Now, how does modern medicine explain this exhausting chronic low back pain? There are complex underlying mechanisms that cannot be fully explained by simple phrases like 'it hurts because of a disc.' We no longer view chronic low back pain as a mere symptom, but understand it as a disease state in its own right.
One of the most critical concepts is central sensitization. When pain persists for too long, the central nervous system, including the brain and spinal cord, becomes overly sensitized to pain signals. Much like a speaker with its volume turned up to the maximum, one begins to experience severe pain even from minor stimuli that normally should not hurt. The brain effectively 'learns' the pain regardless of whether ongoing tissue damage exists, creating a pain-memory circuit that feeds into a vicious cycle. This influences pain-processing areas of the brain such as the insula, anterior cingulate cortex, and even frontal lobe function, which governs cognitive function.
Musculoskeletal imbalances are equally significant. Prolonged sitting or poor posture weakens the deep muscles around the lower back, namely the core muscles. When muscles like the transversus abdominis and multifidus muscle fail to function properly, they cannot stably support the spine, ultimately increasing the load placed on the spine and causing chronic stress to the discs, facet joints, and ligaments. Myofascial pain syndrome, characterized by the formation of trigger points in specific muscles, also serves as a major cause of chronic low back pain.
Furthermore, if we interpret the Korean medicine concept of kidney deficiency in modern terms, chronic stress responses and endocrine system imbalances come to mind. Persistent stress disrupts our body's hypothalamic-pituitary-adrenal axis. The secretion of stress hormones like cortisol becomes dysregulated, triggering a systemic inflammatory response and lowering the pain threshold. Elevated pro-inflammatory cytokines affect neurons, amplifying pain perception. Ultimately, this represents a state where the body's overall recovery and regenerative capacity decline—a state lacking essence qi.
Blood circulation also plays an essential role. Poor microvascular circulation in the muscles around the lower back leads to deficient oxygen supply and waste accumulation, worsening muscle rigidity and pain. Intervertebral discs also require sufficient hydration to cushion shocks, and dehydration or inadequate nutritional supply can accelerate intervertebral disc degeneration.
In conclusion, chronic low back pain is not solely a spinal issue; we must remember that it is a complex condition intimately entangled with the nervous system, muscular system, endocrine system, and lifestyle habits. Often, persistent pain remains even when magnetic resonance imaging or an x-ray shows no specific abnormality, because the root of the pain lies not only in visible structural defects, but deep within unseen functional, psychological, and environmental factors.
