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Back Support (HD)

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CLINICAL APPLICATIONS

 

  • [     Herniated disk, lumbar radiculopathy, prolapsed or bulging disk, or slipped disk with possible severe back pain which may worsen with coughing, straining or laughing, tingling or numbness in the legs or feet, muscle spasm or weakness
  • [     Pain originating from the spinal cord and radiating down the legs

 

WESTERN THERAPEUTIC ACTIONS

 

  • [     Analgesic effect to relieve pain
  • [     Anti-inflammatory effect to reduce swelling and inflammation

 

CHINESE THERAPEUTIC ACTIONS

 

  • [     Activates blood circulation and eliminates blood stasis
  • [     Reduces swelling and inflammation
  • [     Strengthens soft tissues and relieves pain

 

DOSAGE

 

Take 3 to 4 capsules, three times daily, as needed to relieve pain. The dosage may be increased up to 6 to 8 capsules every four to six hours if necessary, especially in the early stages of injury when there is severe and excruciating pain. When the pain subsides, reduce the dosage to 3 or 4 capsules, three times daily. For maximum effectiveness, take the herbs on an empty stomach, with two tall glasses of warm water.

 

INGREDIENTS

 


Bai Shao(Radix Paeoniae Alba)

Che Qian Zi(Semen Plantaginis)

Chuan Niu Xi(Radix Cyathulae)

Chuan Xiong(Rhizoma Ligustici Chuanxiong)

Dan Shen(Radix Salviae Miltiorrhizae)

Dang Gui(Radicis Angelicae Sinensis)

Du Zhong(Cortex Eucommiae)

E Zhu(Rhizoma Curcumae)

Gan Cao(Radix Glycyrrhizae)

Gui Zhi(Ramulus Cinnamomi)

San Leng(Rhizoma Sparganii)

Shen Jin Cao(Herba Lycopodii)

Yan Hu Suo(Rhizoma Corydalis)

Yi Yi Ren(Semen Coicis)

Ze Xie(Rhizoma Alismatis)


 

FORMULA EXPLANATION

 

Back Support (HD)is designed to treat herniated disk, also commonly known as prolapsed or slipped disk. The herbs activate blood circulation and eliminate blood stasis, reduce swelling and inflammation, strengthen soft tissue and relieve pain. It is most effective for acute injuries that are mild to moderate in severity.

 

Dang Gui(Radicis Angelicae Sinensis), Chuan Xiong(Rhizoma Ligustici Chuanxiong) and Dan Shen(Radix Salviae Miltiorrhizae) tonify blood and activate blood circulation. Yan Hu Suo(Rhizoma Corydalis), San Leng(Rhizoma Sparganii)and E Zhu(Rhizoma Curcumae) are among the strongest pain-relieving herbs that also eliminate blood stasis. Bai Shao(Radix Paeoniae Alba)and Gan Cao(Radix Glycyrrhizae) nourish yin to relieve muscle spasms and cramps. They also nourish Liver yin and benefit soft tissues. Ze Xie(Rhizoma Alismatis), Che Qian Zi(Semen Plantaginis)and Yi Yi Ren(Semen Coicis) drain water accumulation to reduce swelling and inflammation associated with herniated disk. Shen Jin Cao(Herba Lycopodii)and Gui Zhi(Ramulus Cinnamomi)open the channels and collaterals to unblock obstructions, especially of the extremities to treat radiating pain and/or numbness. Du Zhong(Cortex Eucommiae) and Chuan Niu Xi(Radix Cyathulae) are channel-guiding herbs that direct to the back and strengthen soft tissues, such as muscles, tendons, and ligaments. They also tonify the Kidney, dominate the marrow and directly benefit the bones and disks.

 

Back Support (HD)is an excellent formula to treat herniated disk, prolapsed disk, or slipped disk. It is most effective for acute injuries that are mild to moderate in severity.

