Integrating Eastern and Western Modalities to Treat Lower Back Pain

Lower back pain can be a temporary or chronic condition that can affect anyone at any age.

Whether you’ve been in practice for a week or a decade, at some point you will find yourself treating a client with lower back pain. It is one of the most common complaints that will come across your table. Treat it accurately and efficiently and you will have a client for life. 

When curating a custom treatment plan for lower back pain, combining techniques from multiple Eastern and Western modalities will give you a comprehensive program that covers all the bases to alleviate pain and keep your client coming back. 

Related CE course: Orthopedic Manual Therapy of the Lumbar Spine

Prevalence of lower back pain 

In 2020, the World Health Organization reported that over 600 million people experienced lower back pain. WHO also reported lower back pain as being the leading cause of disabilities worldwide. 

Lower back pain can be a temporary or chronic condition that can affect anyone at any age from children to elderly clients. Common causes include muscle sprains and tendon strains, but pain may also come from spinal fractures, problems with the intervertebral discs, disease, pregnancy, and postural imbalance. (Lower Back Pain, 2024b) 

With this pain pathology being such a widespread complaint across so many populations, a client with LBP will inevitably come onto your table, be ready to treat it effectively. 

Massage modalities to address lower back pain 

Every massage modality has techniques and treatments to treat lower back pain. Particularly effective is a mix of myofascial release, acupressure points, and Thai stretches, with a Swedish base to keep it all supported.  

Myofascial release 

Myofascial release is an intense modality that is not suitable for every client, but myofascial sacral traction at the beginning of a session will move mountains when it comes to lower back pain. Begin with your client prone on the table, giving direct access to the area surrounding the lumbar spine.  

Sacral traction, myofascial release over the superior portion of the glutes, and skin rolling medial to lateral around the lumbar spine is an incredible introduction to start your treatment. 

Accupressure for lower back pain 

Acupressure is the next modality you can introduce to the session. From a practical standpoint, using acupressure without oil is optimal. From an energetic standpoint, it can be beneficial to open up the channels and allow Qi to flow locally to the sacral and lumbar area before digging any deeper. 

Urinary Bladder 40 is your most important point when treating back pain. Located directly in the center of the popliteal crease, just behind the knee, you don’t need to be a Doctor of Traditional Chinese Medicine to locate it. This is the command point for the lower back and is used to primarily loosen hip flexors that cause lower back pain. 

Gall Bladder 41 is a powerful mover point for the GB channel that runs along the entire side of the body. It is particularly helpful with pelvic pain. Just distal to the ankle, between the fourth and fifth metatarsals, is where you can locate this sensitive spot, so apply pressure cautiously. 

While you’re at the feet, you can hit Urinary Bladder 60, sandwiched between the lateral ankle bone and Achilles tendon. This is a predominant point for pain relief anywhere in the body and is great at mobilizing stiffness anywhere where there is bone-on-bone articulation. 

Effleurage-petrissage-effleurage 

After you’ve energetically opened up the lower back, apply your oil or cream and use an effleurage-petrissage-effleurage combo to circulate blood to the area, relax the muscles that surround the hips, pelvis, and lumbar region, and release tension held in the tissue. Make sure you are giving special attention to quadratus lumborum, piriformis, and spinal erectors. Use specific deeper pressures to release stubborn trigger points or to open up the hips around the greater trochanter. Tie it all together with some big broad strokes connecting the thoracic and cervical spine to the lower back. 

Thai stretches 

At this point, you can have them turn to a supine position. There are several Thai stretches designed to release lower back tension. One of the most effective is a supine twist. Not only is it effective on the table, but your client can perform these stretches at home as a form of self-care for their lower back pain. 

Begin by draping one leg, as if you were going to work on the quad. Supporting the knee, flex and bring the knee towards the chest. This by itself is an excellent stretch for the lower back. Next, take the knee and carry it diagonally across the body, slowly. Direct the client to exhale as you move deeper into the stretch.  

You can also anchor at the shoulder with one hand, while the other pushes the knee across the table, to go a little deeper into the stretch. This twisting is an incredible way to bring mobility to the lumbar spine, the least mobile section of the spine. Repeat on the other side, again guiding your client with verbal cues for breathing. Take them to the first or second resistance level of the stretch. 

This is only a basic guide to begin combining both Eastern and Western modalities into one fluid and effective treatment for lower back pain. You can use this foundation, and then add your own style, creativity, and knowledge to expand and individualize each session.