For most patients, "active recovery" is best - and "bed rest" is counter-productive, as it not
only delays recovery, but also worsens symptoms. Although patients should remain active, they should
avoid specific movements or activities that provoke pain, especially lifting weights,
sitting or standing for extended periods, and impact activities.
During the acute phase of back pain, walking is perhaps the best activity, and application of ice
may be helpful in relieving pain [ACE-AHFS, pg 492].
After the acute phase has passed, application of heat to relieve
muscle spasms may be better, instruction in proper body mechanics and
targeted exercise forms the cornerstone of recovery and prevention of
future exacerbations [ACE-AHFS, pg 494].
The most effective exercise programs are individually designed,
at least partially supervised, and extend over 20 total hours.
Stretching exercises have the greatest impact on pain, while strengthening exercises give the
greatest functional improvements [Hayden2005].
It is important to note that attempting to "work through the pain" when exercising the back is usually
counterproductive. As Stuart M. McGill points out, if an exercise causes pain, the patient is probably
"doing the exercise incorrectly, or more likely, doing the wrong exercise" [ACE-AHFS, pg 499].
- Lu-1 (pain in chest, shoulder & back).
- Lu-2 (pain of lateral costal region and back) [PIHMA].
- Lu-6 (pain of upper lumbar or lower thoracic, Taiyang channel - contralateral [PIHMA, Tan]
- SI-3 (proximal 5th MCP; open Du)
- UB-40 (popliteal; command back; Dr. Shi, Xinmen demonstrated vigorous needling of this point
with the knee bent, until the experiences three electric-shock like sensations [Personal communication, 2010]).
Distal point of thoracic and lower back [Backer2010, pg 128]
- UB-17 (T7; move Xue)
- UB-17 to UB-23 (local points of back) [Backer2010, pg 128]
- UB-23 (local point of lower back @ L2) [Backer2010, pg 128]; Shen Xu
- UB-25 (local point of lower back @ L4) [Backer2010, pg 128]
- UB-37 (distal point of lower back) [Backer2010, pg 128]
- UB-57 (distal point of thoracic and lower back) [Backer2010, pg 128]
- UB-60 (close Du)
- Du-3 (local point of lower back) [Backer2010, pg 128]
- Du-6 (distal point of thoracic back) [Backer2010, pg 128]
- Du-26 (distal point of lower back) [Backer2010, pg 128]
- Huato Jiaji (local points of back) [Backer2010, pg 128]