Lumbar Muscle Strain Treatment - Tuina

Low back pain is a common, disabling musculoskeletal disorder in both developing and developed countries , with chronic low back pain (CLBP) being the leading cause of disability and absenteeism, worldwide . The lifetime prevalence of low back pain in the general population is estimated to be between 70 and 85%, with an annual incidence rate ranging from 6.3 to 15.4% . According to the 2000 UK guidelines, 90% of episodes of acute low back pain resolve spontaneously, with patients returning to work within a month . However, several studies claim that low back pain and related loss of function persist for 3 to 12 months with more than 25% of patients experiencing recurrence of low back pain within a year . Up to 7% of patients develop CLBP . Because CLBP is not life-threatening, its enormous social and economic cost is often underestimated. As of 2010, the global burden of CLBP was reported to be comparable to that of cardiovascular disease, infectious disease, and cancer.

The most common cause of low back pain is a lumbar strain. When the muscles and ligaments in your back are stretched too far, it can cause tiny tears in the tissue. These tears can make your spine less stable causing back pain. Because the nerves stretch out from the spinal cord throughout the entire body, low back strain can cause pain in areas other than your back.

Low back strain can be caused by extreme physical exertion, a fall, bending or crouching repeatedly or by lifting heavy objects. It can also be caused by emotional stress, bad posture, being overweight, sitting in the same position for an extended period of time or even a severe cough.

There are more serious reasons for back pain, including a slipped disc, a fracture, pinched nerves arthritis, or infections, so it’s important to consult with your doctor to get a proper diagnosis.

The pathophysiology of CLBP is poorly understood due to difficulties in localizing the source of the pain. Potential causes of low back pain include, but are not limited to, changes in the spinal disc structure with aging and degeneration, as well as changes in local concentrations of cytokines such as matrix metalloproteinases, phospholipase A2, nitric oxide, and tumor necrosis factor-α. Based on data from the Low Back Pain Group of the Bone and Joint Health Strategies for Europe Project, most cases of low back pain are non-specific, with a specific cause being identified in only 10% of cases; non-specific low back pain is, by its definition, a symptom of unknown cause. Specific conditions contributing to low back pain include degeneration, inflammation, infective and neoplastic causes, metabolic bone diseases, referred pain, psychogenic pain, trauma, and congenital disorders .

In clinical practice, a focused medical history and comprehensive physical examination are required for doctors to make appropriate treatment recommendations. Diagnostic tests, including imaging studies such as X-ray, magnetic resonance imaging (MRI), and computed tomography (CT) are not routinely recommended for uncomplicated low back pain, except when severe or progressive deficits are present or when serious potential factors are suspected. Conventional medications in several classes have been shown to have moderate short-term benefits for patients with low back pain. For most patients, first-line medication options include analgesics like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) . These medications have limited effectiveness and are frequently associated with undesirable side-effects on gastrointestinal, renovascular, and other systems. The heavy economic burden of low back pain has a huge impact on individuals, families, communities, governments, and businesses throughout the world. Thus, alternative back pain treatments are needed that minimize cost and maximize health benefit.

According to TCM, a state of health reflects an underlying state of balance in the Qi and blood of the human body. Pain is usually caused by obstruction of Qi and consequently of blood circulation in the affected body region. Pathogenic factors such as blood stasis, Qi stagnation, phlegm, dampness, and others can be identified as causative factors in the blockage. Thus, the central therapeutic goal of tuina is to remove energetic blocks which lead to Qi stagnation. This leads to increased circulation and reduction of localized edema, which helps to reduce associated pain.

Chinese massage therapy (referred to as tuina) is commonly defined as the ancient healing art of fingers and strength. Tuina has been practiced in China for over 5000 years. It is a well-respected treatment modality known to be helpful and safe for a wide range of conditions. For these reasons, it is rapidly gaining international favor . Tuina involves a wide range of technical manipulations conducted by a practitioner’s finger, hand, elbow, knee, or foot applied to muscle or soft tissue at specific body locations. It incorporates many of the principles of acupuncture including the use of acupoints. For instance, tuina often uses manual techniques such as pushing, rubbing, kneading, or high-intensity, high-frequency patting to clear energy blocks along specific meridians associated with particular conditions .

At present, Chinese massage therapy is widely accepted as a complementary and alternative medicine modality. Its efficacy has been demonstrated for the management of many medical and psychiatric conditions. These include, but are not limited to, failure to thrive in preterm infants, major depressive disorder, substance abuse and dependence, pain syndromes, and immune and autoimmune conditions. Massage therapy has been shown to be particularly effective for disorders of musculoskeletal origin. 

When alternative therapies are used in conjunction with conventional medicine, it is called complementary medicine. Alternative therapy encompasses a variety of disciplines, including acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage and many others.

In the past ten years, strong evidence has been gathered for the benefits of mind-body therapies, acupuncture, and some nutritional supplements for treating pain. Other alternative therapies such as massage, chiropractic therapies, therapeutic touch, certain herbal therapies, and dietary approaches have the potential to alleviate pain in some cases. And there has been a growing acceptance of the benefits of mind-body therapies, acupuncture, and some nutritional supplements for treating pain. Other alternative treatments such as massage, chiropractic therapies, therapeutic touch, certain herbal therapies, and dietary approaches have the potential to alleviate chronic pain.

Massage is a therapy in which muscle and connective tissue are manipulated to enhance function of those tissues and promote relaxation and well-being. Massage is being increasingly used by people suffering from pain, mostly to manage chronic back and neck problems. Massage can reduce stress and relieve tension by enhancing blood flow. This treatment also can reduce the presence of substances that may generate and sustain pain. Available data suggest that massage therapy holds considerable promise for managing back pain.A recent study found that one weekly massage over a 10 week period improved pain and functioning for people with chronic back pain.Chiropractic treatment is the most common non-surgical treatment for back pain. Improvements in people undergoing chiropractic manipulations were noted in some trials. Research also suggests that chiropractic treatments may be helpful for headaches, neck pain, certain arm and leg conditions, and whiplash. Serious complications such as stroke, pinched nerves and worsening of herniated discs have been rarely reported.

If your doctor does determine you have a lumbar strain, conservative treatment is generally recommended. Recovery time can be anywhere between a couple of days to many weeks, but it’s important to allow your back strain to heal properly to avoid chronic back pain or permanent injury.

Symptoms for lumbar strain include pain and stiffness in the back, pain in the buttocks and legs and often in the back of the thigh, and pain that is more severe when bending, stretching, coughing or sneezing. If you experience numbness or weakness in your legs or bowel or bladder problems, you should get immediate medical attention because these symptoms could be a sign of nerve damage.

Common low back strain will generally heal naturally, but there are some things you can do to speed the healing process. You should warm your back as soon as possible to reduce pain and swelling. Generally about 20-30 minutes every 3-4 hours is recommended for the first 2-3 days. After the first few days, Apply a heating pad or warm herb pack to help relax your muscles and increase blood flowing to the affected area.

There are a few things you can do to avoid low back strain. One is to avoid lifting heavy objects, and when you do lift always try to bend at your knees, not at the waist. If you’re overweight, talk to your doctor about a safe weight-loss program. Always practice good posture and when sitting make sure your back is resting against the back of the chair. And avoid sleeping on your stomach; sleep on your back or your side and wedge a pillow under your legs for support if needed.

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