脉∶腰痛之脉，必沉而弦。沉微气滞，弦损肾元；或浮而紧，风寒所缠；湿伤濡细，实闪挫然；涩为瘀血，
滑痰火煎；或引背痛，沉滑等症。
大抵腰痛新久总属肾虚。新痛宜疏外邪、清湿热；久则补肾，兼补气血。
常常腰痛者，肾虚也。
补阴汤 治肾虚腰痛。
当归 白芍（酒炒） 生地黄 熟地黄 陈皮 茴香（盐、酒炒） 故纸（酒炒） 牛膝（去芦，酒洗）
杜仲（去粗皮，酒炒） 茯苓（去皮。各一钱） 人参（五分） 黄柏（去粗皮，酒炒） 知母（酒炒。各七分）
甘草（炙，三分）
上锉一剂，枣二枚，水煎，不拘时服。痛甚大者加乳香、砂仁、沉香，去芍药、生地、陈皮。如常服合丸
药，俱为细末，炼蜜为丸，如梧桐子大。每服五十丸，清心米汤下，酒亦可。
养血汤 治腰痛、腿痛、筋骨疼痛。
当归 生地黄 秦艽 肉桂 牛膝（去芦，酒洗） 杜仲（盐、酒炒） 茯苓（去皮） 防风（去芦。各
一钱） 土茯苓（一钱半） 川芎（五分） 甘草（三分）
上锉一剂，水煎，临熟入酒少许同服。
青娥丸 治肾虚腰痛。
大茴香 杜仲（酒炒） 破故纸（酒炒。各一两） 加熟地黄（二两酒洗，）用胡桃去壳取肉四两，汤泡，
去皮，纸包，捶去油。共五味为末，炼蜜为丸，如梧桐子大。每服五十丸，空心酒
下，或木香汤下亦可。
日轻夜重者，瘀血也。治瘀血腰痛（方见郁症。）根据本方加木香、沉香、茴香、乳香、牛膝，去乌药、官
桂、青皮、牡丹皮。
调荣活络汤 治失力腰闪，或跌扑瘀血凝滞及大便不通而腰痛者。
当归 桃仁 大黄 牛膝（各二钱） 川芎（一钱） 赤芍 红花 生地黄 羌活（各一钱） 桂枝（三分）
上锉一剂，水煎服。
过街笑 治闪腰痛。
木香（一钱） 麝香（三厘）
上为末吹鼻。右边吹左鼻，左边吹右鼻。令病患手上下和之。
遇阴雨久坐而发者，是湿也。渗湿汤治湿伤腰痛（方见湿症。）根据本方加破故纸、杜仲、茴香、木香、乳
香，去浓朴、抚芎。
腰背重注走串痛者，是痰也。二陈汤治湿痰腰痛（方见痰症。）根据本方加木香、茴香、乳香、玄胡索、砂
仁、苍术、羌活、酒芩、当归、杜仲（酒炒）。
肾虚腰痛补遗方
续断丸 治腰痛并脚酸腿软。
续断（二两） 破故纸（酒炒） 牛膝（去芦，酒洗） 木瓜（酒洗） 杜仲（去粗皮酒洗） 萆 （酒浸
。各一两）
上为细末，炼蜜为丸，如梧桐子大。空心，无灰酒送下五六十丸。
又方 大胡桃二个，炮焦去壳细嚼，烧酒送下，腰痛立止。
滋阴补肾丸 滋肾养血，除湿热、止腰疼、腿酸痛。
熟地黄（酒洗、一两五钱） 白芍（酒炒，一两） 当归（酒洗，一两五钱） 川芎（八钱） 破故纸
（盐、酒炒，二钱） 杜仲（姜汁炒，一两五钱） 小茴香（盐、酒浸炒，六钱） 甘枸杞（盐、酒浸炒，
一两） 黄柏（盐、酒浸炒，一两二钱） 桃仁（去皮炒，五钱） 川楝子（一两二钱）
上为细末，炼蜜为丸，如梧桐子大。每服八九十丸，空心，热酒送下。
胡桃丸 治腰痛。
乳香 沉香 木香 母丁香 大茴香 干姜 杜仲（姜汁炒，去丝） 没药 菟丝子（酒制） 破故纸
（酒炒，各等分） 胡桃（四个，去壳）
上为细末，炼蜜为丸，如绿豆大，黄酒送下。
一肾虚腰痛，用六味丸加鹿茸、当归、木瓜。续断。（方见补益。）
一人跌腰作痛，用定痛等药不愈，气血日衰，面耳黎色。余曰∶腰为肾之府。虽曰闪伤，实肾经虚弱所致。
遂用杜仲、补骨脂、五味、山茱、苁蓉、山药，空心服。又以六君、当归、白术、神曲各二钱，食远服，不月
而瘥。（方见补益。）
脉象：腰痛的脉象，必定沉而弦。脉沉微表示气机阻滞，脉弦表示肾元受损；或者脉浮而紧，是风寒邪气缠绕所致；脉濡细是湿邪损伤的表现，脉实则是闪挫伤所致；脉涩代表有瘀血，脉滑代表痰火煎熬；如果疼痛牵引到背部，伴有沉滑等脉象症状。
大抵而言，腰痛无论新发还是久病，总归属于肾虚。新发的腰痛适宜疏解外邪、清利湿热；久病则应当补肾，兼补气血。
补阴汤：治疗肾虚腰痛。
当归、白芍（酒炒）、生地黄、熟地黄、陈皮、茴香（盐、酒炒）、故纸（即破故纸，酒炒）、牛膝（去芦头，酒洗）、杜仲（去粗皮，酒炒）、茯苓（去皮，以上各一钱）、人参（五分）、黄柏（去粗皮，酒炒）、知母（酒炒，以上各七分）、甘草（炙，三分）。
以上药材锉成粗末为一剂，加红枣二枚，水煎煮，不拘时间服用。疼痛剧烈者，加入乳香、砂仁、沉香，去掉芍药、生地、陈皮。如作为常服丸药，将所有药材研为细末，用炼蜜制成梧桐子大小的丸药。每次服用五十丸，用清心米汤送下，用酒送下也可以。
