LBP, SI's and Acupuncture

In ten years of teaching acupuncture I have invariably moaned to beleaguered students at the first class, "Acupuncture is not a therapy, it is part of a complete system of medicine and can not be employed in a recipe or cookbook fashion."

I now publicly reverse myself. Am I getting old and tired? No. Known for centuries in China (and nearly lost for as long) are certain point combinations referred to as the "Sacred Formulas," combinations of points with well-defined and well-understood dynamics that, when used in conjunction with each other, have predictable and reproducible results. Safe and effective, and with only a few contraindications, we must note that an operative word here is "conjunction"; that is to say: add no points nor subtract any points; to do so would alter the specificity of the resonant or inductive relationship of these points and the resultant effect on the body. So with that caveat, doctor, we proceed.

Ubiquitous in the chiropractic clinic are low back pain and SI complaints. It's almost redundant to even make that statement; however, if you employ acupuncture in your clinic, the following two "Sacred Formulas" will improve your LBP and SI patients almost instantly in many cases:

(You will note that both point name and number are listed, this because on the Bladder channel the Chinese and some European systems present differing pathways, and thus differing numbering systems.

Furthermore, some additional Su-antique point information is supplied to satisfy the informed practitioner and to satisfy my desire to inform others.)

Bl-60 Kunlun Jing-River, Fire Phase point.

Located just posterior to the lateral malleolus, at the level of its prominence. Aside from being a good general analgesic point in its own right, the "Fire" property on a "Water" channel has the energetic effect of "vaporizing" the Qi, and thus facilitating circulation in an otherwise stagnant (e.g., muscular spasm) channel.

Bl-57 Chengshan No Su-antique properties.

Located in the belly of the gastrocnemius, halfway between the transverse crease of the popliteal fossa and the prominence of the lateral malleolus. Although not an antique point (having no Phase or "elemental" associations, in conjunction with the other points in this formula, it provides continuity between Bl-60 and the descending flow from the following point, Bl-40.

Bl-40 Weizhong He-Sea, Earth Phase point

Located in the centre of the transverse crease of the popliteal fossa. Being the He-Sea points clearly identifies the descending and exteriorizing characteristics of this point since He-Sea points are always entering or exiting the deep circulation of the principle channels (this depending on their polarity and location: hand or foot). The descending flow of the Foot Taiyang Bladder channel exteriorizes at this point, pulling the Qi down and out, and further relieving the congestion/spasm.

Bl-23 Shenshu Back-shu of Kidney

Located at the level of the transverse processes of L-2 and 3, (a simple mnemonic for its location), 1.5 cun from the midline. It is the Yang root of Kidney energy, and thus has a "softening" effect on paraspinal energy, facilitating spinal manipulation of the hypomobile or "fixed," patient along the entirety of the spine.

Contraindications:

Contraindications are as straightforward as the formula itself:

Pregnancy, any trimester -- question your women patients regarding the date of last menses and the possibility of pregnancy since these points may cause uterine contractions.

Disc herniations -- even though this treatment will reduce disc pain, caution in recognizing the possibility and danger of misdiagnosis and omission of additional necessary therapy is crucial.

Indications for this treatment are modified by the differential: hypo- versus hyper-mobility. For the former, the hypomobile, the acupuncture is performed before adjusting, and with dispersion technique (thirty minutes duration at minimum, with no further manipulation or electrical stimulation of the needle). For the latter, the hypermobile patient, also administer the acupuncture treatment before osseous adjusting, but in this case do so in tonification (fifteen to twenty minutes, again with no further manipulation or electrical stimulation of the needle.) These acupuncture techniques serve to reduce the pain and restore the proper integrity, tonus, and balance of paraspinal musculature, facilitating the adjustment.

Treatment of SI joint pain, because of the differing trajectory of the involved channels, leads us to a completely different combination of points. This time we select points of the Gall Bladder channel and take advantage of a peculiar deviation in its course rarely depicted in full in the contemporary acupuncture texts.

Most charts will show a direct route from GB 29 (Juliao) in the region of the ASIS, immediately connecting to GB 30 (Huantiao). The channel, however, penetrates internally to the sacrum, descends to the coccyx, passes through the genitalia and, after making a connection to the Bladder channel, resurfaces at GB 30. Only by puncturing both GB 29 and GB 30, together, can we ensure proper energetic irrigation of the SI joint. Finally, we include GB 34 (Yanglingquan), the He-Sea point, where the energy exits from the deep circulation; this point acts to facilitate the descending flow of the Gall Bladder channel.

This treatment, done unilaterally (on the affected side) in advance of a side posture adjustment -- especially in patients too sore to take a side posture -- will both reduce the pain and aid the adjustment.

A Final Note: Please refer to your charts and texts for precise point locations. Restricted space prohibits accurate and clear depiction of the point loci.