Low Back Pain, Lumbago

General

Clinical Manifestations
Treatment Principle
Herb Formulas	With lumbar spine deformities and/or a herniated disc: Lu Jiao Jiao Tang
Points	GB-26, GB-30, ST-31, UB-22, UB-25, UB-52 KI-4, SP-2, SP-6, SP-9, SP-11, UB-23, Yaoyan Ahshi, DU-4, UB-23, UB-24, UB-25, UB-26 DU-1, DU-2, ST-3, ST-30, UB-13, UB-28, UB-31, UB-34 UB-23, UB-36, Yaoyan GB-25, SI-6, UB-18, UB-23, UB-40 UB-2 Ahshi, DU-3, DU-4, Huatuojiaji, UB-23, UB-24, UB-25, UB-52, Yaogen Moxa or moxa needle DU-3, DU-4, Shiqihuixia, UB-23, UB-25, Yaoyan Moxa 5 cones on DU-2, UB-23, UB-29 Acute: DU-26, SJ-4, UB-23, UB-40 Cup: 1. DU-3, UB-23, UB-32 2. UB-23, Yaoyan Ear: Lumbar, Lumbago, Adrenal, Shenmen, Subcortex Distal points for acute pain: needle or bleed UB-40, UB-58, UB-59 For acutely distressed who cannot comfortably flex, extend or lie down: LI-4, LIV-3 (needle while patient is lying supine with a pillow under the knees) For pain centered on the midline: DU-26 (needle while patient is sitting or walking, while gently flexing and extending) For one-sided pain that inhibits mobility: Yaotong #1, Yaotong #2, Yaotong #3, (choose the most tender points and needle while patient is sitting or walking, while gently flexing and extending) For low back and neck pain: UB-60 For pain radiating down the Bladder channel: UB-36, UB-37 For buttock or sciatic pain: GB-30 For pain radiating down the Gall Bladder channel: GB-31, GB-34 For pain radiating out from the midline: SI-3, UB-52 (on the affected side) For acute central low back pain pain: DU-3, DU-4, SI-3, UB-40 For acute lateral low back pain pain: SI-3, UB-23, UB-40 Common local points for acute pain: Ahshi Points (points of tenderness), UB-23, UB-25, UB-28, Shiqizhuixia For pain due to extreme Cold: moxa or moxa needle DU-2, DU-4, GB-30, UB-23, UB-31, UB-40, UB-52, UB-57, UB-60 With inability to straighten up: GB-38, LIV-5, ST-33, ST-36 With stiffness: 1. DU-1, DU-2, DU-6, DU-11, REN-9, UB-11, UB-17, UB-20, UB-27, UB-28 2. GB-25, UB-32, UB-52, UB-53, UB-56 With weak neck muscles: GB-20 With difficulty walking: 1. DU-2, LIV-13, UB-40, 7 cones of moxa on UB-60 2. GB-30, GB-40, LIV-2 3. LIV-3, LIV-4 With pain in the lumbar spine: DU-26, UB-40 For soft tissue injury to the low back: UB-37, UB-52 For lumbosacral pain: Shiqizhuixia, UB-26 With leg pain: UB-2, UB-26, UB-36, moxa UB-40 For midline pain: 1. Moxa DU-3, DU-4, DU-14, DU-20 2. Men: Right SI-3, Left UB-62     Women: Right SI-3, Left UB-62, Right KI-6, Left LU-7

Wind-Cold

Clinical Manifestations	Acute lower back ache, unrelieved by changing position or stretching The pain is often accompanied by hypertonicity and a cold sensation in the low back Wandering pain in the back and leg Soreness or itching of the throat Aversion to Wind and Cold Tight sensation and tender points in the back area Limitation of movement When turning from side to side the pain may radiate to the upper back and make turning difficult Stiffness and spasm of the back muscles Symptoms are relieved by warmth and exacerbated by Wind-Cold Fever and chills Shivering Stiff neck Occipital headache Cough with expectoration of thin, watery or frothy white sputum Anhidrosis No thirst Aversion to Wind Blocked and / or runny nose with clear, watery nasal discharge Sneezing General body aches Maybe asthma T: Pink C: Thin, white and moist P: Floating and tight or Floating and soggy
Treatment Principle	Expel Wind Dispel Cold Ventilate the Lungs Resolve Phlegm
Herb Formulas	Jing Fang Bai Du San modified Ge Gen Tang Ma Huang Tang Du Huo San Ren Shen Bai Du San With Internal Cold: Wu Ji San  modified With Damp-Accumulation: Ma Huang Jia Zhu Tang Chinese Patent Medicines: Gan Mao Ling Feng Shi Pian Chuan Xiong Cha Tiao Wan
Points	Cup Ahshi Points, needle GB-20, LI-4, LU-7, UB-12, UB-13 DU-16, GB-20, LI-4 + LU-7 or LI-4 + KI-7, LU-5, UB-12, UB-13 Ahshi Points, DU-16, GB-20, LU-7, UB-12, UB-40, UB-60 DU-3, UB-23, UB-58 DU-3, DU-16, KI-3, UB-54, UB-60 SI-3, UB-62 GB-20, SI-3, UB-60, UB-62 GB-20, LI-4, UB-23, UB-24, UB-40, UB-60 With sweating, moving pain and aversion to Wind and a moderate pulse: + GB-31, UB-12 With vomiting and abdominal pain: + moxa or moxa needle REN-12 With pain and rigidity knees: + KI-3 With spontaneous sweating due to Yang Deficiency: - GB-20, + DU-4

Wind-Cold With Qi Deficiency

Clinical Manifestations	Hemiplegia Asymmetry of the face Slow and slurred speech Fever and chills Semi-consciousness Convulsions Neck rigidity Limited movement of the joints Loss of consciousness Muscle spasms Low back pain Numbness of the muscles and skin T: Pale C: Thin and white P: Floating and Deficient or Tense or Wiry and tense
Treatment Principle	Warm the channels Unblock Yang Dispel Wind Support the Normal Qi Relax spasms
Herb Formulas	Xiao Xu Ming Tang
Points

Tai Yang - Yang Ming

Clinical Manifestations	Fever and chills with fever increasing and chills decreasing Headache Anhidrosis Stiffness and pain of the extremities Orbital pain Eye pain Shoulder and neck tension Lumbago Dry nasal passages Irritability Insomnia Constipation Abdominal fullness Fever Tenesmus Vomiting Thirst Epistaxis T: Normal C: Thin and yellow P: Floating and slightly flooding
Treatment Principle	Dispel Wind Release the muscle layer Clear Interior Heat
Herb Formulas	Ge Gen Jia Ban Xia Tang
Points

Jue Yin Cold

Clinical Manifestations	Long standing cold hands and feet that are cold to the touch and feel cold to the patient Maybe lumbago and leg pain Abdominal pain and distention Midline pain Uterine pain Chills Diarrhea Menstrual abdominal pain Maybe chest pain Increased sweating, particularly of the feet Increased salivation Vomits clear fluid Vertex headache Body cold Diarrhea Spasm and pain of the limbs Scanty urination Pain at the waist, hips, legs and feet Sciatica Joint pain Irregular menstruation Abdominal Cold Migraine headache Vaginal discharge T: Pale C: White P: Deep and thready (may be almost imperceptible).
Treatment Principle	Warm Yang especially in the Liver and Stomach Descend turbidity
Herb Formulas	Dang Gui Si Ni Tang
Points	Moxa REN-4, REN-6, REN-8, REN-9, REN-12, ST-25

Wind-Heat

Clinical Manifestations	Acute lower back pain or Heat, unrelieved by changing position or stretching Cough with thick, sticky, yellow sputum Sore, red, swollen throat Thirst with a desire to drink cold liquids Runny or blocked nose with thick, yellow discharge Fever with perspiration Slight chills Aversion to Wind Headache Maybe dyspnea with flared nostrils Maybe chest pain T: Red tip C: Thin and yellow P: Superficial and rapid
Treatment Principle	Expel Wind Clear Heat Ventilate the Lungs
Herb Formulas	Xiao Chai Hu Tang modified With constipation: Da Chai Hu Tang Chinese Patent Medicines: Yin Qiao Jie Du Pian Gan Mao Ling Xiao Chai Hu Wan
Points	Cup Ahshi Points, needle DU-14, LI-4, LI-11, SJ-5, UB-12 With a severe, swollen, sore throat: + LU-11, SI-17 DU-14, DU-16, GB-20, LI-4 + LU-7 or LI-4 + SJ-5, LU-5, LU-10, LU-11, UB-12, UB-13

Wind-Damp

Clinical Manifestations	Acute lower back pain, heaviness or ache and stiffness, unrelieved by changing position or stretching Usually occurs after exposure to cold, damp weather Generalized sensation of heaviness in the body The pain can radiate to the lower extremities Headache or foggy headedness Mild fever and chills Aversion to Wind Maybe mild superficial edema Worse in damp weather Pronounced numbness in the lower extremities Spontaneous perspiration T: Normal C: Thin and white or Greasy, thin and white P: Floating or Floating and wiry
Treatment Principle	Expel Wind-Damp
Herb Formulas	Qiang Huo Sheng Shi Tang  modified Gan Cao Fu Zi Tang Yi Yi Ren Tang Du Huo Ji Sheng Tang For severe pathogenic Cold, preventing forward and backward bending: Wu Tou Tang For lingering pathogenic Cold that has transformed into Heat: Gui Zhi Shao Yao Zhi Mu Tang Chinese Patent Medicines: Du Huo Ji Sheng Wan Feng Shi Pian Shang Shi Zhi Tong Gao Da Huo Luo Dan
Points	LI-4, LU-6, REN-12, SJ-6, SP-9, ST-36 GB-20, SJ-6, UB-60, moxa or moxa needle LI-4, SJ-5, UB-40 With mid-back pain: + DU-1, SI-3, UB-62 With Dai channel obstruction low back heaviness, a feeling of tight belt around the waist, Warmth in the upper body with Cold in the lower body or vice versa, a feeling of sitting in a bath or pain radiating to the sides of the abdomen: + GB-26, GB-27, GB-41 With pain radiating to the leg along the Bladder channel: + UB-36, UB-56, UB-63 With pain radiating to the leg along the Gall Bladder channel: + GB-29, GB-30, GB-36, GB-40 With pain radiating to the leg along the Stomach channel: + ST-30, ST-34, ST-40, ST-42 With pain radiating to the leg along the Liver channel: + LIV-3, LIV-5, LIV-6, LIV-12 With sacral pain: + UB-32, UB-53 With a feeling of heaviness: + ST-40 With a poor appetite: + SP-4, ST-36 With diarrhea: + UB-20 With scanty urination: + SP-6 With abdominal pain: + UB-25 GB-20, LI-4, SP-9, UB-60 With the feeling of a bag over the head or a tight band around the head: + UB-59 With a high fever: + DU-14 For lumbar and hip pain: + SJ-10, UB-30 For lumbosacral and coccygeal pain: + LIV-9 With with Cold pain in the back and buttocks: + UB-36

Wind-Damp Bi With Liver Blood Deficiency And Blood Stagnation

Clinical Manifestations	Muscle aches Joint pain Radiating pain in the legs Low back pain Edema Numbness in the lower extremities Pain in the trunk and extremities Abdominal pain Sciatica Aversion to Wind and Cold Knee pain T: Pale or Pink with purple spots C: Normal P: Choppy or Taut
Treatment Principle	Unblock and relax the channels Activate the Blood Break up Blood Stasis Dispel Wind-Dampness Strengthen the tendons
Herb Formulas	Shu Jing Huo Xue Tang Gui Zhi Shao Yao Zhi Mu Tang Huang Qi Shou Wu Tang
Points

Wind-Cold Damp

Clinical Manifestations	Low back pain The pain is accompanied by Cold and heavy sensations in the low back as if sitting in water and carrying some weight The sensations are aggravated by col-Damp weather and alleviated by warmth There may be body heaviness and numbness The joints may feel sore and inhibited when bending or stretching No thirst Loose stools T: Pale C: Slimy and white P: Soft and moderate
Treatment Principle	Scatter Cold Transform Dampness
Herb Formulas	Shen Jiao Tang Jia Wei Qiang Huo Tang
Points	Moxa or moxa needle GB-38, SP-9, UB-22, UB-23, UB-24 For severe pain with cold limbs: + moxa or moxa needle DU-4 With lower limb pain: + UB-58 For severe pain with cold limbs: + KI-7 For oppression and distention in the Stomach: + UB-21

