Back Pain, Lumbago

Crooke, Mikrokosmographia, 1618

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Back pain or Lumbago refers to pain int he back, most specifically lower back. Lower back pain may be acute or chronic. Acute back pain can be from muscle or tendon spasm, acute strain, spinal misalignment following stress such as carrying a heavy weight or bending is an unusual position. In most cases, rest with some massage, stretching, exercise, application or warmth etc. is enough to relieve and it will spontaneously resolve. Acute Back Pain that doesn’t resolve in a couple of days, or that is more severe (painful, limited movement etc) can be classified as follows:
Acute Back Pain

• Heat–Inflammatory pain (worse with movement), feels better with cold applied, area may be red, hot and swollen, pulse will be fast or strong.
• Cold–duller pain, worse in cold, feels better with movement, heat or massage. Area feels cold and clammy, pulse is deep and weak or slow.
• Wind–spasmodic and moving pain, may come and go suddenly
• Blood Stasis–fixed pain associated with Trauma, bruising, may have dark veins or capillaries in the area, and the nailbeds or lips maybe slightly cyanotic (blue).

Chronic Back pain
Usually more severe and especially in the elderly often occurs due to degeneration or chronic inflammation. These cases will require longer and stronger treatment, and often may need long-term use of tonic medicines once pain has been relieved.
In general, chronic back pain can be differentiated into:

• Yin Deficient–lower back pain, nocturnal urination, dry mouth and throat, maybe insomnia and night sweats
• Yang Deficient–lower back pain, clear urine, feels the cold, cold hands and feet, pain worse with cold, better with warmth

Structural Damage
Acute Severe or Chronic Back pain can be associated with serious structual damage such as degeneration, rupturing of a disc, or chronic destructive inflammation. These can sometimes be helped with long-term treatment. Herbs such as Comfrey, Soloman’s Seal, Asparagus root and Eucommia Du Zhong are examples of Kidney strengthening medicines that are used for chronic Lower Back pain such as is seen in the old and weak. The various Rehmannia formulas of TCM (Liu Wei Di Huang Wan, Shen Qui Wan, Zuo Gui Wan, Zuo Gui Yin etc.) are useful for these types of chronic back pain too.
Special mention should be made of Velvet Deer Horn (Lu Rong). This is a special type of horn as it grows quickly within one season before ossifying (turning to bone), then falling. During the growth phase it is blood-rich with growth factors to promote bone growth. It is also rich in collagen and calcium. Because of this, it is regarded as a special medicine to restore damaged and degenerated spine and discs in TCM.

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1. Valerian and Turmeric
2. Indian Spikenard, Frankincense, Asparagus root
3. Safflower, Tabasheer, Pearl, Scorpion (Tibetan)
3. Henbane seed, Valerian, Saffron
4. Myrrh, Frankincense, Nux Vomica prepared
Chronic Back Pain:

Chicken Soup, Oxe-Tail Soup and Bone broth are all good.
1. Cyperus rotundus and Frankincense
2. Comfrey and St. Johns wort (spine and nerve involvement)
3. Asparagus root, Comfrey root, Soloman’s Seal
4. Asparagus seed, Cumin (1 dram each), powder and take with white wine. (The Secrets of Alexis, 1615)
5. Elecampane in powder (2 drams) taken in wine.
6. Walnut, Cinnamon, Saffron, Mastic
7. Tormentil root (6 parts), Galangal, Mint (1 parts each). Powder and take with every meal.
8. Withania, Asparagus root, Cyperus rotundus, Zinc Bhasma
9. Withania, Asparagus root, Frankincense, Shilajit
Cold Back Pain

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Formulas
Special Formulas to Take Note of
The following are formulas that may be easily prepared today:
Antidote for Back Pain (Galen)
Pills for Scoliosis
Special Medicine to Strengthen the Back
Chelsea Pensioner

