🌿 Folk Prescriptions

Lumbar disc herniation is a common clinical condition, primarily presenting as lumbar and leg pain and restricted spinal mobility, with severe cases impairing self-care abilities. Various treatments are currently available, including manual manipulation, lumbar traction, physiotherapy, internal and external administration of Chinese herbs, and diverse surgical procedures. Among them, syndrome differentiation-based internal herbal medicine has proven effective, providing significant effects such as promoting blood circulation, resolving stasis, regulating qi, softening hardness, reducing inflammation, and relieving pain. Modern research also confirms that internal herbal medicine can reduce inflammatory responses, shorten the inflammatory phase, lessen connective tissue formation, promote recovery of degenerated nerve fibers, reduce glial fiber proliferation, and alleviate scar tissue compression on surrounding neural tissues.
Lumbar disc herniation falls within the category of "lumbar pain" and "lumbar-leg pain" in traditional Chinese medicine. The *Huangdi Neijing* (Plain Questions) states: "Luo meridian obstruction causes waist pain, making bending and lifting difficult; fear of falling when lifting up, caused by sudden severe injury to the waist." Analysis of etiology indicates that lumbar disc herniation commonly results from external injuries, internal deficiencies, or exposure to wind, cold, and dampness. Thus, clinical syndromes are classified into Qi stagnation and blood stasis, wind-cold obstruction, damp-heat obstruction, and liver-kidney deficiency types.
Qi Stagnation and Blood Stasis Syndrome
Patients experience sharp, stabbing pain in the waist and legs, lighter during the day, worse at night, fixed in location, tender to touch, stiff waist, difficulty turning over while lying prone. Most have recent history of lumbar trauma. Tongue appears dark red, possibly with ecchymosis, pulse is taut and tight or choppy. Treatment focuses on activating blood circulation, removing stasis, relaxing sinews, and relieving pain. Formula: Modified Shentong Zhuyu Decoction, emphasizing potent blood-activating herbs like peach kernel, safflower, angelica root tail, and ligusticum. Complementary herbs include those promoting qi movement or relieving pain, with added qi-regulating agents as needed. Alternatively, take Sanqi powder orally.
Wind-Cold Obstruction Syndrome
Patients suffer from cold, dull pain in the waist and legs, worsening with cold weather or rainy days, limbs feel cold, prefer warmth, fear cold. Tongue is pale, coating white and slippery or greasy, pulse deep and tight or slow. Treatment aims to dispel wind and dampness, relieve pain, tonify liver and kidney, and nourish qi and blood. Formula: Modified Duhuo Jisheng Decoction, emphasizing wind-dispelling, cold-scattering, and pain-relieving herbs. For dominant cold, add dry ginger and processed aconite; for dominant wind, add gentiana and peony. Alternatively, take Warm-Channel Capsules orally.
Damp-Heat Obstruction Syndrome
Clinical presentation includes waist and leg pain, limb heat sensation, pain worsens with heat or rain, aversion to heat, dry mouth and tongue, short, red urine, constipation. Tongue is red, coating yellow and greasy, pulse moist and rapid or stringy-rapid. Treatment focuses on clearing heat and draining dampness. Formula: Modified Siao Miao San, adding plantain seed and capillary wormwood for heavy dampness, greater yellow and anemarrhena for intense heat. Also available as ready-made pills: Pan Tu Zhitong Capsules.
Liver-Kidney Deficiency Syndrome
Persistent waist and leg pain, exacerbated by fatigue, limbs feel numb with cold sensation, heavy and weak, muscle atrophy. For yang deficiency: pale complexion, cold hands and feet or cold waist and legs, impotence, premature ejaculation, women with clear vaginal discharge, pale tongue with white slippery coating. For yin deficiency: flushed complexion, dry mouth and thirst, irritability, insomnia, frequent dreams, or nocturnal emission, red tongue with little coating, fine and rapid pulse.
For yang deficiency: treatment focuses on warming the kidneys and strengthening yang. Formula: Modified Yougui Wan, or take Long Bie Capsules orally.
For yin deficiency: treatment focuses on nourishing yin and unblocking meridians. Formula: Modified Zuogui Wan, or take Liuwei Dihuang Pills orally.
In summary, numerous formulas exist for treating lumbar disc herniation, with a long history and distinct characteristics. Our experience suggests that TCM treatment must carefully assess clinical manifestations, consider systemic changes, actively seek underlying causes, combine all four diagnostic methods (inspection, auscultation, inquiry, and pulse-taking), and differentiate syndromes for targeted treatment. Although "lumbar pain" often stems from "blood stasis" or "kidney deficiency," our hospital is located in Lingnan, a region naturally humid, where dampness predominates and easily transforms into heat. Thus, most patients can be diagnosed as "damp-heat," young adults often combined with "blood stasis," and elderly patients often with "kidney deficiency." Tailoring different formulas accordingly, referencing classical prescriptions and adapting them appropriately, yields effective clinical results.
Importantly, syndrome differentiation-based herbal treatment must be adapted to time, place, and individual. For example, in southern regions with high humidity, excessively drying herbs like angelica should be avoided, as they may harm the body. During hot weather, even if constitutionally deficient and requiring tonics, overly nourishing and greasy tonics should be used cautiously to avoid digestive discomfort.
External herbal applications also offer unique benefits, such as herbal plasters and steam fumigation. We have compiled several effective external formulas: 30g raw aconite root, 30g raw monkshood root, 15g cinnamon twig, 15g angelica root, 30g chicken blood vine, 30g wide tendon vine, 30g bone-piercing herb, 15g rhubarb. Soak the herbs in water, add enough water to make 3–4 liters, boil down to 2 liters, place under the bed to allow steam to fumigate the waist. The decoction can be reused 2–3 times, once daily, yielding excellent results.