Wind-Cold-Damp Bi Wind Predominant

Clinical Manifestations	Migrating pain in the joints especially the : Shoulders Elbows Knees Wrists Fingers Upper back and neck Multiple joints Pain quality changes May move from soreness to numbness to aching Sensitivity varies Pain often appears abruptly, acutely or paroxysmal and then disappears Limited range of motion Chills and fever Aversion to Wind Symptoms are worse in windy weather Sore throat General body aches Maybe perspiration T: Pink C: Thin and white or Sticky and yellow P: Superficial and moderate
Treatment Principle	Eliminate Wind Warm Cold Expel Damp Clear the Channels
Herb Formulas	Juan Bi Tang Qu Feng Tang With Qi and Blood Deficiency: Juan Bi Tang #1 For Wind Invasion With Underlying Yang Deficiency: Xiao Xu Ming Tang modified
Points	GB-20, GB-31, LI-4, LIV-3, SJ-5 DU-14, GB-39, SJ-6 With a fever: + LI-11 With deformities: + UB-11 To disperse Qi and relieve external symptoms: LI-4, UB-12, SJ-5, GB-31 GB-20 Or GB-41, DU-1, LI-11, ST-36, UB-40 Or UB-17, SI-12, DU-16, GB-20, UB-12, SJ-17, SP-10, GB-31 Or DU-20, GB-20, GB-30 GB-34, SJ-5, SP-9, SP-10, UB-12 Upper limbs: + LI-11, LI-15, SJ-14 Lower limbs: + GB-30, GB-35, GB-39 Back: + Huatuojiaji, UB-40, UB-60

Wind-Cold-Damp Bi Damp Predominant

Clinical Manifestations	Numbness and heaviness of the extremities Soreness and fixed pain of joints Stiffness or numbness of the muscles or skin Pain worse on cloudy or rainy days Maybe peripheral or systemic edema Pain is alleviated by pressure and warmth Pain lingers and is recalcitrant to treatment Worse during cloudy or wet weather Limited movement Edema Maybe stifling sensation in chest Maybe anorexia or indigestion Maybe abdominal distention Maybe loose or semi-liquid stools T: Pink or Pale C: Greasy and white P: Slow, moderate and soft
Treatment Principle	Expel Damp Clear the channels
Herb Formulas	Han Shi Bi Tang Astragalus and Drynaria Combination With Qi and Blood Deficiency: Juan Bi Tang #1 For Wind Invasion With Underlying Yang Deficiency: Xiao Xu Ming Tang modified With Blood Deficiency and Blood Stagnation: Shu Jing Huo Xue Tang
Points	GB-31, GB-34, SJ-5, SP-6, SP-9 SP-6, SP-9 To eliminate Dampness and ease sinews: 1. SJ-6, GB-34, SP-5, SP-6, SP-9, LI-10, ST-36, ST-40 2. UB-20, SP-9 When affected by weather changes: 1. SJ-5, UB-35, ST-36, SP-5 2. SP-5, ST-38, ST-36 3. LI-13, ST-32, UB-38, GB-30, GB-34, SJ-8, DU-1 Lower back pain: moxa DU-2 Legs: GB-29, GB-30, UB-40 + General points

Wind-Cold-Damp Bi With Cold Predominant

Clinical Manifestations	Excruciating sharp, stabbing joint pain Pain alleviated by warmth and aggravated by Cold Pain with fixed location Few joints are involved The joints cannot be flexed or extended No local redness or Heat Painful area often feels cold to the touch Pain worse at night and better during the day Pain mostly affects low back and lower extremities Pain intense but short lived Pain changes over days or weeks Ankylosis (stiffness) of joint Aversion to Cold Maybe chills with a slight fever Anhidrosis Frequent nocturnal urination T: Pink or Pale C: Thin and white (thicker than for Wind-Bi) P: Superficial and tight or Wiry and tight - maybe slow
Treatment Principle	Warm the channels Activate Qi and Blood.
Herb Formulas	Qu Han Bi Tang Jia Wei Huo Luo Dan
Points	GB-31, GB-34, SJ-6, SP-9, ST-40 With Yang Deficiency: + moxa or moxa needle REN-4, REN-6 LI-11, REN-6, ST-36 With pain in the upper extremities, shoulder and scapula: + SI-5 To regulate the Qi of the low back and legs: + UB-10 To warm and circulate channels and collaterals: LIV-3, moxa LI-4, ST-36, GB-34, GB-31, SJ-5, SJ-4, UB-23, REN-4 Or Moxa UB-23, REN-4, GB-39 Arm pain: moxa needle GB-21, LI-8, LI-9, LI-10, LI-11, LI-13, LU-9 + General points

Wind-Cold-Damp With Wind And Damp Predominant

Clinical Manifestations	General pain Painful extremities Lumbago Limitation of movement Aversion to Wind and Damp Heaviness of the body Moving pain Poor appetite Loose stools or Diarrhea T: Normal C: Thin, white and greasy P: Floating and slippery
Treatment Principle	Dispel Wind-Cold-Damp Stop pain Relieve spasms
Herb Formulas	Shu Jin Tang
Points

Wind-Cold-Damp With Interior Heat

Clinical Manifestations	Chills and fever (more chills than fever) Anhidrosis Headache Stiff neck Generalized aches and pains Low back pain Slight thirst A bitter taste in the mouth T: Normal C: White P: Floating
Treatment Principle	Induce sweating Expel Wind-Cold Dispel Dampness Drain Interior Heat
Herb Formulas	Jiu Wei Qiang Huo Tang
Points

Wind-Cold Damp Bi With Blood Stagnation

Clinical Manifestations	Aversion to Wind, Cold and Dampness Stiff and painful muscles and joints Limited movement Pain aggravated by Wind Sensitive to climatic changes Pain aggravated by Cold Numbness of muscles Pain aggravated by Dampness Cold joints Pain worse at night Low back pain or soreness Lumbago Fatigue Heaviness of the body Heaviness of the muscles Preference for warmth Weak joints Palpitations Pale face Joint deformity Shortness of breath Preference for dry weather T: Pale or Purplish C: Thin, white and greasy P: Thready and weak or Thready and slippery
Treatment Principle	Dispel Wind-Cold-Damp Tonify Qi Strengthen the tendons Nourish and Activate the Blood Break up Blood Stasis Stop pain
Herb Formulas	San Bi Wan Jia Jian
Points

Wind-Cold Dampness With Kidney And Liver Deficiency

Clinical Manifestations	Painful joints Heavy and painful sensations at fixed locations in lower back and extremities with weakness and stiffness or hypertonicity and immobility Aversion to Cold Attraction to warmth Palpitations Pain in the midline and back during pregnancy Pain worse at night General coldness Sallow complexion Wandering pain Pale complexion Shortness of breath May be paresthesia and numbness Cold pain in the low back and knees Limited movement Soreness, weakness and numbness of the joints Tinnitus Muscle spasms Dizziness T: Pale C: Thin and white or White and moist P: Thin, weak and slow or Deep, thready and weak or slippery
Treatment Principle	Disperse Wind-Dampness Stop Bi pain Tonify the Kidneys and Liver Tonify Qi Nourish the Blood
Herb Formulas	Du Huo Ji Sheng Tang Da Fang Feng Tang
Points	SI-3, UB-62

Wind-Cold-Damp Bi With Qi Deficiency

Clinical Manifestations	High fever accompanied by severe chills and shivering Aversion to Cold Pain worse at night Difficult movement Local inflammation Migratory pain Soreness and pain of the extremities Nasal congestion with sonorous breathing Anhidrosis Pain and stiffness of the head and neck Focal distention and fullness of the chest and diaphragm A productive cough May have numbness and heaviness in the limbs Body aches Lumbago Nasal obstruction Cough with sputum Stuffy nose Joint pain Pain worse with Cold and better with warmth Pain aggravated by Wind Pain aggravated by Dampness Pain is stabbing Muscle weakness Pain alleviated by movement Slight muscle edema Heaviness of the joints Cold joints Headache Dizziness T: Pale or Slightly purple or Purple spots C: White or thin, white, greasy P: Slippery or Slightly superficial or Superficial and soft or Slightly rough or Slow and Soft or Wiry and tight or Superficial and rapid that is forceless under pressure
Treatment Principle	Release the Exterior Augment Qi Remove Wind-Cold-Damp Eliminate Painful Obstruction Circulate Qi and Blood Stop pain
Herb Formulas	Ren Shen Bai Du San
Points

Wind-Cold-Damp Bi With Kidney Jing Deficiency And Blood Stagnation

Clinical Manifestations	Low back pain Sciatica Leg pain Preference for pressure and warmth Pain worse at night Limitation of joint movement Local feeling of Cold Stabbing pain Muscle spasms Referred pain toward the legs Lower back weakness Nocturia Stiffness of the back Numbness of the legs Feebleness of the knees Tinnitus T: Pale or Purplish C: Thin and white or Thin, white and greasy P: Slippery or Wiry or Thready
Treatment Principle	Dispel Wind-Cold-Damp Invigorate the Blood Smooth the channels Harmonize the collaterals Benefit the muscles Tonify Kidney Jing Stop pain
Herb Formulas	Yao Tong Ling
Points	Moxa or moxa needle DU-3, GB-30, Huatuojiaji, needle UB-23, UB- 40 For sciatica: SP-6, ST-36, UB-25, UB-26, UB-37, UB-54, UB-57, UB-60, UB-65

Wind-Cold-Damp With Kidney And Liver Yin Deficiency And Qi And Blood Deficiency

Clinical Manifestations	Rheumatic sciatica Degenerative joint disease Lumbago
Treatment Principle	Disperse Wind-Dampness Stop Bi pain Tonify the Kidneys and Liver Tonify Qi Nourish the Blood
Herb Formulas	Deficient Bi #3
Points	GB-30, GB-31, GB-34, Huatuojiaji, ST-36, ST-41, UB-18, UB-23, UB-54, UB-60

Wind-Damp Heat Bi

Clinical Manifestations	Low back pain with a feeling of burning and heaviness A hot sensation top the touch Limitation of movement which is worse when exposed to warmth of hot compresses and alleviated by Cold Dislike of pressure Generalized body aches and pains Irritability Heavy sensation in the shoulder and back Discomfort or a constricted sensation in the area of the chest and diaphragm Multiple sores, carbuncles furuncles or abscesses Redness Itching Persistent swelling Chest pain Fever Thirst with no desire to drink Aching and painful extremities Aching and painful joints Unbearable swelling and pain of the lower extremities Shoulder stiffness A greasy feeling in the mouth Loose stools or Diarrhea Painful or scanty urination T: Normal or Red C: Greasy and slightly yellow P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight or Floating, superficial and rapid
Treatment Principle	Resolve Dampness Clear Heat Disperse Wind Stop pain Invigorate the Blood Tonify Qi and Blood
Herb Formulas	Dang Gui Nian Tong Tang Xuan Bi Tang With Blood Stagnation: Shang Zhong Xia Tong Yong Tong Feng Wan Chinese Patent Medicine: Shi Re Bi Chong Ji
Points	GB-20, LI-2, LI-4, SJ-5, SJ-6, UB-40, UB-60 With Dai channel obstruction low back heaviness, a feeling of tight belt around the waist, Warmth in the upper body with Cold in the lower body or vice versa, a feeling of sitting in a bath or pain radiating to the sides of the abdomen: + GB-26, GB-27, GB-41 With pain radiating to the leg along the Bladder channel: + UB-36, UB-56, UB-63 With pain radiating to the leg along the Gall Bladder channel: + GB-29, GB-30, GB-36, GB-40 With pain radiating to the leg along the Stomach channel: + ST-30, ST-34, ST-40, ST-42 With pain radiating to the leg along the Liver channel: + LIV-3, LIV-5, LIV-6, LIV-12 With fever: + DU-14 With generalized body pain, an aversion to Cold, a stiff neck and a sore throat: + UB-10, UB-12 For coughing with yellow Phlegm: + UB-32, UB-53 With a severe burning sensation in the lower back: + UB-67 With a feeling of heaviness in the body: + SP-6 With scanty, painful urination: + KI-4, KI-5 With a poor appetite: + REN-12 With diarrhea: + UB-20