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Dorsi doloribus – Back Pain
Decoction for Back Pain and Kidney Stones (Galen)
Special Medicine to Strengthen the Back
Syrup of Polypody
Gelatin of Deer Horn
Pulp of Comfrey root
Bishops Electuary (Electuarium Elescop) (Mesue)
Electuary of Dodder and Fumitory (Mesue)
Electuary for Back Pain (Galen)
Antidote Proven for Hip Pain
Antidote for Lumbar Pain (Galen)
Antidote for Hip Pain and Arthritis
Antidote for Cold Lumbar, Venery, & Defect of Semen
Confection for Cold Kidneys
Powder of Nutmeg Compound
Powder of Cinnamon Compound (Diacinnamonum)
Powder of Galangal Compound (Diagalanga) (Mesue)
Powder for Edema (Nicholas)
Pills of Opopanax
Pills for Scoliosis
Foetid Pills Major
Oil of Fir tree
Oil of Pepper
Oil of Foxes
Oil of Wax
Oil of the Philosophers
Oil of Scorpions
Ointment Martiatum
Ointment for Back Pain
Plaster of Marjoram
Saffron Plaster
Back Pain from Wind, Cold and Damp
Powder of Cinnamon Compound (Mesue)
Powder of Galangal Compound (Diagalanga) (Mesue)
Antidote for Hip Pain and Arthritis (Nicholas)
Arthritic Pills (Nicholas)
Pil. Aggregative Majores (Mesue)
Pills of Opopanax
Pills of Colchicum (Mesue) (Habb E Suranjun)
Pills of Colchicum Greater (Habb E Suranjun Kalan)
Foetid Pills (Mesue)
Pills for Scoliosis
Bishops Electuary (Electuarium Elescop) (Mesue)
Betel Nut 28 (Go yu nyer brgyad)
Yogaraj Guggulu
Pills of Three Tastes (Mongolian Medicine)
Punarnavadi Guggulu (Boerhaavia and Bdellium Pills)
Back Pain from Heat
Kaisor Guggulu
Ointment of Poppy
Back Pain from Cold Kidneys (Yang Deficiency)
Decoction for Back Pain and Kidney Stones (Galen)
Powder of Nutmeg Compound
Powder of Cinnamon Compound (Mesue)
Powder of Galangal Compound (Diagalanga) (Mesue)
Electuary of Calamus (Diacorum) (Mesue)
Electuary of Steel (Unani)
Antidote for Lumbar Pain (Galen)
Antidote for Cold Lumbar, Venery & Defect of Semen
Confection for Cold Kidneys
Diathamaron Magna (Nichols)
Betel Nut 28 (Go yu nyer brgyad)
Back Pain from Deficiency
Special Medicine to Strengthen the Back
Antidote for Lumbar Pain (Galen)
Antidote for Cold Lumbar, Venery & Defect of Semen
Diathamaron Magna (Nichols)
Electuary of Orchis (Diasatyrion) (Mesue)
Betel Nut 28 (Go yu nyer brgyad)
Back Pain from Blood Stagnation–Trauma
Pills for Scoliosis
Troches of Saffron
Saffron Plaster
Madder Pill (Tibetan Medicine)
Antelope Horn 14 (Rgya ru bcu bzhi) (Tibetan) 
Chronic Back Pain from Obstruction
(Damp with Blood Stagnation)
Bishops Electuary (Electuarium Elescop) (Mesue)
Madder Pill (Tibetan Medicine)
Antelope Horn 14 (Rgya ru bcu bzhi) (Tibetan) 
To Purge in Back Pain
Troches for Back and Sacral Pain (Nicholas)
Bishops Electuary (Electuarium Elescop) (Mesue)
Topically
1. Agrimony and Mugwort formed into a salve with (Deer) suet.
2. Comfrey as an oil, plaster or wash
3. Myrrh, Frankincense with Oil of St. John’s wort form a plaster.

TCM Classification
Simples:

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Qi Stagnation
acute or spasmodic lower back pain, worse when stress, irritable, emotional, headache, hypochondriac distention, irregular menstruation
Shao Yao Gan Cao Tang
Cold-Damp Pain
cold lower back, stiffness, worse when still for too long, better after movement, pain aggravated when cold or on rainy day
Huang Qi Gui Zhi Wu Wu Tang
Shen Qi Wan (Jin Gui Shen Qi Wan) (Rehmannia 8)
Heat-Damp Pain
Inflammatory pain, worse with movement, relieved by cold, red tongue with yellow coat
Shang Zhong Xia Tong Yong Tong Feng Wan
Blood Stasis
sharp piercing lower back pain, the pain is fixed in location, painful to move, aggravated by cold, feels better with warmth
Shen Tong Zhu Yu Tang
Huo Luo Xiao Ling Dan
Injury & Trauma
back pain with a recent history of Trauma; fixed pain, painful to touch
Fu Yuan Huo Xue Tang
Huo Luo Xiao Ling Dan
Qi Li San
Die Da Wan
Jiu Fen San
Shen Tong Zhu Yu Tang
Yunnan Baiyao
Kidney Deficiency
chronic lower back pain with degeneration, aggravated when moves too much, very stiff when has been sitting, nocturnal enuresis, deep and weak pulse
Qing E Wan
Zuo Gui Wan
You Gui Wan
Shen Qi Wan (Jin Gui Shen Qi Wan) (Rehmannia 8)

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Special Formula
Xiao Sui Hua He Decoction–Ruptured Disc
  Astragalus Huang Qi   20 grams
  roasted Astragalus Huang Qi  20 grams
  Stephania Han Fang Ji  10 grams
  Dang Gui  10 grams
  Ligusticum Chuan Xiong    10 grams
  Atractylodes Bai Zhu   10 grams
  Earthworm (Di Long)    10 grams
  Leech (Shui Zhi)    6 grams
  Clematis Wei Ling Xian  10 grams
  Pawpaw  10 grams
    Mustard seed (Brassica alba)   6 grams
Decocted in water and taken orally for 8–16 week. This was used as a conservative treatment of ruptured Disc in a group of patients in China, along with bed rest for 2–3 weeks, and certain exercises. It has good effect. (See here and here)
Yiqi Buxue Recipe–Ruptured Disc
  Astragalus Huang Qi   20 grams
  Dang Gui   10 grams
  Ligusticum Chuan Xiong  15 grams
  Earthworm (Di Long)   15 grams
  Stephania Fang Ji  10 grams
  Chaenomelas Mu Gua  10 grams
  White Mustard seed (Bai Jie Zi)   6 grams
  Clematis Wei Lin Xian   10 grams
This was studied and forund effective (see here).
Severe Acute Lower Back Pain
  Centipede (Wu Gong)
  Scorpion (Quan Xie)  equal parts
These are powdered and taken in doses of 1500mg with wine, or they can be taken along another suitable formula such as Du Huo Ji Sheng Wan.