Acute lumbar sprain refers to an acute laceration caused by sudden over-stretching of the lumbar muscles, fascia, ligaments and other soft tissues due to external force. It is also known as “shan yao” and “cha qi” in Chinese. The occurrence of acute lumbar sprain is often related to factors such as strenuous exercise, improper force, falls and injuries. The disease is located in the waist meridian tendon and is closely related to the bladder meridian, Du meridian and other meridians. The basic pathogenesis is obstruction of the waist meridians and stagnation of Qi and blood.

急性腰扭傷是指腰部肌肉、筋膜、韌帶等軟組織因外力作用突然受到過度牽拉而引起的急 性撕裂傷，又稱「閃腰」「岔氣」。急性腰扭傷的發生常與劇烈運動、用力不當、跌僕損傷等因素有關。本病病位在腰部經筋，與膀胱經、督脈等經脈關係密切。基本病機是腰部經絡不通，氣血壅滯。

[Key points of syndrome differentiation辨證要點]
Main symptoms: Sudden waist pain, red, green, or purple skin at the injured area, stiffness, and limited movement.
主症: 突發腰部疼痛，傷處皮色發紅，或青，或紫，僵硬，活動受限。

The Du meridian runs in the middle of the waist, the large intestine meridian tendon of Hand Yangming runs in the jiaji, and the bladder meridian of Foot Taiyang runs on both sides of the spine.
督脈行腰部正中，手陽明大腸經筋夾脊內，足太陽膀胱經行脊椎兩側。

• The pain is in the middle of the spine, and the disease belongs to the Du channel; 痛在脊柱正中，病屬督脈；

Du meridian Route Map 督脈循行路線圖

• Pain at the side of the spine (between the Governor Meridian and the Bladder Meridian) is a tendon disease along the Yangming Meridian tendon of the Hand; 痛在脊旁(督脈與膀胱經之間)，屬手陽明經筋病；

Distribution diagram of the large intestine meridian tendon of Hand Yangming手陽明大腸經筋分布圖

• The pain is along the bladder meridian point of Foot Taiyang on one or both sides of the spine, and the disease belongs to the bladder meridian point of Foot Taiyang.痛在脊柱一側或兩側膀胱經循行線上，病屬足太陽經。

bladder meridian point of Foot Taiyang tour route 足太陽膀胱經巡行路線

【Treatment 治療】
1.Basic treatment 基本治療
Treatment method: smooth meridians and activate collaterals, relax muscles and relieve pain. Focus on local acupoints. 治法: 通經活絡，舒筋止痛。取局部穴位為主。

Main points: Ashi point, EX-UE7 (Yaotong), BL54(Weizhong), SI3(Houxi)
主穴: 阿是穴、腰痛、委中、後溪

EX-UE7 (Yaotong, Low Back Pain) 腰痛

On the back of the hand, between the 2nd and 3rd metacarpal bones and the 4th and 5th metacarpal bones, at the distal end of the transverse crease on the dorsal side of the wrist and the midpoint of the metacarpophalangeal joint。在手背，第2、3掌骨及第4、5掌骨之間，腕背側橫紋遠端與掌指關節中點處。
Method: Slanted insertion toward the wrist, 0.5 to 0.8 units. 向手腕斜刺，0.5 至 0.8寸。

Supplement points: Pain at the spine is assigned to DU26(Shuigou); pain near the spine is assigned to LI10 (Shousanli).
配穴: 脊柱處疼痛配水溝；脊旁疼痛配手三里。

DU26(Shuigou, ditch)水溝, also called (Renzhong, Philtrum)人中

In the philtrum, approximately 1/3 the distance from the bottom of the nose to the top of the lip. 在人中，大約是從鼻子底部到嘴唇頂部距離的1/3。

Indications: Shock, coma, heat exhaustion, seizures, hysteria, psychosis, motion sickness, acute lower back sprain, facial edema, nose diseases, halitosis, spasm of the muscles in the region of the mouth or eyes.
Traditional indications: Apoplectic locked jaw, unconsciousness, convulsions, seizures and insanity; mouth and eyes awry, facial edema, lip tremor, emaciation and thirst, even after drinking, jaundice, edema, twisting pain in the vicinity of the heart and abdomen.
適應症：休克、昏迷、熱衰竭、癲癇發作、癔症、精神病、暈車、急性腰部扭傷、臉部水腫、鼻病、口臭、口部或眼部肌肉痙攣。
傳統適應症：中風下顎閉鎖、意識不清、抽搐、癲癇發作和精神錯亂；口眼歪斜，臉部浮腫，口唇震顫，消瘦口渴，酒後亦有黃疸，浮腫，心腹絞痛。

Needling method
(1)Transverse insertion, directed upward, 0.5-1 unit. Sensation: local pain, possibly distension.
(2) For excessive salivation, first insert the needle upward toward the septum of the nose, then withdraw slightly (keeping the needle under the skin) and direct first toward one of the nostrils, then the other. Sensation: local distension and pain.