Phlegm-Damp Obstructs The Lungs With Kidney Yang Deficiency

Clinical Manifestations	Coughing and wheezing with copious, dilute, white, frothy or lumpy sputum Chest and epigastric congestion Cold legs Pain and full feeling in the chest Dizziness Vertigo Palpitations Dyspnea - worse lying down Sometimes asthma Throat rattle Nausea Vomiting Shortness of breath with labored inhalation and smooth exhalation Acute attack of panting with a high pitched wheezing sound and rapid exhalation Leg Qi Acute cramping Muscle wasting Diarrhea in response to cold or hot weather Maybe anorexia Insensitivity in the lower abdomen Headache Facial edema Palpitations Lumbar pain Weakness in the body and feet Numbness, weakness and aching of the feet and legs Edema of the extremities Fever Dysuria Weakness below the umbilicus Fatigue with a desire to curl up Epigastric distention Disorientation Disordered speech Tinnitus T: Pale C: Thick, white and greasy or sticky P: Slippery or Soft
Treatment Principle	Disperse and Descend Lung Qi Warm and transform Phlegm-Cold
Herb Formulas	Su Zi Jiang Qi Tang
Points

Lung And Kidney Yin Deficiency

Clinical Manifestations	Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Sterility Spermatorrhea T: Red and dry C: None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs Reinforce the Kidneys
Herb Formulas	Bai He Gu Jin Tang Ba Xian Chang Shou Wan Yang Yin Qing Fei Tang + Da Bu Yin Wan Du Qi Wan Mai Wei Di Huang Wan
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

Large Intestine Deficiency

Clinical Manifestations	Chronic unremitting diarrhea Chronic dysentery Maybe fecal incontinence Prolapsed rectum (severe) Diarrhea may contain pus and Blood May be tenesmus Mild persistent abdominal pain Pain better with warmth and pressure Lethargy Red or white dysentery Reduced appetite Weak legs Low back soreness Pale (wan) complexion T: Pale C: White P: Thready and slow
Treatment Principle	Warm the Middle Tonify the Spleen and Stomach Astringe the Intestines Stop diarrhea
Herb Formulas	Zhen Ren Yang Zang Tang
Points

Cold-Damp Distresses The Spleen

Clinical Manifestations	Lower back pain with sensations of heaviness and Stagnation A pale complexion Distention and fullness of epigastrium and abdomen Nausea Vomiting Anorexia Loose stools Diarrhea Reduced sensation of taste No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Lassitude Yin jaundice Heavy head Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of Cold or feeling chilled T: Pink C: Thick, white and greasy or sticky P: Deep and slow
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Ping Wei San With severe Dampness: Fang Ji Huang Qi Tang With significant Spleen Dampness: Shi Pi Yin
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20

Spleen Qi Deficiency With Dampness

Clinical Manifestations	Aching and heaviness in the lower back Poor muscle tone with flabby muscles A tendency to be overweight Poor posture Sallow complexion Fatigue Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White and greasy P: Slippery or soft
Treatment Principle	Strengthen the Spleen Benefit Qi
Herb Formulas	Ping Wei San With flabby muscles: Bu Zhong Yi Qi Tangmodified With mild Dampness: Fang Ji Huang Qi Tang With Spleen Yang Deficiency: Shi Pi Yin  modified Chinese Patent Medicines: Bu Zhong Yi Qi Wan Xiang Sha Liu Jun Zi Wan Fu Zi Li Zhong Wan
Points	General points + SP-3, SP-9, ST-36, ST-40, UB-20 LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

Spleen And Kidney Qi Deficiency

Clinical Manifestations	Milky, turbid spermatorrhea Listlessness Fatigue A shiny, white complexion Anorexia or Increased food intake Restlessness Vaginal discharge Diarrhea Dryness of the external ears Dizziness Enuresis Copious urination Thirst Premature ejaculation Lumbago T: Pale C: White P: Deep and frail
Treatment Principle	Tonify the Kidneys Stabilize Jing Stop leakage Strengthen the Spleen Drain Dampness
Herb Formulas	Fu Tu Dan
Points

Spleen And Kidney Yang Deficiency

Clinical Manifestations	Body cold Limbs icy Complexion white and shiny Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Li Zhong Wan + Jin Gui Shen Qi Wan Fu Zi Li Zhong Wan Si Shen Wan Zhen Wu Tang Shi Pi Yin Bu Yin Tang Yi Qi Jian Pi Fu Zheng Tang
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

Heart Fire With Qi And Yin Deficiency And Damp-Heat In The Lower Jiao

Clinical Manifestations	Restlessness Irritability Thirst Nocturnal emission Insomnia Dream disturbed sleep Lack of spirit Fatigue Low back pain Tinnitus Dysuria Depression Turbid urine Abnormal uterine bleeding Polyuria Enuresis Seminal emission Leukorrhea Blood tinged leukorrhea Anorexia Dry mouth Dry Tongue Five Sole Heat Fever Physical and mental overexertion T: Red C: Little or None P: Deep and rapid
Treatment Principle	Clear Heart Fire Disperse Damp-Heat Benefit Qi and Yin Promote urination
Herb Formulas	Qing Xin Lian Zi Yin modified
Points

Heart Yang Not Vigorous: Water Qi Insults The Heart With Kidney Yang Deficiency

Clinical Manifestations	Palpitations Dysuria Shortness of breath Dyspnea Dizziness Muscular twitching Whole body edema Cold body Icy limbs Cold abdomen with watery stools Edema of limbs Cough Pale complexion Lips and nails cyanosed Soreness and aching of the shoulders and back Abdominal pain Diarrhea Pitting edema Scanty urination or Frequent, clear, abundant urination at night Chills Weak knees Seminal emissions Flaccid abdomen Muscular aching Chronic lower back pain T: Pale or Purple (Lavender) C: White and greasy P: Deep or Deep and minute
Treatment Principle	Support Yang Expel Cold Promote diuresis
Herb Formulas	Zhen Wu Tang
Points	Moxa needle DU-4, KI-3, KI-7, PC-5, PC-6, REN-4, REN-6, REN-9, REN-17, SP-6, SP-9, UB-15, UB-23

Heart And Kidney Yin Deficiency

Clinical Manifestations	Insomnia with much dreaming Spermatorrhea with erotic dreams Premature ejaculation Irritability Easily startled Palpitations Poor memory Dizziness Tinnitus Low back soreness Legs weak Tidal fever Night sweats Dry mouth Red cheeks Urine short and red T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reduce Fire Make Heart and Kidney communicate
Herb Formulas	Jiao Tai Wan Tian Wang Bu Xin Dan Liu Wei Di Huang Wan With Fire Rising: Dao Chi San
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23

Small Intestine Qi Pain

Clinical Manifestations	Vague pain in the lower abdomen involving the low back Pain radiates down into the testicle Abdominal distention Borborygmus Relief after passing wind Hernia pain in the scrotum T: Pale C: Thin and white P: Deep and wiry or Wiry and tight
Treatment Principle	Move Qi Expel knotting
Herb Formulas	Tian Tai Wu Yao San modified
Points	LIV-1, LIV-4, LIV-5, LIV-8, REN-4, SP-6, ST-39

Liver Qi Stagnation

Clinical Manifestations	Low back pain which tends to be irritated by stress or emotional upset Severe distention with mild pain in the back The pain often radiates to the flanks, lower abdomen or hypochondriac region The pain is vague and distending The pain may move from place to place or come and go The pain is worse at dawn but better after getting up and moving around Range of motion is only slightly affected Distention and pain in the sides or flanks Suffocating sensation in the chest Often accompanied by pain and distention hypochondrium and abdomen Tenderness at the origin of the back muscles or ligaments Muscular spasms on one side of the back or abdomen Hypertonicity of the lower abdomen Enduring standing is impossible Tendency to sigh Melancholy Depression Irritability Nervousness Insomnia Headache A poor appetite Inappropriate anger Irregular menses Dysmenorrhea Loose stools when nervous Breast distention and pain before and during menses Distending pain in the genital region T: Pink or Red or Dark or Pale C: Thin and white or Thin and yellow P: Wiry or Wiry and thready or Deep and wiry or Wiry and rapid or Wiry and choppy
Treatment Principle	Soothe the Liver Clear Stagnation
Herb Formulas	Tian Tai Wu Yao San modified Chai Hu Shu Gan Tang  modified Xiao Yao San  modified Jia Wei Qi Xiang Wan Chen Xiang Jiang Qi Tang Chinese Patent Medicines: Chen Xiang Huo Qi Wan Shu Gan Wan Mu Xiang Shen Qi Wan Xiao Yao San
Points	General points + GB-34, LI-4, PC-6 GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SJ-6, SP-6, UB-18 GB-34, GB-41, LIV-3 LIV-3, LIV-4, LIV-5, LIV-11, LIV-12, LIV-14, PC-6, SP-6 With Dai channel obstruction low back heaviness, a feeling of tight belt around the waist, Warmth in the upper body with Cold in the lower body or vice versa, a feeling of sitting in a bath or pain radiating to the sides of the abdomen: + GB-26, GB-27, GB-41 With pain radiating to the leg along the Bladder channel: + UB-36, UB-56, UB-63 With pain radiating to the leg along the Gall Bladder channel: + GB-29, GB-30, GB-36, GB-40 With pain radiating to the leg along the Stomach channel: + ST-30, ST-34, ST-40, ST-42 With pain radiating to the leg along the Liver channel: + LIV-3, LIV-5, LIV-6, LIV-12 With a feeling of fullness and oppression in the chest: + REN-17 With emotional instability: + Sishencong With irritability and nervousness: + LIV-2 With a headache: + GB-20 With insomnia: + HT-3 With abdominal pain: + ST-28 Ahshi, LIV-2, LIV-3, LIV-5 With blurred vision: + KI-3, SP-6 With a distending headache: + GB-41 With a bitter taste in the mouth: + GB-34 With lower abdominal pain just prior to menstruation: + LIV-8, REN-3 With frequent sighing: + LIV-14 With lumbar and lower abdominal pain: + GB-29

Liver Qi Stagnation Invades The Spleen With Blood Stagnation

Clinical Manifestations	Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Dizziness Tinnitus Lumbago Edema Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation Oliguria Palpitations Cold feet Extreme coldness of the hands and feet Vertigo Weakness and numbness of lower back and legs during pregnancy or postpartum Mal position of the fetus Dysmenorrhea Irregular menstruation Right upper quadrant pain Hepatomegaly Anemia Lack of energy Sore back Thirst with no desire to drink T: Pale or pink maybe petechiae on margin C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle	Nourish Liver Blood Soften the Liver Spread Liver Qi Strengthen the Spleen Resolve Dampness Reinforce the Spleen and Kidney
Herb Formulas	Dang Gui Shao Yao San Without Blood Stagnation: Shao Yao Gan Cao Tang
Points

Liver Blood Stagnation Due To Blood Deficiency

Clinical Manifestations	Itchy nose, mouth, eyes, throat, skin, or any area Problems with smell Runny nose Sneezing Tearing eyes Stuffy nose (nasal congestion) Coughing Clogged ears and decreased sense of smell Sore throat Dark circles under the eyes Puffiness under the eyes Fatigue and irritability Headache Memory problems and slowed thinking Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Lumbago Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding Maybe Five Sole Heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale C: Normal P: Thready and wiry or Thready and choppy
Treatment Principle	Nourish the Blood Cool the Blood Clear Heat Regulate the Liver Improve Blood circulation
Herb Formulas	Si Wu Tang Jia Wei
Points

Liver Wind Due To Kidney And Liver Yin Deficiency

Clinical Manifestations	Fatigue Muscle spasms with alternating flexion and extension of the extremities Prostration Clonic convulsions Dizziness - worse with stress or anger Insomnia Dream-disturbed sleep Sore low back and knees Nocturnal emissions Often the patient is on the verge of shock Low-grade fever T: Deep red C: Thin or Peeled P: Weak and faint
Treatment Principle	Nourish Yin Extinguish Endogenous Wind
Herb Formulas	Da Ding Feng Zhu
Points

