Senin, 16 Mei 2011

Acupuncture used for Low Back Pain and Hot Feet


Chief Complaint: lower back discomfort, hot feet.
Medical History: Female approx 50 + y.o.
Presenting Challenge: Discomfort in lower back last 12 months or so, can vary from sore or can’t get comfortable, to a sense of tired, weak. Also digestive challenges leading to diminished appetite pattern of irregular food intake due to varying work schedule.
Irregular menses last 2 years, last period 6mths or so ago.
Otherwise feels general health to be pretty good tho work schedules can be a bit taxing when busy.
Lifestyle: walks, nil cigs, very occasional social alcohol
Questioning exam: see above
Observation: palpation of lower back- it was hot to touch compared to the rest of this patient. Upon questioning also stated that she would get hot feet / sole especially at night.
Pulse: Xu at kidney, a little xu at Liver position and a sense of tight in the middle Jiao. Constitutionally pretty good
Tongue exam: see above
OM Diagnosis: Diagnosis: Kidney Yin Xu and Stomach /Spleen disharmony. I felt that with the correction of the middle jiao the blood would be better and with the improvement in the Kidneys then direct treatment of the liver was unnecessary
Treatment Principle: Rxp : Tonify Kidney Yin and harmonise mid Jiao to improve Transformation / transportation of acquired qi, blood etc.
Point Prescription: Treatment: My thinking here was that the Kidneys were in a little decline due to the natural aging process. This had been exacerbated by the middle jiao disharmony not allowing the correct transformation of acquired qi.
The essence cannot be replaced it can only be maintained through lifestyle therefore to Tonify the Kidney Yin when it is already depleted? My treatment was aimed at facilitating the process of transformation / transportation of acquired qi to assist in supporting the kidneys, build the blood and therefore assist in replenishing the Yin.
Initial Rx: Bl 17 and 20 needle moxa bilateral and Kid 3 (1)
Also some gentle advice re time needed to eat (without distractions), small meals regularly and to not skip breakfast, instead to start the day with porridge or congee.
The next two treatments continued in the same vein, the third treatment I used Cv 4, Cv 12, Lv 13 (2) and good old St 36 (2) needle and moxa.
It was noted at this stage that the lower back was no longer hot to touch and that the sense of tiredness in the back had reduced.
Treatment here moved to the penetrating and conception vessel alternated with the above two combinations. Kid 3 was replaced with Kid 1 on two occasions (needle moxa-
Yang creates Yin?)
Symptoms reduced as treatment progressed. A total of ten treatments in all two times per week and all presenting symptoms had gone.
I personally think that what is interesting in this case, though fairly simple, is that not once was the lower back itself treated with local points or points that would be “typically” used to treat lower back pain.
Herbal Formula: none used
Lifestyle Prescription: see dietary advice
Results: Symptoms reduced as treatment progressed. A total of ten treatments in all two times per week and all presenting symptoms had gone.
I personally think that what is interesting in this case, though fairly simple, is that not once was the lower back itself treated with local points or points that would be “typically” used to treat lower back pain.

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