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Coccyx pain 34

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Pain in the coccyx, according to TCM theory, is often caused by invasion of pathogenic Cold and
Damp or Damp-Heat, deficiency of Kidney-Qi or stagnation of Qi and Blood. Coccyx pain may
be attributed to any of the following disorders in Western medicine: rheumatism, rheumatoid
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arthritis, muscle strain or traumatic injury in the coccyx region, and deformation or injury to the
spinal column and coccyx.

Aetiology and pathology


Invasion by Cold-Damp
In this situation coccyx pain is caused by an obstruction of the circulation of Qi in the channels
and collaterals. Cold and Damp are the Yin pathogenic factors: Cold is characterised by con-
traction and stagnation; Damp is characterised by heaviness and stagnation. When Cold-Damp
invades the coccyx, it may impede the functions of the Qi, and specifically impair the Yang-Qi,
which leads to stagnation of the Qi and Blood in the locality and disturbance of the channels,
causing coccyx pain with a cold sensation and feeling of heaviness to occur.
Invasion of Cold-Damp usually happens to people who live in a cold and damp place for too
long, or frequently go out in the rain without waterproof clothing, or wade through or work in
water, or who remain in clothes drenched from sweating, or consume too much cold or
uncooked food. If in addition there is a deficiency of Qi or Yang of the Spleen or Kidney, such
people will be particularly vulnerable to attack by Cold-Damp.

Invasion by Damp-Heat
Since Damp is characterised by heaviness and stagnation, and Heat is characterised by burning
and consumption of Yin, if Damp-Heat invades the Lower Burner and the coccyx, it obstructs
the circulation of Qi in the channels and collateral and impairs the Yin and Blood, causing
coccyx pain.
Damp-Heat usually invades people who fail to maintain personal hygiene in their genital and
anal regions, who walk and live in a damp and dirty place, or who remain in clothes drenched
from sweating in summer or after work or sport. Moreover, if Cold-Damp persists for a long
time in the body it will gradually transform into Damp-Heat. .
Invasion of Damp-Heat to the coccyx can also be caused by the downward flow of Damp-
Heat to the Lower Burner and coccyx, leading to coccyx pain. Internal Damp-Heat is usually
caused by bad diets, such as frequent eating of pungent, sweet, or fatty or greasy food, or milk