Liver And Kidney Yin Deficiency

Clinical Manifestations	Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Qi Ju Di Huang Wan Yi Guan Jian Da Bu Yin Wan Liu Wei Di Huang Wan Ba Xian Chang Shou Wan Mai Wei Di Huang Wan Zuo Gui Wan  modified With Fire Flaring: Zhi Bai Di Huang Wan With Damp-Heat and Blood Stagnation: Zi Shen Tang With severe Deficiency Heat: Hu Qian Wan
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

Liver And Kidney Deficiency

Clinical Manifestations	Blurred vision Dizziness Tinnitus Profuse dreaming Low back and knee pain and weakness Impotence Seminal emissions Dribbling urination T: Pale C: White P: Thready and weak
Treatment Principle	Enrich and supplement the Liver and Kidneys Tonify Jing Brighten the eyes
Herb Formulas	Bu Shen Ci Shi Wan Jia Wei
Points	DU-4, GB-34, UB-18, UB-20, UB-23 For tinnitus: + SJ-21 For diarrhea: + moxa DU-20 For emaciation of the legs and feet: + ST-36, UB-57 With Yin Deficiency: - DU-4, + KI-3, SP-6

Kidney Yang Deficiency

Clinical Manifestations	Chronic lumbago: low back feels cold, weak and aching The pain is dull and lingering The symptoms are improved by massage and rest Frequent recurrences The pain is aggravated by exertion, prolonged standing, sexual activity and fatigue Weak, sore legs and knees Knees feel cold and aching Heel pain Feeling chilled Aversion to Cold Shortness of breath Cold limbs General debility Pale face Loose teeth Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Jin Gui Shen Qi Wan (Ba Wei Di Huang Wan) You Gui Wan modified Bu Gu Zhi Wan Gui Lu Bu Shen Tang He Che Wan Jie Rong San She Chi Tang Xin Yang San Yang Chuan Yao Da Tu Si Zi Wan Jia Jian Qing E Wan Du Zhong Tang Lu Rong Bu Se Wan With muscular cramping: Shao Yao Gan Cao Fu Zi Tang With Cold Phlegm: Su Zi Jiang Qi Tang Chinese Patent Medicines: Shen Rong Hu Gu Wan Jia Kui Shen Qi Wan Ren Shen Lu Rong Wan Ge Jie Bu Shen Wan
Points	Moxa or moxa needle DU-4, Huatuojiaji when tender, KI-3, REN-4, REN-6, UB-23, UB-25, UB-52, UB-60 Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 Moxa or moxa needle DU-3, DU-4, KI-3, UB-23, UB-40, UB-52, UB-58, UB-60 DU-2, DU-4, GB-30, UB-23, UB-40, UB-57, UB-60 Moxa or moxa needle DU-4, KI-3, UB-23, UB-52 UB-23, UB-30, UB-40 With a stiff, painful low back: + DU-26 Moxa or moxa needle DU-4, DU-20, REN-4, UB-23 Moxa or moxa needle DU-4, KI-3, REN-4, REN-6, UB-23 Moxa needle SP-6, ST-36, UB-23, UB-24, UB-26 For tinnitus: + moxa or moxa needle SJ-21 For dizziness: + moxa DU-20 For seminal emission: + moxa or moxa needle UB-52 For Yang Exhaustion: + KI-3 For pain in the lower extremities: + GB-34, UB-56 Moxa 14 cones on DU-26, UB-23, UB-40 For a stiff low back: + 14 cones on DU-4, needle UB-60 For a sudden inability to straighten up: + LIV-2, UB-52 For spinal pain with inability to flex or extend: With more pain in the upper low back: + LI-4 With more pain in the lower low back: + KI-7, UB-60 For unilateral pain: SI-3, UB-62 For insufferable pain: GB-20, LI-4, UB-60 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

Kidney Yang Deficiency: Kidney Qi Not Consolidated

Clinical Manifestations	Chronic lumbago: low back feels cold, weak and aching The symptoms are improved by massage and rest Frequent recurrences The pain is aggravated by exertion, prolonged standing, sexual activity and fatigue Weak, sore legs and knees Hearing deficit Jing Gate Not Consolidated: Spermatorrhea Premature ejaculation Vaginal discharge Infertility Urinary disorder: Frequent, clear, abundant urination Dribbling after urination Incontinence of urine T: Pale and swollen with teethmarks C: Thin white P: Deep and thready
Treatment Principle	Consolidate the Kidneys Conserve Qi
Herb Formulas	Jin Suo Gu Jing Wan Su Quan Wan Gui Fu Du Jin Zan Yu Dan
Points	Jinggong, KI-3, KI-12, REN-4, REN-6, SP-6, UB-23, UB-52 For spermatorrhea due to Kidney Qi Not Consolidated: 1. Jinggong, KI-3, KI-12, REN-4, REN-6, SP-6, UB-23, UB-52 2. REN-4, SP-6, UB-23 3. Jinggong, KI-3, KI-12, REN-4, ST-36 4. KI-12, REN-4, REN-6, SP-6, UB-23 For urinary incontinence and enuresis: 1. REN-3, SP-6, UB-22, UB-23, UB-28, UB-39 2. REN-3, SP-6, UB-22, UB-23, UB-28

Kidney Yang Deficiency With Water Flooding

Clinical Manifestations	Chronic lumbago: low back feels cold, weak and aching The symptoms are improved by massage and rest Frequent recurrences The pain is aggravated by exertion, prolonged standing, sexual activity and fatigue Weak, sore legs and knees Edema of whole body particularly at and below the waist Pitting edema Low back pain, aching and heaviness Abdominal distention with full sensations Oliguria Cold limbs Face gray and congested or pale Feeling nervous and cold with mental weariness In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready With Water Flooding the Lungs: Cough with copious, thin watery phlegm Asthma with phlegmy sound (wheezing) Dyspnea Facial edema Edema of limbs Dysuria T: Pale and swollen C: White and moist or White and greasy P: Superficial and tight
Treatment Principle	Warm Kidneys Promote diuresis
Herb Formulas	Zhen Wu Tang Ji Sheng Shen Qi Wan
Points	KI-7, REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23, UB-39

Kidney Yin Deficiency

Clinical Manifestations	Chronic lumbago: low back feels weak and aching The symptoms are improved by massage and rest Frequent recurrences The pain is aggravated by exertion, prolonged standing, sexual activity and fatigue Weak, sore legs and knees Dizziness Vertigo Tinnitus or deafness Insomnia Poor memory Aching, soreness or weakness of low back Spermatorrhea or premature ejaculation Aching in bones Aching in leg and heel T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reinforce the Kidneys
Herb Formulas	Liu Wei Di Huang Wan Zuo Gui Wan  modified Ba Xian Chang Shou Wan Bu Yin Tang Mai Wei Di Huang Wan Dang Gui Di Huang Yin Chinese Patent Medicines: Jian Bu Hu Qian Wan Liu Wei Di Huang Wan Zhi Bai Di Huang Wan Da Bu Yin Wan
Points	DU-4, Huatuojiaji when tender, KI-3, REN-4, REN-6, UB-23, UB-25, UB-52, UB-60 KI-1, KI-3, KI-6, REN-4, SP-6, UB-23 KI-3, UB-23, UB-52, UB-60 GB-20, KI-1, KI-2, KI-3, KI-6, LI-11, LIV-3, REN-4, SP-6, ST-36, UB-23 KI-3, KI-7, SP-6, UB-23, UB-52 With Deficiency fire of the Heart and Kidneys: + KI-1, UB-15 With tinnitus: + GB-2 With a sore throat: + KI-6

Kidney Yin Deficiency With Fire Flaring

Clinical Manifestations	Chronic lumbago: low back feels weak and aching The symptoms are improved by massage and rest Frequent recurrences The pain is aggravated by exertion, prolonged standing, sexual activity and fatigue Weak, sore legs and knees Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Sensitivity to Heat Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Occasional urinary irritation or discomfort Urine short and red Heightened libido If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan Zuo Gui Wan  modified Zhu Sheng Teng Er Tang Du Zhong Tang For mild cases: Da Bu Yin Wan Chinese Patent Medicines: Jian Bu Hu Qian Wan Liu Wei Di Huang Wan Zhi Bai Di Huang Wan Da Bu Yin Wan
Points	DU-4, Huatuojiaji when tender, KI-3, REN-4, REN-6, UB-23, UB-25, UB-52, UB-60 KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

Kidney Jing Insufficiency

Clinical Manifestations	Insidious onset of low back and knees weak and aching Pain worsens with fatigue and is better with bed rest A rotating sensation in the brain Dizziness Tinnitus Insomnia In adults: Hair loss Graying or whitening of hair Weak sexual function Atrophy and weakness of feet with difficulty walking Poor memory Senility (premature or mature) Brittle bones Gradual deterioration of hearing In children Retardation in mental and/or physical development Failure to thrive Late or incomplete closing of fontanel Poor bone development, brittle bones With Kidney Yang Deficiency predominant: A Cold sensation in the lower back and abdomen Low potency or impotence A pale complexion Nocturia Cold limbs Aversion to Cold T: Pale with teethmarks C: Moist P: Deep and thready or Deep and slow With Kidney Yin Deficiency predominant: Irritability Insomnia Dry mouth and throat Malar flush Five Sole Heat Constipation T: Red C: Little or None P: Thready and rapid
Treatment Principle	Reinforce the Kidneys Benefit Jing
Herb Formulas	Gu An Fang Bu Yao Tang With Kidney Yang Deficiency predominant: You Gui Wan Jin Gui Shen Qi Wan   With Kidney Yin Deficiency predominant: Zuo Gui Wan modified Bu Yin Tang With Liver Blood Deficiency: Sheng Fa Yin With bone degeneration: Yang He Tang Chinese Patent Medicines: With Kidney Yang Deficiency predominant: Jin Gui Shen Qi Wan Yao Tong Pian With Kidney Yin Deficiency predominant: Liu Wei Di Huang Wan
Points	KI-3, LI-4, SP-6, UB-11, UB-17, UB-18, UB-23 DU-4, KI-3, REN-4, UB-23 DU-4, KI-3, REN-4, UB-11, UB-23 With impaired memory: + HT-7, UB-15 GB-34, GB-39, KI-3, KI-10, SP-6, UB-23, UB-40, UB-58 With Dai channel obstruction low back heaviness, a feeling of tight belt around the waist, Warmth in the upper body with Cold in the lower body or vice versa, a feeling of sitting in a bath or pain radiating to the sides of the abdomen: + GB-26, GB-27, GB-41 With pain radiating to the leg along the Bladder channel: + UB-36, UB-56, UB-63 With pain radiating to the leg along the Gall Bladder channel: + GB-29, GB-30, GB-36, GB-40 With pain radiating to the leg along the Stomach channel: + ST-30, ST-34, ST-40, ST-42 With pain radiating to the leg along the Liver channel: + LIV-3, LIV-5, LIV-6, LIV-12 With a Cold sensation in the lower back: + moxa or moxa needle DU-4 With weak knees: + LIV-8 With impotence: + REN-4, REN-6 With insomnia: + HT-3, PC-6 With dizziness: + GB-20 With generalized fatigue: + DU-20, ST-36 With diarrhea: + UB-20, UB-25 With constipation: + LI-4 With night sweats: + HT-6, KI-2 With nervousness and a headache: + LIV-2 KI-3, SP-6, UB-23, UB-40, UB-52 1. For Kidney Yin Deficiency predominant: With Deficiency fire of the Heart and Kidneys: + KI-1, UB-15 With tinnitus: + GB-2 With a sore throat: + KI-6 2. For Kidney Yang Deficiency predominant: For tinnitus: + moxa or moxa needle SJ-21 For dizziness: + moxa DU-20 For seminal emission: + moxa or moxa needle UB-52 For pain in the lower extremities: + GB-34, UB-56

Kidney Yin And Yang Deficiency With Insufficiency Of Jing And Blood In The Chong , Ren And Du Channels

