失志伤肾，郁怒伤肝，忧思伤脾，皆致腰痛者，以肝肾同系，脾胃表里，脾滞胃闭，最
致腰痛。其证虚羸不足，面目黧黑，远行久立，力不能尽，失志所为也；腹急胁胀，目视
KTKT ，所祈不得，意淫于外，宗筋弛纵，及为白淫，郁怒所为也；肌肉濡渍，痹而不
仁，饮食不化，肠胃胀满，闪坠腰胁，忧思所为也。准此，从内所因调理施治。
肾着腰痛，腰冷如冰，身重不渴，小便自利，食饮如故，腰以下冷重如带五千钱，因作
劳汗出，衣里冷湿，久久得之。 (公对切)腰痛者，伛偻肿重，引季胁痛，因于坠堕，
恶血流滞；及房劳疲力，耗竭精气，致腰疼痛，准此，从不内外因补泻施治。
夫腰痛，皆由肾气虚弱，卧冷湿地，当风所得，不时速治，喜流入脚膝，
为偏枯冷痹，缓弱疼重，或腰痛挛，脚重痹，宜急服此。
独活（三两） 桑生(《古今录验》用续断，即寄生亦名，非正续断也) 杜仲(制，炒断
丝) 细辛(去苗) 牛膝(酒浸) 秦艽(去土) 茯苓 白芍药 桂心(不见火) 芎 防风(
去芦) 甘草(炙) 人参 熟地黄 当归（各二两）
上为锉散。每服四大钱匕，水二盏，煎七分，去滓，空腹服。气虚下利，除地黄，并治
新产腹痛，不得转动，及腰脚挛痛痹弱，不得屈伸。此汤最除风消血。《肘后》有附子一枚
，无寄生、人参、甘草、当归，近人将治 节风并香港脚流注甚效。
小续命汤 治风腰痛最妙。(方见中风门，加桃仁炒去皮尖)
因志向失落而损伤肾脏，因愤怒郁结而损伤肝脏，因忧愁思虑而损伤脾脏，这些都会导致腰痛。这是因为肝肾相互关联，脾胃互为表里，脾运停滞、胃气闭塞，最容易引发腰痛。其症状表现为身体虚弱消瘦、面色黧黑，长途行走或久立时力不从心，这是由志向失落所致；腹部拘急、胁肋胀满，视物模糊（原文“目视KTKT”疑为脱字或误植，通常指视物昏花或目眩），所求不得遂意，意念外驰淫欲，导致宗筋弛缓纵弛，以及出现白淫（指男子滑精或女子带下清稀如精之状），这是由愤怒郁结所致；肌肉浸渍湿邪，麻木不仁，饮食不能消化，肠胃胀满，闪挫坠落导致腰胁疼痛，这是由忧愁思虑所致。依据上述情况，应从内因方面进行调理施治。
肾着腰痛，腰部寒冷如冰，身体沉重但不口渴，小便正常通畅，饮食如常，腰部以下寒冷沉重如同系着五千枚铜钱，这是由于劳作出汗后，衣物内部冷湿，日久累积而成。（公对切：此处疑为音注或衍文，暂略）腰痛伴有脊柱弯曲肿胀沉重，牵引季胁疼痛，这是由于坠跌损伤，恶血瘀滞所致；以及因房事过度疲劳，耗竭精气，导致腰部疼痛，依据上述情况，应从不内外因方面采用补泻法施治。
大凡腰痛，都是由肾气虚弱，睡卧在冷湿之地，受风邪侵袭所致，若不及时迅速治疗，病邪容易流入脚膝，导致偏枯（半身不遂）、冷痹、肢体软弱疼痛沉重，或者腰痛挛急，脚部沉重麻木，应当立即服用此方。
独活（三两） 桑寄生（《古今录验》用续断，即寄生亦名，非正续断也） 杜仲（炮制，炒至断丝） 细辛（去苗） 牛膝（酒浸） 秦艽（去土） 茯苓 白芍药 桂心（不见火） 川芎 防风（去芦头） 甘草（炙） 人参 熟地黄 当归（各二两）
以上药物捣碎成散剂。每次服用四大钱匕，用水二盏，煎煮至七分，去渣滓，空腹服用。若气虚下利，去掉地黄，并治疗新产后腹痛，不能转动身体，以及腰脚挛痛麻木软弱，不能屈伸。此汤最能祛风消血。《肘后备急方》中有附子一枚，无寄生、人参、甘草、当归，近代人用它治疗历节风并香港脚流注非常有效。
小续命汤 治疗风邪腰痛最为奇妙。（方剂见中风门，加桃仁炒去皮尖）
Loss of will injures the Kidney (Shen), depression and anger injure the Liver (Gan), worry and overthinking injure the Spleen (Pi); all these can lead to lower back pain. This is because the Liver and Kidney are closely related, and the Spleen and Stomach are exterior-interior partners. When Spleen transport stagnates and Stomach closure occurs, it most easily causes lower back pain. The symptoms include emaciation and deficiency, dark complexion, inability to exert full strength after long walks or standing for a long time; this is caused by loss of will. Abdominal urgency and hypochondriac distension, blurred vision, unfulfilled desires, external wandering of thoughts and lust, flaccidity of the sinews (Zongjin), and occurrence of white discharge (Baiyin, referring to seminal emission in men or clear vaginal discharge in women); this is caused by depression and anger. Muscle infiltration with dampness, numbness and insensitivity, failure of food digestion, abdominal and intestinal distension, and lower back and hypochondriac pain due to sprains or falls; this is caused by worry and overthinking. Based on this, treatment should be regulated according to internal causes.