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41() BACK PAIN

products, or drinking too much alcohol, which result Acute onset of coccyx pain, lower back pain and
in poor transportation and transformation by the pain in the coccyx region with a heavy and warm
Spleen and Stomach. or hot sensation, or even swelling of the coccyx,
sticky sweating, thirst but with no desire to drink,
fever, or painful urination, is often caused by
Deficiency of the Kidney-Essence
invasion of Damp-Heat.
The Kidney dominates the Bones and produces the Stabbing pain in the coccyx, with rigidity at the
Marrow. Congenital weakness, excessive strain, pro- lower back, aggravation of the coccyx pain by
longed sickness, a poor diet, excessive sexual activity pressure and at night, or a history of physical
or senility, may cause the Kidney to function poorly, trauma to the coccyx or adjacent region, is often
leading to deficiency of the Kidney-Essence. When the caused by stagnation of Blood.
coccyx is not properly nourished by the Kidney- Insidious onset of protracted coccyx pain with
Essence then coccyx pain follows. soreness, weakness of the lower back, legs and
knees, aggravation of the coccyx pain by tiredness
and alleviation of pain by rest, is often caused by
Stagnation of Qi and Blood
deficiency of Kidney-Essence.
The Qi and Blood should circulate freely in the body
and channels. If they stagnate in the region of the
coccyx because of various causes, they block the chan- Treatment
nels, causing coccyx pain. Stagnation of the Qi and
Blood may be caused by emotional disturbance,
INVASION OF COLD-DAMP
trauma or congenital deformity.
Symptoms and signs
Coccyx pain usually occurring after exposure to cold
Treatment based on and damp, which worsens on rainy days, with a heavy
sensation and stiffness of the muscles in the coccyx
differentiation region, and a cold feeling, accompanied by symptoms
such as limitation of extension and flexion of the back,
Differentiation lower back pain radiating to the buttocks and lower
limbs, a cold feeling in the lower back, an aversion to
cold, a slight fever, slight generalised body pain, a
Differentiation of External or Internal origin
white and greasy tongue coating and a superficial and
Coccyx pain can be caused either by invasion of Exter- slippery pulse.
nal pathogenic factors or by Internal disorders.
In case it is caused by invasion of External Principle of treatment
pathogenic factors, it is usually acute, and
Dispel Cold, dry Damp and relieve the pain.
accompanied by External symptoms such as
headache, fever, an aversion to cold, runny nose
or coughing.
If it is caused by disorders of Internal organs, it is
HERBAL TREATMENT
chronic and has no External symptoms.
Prescription
YI YI KEN TANG
Differentiation of character of the pain
Coix Decoction
Acute onset of coccyx pain after exposure to YiYi Ken Semen Coicis 15 g
cold and damp, aggravation of the coccyx pain Chuan Xiong Rhizoma Ligustici C1ll1anxiong 10 g
on rainy days, with a heavy sensation and Ma Huang Herba Ephedrae 10 g
stiffness of the muscles in the coccyx region and Gui Zhi Ramulus Cinnamomi 6 g
a cold feeling, limitation of extension and Qiang Huo Rhizoma seu Radix Notopterygii 10 g
flexion of the back, lower back pain radiating to Du Huo Radix Angelicae Pubescentis 10 g
the buttocks and lower limbs, cold feeling in the Chuan Wu Radix Aconiti Lateralis Praeparaia 6 g.
lower back, an aversion to cold, or a slight fever, decocted for more than 2 hours
is usually caused by invasion of Cold-Damp. Cang Zhu Rhizoma Atractylodis 10 g
COCCYX PAIN 411

