Volume 12, Number 4 | Winter 2017

Clinical Report (Acupuncture)
Kidney Deficiency Low Back Pain

Past history: He was diagnosed with tinnitus inOtolaryngology.

Masanori Takashi and Makoto Arai

Present status: Height: 175cm; Weight 77kg BMI 25.1;

Tokai University School of Medicine

Low back pain Vas 67mm, SLR negative, ATR normal.
There is a reaction to KI3 太渓 and BL26 関元 Pulse:

Introduction: Low back pain is the most frequent

string-like, Tongue: dark pale tongue, tongue fur: Few.

complaint among Japanese people according to theTCM diagnosis: Kidney deficiency

Basic survey of national life1) . The prevalence of low

Therapeutic principle: Tonifying the Kidney

back pain was 38% in 2016, which means one in

Adjust Acupuncture Point: BL23 腎兪・BL18 肝兪・three Japanese had low back pain2). Among them,KI3 太渓・RN4 関元・ST36 足三里・SP6 三陰交

nonspecific low back pain accounted for 80% to 90%3).

(Figure 2)

Sixty% of patients who visited clinic of acupuncture
and moxibustion complain low back pain the mostfrequently.4)
This paper describes a patient with “non-specific lowback pain” treated from the TCM.
Case: 29-year-old male, blasting technician
Chief complaint: Low back pain
Present illness: He had discomfort in his waist three
years ago, and coped with it by acupuncture andmassage. He felt strong low back pain when hechanged his position. and He felt tinnitus one yearago. He visited an orthopedic surgery of the General
Hospital. However, he remained undiagnosed evenafter he had a detailed examination. (Figure 1)

Figure 2

Figure 1
His pain was deteriorated in sitting position twomonths ago. That pain didn’t let him work. He finallycame to my office.
Systemicsymptoms:Tinnitus.

Theurinary

Figure 2

frequency was 10 times a day and once a night.

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Volume 12, Number 4 | Winter 2017

Explanation: BL23 腎兪・BL18 肝兪・KI3 太渓・ST36

Treatedwiththesameacupuncture

Points,

足三里・SP6 三陰交 were subjected to the Tonification

expression of the low back pain on the VAS waswith twirling. RN4 関 元 were subjected to the

53mm immediately after the second session.

purgation with lifting and thrusting. BL23 腎兪 andThird session:KI3 太 渓 were contemplated to the tonifying theExpression of the low back pain on the VAS wasKidney. I also added RN 4 関元 and performed both65mm. After the treatment, he told that thethe yin and yang of the kidney. Also added BL18 肝treatment eased dull pain of his low back. Actually,兪 for Homogeny of Liver and kidney. And tried toexpression of the low back pain on the VAS wasstrengthen yin of the kidney. St36 足三里 and SP6 三50mm. However, the symptom relapsed on the next

陰交 combined to boost qi and blood production.

day of the third session. The same treatment with

The needle used: Seirin-made sterilized acupuncture

acupuncture Points was given.

needle, length1cun6fen, No. 1

Forth session:

Treatment progress: Treatments were administered

Expression of the low back pain on the VAS before

once a week.

the forth session was 63mm. After the treatment,

Course: (Figure 4)

expression of the low back pain on the VAS wasFirst session: KI3 太 渓 made a slow stimulus in

50mm. The effect had lasted for three days. The

Tonification with twirling. Rn4 関元 also warmed up

effect had lasted for three days. The patientElectronic moxibustion device. Immediately after

complained of a dull pain in his low back three days

the treatment, expression of the low back pain on theafter the forth session. Expression of the low back

VAS was 55mm.

pain on the VAS was 54mm at that time.
Fifth session:

VAS
㎜ 100
80Expression

CoursePresbycusis VAS
Low back pain VAS

thelow back pain on theVAS before the fifthsession was 50mm.

506753After the treatment,

45656355606350

expression of the low50 50
42 4040362540

363520202030
1920back pain on theVAS was 42mm. He

2715

told me that he had

1000

befor after beforafter beforafter befor after befor after befor after befor after beforafter beforafter befor after befor after befor afterFirst

SecondThird

Fourth

Fifth

Sixth

SeventhEighthTenthsessionthirteenth fifteenth twentieth

Low back pain
treatment

symptoms

oftinnitus

andpresbycusis for one
month. I asked him

Presbycusis treatment

detailed

Figure 4questionsabout his symptoms
again.

Hehad

suffered from tinnitus and presbycusis for three

Second session:
Expression of the low back pain on the VAS was
63mm on the following day of the first session.

