Chronic lumbar muscle strain is caused when the lumbar muscles are intensely strained in a continuous or repeated way within a short period of time, which exceeds the physiological endurance and, therefore, results in a chronic aseptic inflammation in the lumbar muscular fibers. The occurrence of the illness is closely related with the damp room one lives in or damp ground one  lies or sits on. It manifests itself in a long-time pain in the lumbus of one side, which will e aggravated when the patient is tired, but relieved when he has some gentle activity.

Main Points of Diagnosis

1. The patient has a history of acute lumbar muscle strain which has not been well treated, lingered for a long time and become chronic, or has a history of chronic labour strain which is often seen in doctors or other workers whose backs bent for a long time and sportsmen whose lumbuses have over fatigued.

2. The patient has aching pain, stabbing pain or dull pain in the lumbus which can radiate to the buttocks and the posterior sides of his lower limbs. The pain is obvious after the patient has got up in the morning and relieved after he has done some activity and aggravated when he is fatigued. The pain becomes severe in cold condition and alleviated in warm condition.

3.There is a deep tenderness in one side or both sides along the lumbar region. The pain is aggravated when the patient bends his back. There is a limit t the lumbar movement of flexion, extension or bending sideward.

4. X-ray film helps the differential diagnosis of the illness.  

Differentiation and Treatment of Common Syndromes     

1. Herbal Therapy according to Syndromes.

1) The Type of the Stasis of Blood and Qi and the Obstruction in the Channels and Network-Channels.

Main Symptoms and Signs: The illness has a long duration. The patient has stabbing pain in the lumbus which occurs at a fixed location. Part of the lumbar muscles feels hard and the lumbus becomes rigid and contracted. It will become better after some gentle activity and aggravated when in fatigue. The tongue looked dark with petechiae or ecchymoses on it. The pulse is taut and uneven.

Therapeutic Principle: Relaxing muscles and tendons, activating collaterals and promoting the flow of qi and blood.

Recipe: Decoction for Regulating and Activating the Channels

tail part of Chinese angelica root

red peony root

peach kernel

safflower

pubescent angelica root

achyranthes root

rhubarb

cinnamon twig

All the above herbs are to be decocted in water for oral administration.

2) The Type of Chronic Strain Complicated with the Affection due to Wind, Cold and Dampness

Main Symptoms and Signs: There is chronic lumbago which is sometimes mild and sometimes sever and which is characterized by distending pain, sensation of heaviness and discomfort due to muscular contracture. This illness is relieved in warm weather and aggravated in cold weather.

Therapeutic Principle: Relaxing muscles and tendons, removing obstruction in the collaterals, expelling wind and cold and removing dampness.

Recipe: Pubescent Angelica and Loranthus Decoction.

3)The Type of Chronic Strain Complicated with Deficiency of the Liver and Kidneys.

Main Symptoms and Signs: The lumbago is lingering. The patient feels soreness and weakness of lumbus and can't stand on his feet for long. The illness becomes severe when the patient is fatigued. The patient looks pale. He is in low spirit and has spermatorrhea and prospermia. The female patient may have scanty menstruation. The tongue of the patient is pale with white fur. The pulse is deep and feeble.

Therapeutic Principle: Relaxing muscles and tendons, activating collaterals and tonifying and replenishing the liver and kidneys.

Recipe: Decoction for Tonifying the Kidney and Strengthening the Muscles and Tendons

prepared rehmannia root

dogwood fruit

eucommia bark

Chinese angelica root

poria

white peony root

achyranthes root

carbonized Sichuan dipsacus root

acanthopanax bark

green tangerine orange peel

All the above herbs are to be decocted in water for oral administration

2. Other Treatments

Acupuncture, massage, etc. can be employed as auxiliary treatments.  

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