Gan Cao Radix Glycyrrhizae 6 g ACUPUNCTURE TREATMENT


Sheng Jiang Rhizome Zingiberis 5 g
Chuan Niu Xi Radix Cyathulae 5 g LU-7 Lieque, LI-4 Hegu, GB-20 Fengchi, BL-12
Fengmen, BL-35 Huiyang, BL-58 Feiyang, BL-62
Shenmai, GV-3 Yaoyangguan and 5[-3 Houxi. Reducing
Explanations method is used on these points.
• YiYi Ren and Cang Zhu eliminate Damp in the
Lower Burner and coccyx. Explanations
• Qiang Huo and Du Huo dispel Wind, Cold and
Damp, relieve External symptoms and stop the • LI-4, the Source point of the Large Intestine channel,
coccyx pain. and LU-7, the Connecting point of the Lung
• Chuan Wu and Sheng Jiang warm the Yang-Qi of channel, are a pair of points from Externally and
the body, eliminate Cold-Damp and promote the Internally related channels. Together they dispel
circulation of Qi and Blood. Wind, eliminate Cold, relieve External symptoms
• Ma Huang and Gui Zhi open the skin pores and and stop generalised body pain. LI-4is also a very
promote sweating so as to dispel Wind and Cold good point for sedating the coccyx pain.
and relieve External symptoms. • GB-20 and BL-12 dispel Wind, Cold and Damp in
• Chuan Niu Xi and Chuan Xiong promote the the Bladder channel and Governing Vessel, and
circulation of Blood and relieve the coccyx pain. relieve the coccyx pain.
Chuan Niu Xi also dispels Cold-Damp and leads • BL-20, the Back Transporting point of the Spleen,
the treatment to the Lower Burner and coccyx. activates the Spleen and Stomach, eliminates
• Gan Cao harmonises the actions of the other herbs Damp and relieves the diarrhoea.
in the prescription. • BL-58, the Connecting point, harmonises the
collateral, dispels Wind-Cold and relieves the pain.
• BL-35 and GV-3, the local points, harmonise the
Modifications collateral in the coccyx region and relieve the pain.
• BL-62 and SI-3 in combination dispel Wind, Cold
1. If there is an aversion to cold and general body and Damp, remove blockage in the Governing
pain, add Fang Feng Radix Ledebouriellae 10 g and Vessel and relieve the coccyx pain.
Sang Zhi Ramulus Mori 10 g to dispel Wind-Cold
and relieve External symptoms.
2. If there is lower back pain with a feeling of Modifications
heaviness, add Bu Gu Zhi Fructus Psoraleae 10 g 1. If there is severe heaviness of the back, add SP-9 to
and Du Zhong Cortex Eucommiae 10 g to tonify the eliminate Damp and relieve the feeling of heaviness.
Kidney, strengthen the lower back and relieve the 2. If there is lower back pain with an obvious cold
pain. sensation, add moxibustion on BL-12, BL-58 and
3. [f the coccyx pain worsens at night, add Pu Huang Ll-4 to warm the channels, dispel Cold and relieve
Pollen Typhae 10 g and San Qi RadixNotoginseng the cold sensation.
10 g to promote the circulation of Blood and 3. If there is worsening of the back pain at night and
relieve the pain. waking at night due to severe pain, add SP-6 and
4. If there is a poor appetite and fullness in the HT-7 to promote the circulation of Blood, calm the
abdomen, add Bai Zhu Rhizoma Atractylodis Mind and relieve the severe pain.
Macrocephalae 10 g and Sha Ren Fructus Amomi 5 g 4. If there is nausea with a feeling of heaviness in the
to activate the Spleen and dry Damp. Stomach, add BL-21, the Back Transporting point
5. If there is generalised tiredness, shortness of of the Stomach, to harmonise the Stomach, help
breath and a pale complexion due to deficiency of the Stomach-Qi to descend, resolve Damp and
Qi, add Huang Qi RadixAstragali seu Hedysari 12 g relieve the nausea.
and Dang Shen RadixCodonopsis Pilosulae 10 g to 5. If there is a poor appetite and a feeling of fullness
activate the Spleen and Spleen-Qt. in the Stomach, add SP-4 to help the Stomach-Qi
to descend, dry Damp, improve the appetite and
relieve the fullness.
Patent remedy
6. If there is diarrhoea, add SP-3, the Source point, to
Du Huo [i Sheng Tang Angelica Pubescens and Loranihus dry Damp, activate the Spleen and relieve the
Decoction diarrhoea.
412 BACK PAIN