 

SUPPLEMENTARY FORMULAS

 

 

NUTRITION

 

  • [     Eat whole grain cereals and a wide variety of raw vegetables and fruits to ensure a complete supply of nutrients for the bones, nerves, and muscles.
  • [     Fresh pineapples are recommended as they contain bromelain, an enzyme that is excellent in reducing inflammation. If the consumption of fresh pineapples causes stomach upset, eat it after meals.
  • [     To relieve cramps and spasms, eat plenty of fruits and vegetables, especially those high in potassium, such as bananas and oranges. Also, drink an adequate amount of warm water.
  • [     Adequate intake of minerals, such as calcium and potassium, is essential for pain management. Deficiency of these minerals leads to spasms, cramps, and tense muscles.
  • [     Avoid cold beverages, ice cream, caffeine, sugar, tomatoes, milk, and dairy products.

 

LIFESTYLE INSTRUCTIONS

 

  • [     Stretching and strengthening exercises for the back muscles are essential for long-term recovery.
  • [     Mild exercise such as swimming, yoga, or Tai Chi Chuanon a regular basis is recommended.
  • [     Avoid engaging in activities that may lead to re-injury, such as improper lifting with turning or twisting, or excessive strain on the back. Advise the patient that lifting should involve the use of the knees, not the back. Avoid all strenuous physical activity.
  • [     For those who are overweight, weight loss is strongly recommended to decrease pressure on the joints and relieve pain.
  • [     Finally, adequate rest is essential to recovery. It is wise to review sleeping postures to ensure that the back is appropriately supported and relaxed in sleep.

 

CLINICAL NOTES

 

  • [     Herniated disk can be caused by a prolapsed or slipped disk pressing on the nerves. As a result, there may be shooting pain that starts from the vertebrae and travels outwards to the extremities. While the use of herbs and acupuncture are helpful to relieve pain and reduce inflammation, physical treatment (such as Tui-Naor chiropractic adjustments) may be necessary to correct the underlying problem. In overt cases of radiculopathy, manipulation to the spinal area is contraindicated.
  • [     To maximize the therapeutic effect, this formula should be given to patients before acupuncture treatments. The muscle-relaxant influence from the herbs takes effect within about half an hour. By relaxing the muscles and invigorating qi and blood circulation, there is less stagnation in the channels, and the acupuncture and Tui-Natreatments can be more effective.
  • [     Cold packs may be used for acute injuries during the first 24 to 48 hours to reduce swelling and inflammation. Afterwards, hot packs should be used afterwards to promote blood circulation and enhance healing in the affected area.
  • [     L4-L5 and L5-S1 are the most common area of injury for herniated disk.
  • [     This formula is an adjunct to acupuncture treatment. Optimal results are obtained when acupuncture, electro-stimulation and herbs are included in the treatment regimen.
  • [     The following is a folk remedy to treat acute back pain from sprain and strain: Crack open 2 ocean crabs with a wooden stick (do not use a knife or any metal instruments) and put them into a clay pot with enough vodka or whiskey to cover both crabs. Place the clay pot into another bigger pot with water and steam it for one hour. Serve the crab meat along with the liquor soup.

 

CAUTIONS

 

  • [     Because of the blood-invigorating nature of this formula, it is contraindicated during pregnancy and nursing.
  • [     Patients who have pain radiating to the extremities accompanied by a sudden loss of bladder or bowel control may have a pinched nerve or spinal injury and must be referred out to emergency care if they have not already been evaluated by a specialist. This condition, known as Cauda Equina syndrome, can lead to permanent disability and must be evaluated and treated immediately.
  • [     Dan Shen(Radix Salviae Miltiorrhizae)andDang Gui(Radicis Angelicae Sinensis)may enhance the overall effectiveness ofCoumadin (Warfarin),an anticoagulant drug. Patients who take anticoagulant or antiplatelet medications should nottake this herbal formula without supervision by a licensed health care practitioner.

 

ACUPUNCTURE POINTS

 

Traditional Points:

  • [     Ah shipointson the back, Yinmen(BL 37), and Chengshan(BL 57). Strongly stimulate and remove the needles.
  • [     Shenshu(BL 23), Yaoyangguan(GV 3), Weizhong(BL 40), Huantiao(GB 30), and Chengfu(BL 36).

