A woman (age: 45) visited my office with stiffness and soreness of her low back and pain in her right big toe. She said her low back has bothered her for the last 2 years but it had gotten worse in the previous month. Her toe was diagnosed with arthritis 3 years ago and doesn’t have the flexibility to walk on it. She experiences severe pain when walking for extended periods of time or if she tries to exercise. She had surgery to correct torn ligaments of both knees due to a skiing accident. Another symptom that bothers her is occasional eczema of the foot which causes her skin to be very dry and crack. Her tongue was slightly red without any coating and her pulse was thready and rapid.
DIAGNOSIS: Kidney Yin Deficiency
All of those conditions are Chronic and fall under the domain of the Kidneys. The location of the kidneys is in the low back which influences the energy in the low back. Back pain aggravated by activity indicates a deficient condition. When the kidneys essence is depleted from aging and work, it can manifest in low back, knees and bone pain or weakness.
The kidneys are also responsible for the fluid in the body. When the Kidney Yin is deficient there is dryness in the joints and tendons. In this case it manifested as arthritis of the right big toe and eczema on the foot skin. The pulse and the tongue also support a Kidney Yin Deficiency diagnosis. There is no coating on the tongue from dryness of liquids. The slight redness is because the body is overheated due to insufficient fluids. The pulse is thready – thin, less blood (yin) and rapid due to the heat.
Treatment included acupuncture, soft tissue manipulation and Chinese herbs.
The focus of the treatment was to open the low back, nourish her Kidney Yin by using points on the low back and along the kidney meridian (including the following points: K3, K7, and UB23), reducing the arthritis inflammation of the toe and increase the range of motion of the toe. Other points used to achieve these goals included Lv2 and Lv3.
The herbal formulas used include a variety of roots and barks because of their ability to “strengthen the Kidney, tonify Yin and Yang, [and] nourish the tendons and bones.” One of the roots, Achyranthes (huai niu xi), is “particularly useful for promoting recovery from injury to the lower back.”1
She came back after the first treatment reporting that her back felt much better and she had more flexibility in her toe. Her skin on the foot improved. She continued to come for 5 more visits for this specifically and reported that she doesn’t feel her back ache or toe pain any more and her skin healed.
Because this was a chronic condition, I recommended she keep taking the formula and come for maintenance treatments every other week. She is now coming in for preventative care instead of crisis management.
1 “Chinese Medicine Works Clinical Handbook” Harriet Beinfield, L.Ac. and Efrem Korngold, L.Ac., O.M.D. – Revised Edition 2007