with a heavy and warm or hot sensation, or even


Case history
swelling at the coccyx. Other symptoms include sticky
A 36-year-old man had been suffering from coccyxpain, sweating, thirst with no desire to drink, fever, deep
with a heavy and cold sensation for 3 weeks. Three yellow urine, a red tongue with a yellow and greasy
weeks previously he had caught a cold after walking in coating and a slippery and rapid pulse.
the rain, when he had an aversion to cold, a slight fever,
and headache and coccyx pain. He did not take too
much care over these complaints, and the coccyxpain Principle of treatment
became worse and worse.
When he arrived at the clinic, he stated that when it Clear Heat, eliminate Damp and relieve the pain.
rained his coccyx pain usually worsened and he
sometimes woke up at night. Also, he still had a slight
aversion to cold and a fever (37.4°0, a sensation of HERBAL TREATMENT
heaviness in the coccyx,limitation of extension and
flexion in the lower back with pain radiating to the Prescription
buttocks, a white and greasy tongue coating, and a
superficial and slippery pulse. SIMIAOSAN
Four-Maroel Powder
Diagnosis Huang Bai Cortex Phellodendri 12 g
Coccyx pain due to invasion of Cold-Damp.
Cang Zhu Rhizoma Atractylodis 10 g
Principle of treatment Chuan Niu Xi RadixCyathulae 6 g
Dispel Wind and Cold, dry Damp and relieve the pain. Yi Yi Ren Semen Coicis 15 g
Acupuncture treatment Jin Qian Cao Herba Lysimachiae 20 g
Ll-4, BL-12, BL-3S, BL-S8, BL-62, BL-64, SP-6,GV-3 and
51-3. Reducing method was used on these points. Explanations
Treatment was given once a day.
• Huang Bai and Cang Zhu clear Heat, reduce fever
Explanations and dry Damp in the Lower Burner.
• Ll-4,the Source point, and BL-12 dispel Wind, • Yi Yi Ren clears Heat and promotes urination so as
eliminate Cold, relieve External symptoms and stop to eliminate Damp in the Lower Burner.
generalised body pain. Ll-4 can also sedate the coccyx
pain. • Chuan Niu Xi guides all herbs downward to the
• 5P-6, the crossing point of the three Yinchannels of coccyx region, invigorates the circulation of
the foot, activates the Spleen and Stomach, eliminates Blood, eliminates Blood stasis and reinforces the
Damp, promotes the circulation of Blood and relieves Kidney.
the coccyxpain. • [in Qian Cao promotes urination and eliminates
• BL-58, the Connecting point, and BL-64, the Source Damp-Heat in the Lower Burner.
point, harmonise the channel and collateral, dispel
Wind-Cold and relieve the coccyx pain.
• BL-35 and GV-3, the local points, harmonise the Modifications
collateral in the coccyxregion and relieve the pain.
• BL-62 and 51-3 in combination dispel Wind, Cold and 1. If there is swelling, pain and ulceration around
Damp, remove blockage in the Governing Vessel and the coccyx, add Sheng Di Huang Radix
relieve the coccyxpain. Rehmanniae Recens 10 g and Pu Gong Ying Herba
After three treatment sessions, his general symptoms Taraxaci 15 g to clear Heat, eliminate Toxin,
were much better, and his coccyx pain had also reduce the swelling and promote healing of the
improved somewhat. He could also sleep without ulceration.
waking up at night. After another week of treatment the 2. If the coccyx pain worsens at night, add Pu Huang
coccyxpain was under control. He was followed up 2 Pollen Typhae 10 g and San Qi RadixNotoginseng
months afterwards and he reported that he had
experienced no coccyxpain since the treatment. 10 g to promote the circulation of Blood and
relieve the pain.
3. If there is a fever and thirst, add Zhi Zi Fructus
Gardeniae 10 g to clear Heat, reduce the fever,
INVASION OF DAMP-HEAT eliminate Damp and relieve the pain.
Symptoms and signs 4. If there is lassitude in the loins, a dry throat and
feverish sensations in the palms and sales of the
Coccyx pain that is usually worse on rainy and hot feet, add Zhi Mu Rhizoma Anemarrhenae 12 g to
days, or lower back pain and pain in the coccyx region clear Heat and nourish the Yin.
COCCYX PAIN 413

5. If there is a bitter taste in the mouth and insomnia, 5. If there is a feeling of heaviness in the body, add
add Huang Lian Rhizoma Coptidis 5 g to clear Heat, SP-6 to resolve Damp and eliminate Phlegm from
eliminate Damp and calm the Mind. the body.
6. If there is frequent and urgent painful urination, 6. If the appetite is poor, add BL-20, the Back
add Mu Tong Caulis Aristolochiae 6 g and Che Qian Transporting point of the Spleen, to activate the
Zi Semen Planiaginis 12 g to eliminate Damp-Heat, Spleen and improve the appetite.
promote urination and relieve the urination pain. 7. If there is diarrhoea, add SP-3, the Source point, to
7. If there is bloody urine, add Xiao [i Herba activate the Spleen, eliminate Damp and relieve
Ceplialanopioris 12 g to cool the Blood and stop the the diarrhoea.
bleeding. 8. If there is profuse leucorrhoea, add GB-27 and
8. If there is urethral calculus, add Hai [in Sha Spora GB-41 to eliminate Damp and relieve the
Lygodii 10 g to promote urination and dissolve the leucorrhoea.
stone.

