Master Tung's Points for Low Back Pain
Many of Tung's points on the hands are effective for low back pain and sciatica. Some of the most commonly used points on the hands include Ling Gu (22.05), Da Bai (22.04) and Xia Bai (22.06), 22.07, 22.08, & 22.09.
From a myofascial perspective the points on the LI and SJ meridians are located on the Superficial Back Arm Line (SBAL), and the small intestine meridian points like SI 3, 22.08 & 22.09 are on the Deep Back Arm Line (DBAL). You can see these two myofascial arm lines in the image.
Ling Gu, Da Bai and Xia Bai are some of the best points to start with and are effective for many cases. However, you will encounter clients that don't respond to these points. Getting the best results with these points also requires having the patient do specific movements that benefit the low back. I will usually have the patient do pelvic tilts, hip rotations, squats in a chair, and bridge pose. The movements are highly effective for gently moving the lumbar region, and will provide ROM exercises while the needles are retained.
Myofascial lines or chains are similar to the meridians, and allow for increased understanding of how muscles are stucturally and functionally related through fascia.
If Ling Gu, Da Bai, and Xia Bai don't work, I usually move to the SI meridian and do points like SI 3, 22.08 & 22.09 (Wan Shun Yi & Wan Chu Er). These points work on deeper levels of the fascia and are often more effective when the sacroiliac joint is involved. This is due to the tai yang connection between the small intestine and bladder meridians, and also relates to the craniosacral dynamic. In the image we can see how the SI meridian and DBAL include the levator scapulae and rhomboid muscles.
With conditions like lumbar disc protrusions and herniations, the Ling Gu combination may not get to the deeper levels of the myofascial and skeletal systems. From a myofascial perspective points on the SBAL will effect the more superficial muscles of the back including the trapezius and latissimus dorsi. You can see from the image that the trapezius is included in the superficial back arm line. Though not shown the lats are on the superficial front arm line (SFAL).
Since sciatica involves compression of the nerves it is a deep level disorder of the discs and nerve roots. The points 22.08 and 22.09 can be more effective for disorders of the back and spine when the bones, discs and vertebrae are involved in the pathology. Clearly understanding how the different myofascial arm lines influence various levels of the myofascia in the back, is essential to refining your point selections and getting better clinical results.
Acupuncture Points on the Legs for Low Back Pain
A good strategy for treating low back pain with acupuncture is to start with the hand points and have the patient do the previously mentioned movements. Often times this will be enough to get significant improvement and decrease pain.
After 15 or 20 minutes have the patient take a comfortable position and move to the second round of needles. For these we will want to needle points like 77.17 and 77.18 (Tian Huang and Shen Guan). These points will get into deeper levels of the lumbar region and have a direct effect on the psoas, anterior sacral fascia, piriformis and illiacus.
On the leg yang channels we need to consider if the lumbar pain is in the UB, ST, or GB meridians. For pain in the lateral aspect of the leg and in the GB meridian, the points 88.25 (GB 31), 88.26, 88.27 (Thigh Nine Miles) are some of the best to use. I like this three point combination because it influences all three leg yang channels and three of the myofascial lines in the leg.
Lumbar Pain, the Leg Yang Meridians and Myofascial Lines
The Superficial Back Line (SBL) and Lateral Line (LL) from Anatomy Trains by Tom Myers, Elsevier Publishing.
The point 88.27 is located 1.5 cun posterior to GB 31 / 88.25 and influences the gallbladder and urinary bladder meridians. Many cases of sciatica will involve both of these channels, and it's common to see UB meridian sciatica advance into a more severe version as it moves into the GB meridian.
While 88.27 has an effect on the Superficial Back Line (SBL), the point 88.25 / GB 31 influences the Lateral Line (LL) and tensor fasciae latae muscle. This area holds a lot of tension in GB meridian sciatica, and needling this point powerfully releases tension throughout the lateral line and GB channel.
Master Tung's point 88.26 is 1.5 cun anterior to GB 31 and is between the ST and GB meridians. Needling this point will have an effect on two myofasical lines, the lateral line and superficial front line (GB & ST meridians).
This three point combination of 88.25, 88.26 & 88.27 will therefore influence the three leg yang meridians as well as the three corresponding myofascial lines. From a muscular perspective 88.25 effects the tenor fascia latae, 88.26 influences vastus lateralis, and 88.27 will reach the hamstrings.
Additional Notes about Low Back Pain & GB Meridian Sciatica
For many cases Tung's points on the hands will be effective for quickly treating low back pain and sciatica. When combined with certain movements and exercises the results will be even more impactful. Points on the legs are often not necessary, but will help to induce more relaxation and influence the muscles and myofascial lines of the legs. Leg points are best done in the second half of the treatment so that the patient may do movements and exercises with the hand points retained.
To understand more about how the myofasical lines and Master Tung points on the hands and arms are able to influence the low back and spine, read more via the links below, or take my 202 level course on Tung's points and myofascial lines. In it you will discover how to use over 50 of Master Tung's points from a myofascial perspective. If you are new to Tung's points and have never used them, and are interested in how acupuncture meridians and points relate to myofascial lines check out the 201 level course on Acupuncture and Fascia. Here are some additional links with more information.