Chronic Low Back Pain — When Your Back Has Hurt for Over 3 Months
Table of Contents
The complexity of chronic low back pain
Chronic low back pain is back pain lasting more than 3 months. It is a complex state that goes beyond simple musculoskeletal problems, involving central sensitization, psychosocial factors, and constitutional weakness. About 20% of all back-pain patients progress to chronic pain. In Korean medicine, it is differentiated into kidney-deficiency low back pain (sin-heo yo-tong, 腎虛腰痛), blood-stasis low back pain (eo-hyeol yo-tong, 瘀血腰痛), and damp-phlegm low back pain (seup-dam yo-tong, 濕痰腰痛).
Korean medicine pattern differentiation
- Kidney-deficiency low back pain (腎虛腰痛): The lower back feels cold and weak and worsens with prolonged standing. The knees also weaken and frequent urination at night is common. Right-Restoring Pill (Ugwihwan) is used for kidney-yang deficiency, while Left-Restoring Pill (Jwagwihwan) is used for kidney-yin deficiency.
- Blood-stasis low back pain (瘀血腰痛): A fixed, stabbing pain at a specific spot, worsening at night. It often results from tissue adhesions following trauma or surgery, and the principle of resolving blood stasis (hwalhyeol-geo-eo) is applied.
- Damp-phlegm low back pain (濕痰腰痛): The back feels heavy and dull, and worsens on rainy days or in damp environments. It reflects fluid-dampness stagnation in the lower jiao due to weakened spleen-stomach function.
Combined treatment strategy
For chronic low back pain, an integrated approach combining several treatments is more effective than any single therapy.
- Kidney-tonifying herbal medicine: Strengthens kidney function, the root cause of chronic back pain. Tonic herbs such as Eucommia (duchung, 杜冲), Dipsacus (sokdan, 續斷), and Cibotium (gucheok, 狗脊) are blended according to the patient's constitution.
- Acupuncture and electroacupuncture: Needling Shenshu (腎兪, BL23), Dachangshu (大腸兪, BL25), and Yaoyangguan (腰陽關, GV3) 2–3 times a week activates pain-modulating circuits.
- Chuna manipulation: Restores mobility to chronically stiffened lumbar segments and corrects pelvic asymmetry.
- Moxibustion (灸): Warm moxibustion at Shenshu and Mingmen (命門, GV4) tonifies kidney-yang and promotes blood flow to the lower jiao.
Central sensitization and psychological care
Chronic pain involves not only peripheral tissue problems but also a sensitized central nervous system that amplifies pain signals. Reducing excessive fear-avoidance behavior and gradually increasing activity (graded activity) to restore daily function is the key to long-term management.