Patent remedy DEFICIENCY OF KIDNEY-ESSENCE


San Miao Wan Three-Marne! Pill Symptoms and signs
Insidious onset of protracted coccyx pain with sore-
ness, which worsens when tired and is alleviated by
ACUPUNCTURE TREATMENT rest, accompanied by weakness in the lower back, legs
and knees.
Ll-4 Hegu, TE-6 Zhigou, BL-35 Huiyang, BL-40 If the deficiency is of Kidney-Yang, there is also a
Weizhong, BL-58 Feiyang, BL-62 Shenmai, BL-66 cold feeling in the lower back, pallor, cold limbs, a
Zutonggu, GV-3 Yaoyangguan and 51-3 Houxi. normal taste in the mouth, polyuria, a pale tongue
Reducing method is used on these points. and a deep and feeble, or faint, or deep and slow
pulse.
Explanations If the deficiency is of Kidney-Yin, there is also a dry
mouth and throat, a flushed face, a feverish sensation
• LI-4, the Source point, and TE-6 dispel External in the chest, palms and soles of the feet, irritability,
factors, clear Heat and eliminate Damp. insomnia, a red tongue with a scanty coating and a
• BL-40, a commanding point for the back, and thready and weak or thready and rapid pulse.
BL-58,the Connecting point, promote the free flow
of Qi in the channels and harmonise the collateral in
order to treat the lower back pain and coccyx pain. Principle of treatment
• BL-66, the Spring point, clears Heat and eliminates
Damp in the Lower Burner. Tonify the Kidney, benefit the Essence and relieve the
• BL-35 and GV-3, the local points, harmonise the pain.
collateral in the coccyx region and relieve the pain.
• BL-62 and SI-3 in combination dispel Wind, Cold
and Damp, remove blockage in the Governing HERBAL TREATMENT
Vessel and relieve the coccyx pain.
Prescription a: for deficiency of Kidney-Yang
JIN GUI SHEN QI WAN
Modifications
Kidney Qi Pill
1. If there is a fever, add GV-14 to clear Heat and Shu Di Huang Radix Rehmanniac Pmcparota 12 g
reduce the fever. Shan Yao Rhizoma Dioscoreae 15 g
2. If there is sacral pain, add some local Ah Shi points Shan Zhu Yu Fructus Corni 10 g
to harmonise the collateral and arrest the pain. Ze Xie Rhizoma Alismaiis 10 g
3. If there is a severe burning sensation and aversion Fu Ling Poria 10 g
to heat in the lower back, add BL-67 to clear Heat Gui Zhi Ramulus Cinnamomi 6 g
and relieve the burning sensation. Fu Zi Radix Aconiti Carmichaeii Pracpamta h g,
4. If there is scanty and painful urination, add BL-32 decocted first
and KI-4 to promote urination and relieve the Tu Si Zi Semen CUSClItllC 10 g
urination pain. Du Zhong Cortex Eucommiac 10 g
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Prescription b: for deficiency of Kidney-Yin 4. If there is insomnia due to disharmony between