Clinical Manifestations	Chronic lumbago: low back feels cold, weak and aching The symptoms are improved by massage and rest Frequent recurrences The pain is aggravated by exertion, prolonged standing, sexual activity and fatigue Weak, sore legs and knees Emaciation Weakness Spermatorrhea Blurred vision Daybreak diarrhea Weight loss Dizziness Nocturnal emissions T: Pink or Pale C: White or None P: Thready and frail or Deep, slow and weak
Treatment Principle	Nourish and replenish Yin Tonify Jing Augment Qi Tonify and strengthen Yang Nourish the Blood
Herb Formulas	Gui Lu Er Xian Jiao Du Zhong Wan
Points

Kidney And Liver Yin Deficiency

Clinical Manifestations	Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees, sore and painful Throat dry and painful Five sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Qi Ju Di Huang Wan Yi Guan Jian Da Bu Yin Wan Liu Wei Di Huang Wan Er Zhi Wan Zuo Gui Wan  modified With Fire Flaring: Zhi Bai Di Huang Wan With Blood Deficiency: Gui Shao Di Huang Tang With severe Deficiency Heat: Hu Qian Wan
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

Kidney Jing And Liver Blood Deficiency

Clinical Manifestations	Premature graying of the hair Hair loss Loose teeth Spontaneous emissions Nocturnal emissions Weak and sore low back and knees
Treatment Principle	Enrich the Kidney Jing Nourish the Liver Blood
Herb Formulas	Qi Bao Mei Ran Dan
Points

Kidney Jing, Qi And Yang Deficiency

Clinical Manifestations	General weakness Sexual dysfunction Impotence Premature ejaculation Male infertility Frequent urination Dribbling of urine Lumbar pain or weakness Depression Fatigue and poor memory following ejaculation Weak bladder Low sperm count
Treatment Principle	Tonify the Kidneys Nourish and astringe Jing Tonify Kidney Yang Tonify the Blood
Herb Formulas
Points

Kidney Jing Deficiency Bi With Wind-Cold-Dampness And Blood Stagnation

Clinical Manifestations	Low back pain Sciatica Leg pain Preference for pressure and warmth Pain worse at night Limitation of joint movement Local feeling of Cold Stabbing pain Muscle spasms Referred pain toward the legs Lower back weakness Nocturia Stiffness of the back Numbness of the legs Feebleness of the knees Tinnitus T: Pale or Purplish C: Thin and white or Thin, white and greasy P: Slippery or Wiry or Thready
Treatment Principle	Dispel Wind-Cold-Damp Activate the Blood Smooth the channels Harmonize the collaterals Benefit the muscles Tonify Kidney Jing Stop pain
Herb Formulas	Yao Tong Ling
Points

Kidney Deficiency With Qi Deficiency

Clinical Manifestations	Low back pain Restless fetus Miscarriage Nausea Vomiting Soreness and pain of the lower back Light colored vaginal bleeding Shortness of breath Mal-positioned fetus Difficult delivery Morning sickness General weakness Abdominal pain Palpitations Pale complexion T: Pale C: White P: Small and smooth
Treatment Principle	Tonify Qi Nourish the Blood Regulate Qi Strengthen the Kidneys Calm the fetus Stabilize pregnancy Induce labor
Herb Formulas	Bao Chan Wu Tou Fang
Points

Urinary Bladder Damp-Heat

Clinical Manifestations	Urinary frequency Urinary urgency Painful urination or Continuous dripping of urine or Sudden interruption to the urinary stream Turbid urine or Pus and blood in the urine or Sand and stones in the urine Scanty, dark urine Maybe a bitter taste in the mouth Maybe shoulder pain In Damp-Heat Pouring Downward there may also be: Fever Thirst Dry mouth Low back pain In Damp-Heat Crystallizes in Urinary Bladder there may also be: Colicky pain in the low back, possibly radiating to the groin T: Red C: Yellow or Greasy and yellow P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness by diuresis
Herb Formulas	San Jin Tang Si Miao Wan Dang Gui Nian Tong Tang For urinary disturbance: Ba Zheng San For Blood Lin: Xiao Ji Yin Zi For Stone Lin: Shi Wei San For Milky Lin: Bei Xie Fen Qing Yin
Points	KI-7, LIV-2, REN-3, SP-6, SP-9, UB-23, UB-28, UB-39 For retention of urine: 1. REN-3, SP-6, SP-9, UB-28 2. REN-3, SP-6, SP-9, UB-39 For Blood Lin: 1. KI-3, LIV-2, REN-3, SP-6, SP-9, SP-10, UB-28 2. KI-1, KI-7, LIV-3, REN-3, SP-10, UB-17, UB-23, UB-27 For Stone Lin: 1. KI-2, KI-3, LIV-2, REN-3, SP-9, UB-28, UB-39 2. KI-1, LIV-1, REN-4, UB-23, UB-28, UB-40 For Milky Lin: 1. KI-3, KI-6, LIV-2, REN-3, SP-9, UB-23, UB-28 2. REN-4, REN-6, SP-6, SP-9, UB-22, UB-27, UB-28

Qi And Blood Stagnation

Clinical Manifestations	Pain that is fixed, stabbing and /or severe or Pains that move around Distention Depression Irritability Muscle ache of the neck, back, legs and shoulder Whole body pain Shoulder pain Elbow pain Pain at the waist Arm pain Low back pain Leg pain Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Activate the Blood Break up Stagnation Circulate Qi
Herb Formulas	Shen Tong Zhu Yu Tang
Points	GB-40, GB-41, LIV-3, LIV-14, PC-6, SJ-6, SP-6, SP-10, ST-36, UB-17, UB-18, UB-40

Qi And Yin Deficiency

Clinical Manifestations	Lassitude Fatigue Shortness of breath Dizziness Tinnitus Palpitations Emaciation Lack of strength Dry, rough eyes Possible distended feeling in eyes A pale, lusterless face Possible malar flush Restless Insomnia Poor memory Scanty, yellow urination or Profuse, clear urination Dry, parched throat Tasteless feeling in the mouth Low back and knee soreness and Weakness Low grade fever Five sole heat Possible sweating Possible tremors of the hands and tongue Scanty intake Abdominal distention after meal Loose stools T: Red C: Thin or Peeled P: Empty and rapid or Thready and rapid
Treatment Principle	Tonify the Spleen Augment Qi Supplement the Kidneys Nourish Yin
Herb Formulas	Shen Qi Di Huang Tang
Points

Qi And Blood Deficiency

Clinical Manifestations	Fatigue Loose stools Poor appetite Dizziness Pale face Weak voice Reluctance to speak Sweating with little or no exertion Palpitations Insomnia Dry skin Dry hair Poor memory Paleness Scanty periods Lumbago in women T: Pale or Pale, thin and dry C: Thin and white P: Weak or Thin and choppy
Treatment Principle	Tonify Qi Nourish the Blood
Herb Formulas	Ba Zhen Tang
Points	KI-3, LIV-3, LU-9, SP-6, ST-36, UB-11, UB-17

Qi And Blood Deficiency With Qi Stagnation And Heat

Clinical Manifestations	Constipation Facial flushing Melancholy Restlessness Headache Vertigo Tinnitus Abdominal distention Acid regurgitation Vertigo Stiff shoulders Neurosis Fever Palpitations Lower back pain Hot flashes Belching
Treatment Principle	Tonify Qi Nourish the Blood Regulate Qi Clear Heat
Herb Formulas	Nu Shen San
Points

Qi , Blood And Yin Deficiency With Blood Stagnation And Heat

Clinical Manifestations	Lassitude Fatigue Shortness of breath Dizziness Tinnitus Palpitations Emaciation Lack of strength Dry, rough eyes Possible distended feeling in eyes A pale, lusterless face Possible malar flush Restless Insomnia Poor memory Dry, parched throat Tasteless feeling in the mouth Low back and knee soreness and weakness Low grade fever Five Sole heat Possible sweating Possible tremors of the hands and tongue Scanty intake Abdominal distention after meal Loose stools T: Red C: Thin or Peeled P: Empty and rapid or Thready and rapid
Treatment Principle	Tonify Qi and Blood Promote urination Activate the Blood Dispel Blood Stasis Nourish Yin Generate fluids Clear Heat Drain Kidney Fire Cool the Blood
Herb Formulas	Yi Qi Yang Yin Huo Xue Fang
Points

Blood Stagnation

Clinical Manifestations	Lower back pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Difficulty walking In severe cases, movement is difficult and very painful with restricted range of motion The pain may be worse in the evening and is unaffected by weather or temperature Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Break up Stagnation
Herb Formulas	Huo Luo Xiao Ling Dan modified Fu Yuan Huo Xue Tang Gui Zhi Fu Ling Wan Shen Tong Zhu Yu Tang  modified Zhu Yu Tang With constipation and painful pressure in the lower abdomen: Tao He Cheng Qi Tang With Heat: Xia Yu Xue Tang For irregular menstruation with dark or clotted Blood:Gui Zhi Fu Ling Wan For anemia or pregnancy or childbirth problems: Dang Gui Shao Yao San Chinese Patent Medicines: Jin Gui Shen Qi Wan Qi Li San Gu Zhe Cuo Shang San Zheng Gu Shui Lineament Die Da Zhi Tong Gao Te Xiao Yao Tong Ling Yu Nan Bai Yao
Points	General points + SP-6, SP-10, UB-17 SP-6, SP-10, ST-36, UB-17, UB-40 UB-17, UB-40 LI-4, LIV-3, SP-6, UB-40, UB-64, UB-67 With Dai channel obstruction low back heaviness, a feeling of tight belt around the waist, Warmth in the upper body with Cold in the lower body or vice versa, a feeling of sitting in a bath or pain radiating to the sides of the abdomen: + GB-26, GB-27, GB-41 With pain radiating to the leg along the Bladder channel: + UB-36, UB-56, UB-63 With pain radiating to the leg along the Gall Bladder channel: + GB-29, GB-30, GB-36, GB-40 With pain radiating to the leg along the Stomach channel: + ST-30, ST-34, ST-40, ST-42 With pain radiating to the leg along the Liver channel: + LIV-5, LIV-6, LIV-12 With severe, stabbing pain: + Ahshi points, bleed UB-40 With low back pain which is worse at night: + KI-6 With restlessness and insomnia due to pain: + HT-3, HT-7 With a headache: + GB-20, UB-10 With constipation: + UB-25

Blood Stagnation Due To Cold With Deficiency Cold Of The Chong And Ren

Clinical Manifestations	Mild persistent uterine bleeding Irregular menstruation (either early or late) Prolonged menstruation Skipped period Metrorrhagia Extended or continuous menstrual flow Pain Lower abdominal distention Lower abdominal Cold Lower abdominal pain Infertility Dry lips Dry mouth Spermatorrhea Pale complexion Leukorrhea Amenorrhea Bleeding between periods Low grade fever at dusk Irritability Five sole Heat No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold T: Purple with petechiae P: Thready and choppy
Treatment Principle	Warm the menses Regulate menstruation Dispel Cold Warm the channels Nourish the Blood Dispel Blood Stasis
Herb Formulas	Wen Jing Tang
Points

Blood Deficiency

Clinical Manifestations	Vaginal tract bleeding after having stopped menstruating The amount of Blood is sometimes excessive and sometimes scanty The Blood is fresh red or pale red Low back soreness or Low back and knee soreness and weakness Dizziness Palpitations Insomnia Dry skin Dry hair Poor memory Paleness Fatigue Scanty periods T: Pale C: Thin, white and dry P: Thready and rapid or Weak
Treatment Principle	Nourish Blood Tonify the Spleen
Herb Formulas	An Tai Yin #3 Dang Gui Jian Zhong Tang Si Wu Tang Jia Wei Causing Cold Stagnation in the channels: Dang Gui Si Ni Tang
Points	LIV 3, SP-6, ST-36, UB 11, UB-17

