One of the Most Important Hidden 

Causes of Back Pain

One of the most important things that I've learned in almost 15 years of practice is this: the location of one's pain is usually not where the actual problem is. Why? Your body is designed to compensate for injured areas. The injured areas themselves are usually relatively symptom-free because they are being compensated for (given a break) by another area of the body. The pain occurs in the compensating area is because it finally gets tired of doing more work than it is normally designed to do.

You will find that in these cases direct treatment to the painful area (for example, your back) will usually only result in temporary relief. But if the problem area is discovered and appropriately addressed then the pain will usually go away-- and stay away -- even if the painful area itself is was not touched at all!

The most common problem causing back pain

 

The Bowstring

 

"The bowstring" is a concept described by Rollin Becker, D.O. (one of the greatest osteopaths ever), to explain how abnormal tension in the front of the body can cause reciprocal tension in the back and the spine (eventually causing back pain), just as pulling on a bowstring puts additional tension on the bow. Releasing the abnormal tension in the front of the body results in a spontaneous release of the unnecessary tension in the back, in the same way that releasing a pulled bowstring lets the bow "relax". Then, usually over several days, the associated pain dissipates as the irritated tissues heal.

This abnormal tension can come from many causes. ALL auto accidents -- no matter how small -- are suspect (whiplash is not the only thing that happens during an accident). Taking a direct impact to the front of your body or getting the wind knocked out of you are also common causes. Abdominal surgery is another important cause.

This idea is not well known in the health field and it will be difficult to find someone familiar with treating bowstring injuries to help you (if you are unable to see me). One way is to find a body worker skilled in myofascial release and ask them if they will release the areas listed below: (bring them a copy of this article or the book mentioned below)

• The linea alba on the abdomen
• The respiratory diaphragm
• The scalenes and the anterior cervical fascia (in the supraclavicular fossa)
• The submandiublar fascia and digastric muscle (the soft tissue in the underside of the jaw)
• The masseter (chewing muscles)

This is only a short list meant to try to cover many different scenarios. The book Ligamentous Articular Strain goes into far more detail than I could here and contains an entire section on the bowstring concept.

By far, I find that most of the back pain I am successfully able to eliminate comes from abnormal tension found in the front of the body. The discovery of this hidden cause has contributed more than anything else to simple and permanent resolution of patients' back pain in my clinic.

Example Case Study:

 

A number of years ago a woman sought me out for relief of a bad case of sciatica, which is a nerve pain running through the buttock and, in her case, down the back of the leg. It is often caused by pressure on the nerve where it comes out of the spine or where it runs through the back and buttock muscles. This woman's sciatica was resisting treatment and the most significant events in her history were a number of c-sections, which of course are major abdominal surgeries. I treated only the scar tissue on the lower abdomen using myofascial release techniques and touched nothing else. The sciatica almost completely resolved after the first visit and completely resolve after the second visit. When this same woman saw me 4 or 5 years later for something else, she reported that the pain had never come back since that second treatment. Releasing the scar tissue on the lower abdomen had allowed the abdominal muscles to function more normally, releasing the pressure on the back that was affecting the sciatic nerve.

If you are experiencing back pain that is not resolving with traditional approaches, consider this approach.

Did you know that in Chinese medicine it is not recommended to ice your injuries?

Ice is an unquestioned standard treatment for injuries, but there are actually some significant problems with its use. While it is true that ice does reliably reduce inflammation, the way it does so actually interferes with complete recovery and leaves one susceptible to further injury. It is very common for there to still be puffiness around a joint as much as 6 months to a year (or even years!) after it was injured, and for the patient to report that normal use was never fully recovered. According to Chinese medicine, icing injuries can also even set the stage down the road for degenerative conditions such as arthritis.

How does icing cause these problems? 

 

As described in A Tooth from the Tiger's Mouth, a book about the Chinese medicine approach to treating sports injuries, an injury disrupts the normal flow of blood and fluids the way a dam obstructs the flow of water through a stream. This results in a swollen area of stagnant fluids above the obstruction, which interferes with the normal movement of energy through the tissues causing them to heat up and turn red -- inflammation and pain. Icing cools tissues and causes tiny blood vessels to contract, reducing the flow of blood and fluids into the injured area, reducing swelling.  This is like shrinking a stream to reduce the size of a pond behind a dam.   

The problem with this approach is that it does not get rid of the dam itself, the obstruction caused by the injury. The obstruction remains and  gradually thickens, interfering with full healing and normal function. Eventually, this can cause the affected tissues to start slowly breaking down and, in some people, lead to arthritis.

Treating injuries with Chinese medicine

 

The Chinese medicine approach is to break up the obstruction and the swelling will naturally drain, reducing pain. This keeps the circulation of blood and fluids normal, allowing for full healing and restoration of normal function. Acupuncture, acupressure and herbs are all used in Chinese medicine to break up obstructions caused by injury. This can be started immediately after the injury and it is never too late to address an injury that is still causing problems. Treating recent injuries is relatively simple and much can be done with some basic home remedies. You may want to keep some of these remedies around should you need one:

• Arnica creme is a homeopathic remedy that breaks up obstructions caused by injury and is the premier homeopathic remedy for pain, swelling, bruising and inflammation that accompany injury. Do not use arnica creme over broken skin. Traumeel ointment is a homeopathic formula containing arnica that can be used instead. Arnica creme and Traumeel can be purchased at any health food store, such as Whole Foods.