the Heart and Kidney, add Huang Lian Rhizome
ZUOGUIWAN
Coptidis 5 g and E [iao Colla Corii Asini 10 g to clear
Restoring the Left Pill
Deficient-Fire, balance the Heart and Kidney and
Shu Di Huang Rhizoma Rehmanniae Pracparata 12 g
improve sleep.
Shan Yao Rhizoma Dioscoreae 15 g
5. If there is headache and vertigo due to
Shan Zhu Yu Fructus Corni 6 g
hyperactivity of Liver-Yang caused by deficiency
Tu Si Zi Semen Cuscutae 10 g
of the Yin of the Liver and Kidney, add Tian Ma
Gou Qi Zi Fructus Lycii 12 g
Rhizoma Gastrodiae 10 g and Gou Teng Uncariae
Chuan Niu Xi RadixCyatJlUlae 6 g
cum Uncis 15 g to subdue the Liver-Yang and
Lu Jiao Jiao Colla CerviComus 6 g
relieve the vertigo.
Gui Ban Jiao Colla Plastri Testudinis 10 g
6. If there is a tidal fever or feverish sensation in the
palms and soles of the feet due to deficiency of
Explanations Yin, add Di Gu Pi Cortex Lycii Radicis 12 g to clear
• In [in Gui Shen Qi Wan, Shu Di Huang tonifies the Deficient-Heat.
Kidney, benefits the Essence and consolidates the
bones. Patent remedies
• Shan Yao and Shan Zhu Yu strengthen the Liver and
Spleen to help Shu Di Huang tonify the Kidney. [in Gui Shen Qi Wan Kidney Qi Pill for deficiency of
• Gui Zhi and Fu Zi tonify the Kidney-Yang and Kidney-Yang
dispel Cold. Liu Wei Di Huang Wan Six-Flavour Rehmanniae Pill for
• Ze Xie and Fu Ling remove Damp and promote deficiency of Kidney-Yin
urination.
• Tu Si Zi and Du Zhong tonify the Kidney, benefit
the Essence and strengthen the back and bones. ACUPUNCTURE TREATMENT
• In Zuo Gui Wan, Shu Di Huang tonifies the
BL-23 Shenshu, BL-35 Huiyang, BL-40 Weizhong,
Kidney and benefits the Essence.
BL-58 Feiyang, GB-39 Xuanzhong, KI-3 Taixi, KI-lO
• Shan Yao and Shan Zhu Yu strengthen the Liver and
Yingu, GV-3 Yaoyangguan and SP-6 Sanyinjiao.
Spleen to help Shu Di Huang tonify the Kidney.
Reinforcing method is used on these points.
• Gou Qi Zi nourishes the Yin of the Liver and
Kidney and benefits the eyes.
• Gui Ban [iao, Tu Si Zi and Lu [iao [iao tonify the Explanations
Kidney and strengthen the bones.
• BL-23,the Back Transporting point of the Kidney,
• Chuan Niu Xi has the effect of strengthening the
KI-3, the Source point, and KI-lO, the Sea point,
waist and knees and reinforcing the muscles and
tonify the Kidney, and strengthen the back and
joints.
bones so as to treat the root cause.
• BL-40,a commanding point for the back, and
Modifications BL-58, the Connecting point, promote the free flow
1. If there is shortness of breath, lassitude, a low of Qi in the channels and harmonise the collateral
voice, a poor appetite and diarrhoea due to in order to treat pain in the lower back and coccyx.
deficiency of the Spleen-Qi, add Dang Shen Radix • GB-39, the Gathering point for the Marrow,
Codonopsis Pilosulac 10 g and Huang Qi Radix strengthens the tendons and bones so as to
Astragali Pilosulae 12 g to tonify the Spleen-Qi. consolidate the back and coccyx.
2. If there is diarrhoea before dawn with cold in the • SP-6, the crossing point of the three Yin channels
lower abdomen due to deficiency of Kidney-Yang, of the foot, nourishes the Liver, Spleen and Kidney
add Bu Gu Zhi Fructus Psoraleae 10 g and Wu Wei so as to promote the production of Qi and Blood.
Zi Fructus Schisandrae 10 g to tonify the Kidney- • BL-35 and GV-3, the local points, harmonise the
Yang and stop the diarrhoea. collateral in the coccyx region and relieve pain.
3. If there is seminal emission, enuresis and frequent
nocturnal urination due to deficiency of the
Modifications
Kidney-Qi, add Yi Zhi Ren Fructus Alpiniae
Oxyplzyllae 6 g to tonify the Kidney-Qi and arrest 1. If there is a cold sensation in the lower back,
the seminal emission. add GV-4 with moxibustion and a moxa box on
COCCYX PAIN 415
the lower back to warm the lower back and • GB-39, the Gathering point for the Marrow,
dispel Cold. strengthens the tendons and bones so as to
