Painkillers usually only relieve the pain temporarily but cannot cure the cause of the pain. In terms of Traditional Chinese Medicine (TCM) we say that the back is the mansion of the kidney, therefore backache is always related to the kidney.

In the book ’Huang Di Nei Jin’, written over two thousand years ago, it says, “The back is the mansion of the kidney. If the back cannot move, it means the kidney is weak’.

In the book ‘Jin Kui Yao Lue’, written in the Han dynasty, it says, ‘Back pain with cold feeling can be as heavy as carrying five thousand coins’. The cold referred to here is the cold-dampness effecting the back.

In clinical terms, backache can be caused by wind-cold, damp-heat, blood stasis, injury, pregnancy, labour, over-work, or overactive sexual activity, resulting in kidney deficiency.

Treatment of backache with TCM

First of all we have to tonify the kidney, then reach a dtermination of treatment based on the differentiation of the symptoms and signs.

Cold-damp type backache

Main symptoms

Backache with cold-heavy feeling cannot move, worse when lying down and during cold rainy days, thick white coating on the tongue.


Expel wind-evil and clear away cold, warm and dredge the channel.

If the source of the pain moves, it can mean there is a wind-evil, which has to be expelled. For this we can use Du Huo Ji Sheng Tang.

If you suffer from cold-damp backache, you have to keep warm and dry. Do not go swimming, as the water will effect the damp. Feng Shi You, a kind of herbal oil can be used to rub the back area to warm and relax the muscles or use a medicated plaster which contains herbs. Put this on the back to support it and relieve the pain. Moxibustion is also good for this type of backache.

Damp-Heat type backache

Main symptoms

Backache with warm or burning sensation, worse in hot environments, sometimes easier after movement, Yellow, greasy coated tongue, soft and rapid pulse.


Clear away the heat and expel the damp, soothe the channels and relieve pain.

If there is severe pain, add Ru Xiang Mo Yao. The heat treatment of Moxibustion does not suit this type of backache. It needs something cool to help and it is better to use essential green oil.

Kidney deficiency type backache

Main symptoms

The backache is helped by pressing or massaging for the relief of pain, weakness in the knees and legs, worse when feeling tired; if one lies down it feels better and is easily recurring.

If there is kidney yang deficiency, feel cold, have lower abdominal pain, pale hot flushes, red tongue, rapid and weak pulse.

Treatment method

Kidney yang deficiency: tonify the kidney yang.

Moxibustion, Feng Shi You and medicated herbal plasters are also helpful for this type of backache.

Kidney yin deficiency: tonify kidney yin.

If backache continues for a long time and there are no significant yang or yin deficiencies, it is usually because of kidney deficiency. For this we can use Qin Er Wan.

Blood stasis type backache

Main symptoms

Backache, sharp pain, the source of the pain is fixed, if mild backache feel as though cannot bend. In severe cases, one cannot move because of the source of the pain, the area does not like to be pressed, purple tongue or purple spots on the tongue, hesitant pulse. Some patients may have a history of injury.

Treatment Method

Promote blood circulation to remove blood stasis. Regulate vital energy and elevate pain.

If there is any wind and damp symptoms, add Du Huo, Wei Ling Xian, Qin Jiao to expel the wind-damp. If there is a kidney deficiency, add Xu Duan, Du Zhong, and Huai Niu Xi to invigorate the kidney and strengthen the bones.

Overall, in cases of backache, the root cause of the problem is due to kidney deficiency and the branches of this are external effects, injuries etc. The book ‘Zhen Zhi Zhun Sheng’, says, ‘there are wind, damp, cold, heat injury and blood stasis, vital energy stagnation, phlegm, of all branches, kidney deficiency is the root.’

The key cause is the kidney deficiency. Therefore in TCM, when we treat cold-damp, damp-heat and blood stasis type backache, usually we use some herbs to tonify the kidney and strengthen the back.

There is formula, Han Re Gou Tong Feng. This formula is not extremely hot or cold, but is good for backache with feelings of low energy and osteo-arthritis backache with warm feelings in the back area. Another formula, Zhuan Gu Guan Ji Wan is more suitable for backache with weak and cold feelings in the back area.

In general, gentle exercise like Qigong or Taiji may be beneficial to prevent back injury and the use of herbs to tonify the kidney can also be effective in preventing backache. Anyone may find a combination of these useful.