▶ Watch Teresa’s TCM Clinical Reflections 05

Why Does Lower Back Pain Keep Coming Back?

Lower back pain is one of the most common reasons people seek acupuncture treatment.

Almost everyone experiences lower back pain at some point in life. For some people, the discomfort settles within a few days. For others, it gradually becomes a recurring problem that affects work, exercise, sleep, and daily activities.

One of the questions patients ask me most often is:

“Why does my lower back pain keep coming back?”

From a Traditional Chinese Medicine perspective, answering this question involves looking beyond the pain itself.

Rather than asking only where the pain is located, we also ask why it has developed, what underlying pattern is involved, and how we can help reduce the chance of it returning.

Lower Back Pain Has Many Different Causes

From a Western medical perspective, lower back pain may be associated with muscle strain, ligament injury, degenerative change, disc problems, or poor posture.

In an acupuncture clinic, however, we often see patients whose symptoms are related to prolonged sitting, repetitive work, muscle tension, stress, or chronic overuse.

Although two patients may both describe lower back pain, the underlying causes can be very different.

Understanding these differences allows treatment to become more individualised.

Meridian Theory and Lower Back Pain

Traditional Chinese Medicine has viewed lower back pain from a broader perspective for thousands of years.

The lower back is closely associated with the Bladder Meridian, the Governor Vessel (Du Mai) and the Belt Vessel (Dai Mai).

The lower back is also closely connected with Kidney function in Traditional Chinese Medicine, as the Kidneys are regarded as an important source of strength and vitality.

Different patients may present with different patterns.

Some develop Cold-Damp obstruction.

Others present with Qi stagnation and Blood stasis.

Some experience lower back pain associated with Kidney deficiency after years of overwork or ageing.

Rather than applying the same treatment to every patient, Traditional Chinese Medicine first identifies the underlying pattern before developing an individual treatment plan.

Teresa’s Clinical Insight

This is one of the treatment principles I use most frequently in my own clinical practice.

Many people naturally assume that because the pain is in the lower back, treatment should only focus on the lower back.

However, I often think beyond the back itself.

In Traditional Chinese Medicine, Yin and Yang are closely connected.

The back mainly belongs to Yang, while the front of the body belongs to Yin.

The Governor Vessel travels along the back, while the Conception Vessel travels along the front.

Likewise, the Bladder Meridian on the back works together with the Liver, Spleen and Kidney meridians on the front of the body.

For this reason, when treating chronic lower back pain, I often pay attention not only to the painful area on the back, but also to the lower abdomen.

In many patients, treating the front of the body helps the back recover more effectively.

A Combined Front-and-Back Treatment

One of the reasons I enjoy practising Traditional Chinese Medicine is that it encourages us to look at the body as a connected whole.

In my clinical practice, I often combine treatment on the lower back with treatment on the lower abdomen.

For many patients, acupuncture and cupping are applied to the painful area of the lower back. At the same time, I may also use acupuncture or warming therapy over the lower abdomen, depending on the patient’s pattern.

For patients with Cold-Damp conditions, especially those who have chronic lower back pain, feel cold around the waist, or notice that their symptoms become worse during cold weather, I frequently use ginger moxibustion over points such as Qihai (CV6), Guanyuan (CV4), Zhongji (CV3), Shuidao (ST28) and, in some cases, Tianshu (ST25).

From a Traditional Chinese Medicine perspective, warming these points helps support Yang Qi, promote the circulation of Qi and Blood, and dispel Cold and Dampness. As the lower abdomen becomes warmer and circulation improves, many patients notice that stiffness and discomfort in the lower back gradually begin to ease.

For me, this is not simply treating the abdomen.

It is treating the lower back from another perspective.

Sometimes helping the front of the body recover allows the back to recover more completely.

Every Patient Is Different

One of the strengths of Traditional Chinese Medicine is that treatment is never exactly the same for every patient.

Two people may both have lower back pain, yet their underlying patterns may be completely different.

One patient may need warming therapy to dispel Cold and Dampness.

Another may require treatment to move Qi and Blood because long-standing Blood Stasis is contributing to the pain.

Someone else may benefit from nourishing Kidney Qi after years of physical work or ageing.

This is why an individual assessment is so important.

Rather than treating only the symptom, we try to understand the whole pattern behind the condition.

Lifestyle Matters

Treatment is only one part of recovery.

The way we use our bodies every day is just as important.

Many modern cases of lower back pain are associated with prolonged sitting, poor posture, repetitive lifting, long hours of driving, and insufficient exercise.

For people working at a desk, I usually recommend standing up every forty to fifty minutes to stretch, walk around, and gently move the lower back.

Regular exercise such as walking, swimming, gentle strengthening exercises, Tai Chi, or other enjoyable physical activities can improve circulation, maintain flexibility, and reduce unnecessary strain on the lower back.

Healthy movement is not only one of the best ways to prevent recurrent lower back pain, but also an important part of maintaining overall health and wellbeing.

Clinical Reflection

One of the most valuable lessons I have learned through clinical practice is this:

When treating lower back pain, I do not only look at the back.

I also pay attention to the front of the body.

Traditional Chinese Medicine teaches us that Yin and Yang work together.

The front and the back support one another.

Sometimes helping the front of the body recover allows the back to recover more completely.

This integrated way of thinking is one of the reasons I enjoy practising Traditional Chinese Medicine.

It also reminds me that successful treatment is often about restoring balance rather than simply chasing pain.

About Teresa’s TCM Clinical Reflections

Teresa’s TCM Clinical Reflections is a series exploring common health conditions through the principles of Traditional Chinese Medicine.

Rather than focusing only on diagnosis and treatment, each reflection examines the broader factors that influence recovery, including meridian balance, internal pattern differentiation, lifestyle habits, emotional wellbeing, and the body’s natural healing processes.

The goal is to help patients better understand their condition, appreciate the wisdom of Traditional Chinese Medicine, and support long-term health through a balanced and holistic approach.

Book an Appointment

If you are experiencing persistent or recurring lower back pain, Teresa Shen welcomes you to PhD Win Acupuncture Clinic for a comprehensive Traditional Chinese Medicine assessment and personalised treatment plan.

Book Online:

https://drwin.co.nz/online-booking/

Medical Disclaimer

The information shared in Teresa’s TCM Clinical Reflections is provided for general health education only and should not be considered personal medical advice, diagnosis, or treatment. Individual conditions vary. If your symptoms are severe, persistent, or associated with weakness, numbness, bowel or bladder changes, fever, trauma, or other concerning features, please seek assessment from an appropriately qualified healthcare professional.