2. If there is weakness in the knees, add GB-34, the consolidate the back and coccyx.
Cathering point for the tendons, to strengthen the • BL-35 and GV-3, the local points, harmonise the
collateral in the coccyx region and relieve the pain.
knees.
• GB-20 calms the Mind, smoothes the Liver and
3. If there is impotency, add CV-4 and CV-6 to tranquillises the Mind.
reinforce the Kidney and improve the potency.
4. If there is insomnia, add HT-3 and rC-6 to calm Herbal treatment
Liu Wei Di Huang Wan Six-Flavour Rchmanninc Pill, three
the Mind and improve the sleep.
times per day, 12 pills each time.
5. If there is dizziness, add GB-20 to regulate the Qi
and Blood in the head and relieve the dizziness. After treatment for 1 month, her coccyx pain was almost
under control. After this, acupuncture was given once
6. If there is generalised tiredness, add ST-36 and
every week for another 2 months, by which time her
CV-20 to lift up the energy and relieve the tiredness. coccyx pain had disappeared. She was followed lip a
7. If there is diarrhoea, add BL-20 and BL-25 to year later and she replied she had experienced no
strengthen the Spleen and stop the diarrhoea. further coccyx pain since the treatment.
8. If there is constipation, add LI-4 to promote
defecation.
q If there is profuse night sweating, add HT-6 and STAGNATION OF QI AND BLOOD
KI-2 to clear Deficient-Heat and stop the sweating.
10. If there is nervousness and headache, add LR-2,
Symptoms and signs
the Spring point, to clear Heat in the Liver and A stabbing pain in the coccyx that is aggravated by
calm it. pressure and worsens at night, with a history of phys-
ical trauma to the coccyx or adjacent region, accompil-
Case history nied by rigidity in the lower back, restlessness or
insomnia due to the coccyx pain, a dark purplish
A 75-yeilf-old woman had been suffering from coccyx tongue and a thready or choppy pulse.
pain for 5 years. The onset was gradual, and the pain
mostly occurred when she was tired and resolved after
she had rested. Sometimes she suffered from coccyx pain Principle of treatment
when she walked too much. Other symptoms were heat
Promote Qi and Blood circulation, eliminate Blood
in the body, a thirst, a dry throat, dry stools, slight night
sweating, lower back pain and soreness, weakness in the stasis and relieve the pain.
knees, a poor memory, dizziness, tinnitus in the left ear,
irritability, nervousness, occasional headaches, a red
tongue with a scanty coating, and one small area of HERBAL TREATMENT
peeled coating on the left edge, and a thready, weak and
slightly rapid pulse. Prescription
Diagnosis SHEN TONG ZHU YU TANG
Coccyx pain due to deficiency of Yin of Liver and Kidney. Meridian Passage
Dang Gui RadixAngelicae Sinensis 10 g
Principle of treatment
Nourish Yin, tonify the Kidney and relieve the pain. Chuan Xiong Rhizome Ligustici ClllIallx!cmg 12 g
Tao Ren Semen Persicac 10 g
Acupuncturetreatment Hong Hua Flas Carthami 6 g
BL-23, BL-35, BL-58, GB-20, GB-39, KI-3, KI-7, KI-lO, Mo Yao Resina Myrrhae 6 g
GV-3 and SP-6. Reinforcing method was used on these
points. Treatment was given once every 3 days.
Xiang Fu Rhizoma Cyperi 10 g
Wu Ling Zhi Faeces Trogoptcrorum 6 g
Explanations Chuan Niu Xi Radix Cyathulae 6 g
• BL-23, the Back Transporting point of the Kidney, Di Long Lumbricus 10 g
KI-3, the Source point, and KI-lO, the Sea point, tonify Gan Cao Radix Glycyrrhizae 6 g
the Kidney, and strengthen the back and bones so as
to treat the root cause.
• KI-7, the Metal point, and SP-6, the crossing point of Explanations
the three Yin channels of the foot, nourish the Yin of
the Liver and Kidney and clear Deficient-Heat. • Dang Cui, Chuang Xiong, Tao Ren and Hong Hua
• BL-58, the Connecting point, harmonises the collateral promote the circulation of Blood and eliminate
and relieves the coccyx pain. Blood stasis.
416 BACK PAIN