Blood Deficiency During Menstruation

Clinical Manifestations	Low back pain and weak extremities occuring during menstruation Fatigue A white facial complexion Pale menstrual Blood T: Pale C: White P: Deep and thready
Treatment Principle	Nourish and strengthen the Liver and Kidneys Nourish the Blood Regulate menstruation
Herb Formulas	Si Wu Tang  modified For predominant Blood stasis with painful joints during menstruation which are worse with Cold and at night and ameliorated by Heat: Ge Xia Zhu Yu Tang  modified
Points	SP-6, ST-36, UB-18, UB-20, UB-23 For a dribbling menstrual flow when accompanied by a torpid intake, loose stools and a fat tongue with teethmarks: + moxa or moxa needle REN-4 For a dribbling menstrual flow when accompanied by aversion to Cold, cold limbs and long voidings of clear urine: + moxa or moxa needle DU-4 For severe pain: + UB-32 For lower abdominal pain: + KI-12 For dizziness and tinnitus: + GB-39, KI-3

Blood And Yin Deficiency With Blood Stagnation

Clinical Manifestations	Amenorrhea of gradual onset Soreness of the lower back Abdominal pain Emaciation Achy and uncomfortable flesh and bones of the hands and feet Anxiety Dizziness Light headedness Tidal fever General disquietude Gradually worsening afternoon fevers T: Red C: Scanty P: Thready and rapid
Treatment Principle	Tonify the Blood Nourish Yin Calm the Shen Activate the Blood Unblock menstruation
Herb Formulas	Nu Ke Bai Zi Ren Wan
Points

Jing Stasis

Clinical Manifestations	Stabbing pain in the low back and feet Stabbing pain in the testes Stabbing pain in the penis Stabbing pain in the lower abdomen Occasional swelling and pain in the testes aggravated by resting and sleeping - better with movement Maybe impotence Maybe premature ejaculation Maybe erections without stimulation Maybe partial erection during copulation Maybe ejaculation without stimulation Incomplete ejaculation Maybe ejaculation after copulation Urinary incontinence Dribbling urine Premature graying of the hair Itching or pain of the hairy areas Tinnitus Stuffy head Chest oppression Retardation of response to stimulation Difficulty concentrating Forgetfulness Insomnia High viscosity sperm with a high number of deformed sperm Abnormal sperm count T: Purple spots or petechiae C: Normal P: Choppy and astringent
Treatment Principle	Invigorate the Blood Free the flow of Jing
Herb Formulas	Huo Xue Tong Jing Tang
Points

Jing And Blood Deficiency Due To Kidney, Spleen And Heart Deficiency

Clinical Manifestations	Fatigue Heavy and painful lower back Dream-disturbed sleep General weakness Lack of interest in food or drink Fever Night sweats Seminal emission Forgetfulness Toothache Dizziness Gum swelling General pitted edema which is worse in the lower body Vaginal discharge Discharge of rice-water like urination without dysuria Aversion to Cold Impotence Decreased libido Emaciation Loose teeth Signs of premature aging Abdominal Cold Easily frightened T: Pale or Pale and thick C: Smooth and white P: Moderate and weak or Deep and weak
Treatment Principle	Tonify the Spleen and Kidneys Nourish the Heart Enrich Yin Nourish the Blood and Yang Augment Qi
Herb Formulas	Huan Shao Dan
Points

Cold And Dampness In The Lower Jiao

Clinical Manifestations	Chronic cold pain in the lower back and body with a heavy sensation A preference for warmth Pain worse in Cold and Damp weather Pain radiating downward and to the lower limbs Limited movement of the lower spine Severe hardness and stiffness in the lumbar area with obvious tenderness A cord-like, swollen sensation of the supraspinous ligament on palpation A movable cord-like sensation at the origin of the sacro-spinal muscle Pain and other symptoms worsen gradually A long-lasting course of illness A heavy sensation in the head The lower back region feels Cold to the touch The pain is a deep, unremitting ache The pain may be occasionally be severe Twisting and bending are difficult The pain is aggravated by cold weather Lying down provides no improvement Stiffness which is worse on rainy days Aversion to Cold Cold extremities Sciatica Copious urination Extreme heavy sensation in the lower back Absence of thirst Maybe headaches Nausea Loose stools A poor appetite Maybe general body aches Spontaneous contracture of the limbs Maybe a feverish sensation in the upper body Craves hot drinks and compresses Dizziness Vomiting Profuse, purulent leukorrhea with a foul odor T: Pale C: White or Greasy and white at the root P: Deep, thready and moderate or Deep and slow or Moderate or Slippery and slow
Treatment Principle	Warm Yang Strengthen the Spleen Support the Kidneys Dispel Cold Eliminate Dampness Unblock the channels
Herb Formulas	Gan Cao Gan Jiang Fu Ling Bai Zhu Tang  modified Gan Cao Gan Jiang Fu Ling Bai Zhu Tang  + Shen Shi Tang Lumbago #1 Du Huo Ji Sheng Tang Shen Zhao Tang Wu Ji San modified For severe Cold-Damp or with gastrointestinal disturbances: Wu Ji San With Kidney Deficiency: Du Huo Ji Sheng Tang   modified Topical: Mo Yao Dan For Tai Yang Cold-Damp: Qiang Huo Bai Du San For Shao Yin Cold-Damp: Du Huo Cang Zhu Tang For Shao Yang Cold-Damp: Chai Hu Cang Zhu Tang For Jue Yin Cold-Damp: Si Ni Tang  modified For Yang Ming Cold-Damp: Cang Zhu Bai Zhi Tang For Tai Yin Cold-Damp: Ji Sheng Zhu Fu Tang or Shen Shi Tang If no results from the two above formulas: Wu Ling San Chinese Patent Medicines: Du Huo Ji Sheng Wan Feng Shi Pian Zhui Feng Huo Xue Pian Feng Shi Xiao Teng Wan Han Shi Bi Chong Ji Mu Gua Wan Tian M Wan For severe Cold: Xiao Huo Luo Dan Plaster: Die Da Zhi Tong Gao
Points	Moxa or moxa needle DU-3, DU-4, needle Ahshi points, KI-3, SP-6, UB-40, UB-60 Acute: + LI-9 DU-3, DU-16, KI-3, UB-54, UB-60 SI-3, UB-62 Moxa or moxa needle DU-3, UB-25 Moxa or moxa needle KI-3, SP-9, UB-40, UB-60, needle SP-6, UB-58, UB-64 With extreme aversion to Cold in the low back: + moxa or moxa needle DU-4, moxa box the whole low back With a feeling of heaviness in the body: + ST-40 With a poor appetite: + UB-25 With general fatigue: + moxa needle REN-4 GB-34, SP-9, moxa needle DU-3, DU-4, UB-24 With severer heaviness in the low back: + moxa or moxa needle GB-38 With enduring Kidney Yang Deficiency: - DU-3, + UB-18, UB-23 With dizziness and heavy-headedness: + DU-20, GB-20

San Jiao : Middle Jiao Damp-Heat

Clinical Manifestations	Lethargy Anorexia Maybe jaundice No thirst or Thirst with no desire to drink Nausea Vomiting Afternoon fever Body aches A sallow complexion Scanty urination Diarrhea Chest discomfort Epigastric pain and distention Dull appearance Maybe disorientation Loose stools Maybe skin vesicles Heavy extremities T: Pink C: Greasy and yellow P: Soft and rapid
Treatment Principle	Clear Heat Resolve Damp and turbidity
Herb Formulas	Gan Lu Xiao Du Dan
Points	REN-6, REN-12, SP-9, ST-25, ST-36

Damp-Heat In The Lower Jiao

Clinical Manifestations	The lower back feels hot either to the patient or practitioner Chronic pain in the low back and knees, with possible acute exacerbations Weakness in the low back and knees making it difficult to walk or stand for any time The pain is aggravated by Heat, humid or rainy weather and is not improved by rest Limited lumbar movement Maybe inability to move forward and backward Slight swelling and redness in the back area Obvious tenderness at the sides of the spinous processes or in the sacroiliac joint The low back feels sore and heavy The pain may radiate to the lower abdomen Aches and pains in the bones and sinews Weakness or atrophy of lower extremities Painful and/or scanty yellow urine Red, hot, swollen and painful feet or knees Edema in lower legs Leukorrhea (thick, yellow, foul-smelling) Sores on lower extremities due to Damp Redness, swelling and pain of the knees with burning sensations Oliguria Eczema Irritability Feverishness Spontaneous sweat A bitter taste in the mouth Nausea Vomiting Diarrhea Maybe constipation Thirst Loose stools or Discharge of purulent, bloody stools Yellowish or reddish urine Painful urination Maybe scanty urination T: Normal or Red C: Yellow and greasy P: Soft and rapid or Slippery and rapid
Treatment Principle	Eliminate Heat and Dampness Ease the tendons Stop pain
Herb Formulas	Er Miao San modified Jia Wei Er Miao Wan Si Miao Wan  modified Cheng Shi Bei Xie Fen Qing Yin With a Cold sensation due to Blood Deficiency: Ba Wei Dai Sha Fang For Damp-Heat lower back pain with pain, redness swelling and Heat in the joints: Dang Gui Nian Tong Tang + Cang Zhu San For Damp-Heat lower back pain becoming chronic with Kidney exhaustion: Qi Wei Cang Bai San Chinese Patent Medicines: Qian Jin Zhi Dai Wan Yu Dai Wan Shi Lin Tong Pian Si Miao Wan
Points	General points + GB-34, KI-7, SP-9 KI-7, KI-10, UB-25, UB-27 GB-34, SJ-2, SJ-4, SJ-6, SP-9, UB-58, UB-60, UB-66 With Dai channel obstruction low back heaviness, a feeling of tight belt around the waist, Warmth in the upper body with Cold in the lower body or vice versa, a feeling of sitting in a bath or pain radiating to the sides of the abdomen: + GB-26, GB-27, GB-41 With pain radiating to the leg along the Bladder channel: + UB-36, UB-56, UB-63 With pain radiating to the leg along the Gall Bladder channel: + GB-29, GB-30, GB-36, GB-40 With pain radiating to the leg along the Stomach channel: + ST-30, ST-34, ST-40, ST-42 With pain radiating to the leg along the Liver channel: + LIV-3, LIV-5, LIV-6, LIV-12 With fever: + DU-14 With sacral pain: + Ahshi points With a severe burning sensation and aversion to Heat in the lower back: + UB-67 With scanty, painful urination: + KI-4, UB-32 With a feeling of heaviness in the body: + SP-6 With a poor appetite: + UB-20 With diarrhea: + SP-3 With profuse leukorrhea: + GB-27, GB-41 DU-2, GB-34, LIV-2, UB-40 With abdominal distention: + SP-3 With enduring low back pain and knee aching: + UB-31 GB-34, GB-39, LIV-2, SP-9, UB-27, UB-28 With redness and swelling of the knees and feet: + Bafeng, Xiyan With signs of Yin Deficiency with Fire Rising : + SP-6

Phlegm Accumulation

Clinical Manifestations	Pain with a heavy sensation in one side of the back Coughing Dyspnea A sensation of fullness and oppression in the chest Obesity Tenderness and a node-like swelling or mass at the tip of the L-3 spinous process or over the sacroiliac joint on palpation Maybe pain and heaviness in the head and limbs P: Slippery or Wiry
Treatment Principle	Eliminate Phlegm Dredge the channels and collaterals
Herb Formulas	Di Tan Tang  modified
Points	SP-9, ST-40, UB-20

Phlegm-Damp In The Lower Jiao

Clinical Manifestations	Lower back pain accompanied by heaviness in the low back Anorexia Edema, especially below the waist A feeling of heaviness in the waist and knees Maybe a cold low back A bright white facial complexion Abdominal distention Chest and hypochondriac distention Dizziness Nausea Vomiting Vertigo Thirst with no desire to drink Maybe no thirst Palpitations Shortness of Breath Fatigue Oliguria T: Normal C: Thick and slippery P: Slippery, full and maybe wiry or Slow, deep and forceless
Treatment Principle	Dry Dampness Transform Phlegm Warm Yang
Herb Formulas	Shen Shi Tang Er Chen Tang  modified Gui Chun Wan
Points	PC-6, SJ-6, SP-6, SP-9, ST-40, UB-13, UB-20, UB-23 REN-4, REN-6, REN-9, SP-9, UB-23, UB-26 For long voidings of clear or whitish urine: + moxa or moxa needle DU-4 With a simultaneous invasion of Wind-Cold: + UB-12 For Stomach oppression and loose stools: + ST-36 For oliguria: + LI-16, LI-17

