Low back pain
Low back pain, a leading cause of disability in the Western countries, has a significant economic impact not only on lost productivity but also on healthcare expenditures. Approximately a fifth of patients will see multiple physicians in their quest for relief of low back pain. Primary care physicians therefore play a crucial role in the initial approach to these patients.
Of course, it is important to always make a diagnosis in an orthodox way, before deciding on a treatment with natural medicine. Both clinical examination and history taking can bring crucial information. It is obvious that biopuncture is not the appropriate treatment for many diseases, like tumors, certain inflammatory processes, important degenerative processes, or serious intervertebral disc disease. The majority of spinal disorders however can be treated with biopuncture in a safe and economic way by giving injections in muscles, tendons, joints and ligaments; such injections are advantageous in both acute and chronic pain syndromes.
Especially the use of injections in myofascial trigger points and painful ligaments is a very interesting option in general practice. There is no adequate explanation as to why some people more than others are prone to activate trigger points in their spinal muscles or are prone to develop painful spots in their ligaments, where in some people these cause acute pain, and in others recurrent or even chronic pain. Certainly there is no definite evidence that specific structural disorders of the spine make any significant contribution to this. Several authors (Baldry, Simons, Travell) suggest the importance of perpetuating factors such as chronic overloading of muscles and tendons by sudden overload (e.g. lifting objects whilst in an awkward position such as with the back twisted and flexed), repetitive abuse (e.g. at work, during athletic activities), and psychological factors (psychological problems at the workplace or at home).
To treat low back pain with biopuncture, one can inject subcutaneously, inject in pain points (PPs) and pain zones (PZs), which can be tendineal, ligamental and/or myofascial. Some also inject into trigger points on the enthesopathy or in the periost. In biopuncture, the focus is on both the muscles and the ligaments. During physical examination, tenderness in the low back muscles or laxity in the lumbosacral ligaments can be tested by palpating the muscles and ligaments with the thumb to elicit tenderness, jump sign or referred pain. Typical referral pain patterns originating form ligamentous injury can sometimes be elicited in certain positions of the body. Active trigger points in the low back muscles and in the gluteus muscles (minimus, medius and maximus) each have their characteristic pain referral patterns: to the lateral side of the leg, the sacrum, and / or the buttock region (see also: webpage about pseudosciatica).
Case:
A 32-year-old woman suffered an acute attack of lumbago for two weeks. She told me that she had had this problem regularly, and that further investigations (X-Rays, CT scan, blood analyses) were normal. Each time she received a symptomatic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), and recovered after a week. However, because she had gastrointestinal problems the last time she took the NSAIDs, she wanted to try another approach.
I gave her injections with a mixture of Traumeel and Discus compositum in the paravertebral muscles, exactly in the zone she was complaining of (fig. 33). Four sessions of local intramuscular injections in the zone of pain referral were enough to alleviate the pain, without the use of conventional painkillers or NSAIDs.
Case
A 64-year-old man complained of serious low back problems for four weeks. His general practitioner prescribed an NSAID, which helped for about two weeks. X-rays showed degenerative changes of the facet joints on level L3 and L4. When he came to see me, I gave him injections with Zeel and Discus compositum in the muscles of the lumbar spine. Although he received three sessions of these injections in one week, he still had a lot of pain. He told me he even had to take additional painkillers in order to be able to sleep at night. I ordered a CT scan of the lumbar spine, which revealed a metastatic process in the second lumbar vertebra. I explained that he needed further investigation to look for the origin of this tumor process and added that biopuncture would not be able to help him here. I sent him to his general practitioner for further examination.