Kidney-attaching lower back pain presents with coldness in the waist like ice, heaviness in the body without thirst, normal urination, and normal appetite. The area below the waist feels cold and heavy as if bound with five thousand coins. It arises from sweating during labor, with cold and damp clothes remaining against the skin for a long time. Lower back pain accompanied by stooping, swelling, and heaviness, radiating pain to the lateral costal margin, is caused by falls or trauma leading to stasis of evil blood. Also, exhaustion from sexual activity depletes essence and qi, causing lower back pain. Based on this, treatment should employ tonification and purgation methods according to non-internal and non-external causes.
Generally, lower back pain is caused by weakness of Kidney Qi, lying on cold and damp ground, and contracting wind pathogens. If not treated promptly, the pathogen tends to flow into the feet and knees, causing hemiplegia (Pianku), cold bi-syndrome, weakness, and heavy pain, or lower back pain with spasms, heavy and numb feet. One should immediately take this prescription:
Du Huo (Radix Angelicae Pubescentis, 3 liang) Sang Sheng Ji (Herba Taxilli, note: *Gu Jin Lu Yan* uses Xu Duan, which is also a name for Sang Ji Sheng, but is not the true Xu Duan) Du Zhong (Cortex Eucommiae, processed, stir-fried until fibers break) Xi Xin (Radix et Rhizoma Asari, remove seedlings) Niu Xi (Radix Achyranthis Bidentatae, soaked in wine) Qin Jiao (Radix Gentianae Macrophyllae, remove soil) Fu Ling (Poria) Bai Shao Yao (Radix Paeoniae Alba) Gui Xin (Cortex Cinnamomi, do not expose to fire) Xiong (Radix Chuanxiong) Fang Feng (Radix Saposhnikoviae, remove rhizome head) Gan Cao (Radix Glycyrrhizae, honey-fried) Ren Shen (Radix Ginseng) Shu Di Huang (Radix Rehmanniae Preparata) Dang Gui (Radix Angelicae Sinensis) (each 2 liang).
Grind the above into a coarse powder. Take four large qian-bi per dose, add two zhan of water, decoct to seven-tenths, remove dregs, and take on an empty stomach. For qi deficiency with downward diarrhea, remove Di Huang. It also treats postpartum abdominal pain preventing movement, as well as lower back and leg spasmodic pain, numbness, weakness, and inability to flex or extend. This decoction is best at dispelling wind and resolving blood stasis. *Zhou Hou Bei Ji Fang* includes one Fu Zi (Radix Aconiti Lateralis Preparata), but lacks Sang Ji Sheng, Ren Shen, Gan Cao, and Dang Gui. Modern practitioners use it to treat Li Jie Feng (rheumatoid arthritis-like conditions) and Hong Kong Jiao Liu Zhu (gouty arthritis with flowing obstruction) with great efficacy.
Xiao Xu Ming Tang (Minor Decoction that Preserves Life) is excellent for treating wind-induced lower back pain. (See formula in Stroke chapter, add Tao Ren [Semen Persicae], stir-fried, peeled, and crushed.)