Insufficiency Of The Chong And Ren Channels

Clinical Manifestations	Abdominal pain Uterine bleeding (metrorrhagia) Excessive menstruation Menstruation with constant spotting Postpartum bleeding Bleeding during pregnancy The Blood is pale and thin without clots Weakness Dizziness Sore lower back Post abortion bleeding Dull complexion Weakness and pain of the legs Light red, unelevated and indistinct eruptions Hematuria T: Pale C: Thin and white or Whitish and moist P: Thready and weak
Treatment Principle	Nourish and warm the Blood Stop bleeding
Herb Formulas	Jiao Ai Tang Si Wu Tang:
Points

Yang Deficient Bi

Clinical Manifestations	Excruciating stabbing pain in the extremities Painful, numb bones and joints Deformed bones and joints Localized Cold sensation Muscles and sinews atrophied Pale, lusterless face Cold body and limbs Spine bent forward (hunched) Weak, sore low back Weak, sore knees Profuse urination Watery stools Daybreak diarrhea T: Pale C: White P: Deep and Weak
Treatment Principle	Warm the Yang Augment Qi Alleviate pain
Herb Formulas	Fu Zi Ba Wu Tang
Points

Deficiency Of Ming Men Fire

Clinical Manifestations	Impotence Infertility Listlessness Lack of Spirit Weakness and aching of the low back A pale, shiny complexion T: Pale C: White P: Deep and thready
Treatment Principle	Warm and tonify the Kidneys
Herb Formulas	Zan Yu Dan
Points

Wei Syndrome Due To Kidney And Liver Yin And Blood Deficiency

Clinical Manifestations	Slow and gradual onset Weak and flaccid lower limbs Muscle twitching Soreness and weakness of the lower back and spine Inability to stand for a long time Total loss of mobility and severe loss of muscle mass can result with exacerbation No obvious tender points Dizziness Vertigo Hair loss Dry throat Tinnitus Fatigue Nocturnal emissions Enuresis Pain radiates to the lower abdomen with difficult urination or Fecal and urinary incontinence Irregular menstruation Dysmenorrhea T: Red or Pale C: Little or None P: Thready and rapid
Treatment Principle	Tonify the Liver and Kidneys Nourish Yin Clear Heat
Herb Formulas	Hu Qian Wan modified Zi Shui Qing Gan Yin He Che Da Zao Wan Da Bu Yin Wan Liu Wei Di Huang Wan Zuo Gui Wan Zuo Gui Yin Yi Sui Tang Du Huo Ji Sheng Tang modified With Yang Deficiency: Ba Wei Di Huang Wan
Points	General points + KI-3, LIV-3, REN-4, SP-6, UB-18, UB-23 Huatuojiaji, KI-3, LIV-3, LIV-8, REN-4, SP-6, ST-31 to ST-41, UB-23 DU-4, KI-3, REN-4, SP-6, ST-36, UB-23, UB-52 DU-4, GB-34, KI-3, REN-4, UB-18, UB-23 For tinnitus: + GB-2 For dizziness and vertigo: + GB-20, UB-2

Interior Deficiency With Cold Blood

Clinical Manifestations	Postpartum abdominal pain Cold abdominal hernial pain Hypochondriac pain Spasmodic pain in the flanks Sallow complexion Fatigue Dizziness Tinnitus Lumbago The pain is better with warmth and pressure Swollen, indurated scrotum T: Pale C: White P: Deep, wiry and forceless or Deep, wiry and choppy or Soft and feeble
Treatment Principle	Warm the Interior Nourish the Blood Regulate the Liver function Alleviate pain
Herb Formulas	Dang Gui Sheng Jiang Yang Rou Tang
Points

Stone Lin

Clinical Manifestations	Urinary frequency Urinary urgency Painful urination or Continuous dripping of urine or The pain occurs intermittently and is unbearable when it attacks Sudden interruption to the urinary stream Dark colored urine with sand and stones or Colicky pain in the low back, possibly radiating to the groin Profuse sweating when the pain is severe T: normal or Red C: Yellow P: Slippery and rapid or Wiry
Treatment Principle	Clear Heat Eliminate Dampness by diuresis Disinhibit urine Alleviate pain
Herb Formulas	Shi Wei San  modified
Points	KI-7, LIV-2, REN-3, SP-6, SP-9, UB-23, UB-28, UB-39 GB-25, LIV-8, UB-23, UB-28, UB-40 With hematuria: + SP-10 With a stone in the upper urinary tract: + ST-25 With a stone in the lower urinary tract: +REN-3 With vomiting: + PC-6 With constipation: + SJ-6, ST-25 With severe pain: + LIV-4 For retention of urine: 1. REN-3, SP-6, SP-9, UB-28 2. REN-3, SP-6, SP-9, UB-39 For Stone Lin: 1. KI-2, KI-3, LIV-2, REN-3, SP-9, UB-28, UB-39 2. KI-1, LIV-1, REN-4, UB-23, UB-28, UB-40

Trauma Causing Qi And Blood Stagnation

Clinical Manifestations	Back pain with a history of injury to the low back The pain is often prickly ,fixed and/or severe The pain is worse with exertion, movement and, in severe cases, breathing The pain often gets worse at night Limited movement Difficulty turning the body or lying on the back Fixed spine or soft tissue tenderness Local redness and/or swelling Muscular stiffness and spasms Bruising Swelling Fatigued libs Slight fever Rest often relieves pain T:Dark with maculae C: White P: Wiry or deep and choppy
Treatment Principle	Invigorate the Blood Stop pain
Herb Formulas	Shen Tong Zhu Yu Tang  modified Gu An Fang Tao Hong Si Wu Tang  modified Jiu Wei Yao Tong Fang With menstrual irregularity: Tao Hong Si Wu Tang  modified
Points	Ahshi Points, LI-9, SI-3, UB-40, UB-60, Yaotang 1, Yaotang 2, Yaotang 3 UB-17, UB-32, UB-40 DU-26, LU-5, REN-6, UB-34, UB-40, UB-60, UB-65 DU-26, GB-34, LU-5, SJ-6, UB-40, UB-60, UB-65 DU-26, UB-40 UB-23, UB-40, UB-60 SJ-5 through to PC-6, SI-6 Ahshi, SI-3, UB-37 KI-3, LI-4, SP-6, UB-11, UB-17, UB-18, UB-23 Ahshi, DU-26, UB-40 With menstrual irregularity: + SP-8. SP-10 With a thready pulse: + SP-6, ST-36 With rib pain: + GB-26 Acute: 1. DU-26, KI-2, bleed UB-40 2. Ahshi, DU-28, UB-40 3. Ahshi, DU-26, KI-2, SI-6, ST-9, UB-40, Yaotong #1, Yaotong #3 Difficulty getting up: moxa 3 cones on DU-26, UB-23, 2 cones on DU-2, DU-4, UB-29 With rib pain: LI-4, LI-5, LI-10, LI-11, LIV-2, SP-6, SP-9, ST-36 Ear: Lumbar Vertebrae, Lumbago, Shenmen, Subcortex, Adrenal

Thirteen Types Of Channel Involvement

Clinical Manifestations	1. Attack of the Bladder Channel: The pain radiates along the spine upward to the neck and downward to the coccyx 2. Attack of the Gallbladder Channel: The pain feels like pricking by needles Cannot stoop, rise or turn 3. Attack of the Stomach Channel: Cannot turn If people try to turn, they experience fear or terror Moans a lot 4. Attack of the Kidney Channel: Localized Interior pain The pain radiates along the spine upward to the neck 5. Attack of the Liver Channel: The spine feels stiff and stretched like a bow The patient likes to talk 6. Attack of the Tendino-Muscular Channels: Pain radiates toward the shoulder Visual difficulties Urinary incontinence The pain feel like a belt that is too tight There may be a rupture in the renal region Uneasiness and fear 7. Attack of the Yang Qiao Channels: Swelling and projections from the renal area 8. Attack of the Yang Wei Channels: Lumbar swelling 9. Attack of the Chong Channel: Impediment of forward and backward bending If the patients bend forward they lose their balance This generally occurs after lifting a heavy weight 10. Attack of the Ren Channel: Pain accompanied by perspiration After sweating, the patient wants to drink After drinking, the patient wants to run 11. Attack of the Yin Wei Channels: The low back is always painful Continual lamentations and fright 12. Attack of the Yin Qiao Channels: The pain radiates towards the chest A sensation of fractures at the renal level Blurred vision A stiff tongue Difficult speech 13. Attack of the Du Channel: Fever If the fever is high there will be somber thoughts Stiff renal region Urinary incontinence
Treatment Principle
Herb Formulas
Points	1. Attack of the UB Channel: Bleed UB-40 (except in Spring) 2. Attack of the GB Channel: Bleed GB-34 (except in Autumn) 3. Attack of the Stomach Channel: Bleed St-36, ST-37, ST-39 (except in Autumn) 4. Attack of the Kidney Channel: Tonify KI-2, KI-3 (bleed both except in Spring) 5. Attack of the Liver Channel: LIV-5, LIV-6, LIV-7 6. Attack of the Tendino-Muscular Channels: needle the inter-articular space of the knee and the large capillaries at this level, then bleed until the black Blood changes color to red 7. Attack of the Yang Qiao Channels: UB-59, UB-61, UB-62 8. Attack of the Yang Wei Channels: GB-35, UB-63 9. Attack of the Chong Channel: UB-38, UB-39 10. Attack of the Ren Channel: Bleed DU-3, DU-4, DU-5 11. Attack of the Yin Wei Channels: KI-9 12. Attack of the Yin Qiao Channels: KI-6, KI-8 13. Attack of the Du Channel: REN-4, REN-6

Transverse Or Layered Lower Back Pain (Acute)

Clinical Manifestations	Qi Movements: 1. Obstruction of the Outward Movement of Yang Qi toward the Lower Limbs: Strain- induced lower back pain Pain aggravated by coughing and straining Referred Pin on the posterior aspect of the lower limb, along the Bladder Channel Often affects only one leg at a time 2. Obstruction of the Movement of Yin Qi from the Lower Limbs to the Trunk: Acute lower back pain which is ameliorated by Cold and pressure A heavy sensation in the legs Cramps Often, peripheral venous disorders or Pain on the medial aspect of the thigh resembling an obturator neuralgia Channel Pathology: 1. Chong Channel: Pain elicited by attempting to lift an object that is too heavy 2. Yang Wei Channel: Diffuse joint pain Sensitive to weather changes A swelling sensation in the lower back Fever and chills Headache P: Floating 3. Shao Yin Collateral: Lower back pain
Treatment Principle
Herb Formulas
Points	Qi Movements: 1. Obstruction of the Outward Movement of Yang Qi toward the Lower Limbs: UB-29, UB-36, UB-60 With Internal Cold: Moxa KI-13, UB-31 - UB-34 2. Obstruction of the Movement of Yin Qi from the Lower Limbs to the Trunk: LIV-11 With lingering pain: REN-3 Channel Pathology: 1. Chong Channel: PC-6, SP-4, UB-38, UB-39 2. Yang Wei Channel: GB-35, GB-41, SJ-5 3. Shao Yin Collateral: DU-26, KI-3, UB-58

Longitudinal Lower Back Pain (Acute)