• Mo Yao and Wu Ling Zhi eliminate Blood stasis • BL-40, a commanding point for the back, BL-58,
and sedate coccyx pain. the Connecting point, and BL-63, the
• Xiang Fu promotes the circulation of Qi to Accumulation point, promote the free flow of Qi
reinforce the effect of the circulation of Blood. in the channels and harmonise the collateral to
• Chuan Niu Xi and Di Long promote the circulation relieve the pain in the lower back and coccyx.
of Blood in the channels and relieve coccyx pain. • BL-62and 51-3in combination open the Governing
• Chuan Niu Xi guides Blood stasis down and Vessel and relieve coccyx pain.
tonifies the back and coccyx. • BL-35and GV-2, the local points, harmonise the
• Gan Cao harmonises the actions of the other herbs collateral in the coccyx region and relieve pain.
in the prescription.
Modifications
Modifications 1. If there is a severe coccyx pain, add LI-4 and LR-3
1. If there is swelling around the coccyx, add San Qi to promote the circulation of Qi and Blood and
Radix Notoginseng 10 g to promote the circulation relieve the pain.
of Blood, eliminate Blood stasis and reduce the 2. If there is swelling around the coccyx, add some
swelling. local Ah 5hi points to promote the circulation of
2. If there is lower back pain with an aversion to Qi and Blood and reduce the swelling.
Wind-Damp, add Du Huo Radix Angelicae 3. If there is restlessness due to pain, add GB-20 to
Pubescentis 10 g to dispel the Wind and relieve the calm the Mind.
pain. 4. If there is insomnia, add HT-3 and HT-7 to calm
3. If there is lower back pain with weakness of the the Heart and tranquillise the Mind.
lower back, add Du Zhong Cortex Eucommiae 5. If there is aversion to cold in the lower back, add
10 g and Shu Di Huang RadixRehmanniae moxibustion to warm the channel and dispel
Praeparata 12 g to tonify the Kidney and relieve Cold.
the pain.
4. If there is irregular menstruation due to stagnant
Case history
Blood, add Yi Mu Cao Herba Leonuri 10 g to
regulate the menstruation. A 20-year-old man had been suffering from coccyx pain
5. If there are cold limbs, a pale complexion, a deep after falling down whilst horse riding 5 days previously.
and slow pulse and a pale tongue, add Gui Zhi He visited his doctor and was given some painkillers;
Ramulus Cinnamomi 6 g and Gan Jiang Rhizoma however, the pain did not improve much.
Zingiberis 6 g to warm the Kidney-Yang and When he arrived at the clinic, he still had some
relieve the pain. swelling around the coccyx, together with a big blue
spot, which was about 10 x 10 em, worsening of the
pain at night and frequent waking due to pain,
Patent remedy restlessness, an inability to sit and lie down and,
because of the coccyx pain, he could not easily defecate
Te Xiao Yao Tong Ling Special Efficacy Lower Back Pain as usual. His appetite, tongue coating and pulse were
Pill normal.
Diagnosis
Coccyx due to stagnation of Blood.
ACUPUNCTURE TREATMENT
Principle of treatment
BL-17 Geshu, BL-35 Huiyang, BL-40 Weizhong, BL-58 Promote circulation of Qi and Blood, eliminate Blood
stasis and relieve the pain.
Feiyang, BL-62 Shenmai, BL-63 [inmen, 51-3 Houxi,
GV-2 Yaoshu and 5P-6Sanyinjiao. Reducing method is Acupuncture treatment
used on these points. GV-2, GV-26, BL-17, BL-40, BL-3S, BL-S8 and SP-6.
Reinforcing method was applied for all these points.
Treatment was given two times per week.
Explanations
Explanations
• BL-17,the Gathering point for the Blood, and 5P-6, • GV-2 and BL-3S are the local points to promote the
the crossing point of the three Yin channels of the circulation of Qi and Blood, harmonise the collateral
foot, promote the circulation of Blood and and relieve the coccyx pain.
eliminate Blood stasis. • Needling at GV-26 with reducing method conducts
COCCYX PAIN 417
the circulation of Qi and Blood in the Governing foot, were used to promote the circulation of Blood,
Vessel, which passes through the sacral region. eliminate Blood stasis and relieve the pain.
• BL-40, the commanding point for the back, and BL-58, After 1 month of treatment, his coccyx pain had
the Connecting point, disperse the stagnation of disappeared. Two months later, he was followed up by
Blood from the collateral and relieve the pain. telephone and he replied he had experienced no pain
• BL·17, the Gathering point for the Blood, and SP-6, since the treatment.
the crossing point of the three Yin channels of the