Presentation summary

Introduction :
Back pain is one of the most prevalent musculoskeletal conditions affecting millions worldwide and significant lyimpacting quality of life, productivity and healthcare costs. Conventional treatments including pharmacological interventions and physical therapy, often provide limited relief or are associated with undesirable side effects. Given the growing emphasis on non-opioid pain management strategies, medical acupuncture is an effective and evidence-based treatment for back pain. While we already have strong evidence of the benefits of acupuncture in the treatment of back pain, by understanding the mechanism and root cause of back pain, we can improve our clinical results with better outcomes for our patients.

Method :
Understanding Hip Rib Impingement :
While musculoskeletal impingements, including nerve compression and myofascial restrictions, are often considered primary contributors to back pain, the Hip Rib Impingement (HRI) theory presents a fundamental bio-mechanical mechanism that precedes and explains these dysfunctions.
Hip Rib Impingement occurs when common everyday postures, movements and exercises cause excessive approximation between the lower ribs and the superior aspect of the iliac crest resulting in impingement of the regional muscles, nerves and periosteum. The reason the medical profession is unaware of this phenomenonis that over the years, the gap between the tip of the lower ribs and the iliac crest has decreased. This results in :
• Myofascial trigger point formation due to impingement of lumbar, lateral abdominal and gluteal muscles causing referred pain patterns.
• Secondary weakness of these muscles with resultant Increased spinal compression, degeneration and nerve decompression.
• Impingement of the Cluneal nerves at the iliac crest causing referred pain to the back and buttocks mimicking piriformis syndrome and sciatica.
• Referred pain patterns from myofascial trigger points may be a significant contributor to abdominal