation, lack of use, inactivity. That's one of the ways we can view this. Now, one of the most famous quotes in Chinese medicine is the quote here, that basically, if there's no flow, there's pain. And if there's free flow, or if there is flow, there's no pain. So often what we utilize acupuncture for is to increase the flow. One thing is of circulation in the channel where there may be pain. For example, if there's back pain, a lot of time people treat the bladder channel, which goes along the whole posterior part of the body, from the back of the calf down to the heel, all the way up to the back of the neck, even over the head. And you can needle both the heel and locally in the back to help with the pain. Or along the flanks, the xiaoyang channels, like the liver and the gallbladder, that kind of thing, along, you know, the outside of the leg, especially if there's hip pain as well, going down to the outside of the ankle. So often we're treating the whole length of the channel and not just locally for pain. Usually skilled practitioners in my field are not needling locally, specifically for pain. And that's one of the ways that you know they're a skilled practitioner. They may also needle locally, but there's often distal acupuncture or even this kind of mirror acupuncture across the other sides of the body. In general, what can you do about this without coming to see me or see an acupuncturist or a Chinese medicine practitioner? One of the best ways is foam rolling. So foam rolling is one of the ways at home you can treat musculoskeletal pain that is related to something going on with the musculature. So you can treat trigger points, you can increase the circulation, you can just help with overall circulation in that area. And one of the things that's interesting is that, like massages, not only these physical therapies that are manual or somatic in nature, they do increase circulation, they can stimulate the vagus nerve, and even if there's physical touch involved, can release a cocktail of chemicals like oxytocin, like endorphins, that are related to making you feel good. But in general, the point is increasing circulation and increasing activity in that area will often help with pain. Now one final thought about foam rolling is if you have back pain, for example, is to roll along the whole Chinese medicine channel pathway. So if you have back pain, don't just foam roll locally in your back. Go through the lumbar, go through the thoracic, don't go in the cervical vertebrae, but go up the thoracic spine. Do the base of the spine, the suboccipital area, and go all the way down the hamstrings, go down the calves. Do the calves, the hamstrings, the low back, the thoracic spine, and then even the base of the skull, the suboccipital area. Because then you're factoring in, we're trying to increase circulation throughout the entire channel for the pain, and that's something that's going to make a much bigger difference as opposed to just foam rolling or putting a tennis ball on your low back and rubbing it all the time. If you can work along the entire fascial pathway, it'll help a lot more with getting to the root of that chronic pain as opposed to just doing it locally. So that's one part, ancient medical knowledge about where pain comes from within Chinese medicine and why warmth makes it better, and pragmatically about something you can apply in daily life. So my two cents on back pain, just a very quick general overview. Check it out. Don't forget to check the links below this video and the two other related videos for you right there.