Acute lumbar strain, also known as “acute lumbar muscle and fascia strain” and commonly referred to as “straining one’s back,” is most commonly seen in young and middle-aged manual laborers. The incidence rate among those aged 20 to 30 is over 50 percent. In more than 90 percent of cases, the injury occurs in the lumbosacral region, the bilateral sacral erector spinae muscles, and the sacroiliac joints. It is often caused by excessive forward or backward flexion, twisting, or bending of the lower back beyond the normal range of motion; by lifting heavy objects with excessive weight or using improper lifting techniques; by falls, twists, or bruises; or even by direct force applied to the lower back. These factors cause the soft tissues of the lower back—including muscles, fascia, and ligaments—to be twisted or stretched, resulting in sudden onset of lower back pain.
Clinical Manifestations: These include varying degrees of lower back pain and limited mobility. In severe cases, intense lower back pain occurs immediately after the injury, with significantly restricted movement; sitting, lying down, and walking become difficult. Pain is exacerbated by coughing, sneezing, and breathing. Several hours or 1–2 days later, the pain gradually worsens, leading to complete immobility of the lower back and, in extreme cases, radiation into the lower limbs. A fixed tender point may be present in the lower back. X-rays often show no abnormal changes, but most patients exhibit alterations in the spine’s physiological curves, such as scoliosis or loss of the physiological lordosis; the straight leg raise test and pelvic rotation test are typically positive.
Manual Therapy: Massage and tuina therapy are highly effective for acute lumbar sprains. Through massage and tuina, muscle spasms can be relieved, blood circulation increased, and stasis eliminated, thereby relaxing tendons, activating meridians, reducing swelling, and relieving pain.
(1) Traction and Massage Method: The patient lies in the prone position with the limbs relaxed. Secure the patient’s shoulders, grasp both ankles, and apply gentle, resistive traction. After maintaining this position for a certain period, use the thumbs or palms of both hands to massage from the shoulders down along both sides of the spine, following the Bladder Meridian (Foot-Taiyang). After passing the Chengfu acupoint, switch to a kneading technique, continuing to the Yimen, Weizhong, and Chengshan acupoints. Repeat the massage several times.
(2) Leg-Lifting and Lower Back Massage Method: Place one hand on the patient’s painful area, while the other hand supports the middle of the patient’s thigh with the palm. Hook the elbow under the front lower part of the thigh, lift the thigh upward, and simultaneously stretch and rock it; a cracking sound may sometimes be heard. Repeat several times, once daily.
Acupuncture Therapy
(1) Body Acupuncture: Select the Renzhong, Houxi, Weizhong, and Ashi points in the lumbar region. After obtaining the “qi,” leave the needles in for 10 minutes. Perform once daily.
(2) Auricular Acupuncture: Select tender points in the lumbosacral region, as well as the Shenmen and Subcortical points. Use fine needles or the bean-pressing method; retain needles for 1–3 hours. With the bean-pressing method, the beans may be left in place for 1–3 days, but they must be massaged and pressed once daily. Both methods yield significant results.
Electroacupuncture: This method has analgesic, anti-inflammatory, antispasmodic, sedative, and cerebral cortex-regulating effects. Acupoints are selected along the meridians, corresponding to those used in body acupuncture. After locating the acupoints, rubber electrodes are secured in place, and electrical stimulation is applied. The intensity, waveform, and frequency are adjusted according to the patient’s tolerance. It is highly effective for acute lumbar sprains. Administer once daily for 30 minutes per session.
Field Effect Therapy Device Treatment: This method dilates blood vessels, unblocks meridians, warms the meridians to dispel cold, reduces inflammation, and relieves spasms and pain. Place the device on the painful area once daily for 30 minutes; it is particularly effective for acute lumbar sprains.
Combined Treatment: Clinically, combining several of these methods simultaneously yields better results. Herbal decoctions may also be added based on the patient’s condition to consolidate the therapeutic effects.