Acupuncture for the syndrome of prolapsed lumbar Intervertebral disc

1
Acupuncture for the syndrome of prolapsed lumbar
Intervertebral disc --Case studies and personal
experiences
By Dr. Yin Hongchun
Email doctoryin_at_btinternet.com Tel
07880557407
2
Main point of diagnosis (1) History acute or
chronic injury in the lumbar region. (2)
Symptoms and signs lumbago with pains radiating
to the leg. (3) P.E tender point, percussion
pain ,Straight leg raising test (), intensive
leg raising test (), coughing test and abdomen
raising test (), and neck raising and chest
pressing test (). (4) X-ray, CT scan, and MRI.
3
The prolapsed disc
4
The prolapsed Disc
5

• Case 1 Acute Lumbago
• Mr. Li, age 42, a chef.
• Acute lumbago 3 days and pains radiating to the
  left leg.
• The spine apparently shifted to the left.
  Straight leg raising test (), percussion pain
  (), and tender point on the left side of L5-S1.
• CT scan L5-S1 Prolapsed Lumbar Intervertebral
  Disc with an oppressing nerve root.
• The tongue pale and dark with teeth prints on
  the edges and a thin layer of white fur.
• Pulse thready and uneven.

6
Diagnosis

• Syndrome of prolapsed lumbar Intervertebral disc
  (L5-S1)
• Stagnation of Qi, Blood stasis and kidney
  deficiency

7
Treatment principle and method

• Active Blood and Qi, resolve stasis, relieve
  pain, nourish the kidney, strengthen the waist
  and correct the joint.
• Acupuncture
• 1) shen shu (BL23), Da chang shu (BL25),
  wei zhong (BL40), Tai xi (Ki3), Kun lun (BL60),
  Yang ling Quan (GB34) and Jue gu (GB39). All of
  above should be tranquilised.
• 2) A-shi point is used for bleeding and
  cupping therapy.
• Tuina
• 1) relax manipulation
• 2) oblique pulling manipulation

8
(No Transcript)
9
Required for the patient

• Continue treatment for 10 sessions, once every
  two days
• Sleep on a hard surfaced bed
• Refrain from sex while on treatment
• Lumbar region exercises are required (after 10
  sessions) e.g. Taiji.

10
Result

• After 10 sessions, Mr. Li is free from pain and
  went back to work.

11
Case 2, post-operative pain on back and legMr.
N. S, 40 years

• L4-5 Intervertebral disc was removed two years
  ago.
• Pain and numbness remained on the lateral side of
  the left leg and lower back pain.
• No radiating percussion pain, straight-leg-raising
  test(60). Left leg muscle atrophy.
• Tongue Enlarged and purple, dark spots.
• Pulse weak and thready

12
Diagnosis

• Shao Yang channel being blocked by Qi and blood,
  with blood deficiency.

13
TreatmentClearing away the obstruction in the
channel, nourish Qi and blood

• Acupuncture Shen shu (BL23), Da chang shu
  (BL25), Huan qiao (GB30), Feng shi (GB31), Yang
  ling quan (GB34), Jue gu (GB39), Qiu xu (GB40),
  Zu san li (ST36), and A shi point.
• Shen shu and zu san li should be tonified,
  a-shi point requires bleeding therapy. all others
  need tranquilised.
• Herbal medicine Tao hong si wu wan, 3 times
  daily, 10 pills each time.

14
(No Transcript)
15
Result

• After 6 treatments, no pain, no numbness.
• Requested he continued to take the herbal tablets
  two months.
• After two months, he expressed his appreciation
  to me and the excellent effect of acupuncture in
  letter.

16
Clinical experience

1. The combination of points according to channels
   and differentiation can offer a better curative
   effect.
2. For obvious blood stasis, bleeding therapy on the
   a-shi point has a great effect on pain relief.
3. For chronic pain, acupoints to nourish kidneys
   and activate blood should be added shen shu
4. For serious lumbar pain, choose Ren zhong to
   relieve the pain

17
Clinical experience

1. If local acupuncture can not be applied first due
   to serious leg pain, the distant points should be
   treated instead, e.g. hand points.
2. Post-operation, if pain remains on the lumbar and
   atrophied leg, should add pi shu (BL20) and Zu
   san li (ST36).
3. With stomach-ache, it is caused by blockage of
   Ren mai and Du mai, Choose Guan yuan,Qi hai and
   Ming men.
4. With constipation, add Qian shu (ST 25) and Shang
   ju xu (ST37).

18
Clinical experience

1. With chronic incontinence of urine and faeces,
   acupuncture can be a great help.
2. If one or two affected parts remain painful or
   numb, find out which channel it is located in to
   choose the point.
3. Sexual function disorder, for excessive case
   choose Gan Shu, Tai Chong and San Yin Jiao. For
   deficiency case choose Tai Xi, Ming Men, Ci Liao,
   and Qi Hai.
4. For joint disorder, Tuina treatment should be
   performed first.

19
Differential diagnosis

• For the case which are already showed
  prolapsed disc by CT scan or MRI.
• The physical examination does not support the
  diagnosis.
• The pain was caused by another problem, for
  example
• Ligament damage (Interspinal and Supraspinal
  ligament). (case)
• Semi dislocation of sacrum-iliac joint.
  (case)

20
(No Transcript)
21
(No Transcript)
22
Summary

• Acupuncture is useful for the Syndrome of
  Prolapsed Lumbar Intervertebral Disc. It can
  relieve the pain, relax the muscle and recover
  the nerve function.
• Physical examination is the most important part
  of diagnosis.
• Correct identification of affected channels with
  differentiation to choose the point can obtain
  outstanding results.

23
Thank you