A common question people ask is if I can help with pain that’s been around for many years. I recently received a call asking if acupuncture could help a man who had a twenty year history of back pain. He reported the pain as being on and off over the years until the last two years when it has become more of a chronic problem.

When I hear that a patient has had pain for 20 years on and off, it makes me think of a smoldering flame waiting for a gust of air which then fans the fire (increased pain). I usually ask about the history of auto accidents, falls or physical traumas. Especially when the diagnostic tests such as MRI’s or X-Rays are inconclusive and there is no apparent problem beyond general aging issues with the lumbar vertebrae.

When there has been a history of physical trauma like a serious fall or accident when younger, the tendency is usually to brush it off, especially if all that is felt is a little soreness and achiness. When young, active and busy, life keeps going without paying much attention to general aches and pains. Those aches and pains get better, but perhaps not completely and they smolder just under the surface as the aging process continues. And then 20 years, even 30 years later, all of a sudden, there is a flare up and increase in pain and no recent memory of what could have caused the pain. Sometimes its hard to find an apparent reason for the pain. In reality, the area that was hurt many years before ends up coming back to haunt if it’s not properly addressed at the time of the initial accident. Sometimes all it takes to fan the flame years later is a awkward move or stress and then there’s a flare-up.

The first thing to do when the pain is severe is to go the doctor. You want the diagnostic tests to rule out anything serious and/or to get an idea of what is going on with the low back or area of pain.

When I asked my patient about the diagnostic test results he said “the best they can tell is I got a problem with my L3-4 and L4-5, those discs.”

Lumbar disc problems are the most common cause of low back pain that I see in the clinic. Lumbar 3, 4,5 and the first sacral disc are the usual culprits. Sometimes you get your mid back pain in your thoracic spine area but when it comes to low back pain, that’s really where most of the problem is, quite often from a fall or accident. Frequently when there is no obvious source of pain the doctor will tell the patient it’s age associated arthritis.

So what would I do if you came in with this type of complaint? I would take a history and get a sense of where the pain is. Does it radiate out to your side or to your hip? Does it go down your leg? Does it go down the side of your leg or the back of your leg or is still pretty much located in your low back and buttocks area? Once I have a pretty good idea of the channels that are affected, I will come up with a strategy of points to treat the problem.

Over the years I have received extensive training in various styles of acupuncture. One of the methods is called the Balance Method. In general, the needles rarely get put in at the location of the pain. I will identify the painful channels or meridians and then treat areas opposite and farther away but that have a relationship with the channel(s) that have pain. For example, if the pain is on the lumbar spine and across the low back, I might put some needles in the back of your head to treat the end of the channel where the lumbar pain is and where it mirrors your lower vertebral column. I might also put some needles in your opposite shoulder and upper arm to mirror the buttock or low back or on the hand, behind the knee or side of the ankle that correspond to the channel of pain.

Then we can play show-and-tell and have you move in a way that usually causes pain. We then see what happens to the pain. In the majority of cases, there is relief on the table.

I can generally tell within four to eight treatments if I can help you. I won’t have you come for six months and say, “Oh, by the way, this isn’t working.” I’m pretty clear in terms of being able to help a patient. If a patient is not getting any relief between four and eight treatments, then sometimes surgery is required or another set of diagnostic tests to see if something was overlooked. I have sent patients to a neurosurgeon or for another MRI or X-ray if there’s no relief. I can usually tell by how the patient responds to the acupuncture if this modality is a right fit.

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