 

Balance Method by Dr. Richard Tan:

  • [     Lingku, Dabaiand Zhongbai. Needle all three points bilaterally 1.0 to 1.5 cun. Leave the needles in for 15 minutes and have the patient move the affected area in the back to help with circulation of qi and blood.
  • [     All ah shipoints from Houding(GV 19)to Xuanji(CV 21). Needle obliquely towards the back.
  • [     Needle the following points on the side opposite of the pain:Hegu(LI 4),Houxi(SI 3),Wangu(SI 4), Dazhong(KI 4) orah shipoints nearby, and Fuliu(KI 7) orah shipoints nearby.
  • [     Needle the following points on the same side as the pain:Chize(LU 5),Shugu(BL 65), and Kongzui(LU 6)orah shipointnearby.
  • [     Note: Lingku, Dabaiand Zhongbaiare Master Tong’s points on both hands. Lingkuis located in the depression just distal to the junction of the first and second metacarpal bones, approximately 0.5 cunproximal to Hegu(LI 4), on the yangmingline. Dabaiis located at about 0.5 cunproximal to Sanjian(LI 3), on the yangmingline. Zhongbaiis located at about 0.5 cunproximal to Zhongzhu(TH 3), on the shaoyangline.
  • [     For additional information on the Balance Method, please refer to Twelve and Twelvein Acupunctureand Twenty-Four More in Acupunctureby Dr. Richard Tan.

 

Ear Points:

  • [     Lower back (search for most sensitive and painful point), Shenmen, and Adrenals.

 

 

 

MODERN RESEARCH

 

Back Support (HD)was developed specifically to treat herniated, prolapsed, or slipped disk. It contains herbs with marked analgesic effects to relieve pain, and anti-inflammatory effects to reduce swelling and inflammation. Furthermore, many of these herbs have effect to treat other related conditions, such as sciatica,arthritis, and neuralgia.

 

One of the most important herbs in this formula is Yan Hu Suo(Rhizoma Corydalis), generally considered the herb with most potent analgesic and anti-inflammatory effect in the traditional Chinese pharmacopoeia. It is used to ensure the overall efficacy to relieve pain and reduce inflammation.[1]The effectiveness of Yan Hu Suo(Rhizoma Corydalis)is similar to that[J1]of morphine. Though the herb has a slower onset and weaker analgesic effect, it is associated with far fewer side effects, including absence of addiction and much slower development of tolerance.[2]In addition, the analgesic effect of Yan Hu Suo(Rhizoma Corydalis)can be enhanced significantly when combined with electroacupuncture.[3]

 

Dang Gui(Radicis Angelicae Sinensis)has marked analgesic and anti-inflammatory effect, with potency similar to or stronger than that of acetylsalicylic acid.[4],[5]Du Zhong(Cortex Eucommiae)also has marked anti-inflammatory action. Its mechanisms are attributed to a stimulating effect on the endocrine system and the consequent secretion of endogenous steroids from the adrenal cortex.[6]Another herb in this formula that has analgesic and anti-inflammatory effects is Du Huo(Radix Angelicae Pubescentis).[7]

 

With regards to clinical applications, many herbs in this formula have been used with great success to specifically treat nerve pain. For example,Du Zhong(Cortex Eucommiae)has been used in various formulas with good results to treat sciatica.[8]Chuan Xiong(Rhizoma Ligustici Chuanxiong),Dang Gui(Radicis Angelicae Sinensis),Dan Shen(Radix Salviae Miltiorrhizae)and others have been used with a greater than 90% rate of effectiveness to treattrigeminal nerve pain.[9]Chuan Xiong(Rhizoma Ligustici Chuanxiong)may be used to treat nerve pain from bone spurs.[10]Gui Zhi(Ramulus Cinnamomi)is commonly used in many herbal formulas to treat arthritis.[11]Bai Shao(Radix Paeoniae Alba)and Gan Cao(Radix Glycyrrhizae)are effective in treating neuralgia.[12]Bai Shao(Radix Paeoniae Alba)and Zhi Gan Cao(Radix Glycyrrhizae Preparata) have also demonstrated effectiveness to treat pain in the entire body, especially lower back and legs.[13]

 

In conclusion, Back Support (HD)is developed specifically to treat herniated disk, prolapsed disk, or slipped disk. It contains herbs with marked analgesic effect to relieve pain, and anti-inflammatory effect to reduce swelling and inflammation.