养血汤：治疗腰痛、腿痛、筋骨疼痛。
当归、生地黄、秦艽、肉桂、牛膝（去芦头，酒洗）、杜仲（盐、酒炒）、茯苓（去皮）、防风（去芦头，以上各一钱）、土茯苓（一钱半）、川芎（五分）、甘草（三分）。
以上药材锉成粗末为一剂，水煎煮，临熟时加入少许酒同服。
青娥丸：治疗肾虚腰痛。
大茴香、杜仲（酒炒）、破故纸（酒炒，以上各一两）。加入熟地黄（二两，酒洗），用胡桃去壳取肉四两，开水泡过，去皮，用纸包裹，捶打以去除油脂。共五味药材研为细末，用炼蜜制成梧桐子大小的丸药。每次服用五十丸，空腹时用酒送下，或者用木香汤送下也可以。
疼痛白天轻晚上重的是瘀血。治疗瘀血腰痛（方剂见郁症章节）。根据本方加入木香、沉香、茴香、乳香、牛膝，去掉乌药、官桂、青皮、牡丹皮。
调荣活络汤：治疗因用力不当导致的腰部闪挫，或跌扑后瘀血凝滞以及大便不通引起的腰痛。
当归、桃仁、大黄、牛膝（以上各二钱）、川芎（一钱）、赤芍、红花、生地黄、羌活（以上各一钱）、桂枝（三分）。
以上药材锉成粗末为一剂，水煎服。
过街笑：治疗闪挫腰痛。
木香（一钱）、麝香（三厘）。
以上研为细末吹入鼻中。右边腰痛吹左鼻，左边腰痛吹右鼻。让病患上下活动手部配合。
每逢阴雨天气久坐而发作的，是湿邪所致。渗湿汤治疗湿伤腰痛（方剂见湿症章节）。根据本方加入破故纸、杜仲、茴香、木香、乳香，去掉浓朴、抚芎。
腰背沉重且疼痛走窜的，是痰邪所致。二陈汤治疗湿痰腰痛（方剂见痰症章节）。根据本方加入木香、茴香、乳香、玄胡索、砂仁、苍术、羌活、酒芩、当归、杜仲（酒炒）。
续断丸：治疗腰痛并伴有脚酸腿软。
续断（二两）、破故纸（酒炒）、牛膝（去芦头，酒洗）、木瓜（酒洗）、杜仲（去粗皮酒洗）、萆薢（酒浸，以上各一两）。
以上研为细末，用炼蜜制成梧桐子大小的丸药。空腹时，用无灰酒送下五六十丸。
又一方：大胡桃两个，炮焦后去壳细细咀嚼，用烧酒送下，腰痛立即停止。
滋阴补肾丸：滋肾养血，除湿热，止腰痛、腿酸痛。
熟地黄（酒洗，一两五钱）、白芍（酒炒，一两）、当归（酒洗，一两五钱）、川芎（八钱）、破故纸（盐、酒炒，二钱）、杜仲（姜汁炒，一两五钱）、小茴香（盐、酒浸炒，六钱）、甘枸杞（盐、酒浸炒，一两）、黄柏（盐、酒浸炒，一两二钱）、桃仁（去皮炒，五钱）、川楝子（一两二钱）。
以上研为细末，用炼蜜制成梧桐子大小的丸药。每次服用八九十丸，空腹时，用热酒送下。
胡桃丸：治疗腰痛。
乳香、沉香、木香、母丁香、大茴香、干姜、杜仲（姜汁炒，去丝）、没药、菟丝子（酒制）、破故纸（酒炒，以上各等分）、胡桃（四个，去壳）。
以上研为细末，用炼蜜制成绿豆大小的丸药，用黄酒送下。
有一例肾虚腰痛，使用六味丸加入鹿茸、当归、木瓜、续断。（方剂见补益章节。）
有一人跌伤腰部导致疼痛，使用定痛等药物无效，气血日渐衰弱，面色和耳廓发黑。我说：腰是肾的府邸。虽然说是闪挫受伤，实际上是肾经虚弱所致。于是使用杜仲、补骨脂、五味子、山茱萸、肉苁蓉、山药，空腹服用。又以六君子汤、当归、白术、神曲各二钱，饭后远时服用，不到一个月就好了。（方剂见补益章节。）
Pulse: The pulse of lower back pain must be deep (Chen) and wiry (Xian). A deep and weak pulse indicates Qi stagnation, while a wiry pulse indicates damage to the Kidney Yuan; alternatively, a floating (Fu) and tight (Jin) pulse is caused by entanglement of Wind-Cold pathogens; a soggy (Ru) and fine (Xi) pulse indicates injury by Dampness, whereas a solid (Shi) pulse results from sprain or strain; a choppy (Se) pulse signifies Blood stasis, and a slippery (Hua) pulse indicates frying by Phlegm-Fire; if the pain radiates to the back, accompanied by deep-slippery and other pulse patterns.
