Medical Record:
The patient, suffering from back pain and lumbar disc herniation, is a 58-year-old retiree who used to be a marine police officer. He was part of a small anti-smuggling boat team at sea. No joke, back then, chasing smugglers across rough seas was extremely dangerous and very damaging to the spine. Everyone was injured to the point of dislocation.
In summer, we were exposed to the sun and rain, and in winter, the north wind howled through the air. Back then, as young men, we could endure it, even finding it exhilarating and exciting. The retirement age for the disciplined forces is 55, but I never imagined retirement would be such a disaster. I spent two years seeing doctors, suffering from neck pain, back pain, and lower back pain, until even my legs became numb. An MRI revealed sciatica, a herniated disc, and degeneration in my cervical, thoracic, and lumbar vertebrae, along with bone spurs. Surgery was necessary, but I didn't know where to operate, as so many areas were problematic. Afraid of surgery, a former colleague recommended acupuncture treatment. When I described my symptoms, I became emotional, saying the pain and numbness were unbearable, I felt like dying, but I couldn't bear leaving my wife, who had always been there for me, accompanying me to every doctor's appointment.
It turns out the patient not only suffered from lower back and leg pain, but also anxiety and depression. Please note that 71% of chronic pain patients in Hong Kong experience anxiety or depression , or both, and 38% experience disruptions to their work or require sick leave. To resolve anxiety or depression, the pain must first be addressed. Without pain, mood naturally improves. After examination and diagnosis, a treatment plan was immediately developed. I told the patient, "If you don't want surgery, acupuncture combined with massage and bone setting is the best method. My profession is non-surgical." After several treatments, the patient improved significantly and actively cooperated with the treatment, swimming frequently and applying heat to the affected area, leading to further symptom relief and a quick recovery. I also reminded the patient that after retirement, they must find work, learn something new, do part-time work, or volunteer work. Otherwise, they'll be constantly seeing doctors. For men, 58 is their prime!
Treatment
1. Massage: Techniques to relax strained and stiff muscles in the lower back and hips.
2. Bone setting: Reduction techniques relieve misalignment of facet joints and lumbar disc deviation, reducing pressure on nerves.
3. Acupuncture: Select acupoints at tender points in the lower back and buttocks. Acupoints unblock meridians, improve blood circulation, and help repair damaged areas, thus relieving pain and reducing edema.
4. Oral Chinese medicine: For Qi stagnation and blood stasis type: promote blood circulation and relax muscles and tendons.
For the cold-dampness obstruction type: it is advisable to dispel dampness and cold, and promote blood circulation and relieve pain.
For those with liver and kidney deficiency: it is advisable to nourish the liver and stomach, and promote blood circulation.
Acupuncture at specific acupoints yields the best results, followed by external application of a liniment for reducing swelling and bruises, and internal administration of a blood-activating, stasis-removing, and pain-relieving pill, as well as a spleen-strengthening and liver-soothing pill.
Kind tips
If lumbar disc herniation becomes severe, it can prevent the condyle of the affected limb from dorsiflexing, or cause urinary and fecal incontinence, and severe muscle atrophy in the affected limb. If such symptoms are present, surgery is necessary. Most cases of disc herniation do not require surgery. Conservative treatment, without surgery, mainly relies on acupuncture and oral herbal medicine. Patients can also apply heat themselves, using a hot water bottle or electric heating pad to the affected lower back. They should avoid spicy, alcoholic, fried, and damp-heat-inducing foods, and should increase their swimming ability. If they cannot swim, they can kick or walk in the water.
Keep warm. Patients with this condition are sensitive to rainy, damp weather, and cold air. During periods of pain and swelling, it is advisable to rest in bed as much as possible to reduce pressure on the lumbar spine. Avoid lifting heavy objects, running, jumping, sitting on soft sofas, and sleeping on very soft mattresses. Wear a lumbar support belt while working to protect the lower back, but it is not necessary while sleeping. If patients are willing to comply, recovery will be much faster. Let me also explain why acupuncture is effective. The key is accurate and precise needle insertion. Acupuncture can stimulate signals to the brain, triggering the brain's endocrine system and endorphins to produce pain relief. It can also direct immune cells, lymphocytes, white blood cells, and phagocytes directly to the affected area to reduce inflammation and swelling, repair damaged areas, and cause the intervertebral discs to contract, relieving nerve compression. Therefore, it is a good treatment method with no side effects. The most important thing is the psychological fear of needles. Of course, the skill and technique of the practitioner are crucial.
Source: [The Complete Book of Pain Management - by Zhang Yong]
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