Acupuncture Case Study: Lower Back Pain Referring Into The Right Leg
Case Study: Healing Acupuncture Treatment For Lower Back Pain Referring Into The Right Leg.
John, a 45-year-old site manager, was hunched over in pain when he first walked into the clinic. Five days earlier, he had lifted something at work. Since then, he had been struggling with a sharp, burning pain that shot from his lower back down into his right leg. It wasn't just pain – his foot tingled, his calf felt numb and he struggled with every step he took.
"It feels like an electric shock running down my leg" was how he described the pain he was experiencing, rating the intensity of pain as "an eight out of 10", adding that it was keeping him awake at night.
John had never experienced serious back problems before and had no significant history of any other issues. His job required a lot of heavy lifting, but he had always managed fine – until now. A physical examination revealed tenderness over his right, lower back muscles, difficulty bending due to the pain, and neurological signs into the leg, including mild weakness in his right foot, reduced sensation in the right lateral calf and top of the foot and a sluggish right-sided Achilles reflex. The straight leg raise test reproduced John's pain at 30 degrees and there was some sensitivity on slump testing too. He had visited his GP who had prescribed some analgesia along with anti-inflammatories. It was suspected that there was a mild disc protrusion at L5-S1, pressing on the right S1 nerve root, though there were no signs of any Red Flags or anything more serious.
Due to the level of pain, the focus on John's treatment in the first instance was acupuncture with education and advice regarding his issue. It is very important that the patient understands what's happening to their body and why as it can be extremely frightening! It can be useful to start treatment with acupuncture to begin reducing the pain whilst we explain and discuss our treatment plan.
The 'Four Gates'
The Four Gates (Siguan) is the terminology used to describe the combination of the bilateral Hegu (LI-4) and Taichong (LIV-3) which play a key role in relieving pain by communicating with the brain's pain centres along with improving circulation. Whilst these 'gates' are positioned in the hands and the feet (see images), they are not the first thing you'd think of for low back pain!
Together, the combination stimulus of LIV3 and LI4 work to circulate the Qi and blood through the body. They help to open all meridians, increase circulation and decrease pain anywhere in the body.
These points were stimulated throughout John's session to enhance Qi flow and provide analgesic relief. Additional acupuncture points along the Bladder and Gallbladder Meridians – such as BL23 BL25, BL40, GB30 and GB34 – were carefully selected to target the sciatic nerve pathway and alleviate radiating symptoms into the leg. These are located within the area affected by pain, notably the lower back and right leg.
Left Image: Hegu LI-4 is an acupoint located on the back of the hand between the base of the thumb and index finger, and is known as an Immune Booster and Pain Reliever.
Right Image: Taichong LIV-3 is located on the top of the foot between the first and second metatarsal bones. It is also known as 'Zhongu' (Central Gate).
Cupping therapy was also used along the lumbar spine and helped improve circulation and accelerate the healing by releasing the tight muscles. Cupping also stems from Traditional Chinese Medicine (TCM), and uses suction cups to create space within the tissues as well as stimulating the Meridian Points as before.
Alongside his acupuncture, John was guided through a structured physiotherapy programme that included Mckenzie extension exercises to ease disc pressure, and core strengthening to stabilise his spine. He was advised to avoid heavy lifting or prolonged sitting and to incorporate regular walks into his daily routine. Ergonomic adjustments at work and home were recommended to prevent further strain, and he was educated on proper lifting techniques and ice/heat therapy for pain management.
Following a period of six weeks, John's symptoms were noticeably improved. His pain had decreased to a manageable "three out of 10", allowing him to return to work with modified duties. He was moving more comfortably, sleeping better and felt significantly more functional in his daily activities. The Four Gates acupuncture technique, in combination with targeted Meridian Therapy, had made a profound difference in his recovery. Though he still had mild numbness in his foot, it was stable and no longer interfering with his mobility. This is expected to continue to improve with time.
In conclusion, John's case shows how acupuncture can serve as a powerful and effective treatment adjunct for acute back pain with radiculopathy. By integrating the Four Gates technique for systemic pain relief, targeted acupuncture for nerve health and manual therapy, he was able to regain function and avoid the need for onward referral. He understands that staying active, continuing acupuncture as needed and maintaining proper spinal health habits will be crucial in preventing future flare-ups.
If you would like to find out more about how acupuncture treatment may help you, please phone our friendly admin team in our Hope and Totley clinics to find out more.
If you would like to book an appointment with one of our team, call our friendly receptionists on:
Totley: 0114 235 2727
Hope: 01433 623 602