Generally speaking, whether new-onset or chronic, lower back pain is fundamentally attributed to Kidney deficiency. New-onset pain should be treated by dispersing external pathogens and clearing Damp-Heat; chronic cases require tonifying the Kidney, along with supplementing Qi and Blood.
Frequent lower back pain indicates Kidney deficiency.
Buyin Decoction (Tonify Yin Decoction): Treats lower back pain due to Kidney deficiency.
Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba, stir-fried with wine), Shengdihuang (Radix Rehmanniae Preparata), Shudihuang (Radix Rehmanniae Glutinosae Preparata), Chenpi (Pericarpium Citri Reticulatae), Huixiang (Fructus Foeniculi, stir-fried with salt and wine), Guozhi (Fructus Psoraleae, stir-fried with wine), Niuxi (Radix Achyranthis Bidentatae, remove rootlet, wash with wine), Duzhong (Cortex Eucommiae, remove rough bark, stir-fried with wine), Fuling (Poria, remove skin, each 1 qian), Renshen (Radix Ginseng, 0.5 qian), Huangbai (Cortex Phellodendri, remove rough bark, stir-fried with wine), Zhimu (Rhizoma Anemarrhenae, stir-fried with wine, each 0.7 qian), Gancao (Radix Glycyrrhizae Uralensis, honey-fried, 0.3 qian).
Crush these ingredients into coarse powder for one dose. Add two Jujubes (Fructus Ziziphi Jujubae), decoct in water, and take at any time. If pain is severe, add Xurong (Resina Olibani), Sharen (Fructus Amomi Rotundus), and Chenxiang (Lignum Aquilariae Resinatum); remove Shaoyao, Shengdihuang, and Chenpi. For regular use as pills, grind all ingredients into fine powder, mix with refined honey to form pills the size of Sophora seeds. Take 50 pills per dose, washed down with clear rice soup or wine.
Yangxue Decoction (Nourish Blood Decoction): Treats lower back pain, leg pain, and bone-tendon pain.