Clinical Manifestations	Leg Tai Yang Sinew Channel: Sharp pain with a breaking sensation in the spine A stiff vertebral column The vertebral column is bent backwards Pain in the posterior aspect of the lower limb Contractures of the neck, sinews and muscles Difficulty lifting the arm Stabbing pain in the arm pit Stabbing pain in the supraclavicular fossa Migraine Facial pain Leg Shao Yin Sinew Channel: Paramedial pain which is deep but not reproduced by palpation Contractures of the whole body or Contractures restricted to the soles of the feet or Contractures of the medial aspect of the lower limbs If the posterior and superficial aspects of the body are affected: A sensation of heaviness in the lower back Difficulty bending forward If the anterior and deep aspects of the body are affected: Difficulty bending backward Urinary Bladder Primary Channel: Sharp, wrenching-type pain in the lower back and spine A breaking sensation in the lumbar area that is deeper than the Leg Tai Yang Sinew Channel related pain Painful areas along the pathway to the lower limbs, neck and head Kidney Primary Channel: The pain is deep and medial Affects the thoracic and lumbar vertebrae Cold feet Painful soles of the feet Pain in the posteriomedial aspect of the lower limb Sore throat Dry mouth Yang Qiao Channel: The entire back is painful The whole body is stiff The lower back feels like it has been pounded by a hammer A swelling sensation of the affected area Difficulty getting up May develop an antalgic posture, bending toward the affected side Pain along the channel pathway in the shoulder Insomnia Eye pain Contractures of the lower limb Du Channel: Stiff spine The entire back is painful Difficulty lying on one's back If the pathology arises through an invasion of DU-16: Pseudo flu-like symptoms Vertebral pain progressing down the spine If the condition results from a Urinary Bladder Primary Channel invasion spreading to the Du Channel: Symptoms common to both locations will be found, particularly Headaches Pain in the nape of the neck Du Channel Collateral Vessel: Stiffness and heaviness of the upper and lower back and spine The body is bent The head feels full Sensitivity at the vertex Maybe seizures
Treatment Principle
Herb Formulas
Points	Leg Tai Yang Sinew Channel: UB-67 Due to trauma: + Ahshi points, UB-57, UB-60 Due to Wind-Cold-Damp: + SI-18 Leg Shao Yin Sinew Channel: KI-1, KI-2, REN-2, REN-3 Urinary Bladder Primary Channel: Due to External Cold: 1. UB-60, UB-66, UB-67 2. UB-58, UB-65 If Wind is predominant: UB-12, UB-65 If due to an Internal Urinary Bladder condition: KI-4, UB-40, UB-64 Kidney Primary Channel: KI-2, KI-3, UB-58 With pathogenic Cold: KI-1, KI-3, KI-4, KI-7 Yang Qiao Channel: SI-3, UB-59, UB-62 Du Channel: DU-16, moxa DU-20, SI-3, tonify Kidney Qi Du Channel Collateral Vessel: DU-1

Sacroiliac Pain

Clinical Manifestations	Leg Shao Yang Sinew Channel: The pain is mostly located in the sacroiliac and sacral regions The pain radiates toward the buttocks and lateral aspect of the lower limb The pain can reach the fourth toe Difficulty bending the knee Flank pain Gall Bladder Primary Channel: Sacroiliac pain radiates toward the lateral aspect of the lower limb Right hypochondriac pain Headaches Chills Vomiting
Treatment Principle
Herb Formulas
Points	Leg Shao Yang Sinew Channel: Due to trauma: GB-40, GB-44 Due to invasion of pathogenic influences: GB-43, SI-18 Gall Bladder Primary Channel: Due to Wind-Cold: GB-30, GB-38, GB-43, GB-44 If associated with an Internal Gall Bladder disorder: GB-34, GB-40, LIV-5 If the entire Shao Yang Channel is involved: GB-37, GB-41

Thoracolumbar Pain

Clinical Manifestations	Leg Tai Yin Sinew Channel: Deep posterior thoracic pain Pain may radiate to the lower back and anterior thorax Contracture of the big toe Twisting pain in the medial malleolus Pain in the medial aspect of the thigh A wrenching sensation in the genitals that radiates toward the umbilicus and flanks Leg Yang Ming Sinew Channel: Transverse pain in the lower middle back The pain gathers around the flanks Pain on the anterior aspect of the lower limb Abdominal tension Leg Tai Yang Sinew Channel: Middle and upper lumbar pain Stuffy nose Headaches
Treatment Principle
Herb Formulas
Points	Leg Tai Yin Sinew Channel: Due to trauma: Local Ahshi points, SP-1, SP-5 Due to pathogenic Dampness: Local Ahshi points, REN-2, REN-3, SP-1, SP-3, SP-5 Leg Yang Ming Sinew Channel: Due to trauma: ST-41, ST-45 Due to heat or Cold: Local Ahshi points Leg Tai Yang Sinew Channel: UB-58

Recurrent Or Chronic Lower Back Pain

Clinical Manifestations	Lower Limb Yang Deficiency: Dull lower back pain Better with pressure, warmth and rest Aggravated by Cold and strain Localized Qi Stagnation: Occurs during rest, when sitting or standing for long periods of time or When arising in the morning with difficulty getting started Decrease in pain after a warm up period of some duration Pain improves with walking, massage and warmth Aggravated by Cold Localized Blood Stagnation: Stabbing pain which, when severe, feels like dagger stabs Worse at night Difficult movement In women, relapses may occur during ovulation or premenstrually Frequent hemorrhoids T: Deep purple P: Choppy Channel Pathology: 1. Urinary Bladder Primary Channel: Sharp, wrenching-type pain in the lower back and spine A breaking sensation in the lumbar area that is deeper than the Leg Tai Yang Sinew Channel related pain Painful areas along the pathway to the lower limbs, neck and head 2. Liver Primary Channel: Low back pain preventing flexion and extension of the trunk Scrotal pain or discomfort Pruritis of the external genitalia Women: Pelvic disorders 3. Du Channel: Chronic pain affecting the entire back A history of scoliosis or Scheuerman's disease 3. Yin Qiao Channel: Low back pain with pain in the lower abdomen and hip which radiates toward the genitals May be triggered by menstruation or ovulation 4. Dai Channel: Low back pain encircling the waist and radiating toward the medial aspect of the thigh Abdominal and periumbilical pain A sensation of sitting in cool water Dysmenorrhea Leukorrhea Looseness of the ankles When the Dai Channel is deficient: Disability of the lower limbs 5. Ren Channel: Lower back pain starts ant the bottom of the back or Deep lower back pain, usually on the midline Pain is affected by sexual activity Profuse sweating Thirst Patient feels like walking after drinking Hernias Abdominal masses Gynecological disorders Sexual disorders 6. Yin Wei Channel: Low back pain Swelling of the flanks Pain in the chest Stabbing, piercing pain in the Heart area Pain in the genitals Headaches Organ Pathology: 1. Kidneys: Lumbar pain Lumbar stiffness and weakness Pain is ameliorated by light massage Weak legs and knees Aggravated by physical activity Better with rest Frequent relapses If Yang Deficiency predominates: Spasms in the lower abdomen Pale face Cold limbs T: Pale| P: Deep and thready If Yin Deficiency predominates: Lower back pain Worry Restlessness Insomnia Dry throat Dark urine Hot flashes Five Sole Heat T: Red P: Wiry, thready and rapid Blockage of Kidney Qi: Low back pain Diarrhea Emotional stress 2. Liver: Lower back pain radiating to the flanks and abdomen Abdominal distention Inability to stand for long periods Skepticism Worrying about the future Being thin-skinned Irritability Anger Vertex headaches Visual disorders Cramps T: Red C: Thin P: Wiry or Deep and wiry 3. Small Intestine: Abdominal pain radiating to the back and spine Dark, almost red urine Pain in the external genitalia T: Red tip and edges C: Yellow P: Slippery and rapid 4. Large Intestine: Lower back pain Digestive disorders Intestinal transit disorders 5. Spleen: Lower back pain A heavy sensation Stiffness in the limbs Pale face Poor appetite Abdominal distention Diarrhea T: Pale C: White P: Soft and slippery Painful Obstruction: 1. Cold-Damp Low Back Pain: Sudden onset Pain is accompanied by a cold, heavy sensation in the lower back Pain progressively worsens Rotation of the trunk is difficult Resting in a recumbent position only partially alleviates the pain and may aggravate it The pain increases in cold, damp weather As the disorder progresses to the chronic stage, there are periods of crises alternating with lulls T: Normal: C: White and greasy P: Deep and slow 2. Damp-Heat Low Back Pain: Pain accompanied by local sensations of Heat A heavy sensation while walking The pain is aggravated by hot, rainy weather The joints may be red and swollen Thirst Restlessness Dark urine Constipation T: Normal C: Yellow and greasy P: Soft and rapid 3. Damp-Phlegm Low Back Pain: The pain radiates toward the sacrum A dull, heavy sensation when getting started or while standing around Subcutaneous nodules in the painful area Trigger Points: 1. Serratus Inferior Posterior Muscle: Referred pain: Mildly stabbing pain in the posterior and inferior aspect of the rib cage Pain is improved by twisting and stretching The pain follows the pathways of the lateral branch of the Bladder channel and Stomach channel 2. Iliocostalis Thoracis Muscle: Referred pain: Pain in the posterior and inferior aspect of the rib cage radiating along the spine The pain follows the pathway of the Bladder channel in the scapula and iliac fossa 3. Iliocostalis Lumborum Muscle: Referred pain: Pain in the lower back and buttocks following the pathway of the Bladder channel 4. Longissimus Thoracis Muscle: Pain in the lower back and buttocks The pain follows the pathway of the Bladder channel Pain in the posterior aspect of the iliac crest 5. Multifidi and Rotatores Muscles: Pain in the sacrococcygeal and buttock area Lower back and abdominal which may be confused with visceral pain Pain in the sacrococcygeal area, sensitive to pressure which Evokes a coccygodynia on the posterior aspect of the thigh along the Bladder channel and in the hypogastrium 6. Rectus Abdominus Muscle: Bilateral pain in the lower posterior thoracic area encircling the body Maybe a sensation of abdominal fullness Epigastric pain Nausea Vomiting Lower back encircling pain
Treatment Principle
Herb Formulas
Points	Lower Limb Yang Deficiency: ST-31 Localized Qi Stagnation: GB-30, REN-4 When associated with the Dai Channel: GB-25 Localized Blood Stagnation: UB-17, UB-32, UB-40, UB-53 When associated with the Dai Channel: GB-28 Urinary Bladder Primary Channel: DU-3, DU-14, UB-11, UB-57 With middle and lower back pain: SP-5, UB-57 or SP-8, UB-57 With trapezius muscle involvement: GB-23, SI-11, UB-29 Liver Primary Channel: LIV-2, LIV-4 Du Channel: DU-1, UB-11 Yin Qiao Channel: KI-6, KI-8, LU-7 Dai Channel: GB-26, GB-41, SJ-5 When the Dai Channel is deficient: + ST-30, ST-36, ST-37 Ren Channel: KI-6, LU-7, REN-2, REN-4, REN-6 Yin Wei Channel: KI-9, PC-6, SP-4 Kidneys: If Yang Deficiency predominates: moxa or moxa needle DU-4, DU-20, UB-23 If Yin Deficiency predominates: KI-3, KI-15, UB-23, UB-52 Blockage of Kidney Qi: DU-5 Liver: LIV-3, LIV-6, UB-18 Small Intestine: SI-2, ST-39, UB-27 Large Intestine: DU-3, UB-25 Spleen: REN-12, SP-3, ST-40, UB-20 Painful Obstruction: 1. Cold-Damp Low Back Pain: Local Ahshi points, DU-3, DU-16, Huatuojiaji (local area), SP-3, UB-40, UB-60, moxa or moxa needle UB-23 2. Damp-Heat Low Back Pain: Huatuojiaji (local area), KI-3, KI-10, UB-23, UB-32, UB-52 3. Damp-Phlegm Low Back Pain: SP-3, ST-40 Trigger Points: 1. Serratus Inferior Poster Muscle: The area surrounding UB-48 2. Iliocostalis Thoracis Muscle: The area surrounding UB-49 3, Iliocostalis Lumborum Muscle: The area surrounding UB-51 4. Longissimus Thoracis Muscle:     Pain follows the pathway of the Bladder channel: The area     surrounding UB-49     Pain in the lower back, buttocks and posterior aspect of the     iliac crest: The area surrounding UB-22 5. Multifidi and Rotatores Muscles:     Pain in the sacrococcygeal and buttock area: The area     Surrounding UB-30     Lower back and abdominal which may be confused with visceral     pain: The area surrounding UB-23     Pain in the sacrococcygeal area, sensitive to pressure which     Evokes a coccygodynia on the posterior aspect of the thigh     along the Bladder channel and in the hypogastrium: UB-27 6. Rectus Abdominis Muscle:     Bilateral pain in the lower posterior thoracic area encircling the     Body, a sensation of abdominal fullness, epigastric pain,     Nausea and vomiting: The area surrounding KI-21     Lower back encircling pain: The area surrounding KI-11