Sciatic and groinI learned all about sciatic pain and low back pain in school. From a TCM perspective you look for injury, treat any Kidney deficiency, cup the back, put needles into Bl 23 and Gb 30 and/or Huanzhong, needle Bladder 40, yadda yadda yadda….you know where I’m going with this, right? Of course you do. It’s pretty common and probably describes the treatment I give for about 50% of my patients.

But what about when the pain refers to the front of the hip, anterior thigh, and groin? This is a rarer occurrence. Four weeks ago I treated one of these rarer cases and here’s how it went.

The patient, a gentleman in his late 40’s, had a long history of playing a punishing professional sport that rhymes with “Sootball,” but HIPAA might prevent me from tell you more than that. You wouldn’t guess it in a million years (tongue in cheek, yes), but this sport results in an awful lot of violent hits and tackles which has caused a lot of body damage to this guy. Now he spends a lot of time driving long distances for his job, then standing on hard concrete floors for hours on end. In the last 2 months he’s had some lower back discomfort, but woke one morning in agony with lower back pain that was referring to his left groin. Unlike most post-40 year old back pain, his was worse with activity and best in the morning when he first got up. Despite over the counter pain killers the pain rarely dipped below a 5/10. When he tried to walk or stand for any length of time over 10 minutes the pain would rocket to a 9.5 out of 10 and hover there until he went to lie down.

Cat's TCM Notes - Tylenol can cause liver and stomach damage - try acupuncture for lower back and groin painThe day he came to see me he was limping and moving slowly. He had taken what he described as “a shit-ton of Tylenol” to sleep the previous night. He slept well and was pain-free until he got up and walked around for a couple of minutes. He said it felt as if his back ‘seized’ and the pain quickly shot up to about an 8-9/10. He went to his chiropractor that morning who imaged his back and ruled out bone degeneration or disc herniation. An adjustment reduced the pain by about 50%.

When he came to my office an examination revealed a short pulse that was also somewhat wiry. There was a detectable weakness and depth to both 3rd position pulses and a somewhat soft feeling in the right 2nd pulse. His tongue was a bit swollen, but otherwise unremarkable except that the coating looked a tiny bit thicker in the rear third and seemed a little too wet. He denied any knee weakness, but said he had noticed an increase in night-time urination and volume of urine and a decreased sex drive.

I had him lie face down and did static cupping on his lower back from T10 through the lumbar vertebrae and along the sciatic nerve pathways to Gb 30 to release muscle tension in the lower back, then had him move to a face-up position for the bulk of the session. Though he denied the presence of stress in his life, he did say his stress level was routinely 7-8/10. I inserted the following points to address stress, pain, and underlying deficiencies.

  • Du 20, Du 24, and Yintang to address stress.
  • Auricular right side Autonomic and Shenmen points to address stress as well as Relax Muscle and Lumbar to work on the back pain.
  • Ling Gu and Da Bai (Tung points 22.04 and 22.05) on the left side of the body coupled with Gb 34/36/39 to address pain in the Shaoyang channel. I also added Bl 40/60/63/65 for pain in the Taiyang areas, and St 34/36/44 for pain in the Yangming areas (and also to tonify the Middle Jiao). I also added the Lower Three Emperors and Kidney gate to tonify the Kidney.

Most of the pain went away except for a small point at Gb 27 and a small spot on his back next to the iliac crest. I inserted a needle at Gb 27 then reached underneath his back and massaged the point near the iliac crest for a few minutes.

Cat's TCM Notes - Master Tung's Sancha points for lower back pain referring to groin Once the pain had receded I let him rest for about 30 minutes. When I removed the needles he said his back felt about 90% better. I decided that wasn’t good enough, so I inserted Master Tung points A02-A04 on the left hand. You will find them listed in Master Tung reference books as Sanchayi, Sancha’er, and Sanchasan, but I just refer to them as the “Wolverine points.” I added Ling Gu and Da Bai on the same hand as well as Si 4 and had him walk around my office suite for about 5 minutes. There was still a nagging ache in the Gallbladder area of the hip, so I added Sj 4 and had him walk another 2 minutes. The pain went away completely, even with about 10 minutes of walking, which had not been possible the day before.

The pain returned about 2 days later after several long drives and long work hours into the night, but the level was a 4/10 instead of a 10/10. I treated him again, repeating much of the protocol above, and gave him a bottle of Evergreen’s Back Support (Acute). This time the pain was gone for a week and returned at a 2/10. We repeated treatment three more times with increasing time between treatments. He is now on a maintenance formula for back support, Kidney deficiency, Spleen deficiency, and sex drive. He is also working with a pelvic floor specialist to strengthen his core muscles safely.


Comments

Case study: Low back pain referring to groin — 2 Comments

    • Definitely! I work with a pelvic floor specialist named DeLora Frederickson here in Austin on cases like this. The acupuncture helps the pain tremendously and herbs help the root cause, but pelvic floor stability and/or a strength imbalance between front and back often need to be addressed as well.