Danggui (Radix Angelicae Sinensis), Shengdihuang (Radix Rehmanniae Preparata), Qinjiao (Radix Gentianae Macrophyllae), Rougui (Cortex Cinnamomi), Niuxi (Radix Achyranthis Bidentatae, remove rootlet, wash with wine), Duzhong (Cortex Eucommiae, stir-fried with salt and wine), Fuling (Poria, remove skin), Fangfeng (Radix Saposhnikoviae, remove rootlet, each 1 qian), Tufuling (Rhizoma Smilacis Glabrae, 1.5 qian), Chuanxiong (Rhizoma Chuanxiong, 0.5 qian), Gancao (Radix Glycyrrhizae Uralensis, 0.3 qian).
Crush these ingredients into coarse powder for one dose. Decoct in water. Just before completion, add a small amount of wine and take together.
Qing'e Wan (Blue Ears Pill): Treats lower back pain due to Kidney deficiency.
Da Huixiang (Fructus Foeniculi), Duzhong (Cortex Eucommiae, stir-fried with wine), Po Guzhi (Fructus Psoraleae, stir-fried with wine, each 1 liang). Add Shudihuang (Radix Rehmanniae Glutiosae Preparata, 2 liang, washed with wine). Use four walnuts (Semen Juglandis), remove shell, take flesh (4 liang), soak in hot water, remove skin, wrap in paper, and pound to remove oil. Grind these five ingredients into fine powder, mix with refined honey to form pills the size of Sophora seeds. Take 50 pills per dose on an empty stomach with wine, or washed down with Muguetang (Wood Fragrance Decoction).
Pain that is lighter during the day and heavier at night indicates Blood stasis. To treat lower back pain due to Blood stasis (see Formula in Yu Syndrome chapter), modify this formula by adding Muxiang (Radix Aucklandiae), Chenxiang (Lignum Aquilariae Resinatum), Huixiang (Fructus Foeniculi), Xurong (Resina Olibani), and Niuxi (Radix Achyranthis Bidentatae); remove Wuyao (Radix Linderne Radiculae), Guangui (Cortex Cinnamomi Cassiae), Qingpi (Pericarpium Citri Reticulatae Viride), and Mudanpi (Cortex Moutan).
Tiaorong Huoluo Tang (Regulate Prosperity and Activate Collaterals Decoction): Treats lumbar sprain due to excessive effort, blood stasis coagulation from falls/blows, and lower back pain associated with constipation.
Danggui (Radix Angelicae Sinensis), Taoren (Semen Persicae), Dahuang (Radix et Rhizoma Rhei), Niuxi (Radix Achyranthis Bidentatae, each 2 qian), Chuanxiong (Rhizoma Chuanxiong, 1 qian), Chishao (Radix Paeoniae Rubra), Honghua (Flos Carthami), Shengdihuang (Radix Rehmanniae Preparata), Qianghuo (Rhizoma Notopterygii, each 1 qian), Guizhi (Ramulus Cinnamomi, 0.3 qian).
Crush these ingredients into coarse powder for one dose. Decoct in water and take orally.
Guojie Xiao (Crossing Street Laugh): Treats lumbar sprain.
Muxiang (Radix Aucklandiae, 1 qian), Shexiang (Moschus, 3 li).
Grind into fine powder and insufflate into the nose. For right-sided pain, insufflate into the left nostril; for left-sided pain, into the right nostril. Instruct the patient to move their hands up and down to assist.
Onset triggered by sitting for long periods on rainy days indicates Dampness. Shenshi Tang (Drain Dampness Decoction) treats lower back pain due to Dampness injury (see Formula in Shi Syndrome chapter). Modify this formula by adding Po Guzhi (Fructus Psoraleae), Duzhong (Cortex Eucommiae), Huixiang (Fructus Foeniculi), Muxiang (Radix Aucklandiae), and Xurong (Resina Olibani); remove Houpo (Cortex Magnoliae Officinalis) and Fuxiong (Radix Ligustici Chuanxiong).
Heavy sensation in the waist and back with wandering pain indicates Phlegm. Erchen Tang (Two-Aged Decoction) treats lower back pain due to Damp-Phlegm (see Formula in Tan Syndrome chapter). Modify this formula by adding Muxiang (Radix Aucklandiae), Huixiang (Fructus Foeniculi), Xurong (Resina Olibani), Yanshusu (Rhizoma Corydalis), Sharen (Fructus Amomi Rotundus), Cangzhu (Rhizoma Atractylodis Lanceae), Qianghuo (Rhizoma Notopterygii), Jiuqin (Radix Scutellariae, wine-fried), Danggui (Radix Angelicae Sinensis), and Duzhong (Cortex Eucommiae, wine-fried).