• Rhus Tox, another homeopathic remedy, is appropriate when there is a sprain or strain. 3-4 pellets of the 6X or 6C potency can be taken as often as every hour or two the day of the injury and 3-4 times a day after that. Rhus Tox can be taken the same time as arnica if needed. Rhus Tox can be purchased at any health food store, such as Whole Foods.

• Epsom salts soak is a time honored remedy for soreness, swelling and inflammation. Follow the directions on the box for making a soak and soak the injured part at least once a day the first 3 days of the injury and once a day after that. Epsom salts can be purchased at any grocery store.

• San Huang Gao is a Chinese herbal poultice that can be ordered from Kamwo Herbal Pharmacy (click on link) and is the premier herbal formula for treating fresh injuries. It is a paste that is spread over the injured site and covered with a medical pad, gauze or  a paper towel and wrapped (not tightly) with an ace bandage to hold in place. San Huang Gao can be left in place for as long as 12 hours before being renewed. San Huang Gao is generally discontinued after 3 days.

• Yunnan Baiyao Plaster is an excellent all-around Chinese herbal plaster, similar in action to San Huang Gao, but not as strong, that is more convenient to use. Simply gently warm against your body until softer, peel off the cellophane and apply over the affected area. You can leave a plaster on for up to 12 hours at a time. Yunnan Baiyao  Plaster is particularly effective when there is a lot of bruising with the injury. Available at Kamwo (click link).

• Wu Yang Plaster is a Chinese herbal plaster that is good for sprains. San Huang Gao is more effective, but Yunnan Baiyao is more convenient, especially for use on the back, where applying a paste and securing a covering is more difficult. Many people who sprain their backs easily keep a supply of Wu Yang plaster around. Use the same way as Yunnan Baiyao plaster. Available at Kamwo (click link).

Acupuncture and/or acupressure can also substantially reduce the swelling and pain of a recent injury. A skilled acupuncturist who is experienced in treating injuries can make a big difference, especially with a particularly bad injury.

You may need to seek the services of a acupuncturist experienced in treating injuries to help a particularly bad injury finish healing. Treating older injuries can be a bit complex, so it is recommended that you find an acupuncturist experienced in treating old injuries to sort out what needs to be done to fully resolve the old injury. You're welcome to drop me a line if you have a question about treatment.

Using these strategies can help you have a much quicker and more complete recovery from an injury such as a sprain, strain or a bad bruise.  So, if someone tells you that you should ice your recent injury, follow Nancy Reagan and just say "No!"

Welcome!

Welcome to the blog for Robert V. Clickner, Lic.Ac. (Licensed Acupuncturist) here in Charlottesville, VA!  This is a blog dedicated to sharing insights and information to help you in your search for health and healing.  Over the years I have come across many different things, many not commonly known, that have helped many people obtain better health.  I have always wanted to be able to share these things with a wider audience than just those who have come into my office for an appointment.  I have also wanted to have a resource for those who want to review something that was covered during their visit or to learn about something relating to a different health issue than we covered in clinic.

Over the years my research for answers to the health problems my patients were bringing me took me in many different directions.  I noticed, over time, that there was a quiet little voice inside me that would "speak up" when I came across something that I would find out later was important.  It reminded me of the description Socrates gave of the "inner voice" that guided him from childhood.  I was taught to trust and listen to that inner voice (which I believe comes from God) as it seemed to direct me towards certain things to learn about and study and away from other things.  It was always interesting to see how the new information or concept would come into play in clinic to help someone -- or many people.  Sometimes years go by between when I get the nudge to hold on to an idea or piece of information and when it is needed in clinic!  I often didn't know why I was given the nudge to hold on to something, but I knew enough to do so and it has been an adventure!

I plan to share ideas and insights across a wide range of topics related to health and I hope that over time I am able to provide you with something that will help you.  If you don't see what you are looking for in the blog, please contact me to let me know what you are looking for.  If you are not already a patient of mine and are interested in my services, please check out my website for more detailed information on my practice, including testimonials, and how to make an appointment.  Feel free to visit my Facebook page for more interesting health related posts.  Please share this blog with your friends and family who may also be looking for answers to their health concerns.  I will do my best to help them.

Thank you for visiting my blog and I hope that you enjoy it!

Bob Clickner, Lic.Ac.

P.S.  If you are interested in finding out more about how you can learn to follow that inner voice as I described above, go to Uplift with Dreams to find out about retreats and workshops that specifically teach this.  Each of us has this innate ability and only needs to be gradually shown how to use it accurately.  This process starts with studying your dreams and learning to understand what you are being shown through them.  Uplift With Dreams offers Dream Study retreats and workshops and more to give the seeker the knowledge and experience they need to become proficient in this ancient art form.