Why Did Severe Back and Leg Pain Improve After Several Treatments Following a Two-Week Hospital Stay?

Dr Win Huang’s Clinical Reflections

By Dr Win Huang, PhD (Chinese Medicine & Acupuncture)

Recently, a middle-aged woman came to my clinic after experiencing severe lower back and leg pain. Her condition had previously been serious enough to require two weeks in hospital. At its worst, she could barely walk normally, and even driving had become difficult.

During her hospital stay, she underwent two MRI examinations and received several medications. According to her account, the investigations did not identify an abnormality that clearly explained the severity of her symptoms.

She also experienced numbness in her left leg, foot and toes. Understandably, she worried that something serious had happened to her spine or nerves.

Months later, she was still struggling.

Why Had Rest Not Solved the Problem?

After leaving hospital, she became extremely cautious. She avoided lifting, exercise and household activities, hoping that sufficient rest would allow her back to recover.

However, the pain continued. Turning in bed was painful, getting in and out of a car remained difficult, and even light housework could aggravate her symptoms. The tingling and numbness in her leg and foot had not completely disappeared.

I began to consider whether she had developed a persistent protective response.

When pain first occurs, protective muscle contraction is a normal physiological reaction. But when pain continues, especially when someone fears serious nerve damage, the body may remain in a prolonged state of guarding.

Pain encourages reduced movement. Reduced movement may contribute to stiffness and persistent muscle guarding. Continued symptoms then reinforce the patient’s concern that something is seriously wrong.

What began as a protective response may gradually become one of the factors maintaining the problem.

What Did My Clinical Assessment Reveal?

She was subsequently referred to my clinic by her doctor.

During my examination, I did not identify clear signs of significant neurological impairment. I also found no convincing positive findings supporting a major sacroiliac, lumbar facet joint or deep gluteal nerve entrapment problem.

Instead, there was marked tenderness involving the gluteus medius, gluteus minimus and iliopsoas muscles.

These findings led me to focus the current treatment on the muscular and surrounding soft-tissue components of her condition.

However, this did not establish what had caused her original episode.

I had not examined her during the acute stage, when her symptoms were severe enough to require hospitalisation. The initial problem may have involved muscle injury, another spinal condition, or a combination of factors followed by persistent protective muscle activity.

The original cause may remain uncertain, but the factors maintaining the current symptoms still need to be identified.

That distinction became central to my clinical reasoning.

The Treatment Was Not Particularly Complicated

I used an approach familiar from my everyday musculoskeletal practice.

First, I performed distal acupuncture at Tianzhu (BL10), aiming to provide sensory input that might help modulate her pain experience.

I also positioned her prone on the treatment table, reducing the postural demands placed on her lower back and surrounding muscles. Within a comfortable range, I encouraged gentle lumbar movement rather than prolonged immobility.

The intention was to help reduce protective muscle guarding and allow her to experience movement without the same level of fear or discomfort.

Another important part of the consultation was explaining my findings.

I told her that my current examination had not identified clear signs of severe neurological impairment and that the most relevant findings were concentrated in the muscles and surrounding soft tissues.

This did not mean that her pain was imaginary or that every serious condition had been excluded. It meant that she did not need to assume her back was so fragile that ordinary movement would necessarily cause further damage.

Looking back, the treatment addressed three related elements: pain, protective muscle tension and the patient’s confidence in moving again.

From a Negative Cycle to a Positive One

Her improvement was more noticeable than I had initially expected.

After the first treatment, she felt lighter and began walking again. Following the second session, she could walk further, manage more household activities and use the stairs more comfortably.

After the third treatment, she left a detailed five-star Google review describing herself as feeling “light as a feather”.

What interested me was that she described more than physical improvement. She also reported changes in her energy, mood and general sense of wellbeing.

This made me reconsider the entire recovery process.

Previously, pain had discouraged movement. Reduced movement may have contributed to ongoing guarding, while persistent symptoms reinforced her concern about her body.

Once her pain began to settle, she felt able to move again. Each successful activity helped rebuild confidence. With less fear and more movement, her overall condition continued to improve.

A negative cycle may have begun to turn into a positive one.

Of course, this individual case cannot establish the precise physiological mechanism responsible for her improvement. Nor can it tell us how much each treatment component contributed.

What I could observe was a meaningful change in her symptoms, function and confidence.

Finding the Factor That Keeps the Problem Going

The most interesting part of this case was not how many needles I used or whether one particular acupuncture point was especially effective.

It was how a patient who had remained in pain and protective guarding for months began to recover after several important factors were addressed.

This principle extends beyond acupuncture. Different appropriate interventions may help when they target factors that are currently contributing to persistent symptoms.

The original cause of a condition and the mechanisms maintaining it months later are not necessarily identical.

That is why reassessment matters.

We are not simply treating a painful area. We are trying to understand what is preventing the patient from recovering.

Sometimes a clinical problem appears complicated, yet the factors that need to change may be relatively straightforward.

When those factors are identified and addressed, the body’s recovery process may begin to move forward again.

Booking CTA

Persistent or recurrent back and leg pain may require reassessment to clarify the current contributing factors and determine whether treatment, further investigation or referral is appropriate.

Medical Disclaimer

This article presents an individual clinical experience and is intended for educational purposes. Outcomes vary. Progressive weakness, saddle sensory changes or new bladder or bowel dysfunction require urgent medical assessment.