針刺法
(1)向上平刺，0.5-1寸。感覺：局部疼痛，可能有脹痛。
(2)流涎過多的情況，先將針頭向上刺入鼻中隔，然後稍微抽出（將針保持在皮膚下），先刺向一個鼻孔，然後刺向另一個鼻孔。感覺：局部脹痛。

Remarks
Point of intersection of the Stomach and Large Intestine channels on the Governing channel.胃經、大腸經和督脈的交會穴

LI10 (Shousanli, Arm’s Three Measures) 手三里

2 units distal to LI-11 (Quchi) on the forearm. 位於前臂上 ，曲池遠端 2 寸

Indications: Pain in shoulder and arm, paralysis of upper limb, ulcer, stomachache, abdominal pain, diarrhea, indigestion.
Traditional indications: Toothache, loss of voice, swelling of the mandible and cheek, scrofula, vomiting with diarrhea, hemiplegia

主治：肩臂疼痛，上肢麻痺，潰瘍，胃痛，腹痛，腹瀉，消化不良。
傳統主治：牙痛、失聲、下顎頰腫、瘰癧、嘔吐洩瀉、半身不遂

Needling method: Straight insertion, 1-2 units. Sensation: local distension and soreness, sometimes extending along the forearm.
針法：直刺，1-2寸。感覺：局部脹痛，有時沿著前臂延伸。

Prescription方義:

• Ashi point can regulate the qi and blood of local meridians, collaterals and tendons, stimulate meridians and relieve pain; 阿是穴可通調局部經脈、絡脈及經筋之氣血，通經止痛；
• EX-UE7 (Yaotongdian) is an empirical point; 腰痛穴為經驗點；
• BL54(Weizhong) is the bladder meridian point of Foot Taiyang. The saying of ” The solution for waist and back is to ask Weizhongqiu” indicates that BL54(Weizhong) regulates Qi and blood in the bladder meridian of the waist and back; 委中為足太陽膀胱經穴，「腰背委中求」，可疏調腰背部膀胱經之氣血；
• Acupuncture at SI3(Houxi) can activate qi and blood and unblock the meridians of lumber, so that the function of the injured tissue can be restored to normal. 針刺後溪可行氣血而通腰背經絡，使受傷組織功能恢復正常:
  • SI3(Houxi) is the Shu point of the small intestine meridian of the Hand Taiyang. “Shu point is responsible for the heavy body weight and joint pain” 後溪為手太陽小腸經輸穴，“輸主體重節痛”，
  • The Qi of the same name meridians of the Hand and Foot Taiyang are connected. 手、足太陽同名經脈氣相通，
  • SI3(Houxi) is one of the eight meridians intersection points to connect the Du meridian. 後溪穴又為八脈交會穴之一，通督脈

Operation: Conventional acupuncture with purgative method. Generally, it is advisable to acupuncture distal acupoints first, in conjunction with waist movements. 操作: 毫針常規刺，用瀉法。一般宜先針遠端穴位，配合腰部活動。

【note 按語】

1. Acupuncture has a rapid effect on acute lumbar sprain. 針刺對急性腰扭傷療效快速。
2. The clinical symptoms of many diseases, such as spinal tuberculosis, tumors, fractures, dislocations, ligament ruptures, etc., can sometimes be similar to acute low back pain. Care should be taken to identify and rule out the primary disease. 許多疾病如脊椎結核、腫瘤、骨折、脫位、韌帶斷裂等臨床症狀有時可與急性腰扭傷相似，應注意鑑別，排除原發病。

[Excerpt from literature 文獻摘錄]

1. “Acupuncture and Moxibustion A and B Jing· Volume 9”: If you have low back pain and you cannot lie down, use Shousanli to treat it. 《針灸甲乙經·卷九》:腰痛不得臥，手三里主之。
2. “Xi Hong Fu”: Weizhong is specially used to treat waist pain. 《席弘賦》:委中專治腰間痛。
3. “Encyclopedia of Acupuncture and Moxibustion·Volume 4”: For sudden lower back pain with difficulty in walking, one point in the Jizhong, two points in the Yaoshu area, two points in the Shenshu area, and two points in the Weizhong area. 《針灸大全·卷之四》:閃挫腰痛，起止艱難，脊中一穴，腰俞二穴，腎俞二穴，委中二穴。

Reference:

1. 針灸治療學，新世紀第四版，主編高樹中，楊駿
2. Acupuncture, A Comprehensive Text, Shanghai College of Traditional Medicine translated and edited by John O’Connor and Dan Bensky, 1981
3. 針灸學，新世紀第四版，主編梁繁榮，王華，2016.8
4. 五版經絡學，主編李鼎，上海科學技術出版社出版，1990.10
5. 實用人體俞穴解剖圖，徐國成，韓秋生，杜立陽，劉悅，遼寧科學技術出版社，瀋陽，2008
6. 百度: 人中穴