18ofyears. However, he did not visit a clinic because hethought it would be due to his work environment
where great noises always pealed out. It was two

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017

years ago that he finally visited a hospital. He had aexpression of the low back pain on the VAS wasdetailed examination, however, the cause of these

20mm. His symptoms weresymptoms were still unknown. He had visited theEighth session:

hospital for six months, however, his symptoms were

The dull pain in the low back became strong last

not improved. His symptoms of tinnitus hadweek. Expression of the low back pain on the VAS

deteriorated for one month. The patient was referred

before the fifth session was 35mm. After theto Otolaryngology. He had a detailed examination

treatment, expression of the low back pain on theagain, however, the cause of these symptoms were

VAS was 20mm. Expression of the tinnitus andstill unknown. (Figure3)

presbycusis on the VAS was 50mm. The induration

improved tendency.

of KI3 decreased by 40%. The same treatment withAcupuncture Points was given.
Tenth session:
Expression of the low back pain on the VAS before
the fifth session was 36mm. After the treatment,
expression of the low back pain on the VAS was
19mm. Expression of the tinnitus and presbycusis on
the VAS was 50mm. The same treatment withAcupuncture Points was given.
Thirteenth session:
Expression of the low back pain on the VAS before
the fifth session was 35mm. After the treatment,
expression of the low back pain on the VAS was

Figure 320mm. Expression of the tinnitus and presbycusis on

He aspired to be given acupuncture and moxibustion.
Expression of the tinnitus and presbycusis on theVAS was 50mm. Tinnitus and presbycusis wereconsidered kidney essence insufficiency pattern/syndrome. The treatment was added to the SI19 聴宮 and GB2 聴 会 .Adjust Acupuncture Point was
BL23 腎兪・BL18 肝兪・KI3 太渓・RN4 関元・ST36
足三里・SP6 三陰交・SI19 聴宮・GB2 聴会.
Sixth session:
There was no abnormality in the examination of thehearing loss. Expression of the tinnitus andpresbycusis on the VAS was 50mm. Expression of thelow back pain on the VAS before the fifth session was40mm. After the treatment, expression of the lowback pain on the VAS was 36mm.
Seventh session:
Expression of the low back pain on the VAS before

the VAS was 45mm. The same treatment withAcupuncture Points was given.
Fifteenth session:
Expression of the low back pain on the VAS before
the fifth session was 27mm. After the treatment,
expression of the low back pain on the VAS was15mm. Expression of the tinnitus and presbycusis on
the VAS was 40mm. The same treatment withAcupuncture Points was given.
Twentieth session:Expression of the low back pain on the VAS before
the fifth session was 10mm. After the treatment,
expression of the low back pain on the VAS was 0mm.
Expression of the tinnitus and presbycusis on theVAS was 25mm.
Because of the work transfer therefore treatment
was ended.

the fifth session was 40mm. After the treatment,

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Volume 12, Number 4 | Winter 2017

Discussion:

Reference

It is said that nonspecific low back pain repeats the1) https://www.mhlw.go.jp/toukei/saikin/hw/k-deterioration and improvement over a long period oftime once it emerges. Nonspecific low back pain isstrongly involved in psychosocial elements. It has

tyosa/k-tyosa16/dl/04.pdf
2) Yoshimura N, et al.: Prevalence of knee pain.
humbar pain and its …

been reported that those patients may have3) masatoshi TERAGUCHI et.al.: Epidemiology ofsymptom of depression.5) In this case, we planned an

Low Back Pain from The Wakayama Spine Study,

Oriental Medicine(TCM) treatment because theClinical orthopedic surgery, 52(12), 1125-1131,

patient

2017hasfewpsychologicalandorganic4) TAKANO Michiyo et al.:A Cross-sectional Sarvey

observations.
According to 『 Suwen 』 Chapter 17, there is theofrelationship between the waist and the kidney.

Treatment in Japan, Zen Nihon Shinkyu Gakkai

lumbar area is the residence of the kidney. If it canZasshi, 52(5), 2002,

not be turning, the kidney energy has been

Patient

Safisfacfion

afterAcupuncture5) HARA Yoshihiro: 原 慶 宏 : Discrimination fromexhausted.6)

diagnosis of low back pain, Diagnosis andHearing loss and tinnitus are described in 『Lingshu』

treatment 98(6): 1023-1027, 2010

Chapter 37 in which the relationship between the6) Yellow Emperor’s Canon of Internal Medicine

kidney and the ear.7) As for the function of the ear, it(Huang di nei ching Suwen 黄 帝 内 経 素 問 )is described that the enhancement of renal care is

Chapter 17 The Essentials and Fandamentals ofinvolved in the auditory function of the ear in

Diagnostic Palpation 脈要精微論 (in Chinese)『Lingshu』Chapter 17.8) These symptoms may be7) Yellow

Emperor’sCanonofInternal

attributed to his work environment in which he hadMedicine(Huangdi Neijing Lingshu 黄帝内経霊been continuing to hear the large sound. Frequent枢) Chapter 37 Determining the Conditions ofurination and nocturia are lack of harmony of

the five viscera by Examining the Five Sense"opening and closing" of bladder due to a decrease ofOrgans 五閲五使篇第三十七 (in Chinese)

activities of kidney-Qi. "opening" is to excrete extra

8) Yellow

Emperor’sCanonofInternal

water and waste products. "closing" means keeping

Medicine(Huangdi Neijing Lingshu 黄帝内経霊the water in the body constant and recycling. Due to枢) Chapter 17 The Length of Channels 脈度篇第abnormality of activities of kidney-Qi, the symptoms

十七 (in Chinese)such as edema, urinary incontinence, frequenturination appear.
As we did the treatment to him, the difference
between the VAS before the treatment and afterbecame bigger. This result may suggest that it isimportant for patients with low back pain thetreatment like this case to get treatments severaltimes.
*This case report is a result of slight modification towhat was published in "The Journal of Kampo
Medicine" (Japanese edition)" Vol.59 No 10

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The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)