 

PHARMACEUTICAL DRUGS & CHINESE MEDICINE: A COMPARATIVE ANALYSIS

 

Western Medical Approach: Pain isa basic bodily sensation induced by a noxious stimulus that causes physical discomfort (as pricking, throbbing, or aching). Painmay be of nociceptive, neuropathic, or psychogenic types. For neuropathic pain due to herniated disks, drugs [aspirin, non-steroidal anti-inflammatory agents (NSAID) and opioid analgesics] offer few benefits. Use of drugs do not change the underlying condition [herniated disk], they only mask the symptom [pain]. Most patients are simply told to relax at home, stay confined to bed, and take drugs as needed for pain. If the pain persists, more and more drugs are needed, thereby creating more side effects and complications. If the pain becomes worse, invasive treatment such as surgery is often suggested. In other words, western medicine offers few or no options. [Note: Common side effects of aspirin and NSAID’s include gastric ulcer, duodenal ulcer, gastrointestinal bleeding, tinnitus, blurred vision, dizziness and headache. Serious side effects of newer NSAID’s, also known as Cox-2 inhibitors [such as Celebrex (Celecoxib)], include significantly higher risk of cardiovascular events, including heart attack and stroke. Side effects of opioid analgesics [such as Vicodin (APAP/Hydrocodone)and morphine] include dizziness, lightheadedness, drowsiness, upset stomach, vomiting, constipation, stomach pain, rash, difficult urination, and respiratory depression resulting in difficult breathing. Furthermore, long-term use of these drugs leads to tolerance and addiction.]

Traditional Chinese Medicine Approach: Treatment of pain is a sophisticated balance of art and science. Proper treatment of pain requires a careful evaluation of the type of disharmony (excess or deficiency, cold or heat, exterior or interior), characteristics (qi and/or blood stagnations), and locations (upper body, lower body, extremities, or internal organs). Furthermore, optimal treatment requires integrative use of herbs, acupuncture and Tui-Natherapies. All these therapies work together to tonify the underlying deficiencies, strengthen the body, and facilitate recovery from chronic pain. Herbs and acupuncture are effective to treat the symptom (pain), and Tui-Nais effective to correct the underlying cause (herniation). By addressing both symptom and cause, TCM therapies often achieves immediate and long-term success. Furthermore, TCM therapies are often associated with few or no side effects. However, it is important to also recognize the limitation of TCM therapies. Integrative use of herbs, acupuncture and Tui-Naare excellent for initial stages of herniated disks of mild to moderate severity. When applied properly, they are often very successful to treat pain, correct the underlying problem, and restore normal physical functions. However, certain conditions may still require surgical treatment, such as in severe cases of herniated disks (such as ruptured disk) or chronic conditions where all other options have failed.

 

Summation: Optimal treatment of herniated disks is to understand all available options (from western and traditional Chinese medicine), and utilize the most effective modality for each specific condition.

 



[1]Biol Pharm Bull, 1994; Feb; 17(2):262-5

[2]Zhong Yao Yao Li Yu Ying Yong(Pharmacology and Applications of Chinese Herbs), 1983; 447

[3]Chen Tzu Yen Chiu(Acupuncture Research), 1994; 19(1):55-8

[4]Xin Yi Yao Xue Za Zhi(New Journal of Medicine and Herbology), 1975; (6):34

[5]Yao Xue Za Zhi(Journal of Medicinals), 1971; (91):1098

[6]Zhong Cao Yao(Chinese Herbal Medicine), 1983; 14(8):27

[7]Zhong Yao Yao Li Yu Ying Yong(Pharmacology and Applications of Chinese Herbs), 1983; 796

[8]Zhong Yao Xue(Chinese Herbology), 1998; 797:799

[9]He Bei Zhong Yi Za Zhi(Hebei Journal of Chinese Medicine), 1982; 4:34

[10]Xin Yi Xue(New Medicine), 1975; 6(1):50

[11]Shi Zhen Guo Yao Yan Jiu(Research of Shizhen Herbs), 1991; 5(4):36

[12]Zhong Yi Za Zhi(Journal of Chinese Medicine), 1983; 11:9

[13]Yun Nan Zhong Yi(Yunnan Journal of Traditional Chinese Medicine), 1990; 4:15


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