(237) Spinal Stenosis

[HB KIM]

WESTERN REVIEW
Definition: Spinal stenosis is narrowing of the vertebral openings which can cause pressure on the spinal cord or spinal nerves. 
Signs and symptoms: Symptoms include pain in the neck or back, and numbness, weakness, or pain in the arms, legs, or feet.  Symptoms often occur gradually.  Some people may not experience any symptoms.
Causes: Diseases such as arthritis or scoliosis can cause spinal stenosis; it occurs more often in people over 50 years old.  Traumatic injury is another cause of spinal stenosis.
Western treatment: Medications, physical therapy, braces, surgery


TCM PATTERNS
Spinal stenosis belongs to "Muscle-Bone Bi syndrome" or "Back/Leg Pain" according to TCM disease differentiation.

1. Wind-Cold-Damp: Spinal stenosis with symptoms worsened by windy and damp weather, pain alleviated by warmth, difficult to turn body, pain does not subside even when lying down, thin and white tongue coating, deep pulse

Treatment principle: Expel pathogen, open collaterals, tonify Kidney, nourish Blood
9g  Du Huo
6g  Sang Ji Sheng
6g  Du Zhong
6g  Huai Niu Xi
6g  Xi Xin
6g  Qin Jiao
6g  Fu Ling
6g  Rou Gui
6g  Fang Feng
6g  Chuan Xiong
6g  Ren Shen
6g  Gan Cao
6g  Dang Gui
6g  Bai Shao
6g  Shu Di Huang


2. Blood Stasis: Spinal stenosis caused by trauma, severe low back pain, aversion to touch, inability to turn body, difficulty walking or moving, purple tongue, hesitant and wiry pulse

Treatment principle: Move qi and blood, remove blood stasis, stop pain
3.0g  Tu  Bie Chong
6.0g  Dang Gui
1.2g  Ru Xiang
1.8g  Zi Ran Dong (duan)
1.2g  San Qi


3. KD Yang deficiency: Spinal stenosis, dull lower back pain, prefers massage or touch, low back and knee weakness, cold body and limbs, pale and abundant urination, thin and white tongue coat, deep and weak pulse

Treatment principle: Tonify and warm Kidney Yang
13g   Shu Di Huang
6.0g  Shan Yao (fried)
4.5g  Shan Zhu Yu
6.0g  Gou Qi Zi
6.0g  Lu Jiao Jiao (fried)
6.0g  Tu Si Zi
6.0g  Du Zhong (fried with ginger juice)
4.5g  Dang Gui
3.0g  Rou Gui
3.0g  Fu Zi


4. KD Yin deficiency: Spinal stenosis with dull lower back pain, irritability, insomnia, dry mouth and throat, heat sensation in 'five palms,' red tongue, scanty or no coating, thready and rapid pulse

Treatment principle: Tonify Kidney Yin
13g   Shu Di Huang
6.0g  Shan Yao (fried)
6.0g  Gou Qi Zi
6.0g  Shan Zhu Yu
4.5g  Chuan Niu Xi
6.0g  Tu Si Zi
6.0g  Lu Jiao Jiao
6.0g  Gui Ban Jiao


5. Under-nourished Bones and Sinews: Spinal stenosis with Cauda Equina Syndrome, difficulty controlling bowel and bladder, frequent urination, incontinence, constipation, numbness around the genitals, impotence, progressive numbness or weakness of the legs

Treatment principle: Tonify Liver and Kidney, nourish muscle and bones
30g   Shu Di Huang
1.5g  Ma Huang
9.0g  Lu Jiao Jiao
6.0g  Bai Jie Zi (fried)
3.0g  Rou Gui
3.0g  Gan Cao
1.5g  Pao Jiang