Volume 13, Number 4 | Winter 2018

Clinical Report (Acupuncture)
A Case of Low Back Pain

Case Study
75 year old man
Akio Manabe

Acupuncture & Moxibustion Care Unit of East Asian
Traditional Medicine,
Ehime Prefectural Central HospitalFirst visit:
May 11th of X year
Chief complaint:
Left lumbago, right buttock pain, stiff neck(started from June of X-1 year)

Introduction
When we diagnose and treat our patients, wePast History:emphasize on the time series data obtained frompatient's life and medical history.

By writing theinformation in the Chronological Chart (Fig.1), we
can find the relation between patient's life eventsand their chronic health problems and will be able tounderstand them structurally. This understanding isOtitis media operation and tonsillectomy in hischildhood, decompression surgery for trigeminal
neuralgia in his 49 year old, hemorrhagic
operation in his 60 year old, treatment ofhypertension in his 69 year old, shingles on theright front forehead in his 71 year old.

comprehensive and useful for planning MITATE(diagnosis, treatment and prognosis) that weemphasize.

Figure 1
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

9Volume 13, Number 4 | Winter 2018

Present illness:
In June of X year, he went to see an orthopedic
doctor because he bruised the waist when heassisted his mother taking bath. He wasadmitted to the hospital because of a first lumbar
compression fracture for 40 days. After thedischarge his muscular strength fell down andhe had a lumbar pain and right buttock pain
while he bent or stood up. The orthopedic doctor
mentioned the reason not of lumbar fracture butof the muscle pain. He remembered that he wastreated well his right elbow pain in ouracupuncture and moxibustion care unit, so hedecided to come to see us again.
Living conditions:
He was running a company with wife and taking
care of a 95 year old mother living in theneighborhood in the same town.
Present status:
His height is 167cm and his weight is 67kg. His
blood pressure is 137/84mmHg(pulse 71c/s) andcontrolled well with telmisartan 40mg/day.
Subjective problem:
Severe coldness in his toes

Objective findings:
Straight leg raising and femoral nerve stretching
tests are within the normal range
Oriental medical findings:
Tongue diagnosis;
purple colored, extended sublingual veins,swelling tongue and tooth impression
Pulse diagnosis;
sunken pulse
Abdominal diagnosis;
umbilical tenderness and resistance near
ST27, weakness of the lower abdominal

region.

This means Kidney qi deficiency
Back diagnosis;
Small superficial vessels near GV4.
This means traumatic blood stagnation also
his many operations history.
Pressure sensitive hardening near BL17,
Pressure sensitive depression near GV11・GV12. This means somatoform disorders
caused by the life stress of taking care of hismother. Treatment: (Fig.2)

Figure 210(Fig.2)

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

Volume 13, Number 4 | Winter 2018

Our treatment for this patient is mainly as

Conclusion

follows.

When we treat our patient we emphasize on1)

The traumatic blood stagnation was treatedtheir constitutional condition such as; traumaticby bloodletting of small superficial veinsstagnation, qui deficiency, and somatoform

near 命門(GV4).

disorder. These basic treatment prevent theThe Kidney qi deficiency was treated byrecurrence of their disease. As for this kind ofmoxibustion on the top of needle near CV4.

diagnosis,

The somatoform disorder was treated byprevention) we call them together MITATE.

2)
3)

treatmentandprognosis(ordirect moxibustion on GV11・GV12.
4)

Moxibustion to right buttock pain, The pintof ONODERA buttock points.
The pint of ONODERA buttock points aregood for lumbago as well as stomach pain.

5)

The herbal medicine keishibukuryogan wasused

becauseof

thetraumaticblood

stagnation.
Clinical course:
The patient was treated every 2-4 weeks. Fourweeks after the first visit, left lumbago pain
decreased from 10 to 5 in numeric rating scale(NRS) and right buttock pain decreased from10to 5.
After 3 months, the degree of left lumbago pain
decreased from 5 to 1, the right buttock was
painless and only dull feeling.
After treating for about a year, patients wereable to continuing self medication of moxibustion
at home, so treatment was terminated.

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

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