Supplementary Formulas for Lower Back Pain due to Kidney Deficiency
Xuduan Wan (Teasel Pill): Treats lower back pain accompanied by soreness and weakness in legs and feet.
Xuduan (Radix Dipsaci, 2 liang), Po Guzhi (Fructus Psoraleae, stir-fried with wine), Niuxi (Radix Achyranthis Bidentatae, remove rootlet, wash with wine), Mugua (Fructus Chaenomelis, washed with wine), Duzhong (Cortex Eucommiae, remove rough bark, wash with wine), Biba (Rhizoma Dioscoreae Hypoglaucae, soaked in wine, each 1 liang).
Grind into fine powder, mix with refined honey to form pills the size of Sophora seeds. Take 50-60 pills on an empty stomach, washed down with pure wine (without ash content).
Another Prescription: Roast two large walnuts (Semen Juglandis) until charred, remove shell, chew thoroughly, and swallow with strong liquor. Lower back pain will cease immediately.
Ziyin Bushen Wan (Nourish Yin and Tonify Kidney Pill): Nourishes Kidney and Blood, drains Damp-Heat, stops lower back pain and leg soreness.
Shudihuang (Radix Rehmanniae Glutinosae Preparata, washed with wine, 1.5 liang), Baishao (Radix Paeoniae Alba, stir-fried with wine, 1 liang), Danggui (Radix Angelicae Sinensis, washed with wine, 1.5 liang), Chuanxiong (Rhizoma Chuanxiong, 8 qian), Po Guzhi (Fructus Psoraleae, stir-fried with salt and wine, 2 qian), Duzhong (Cortex Eucommiae, stir-fried with ginger juice, 1.5 liang), Xiaohuixiang (Fructus Foeniculi, soaked in salt wine and stir-fried, 6 qian), Gougouzi (Fructus Lycii, soaked in salt wine and stir-fried, 1 liang), Huangbai (Cortex Phellodendri, soaked in salt wine and stir-fried, 1.2 liang), Taoren (Semen Persicae, peeled and fried, 5 qian), Chuannanzi (Fructus Toosendan, 1.2 liang).
Grind into fine powder, mix with refined honey to form pills the size of Sophora seeds. Take 80-90 pills per dose on an empty stomach, washed down with hot wine.
Hetao Wan (Walnut Pill): Treats lower back pain.
Xurong (Resina Olibani), Chenxiang (Lignum Aquilariae Resinatum), Muxiang (Radix Aucklandiae), Mudingxiang (Flos Caryophylli), Da Huixiang (Fructus Foeniculi), Ganjiang (Rhizoma Zingiberis Recens), Duzhong (Cortex Eucommiae, stir-fried with ginger juice, remove fibers), Moyao (Resina Myrrha), Tusizi (Semen Cuscutae, wine-processed), Po Guzhi (Fructus Psoraleae, stir-fried with wine, equal parts), Hetao (Semen Juglandis, four nuts, shelled).
Grind into fine powder, mix with refined honey to form pills the size of mung beans. Take with yellow wine.
Case 1: Lower back pain due to Kidney deficiency was treated with Liuwei Wan (Six-Ingredient Pill with Rehmannia) supplemented with Lurong (Cornu Cervi Pantotrichum), Danggui (Radix Angelicae Sinensis), Mugua (Fructus Chaenomelis), and Xuduan (Radix Dipsaci). (See Formula in Tonification chapter.)
Case 2: A patient suffered lower back pain after a fall. Treatment with analgesics failed, leading to daily decline in Qi and Blood, with dark complexion and ears. I stated: "The waist is the mansion of the Kidney. Although it is a sprain injury, it is actually caused by weakness of the Kidney Meridian." Thus, I prescribed Duzhong (Cortex Eucommiae), Buguzhi (Fructus Psoraleae), Wuweizi (Fructus Schisandrae Chinensis), Shanzhuyu (Fructus Corni Officinalis), Congrong (Herba Cynomorii), and Shanyao (Rhizoma Dioscoreae Oppositae), taken on an empty stomach. Additionally, I prescribed Liujun Zi Tang (Six-Gentlemen Decoction) with Danggui (Radix Angelicae Sinensis), Baizhu (Rhizoma Atractylodis Macrocephalae), and Shenqu (Massa Medicata Fermentata), each 2 qian, taken well after meals. The patient recovered within a month. (See Formula in Tonification chapter.)