Volume 13, Number 1 | Spring 2018

Clinical Report (Acupuncture)
Two Cases of Low Back Pain / Sciatica Improved by
Meridian Therapy
Michihiro Baba
Baba Kaiseido Acupuncture Clinic

excess of the gallbladder channel. Otherwise a mild
degree of liver deficiency and stomach channel
excess was observed.
[Treatment plan]
Based on the principles for reinforcement andreduction of deficiency and excess, deficiency of theI. Preface

kidney channel was tonified and excess of theMeridian therapy we perform is based on a system

gallbladder channel was reduced.

where we determine the state of deficiency or excess[Treatment]

according to the three bilateral radial pulses andTonifying with single short needle insertions at KI7,

tonifyorreduce

accordingly

been

KI10, LR8, BL23. Reduction at GB31, ST37, BL19

established in the 1930th by Sorei Yanagiya and Sodo

andhasand BL21. Moxa with paper mats were used for theOkabe. The author has used this method inherited

moxibustion, applying 5 half-rice grain sized cones

from his predecessors for his acupuncture andeach at BL23, KI7, LR8 and GB31.

moxibustion treatment for approximately 20 years.

[Course]On this occasion I would like to introduce theUpon his visit for the second treatment session

treatment we routinely use to treat low back pain.

(April 17) the lancinating pain had subsided. Since

Here I will briefly show some cases and explain thethe pulse revealed that the kidney deficiency andsignificance of the points we use for our standard

gallbladder excess still remained, we administeredtherapy.

the same treatment as before.
During the patient's visit for the third treatment

II. Casesession (April 20) the patient reported almost no[Case No. 1] 67 years, male, 170 cm, 63 kg

pain and intended to go and play golf the following[First visit] Year X, April 14week. The gallbladder pulse had significantly[Chief complaint] Low back pain

improved.

[Present illness]

During the visit for the fifth treatment session (MayFive days ago the patient went shellfish gathering10) the patient reported having been able to play golf

and spent a prolonged time with his back bent. On

the other day and apart from some tension had nothe following day (4 days ago) low back pain

low back pain. The pulse diagnosis revealed only adeveloped. After awaking in the morning and rising,slightly concerning degree of kidney deficiency.

bending forward triggered lancinating pain. It was

On July 28 of the same year he visited our clinic

stronger on the right than on the left side. There was

because of a common cold and reported being free ofno associated leg pain. The patient suffers from low

low back pain.

back pain about once a year, but the pain has never[Discussion]

been this intense before. He did not visit any medical

Pulse diagnosis revealed for this patient a kidney

facilities like an orthopedic clinic.

channel deficiency and a gallbladder channel excess,[Past history]

so that we chose a standard set of acupoints for the

He is on hypotensive medication. At home blood

treatment, which then led to a recession of thepressure is stable at an average ofsymptoms. If low back pain is the chief complaint,

120/70 mmHg.

[Oriental medical diagnosis]

recovery of the kidney channel deficiency and a

Diagnosis of the three bilateral radial pulses shows

gallbladder channel excess revealed by the pulse

a marked deficiency of the kidney channel anddiagnosis represents one indicator. Further, in cases

14

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

Volume 13, Number 1 | Spring 2018of severe pain the left guan (bar) pulse tends to show

[Treatment]

an excess pattern. In this cases present basically asTonification at KI7, KI10 and BL23. Reduction ata kidney deficiency pattern, making it highly

GB31,

possible that insufficient tonification of the kidney

Moxibustion at BL23, KI7, GB31 and LU6, applying

channel results in recurrent attacks of low back pain.

5 cones each (10 cones only at KI6).

The present case was considered to be such a typical

Course: Second session (July 8), no change.

example.

Third session: (July 10) too no change.

ST37,

LU6,

BL21,

BL19

andBL13.

Walking had become slightly easier after the[Case No. 2] 78 years, male, 159 cm, 50 kg

treatment of the fourth session (July 12). Four days

[First visit] Year X, July 4

later another nerve block injection was scheduled,[Chief complaint] Pain from the right buttock to thebut the patient now had doubts about it. He said, heright knee

does not want to receive injections because they hurt.

[Present illness]

After the fifth session (July 15) the orthopedist said

The patient took a leave of absence from work

after observing the patient's gait, that the condition(butcher) approximately 10 days earlier because of

had improved sufficiently and there is no need forsevere lancinating pain occurring when he puts his

any further injections. The patient continued to takeright foot down during walking and standing. Hethe analgesics though.

consulted two different orthopedists and wasWhen the patient consulted the physician after thediagnosed with a herniated intervertebral disk atseventh session (July 21) regarding his constipation,

L2-3 and received nerve block injections, but thesethe dose of the analgesics was decreased to half thewere not effective. He was told to have an MRI

original amount. Walking had become much easier.

examination on the following day. The physician

After the ninth (July 29) session walking was almost

administered several nerve block injections, butpain free and the patient discontinued the analgesics

since they were not effective, the patient was told toafter consultation with the physician. Since August

consider surgery. The patient also used analgesics,

the patient visited our clinic regularly because of his

but they too were not effective and only aggravatedkidney disease, but the severe pain did not recur andhis constipation, so that he did not want to use them.

he returned to work.

[Past History] On steroids because of kidney disease[Discussion](nephrotic syndrome).

When herniated intervertebral disks or spinal canal[Oriental medical diagnosis]

stenosis is associated with sciatica, it often takes

Diagnosis of the three bilateral radial pulses shows

between 1 and 3 months until an alleviation of thea marked deficiency of the kidney channel, excess of

pain is achieved. This was the case in this patient too

the gallbladder, stomach and lung channels. The

and although until the third session almost nopulse was overall floating and slightly rapid.

changes were achieved, we continued treatment[Treatment plan]maintaining the protocol of the first session. This

Based on the principles for reinforcement andpatient required some time to recover from thereduction of deficiency and excess, treatment

kidney channel deficiency, but the gallbladderconcentrated on tonification of the kidney channel,channel excess as a pain indicator actually did

while reducing the gallbladder, stomach and lung

improve faster than expected. That was consideredchannels.

to be due to the action of the simultaneously
administered analgesics. I have often experienced,
thattheadministration

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)ofacupunctureand15

Volume 13, Number 1 | Spring 2018

moxibustion treatment augments the effects ofmedications and this patient seemed to have beensuch a case. In case of low back pain or sciatica akidney channel deficiency is often the core of thecondition, but it is important to identify othersimultaneously manifesting excess patterns.
III. Conclusions
The two cases described here are representative forgeneral cases often encountered in my clinic. Pulse
patterns that need to be noted for the treatment oflow back pain and sciatica are "kidney channel
deficiency" and "gallbladder channel excess". Keep inmind, however, that besides those "liver channel
deficiency","stomachchannelexcess","largeintestine channel excess" and "bladder channelexcess" too often appear. The selection of acupoints
follows the pulse pattern. Basic points are thoseshown for the treatment in the case reports above. In
addition, KI10, EX-19, LI13 may also be reactive
points. Further, attention should also be paid toindurations in the area of the back transport point
group from BL23 to BL18 and if present, using thesepoints for the treatment.

16The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)