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 Table of Contents  
Year : 2023  |  Volume : 11  |  Issue : 1  |  Page : 67-76

Exploring the bioenergy pathways affecting the low back pain – A review

1 Division of Yoga and Life Science, S-VYASA, Bengaluru, Karnataka, India
2 Deputy Dean, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
3 Yoga-Spirituality Division, S-VYASA Yoga University Karnataka, India

Date of Submission20-Aug-2022
Date of Acceptance09-Jan-2023
Date of Web Publication03-Feb-2023

Correspondence Address:
Mr. Keshava murthy
104, 4th Cross, Syndicate Bank Colony, Arekere, Bg Road, Bengaluru - 560 076, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jacs.jacs_16_22

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Low back pain (LBP) is the most common health problem affecting the daily activity of a person. The subtle energy pathways with the imbalance of the wind element/Vata dosha are the cause of back pain, as per ancient texts. Releasing these energy blockages through different approaches from the traditional healing system is found to be effective in treating LBP conditions. To explore and compile the different subtle energy pathways of the human body and identifying the energy lines affecting back pain and possible remedial approach. Relevant information was obtained and compiled using different sources such as Classical texts of Yoga, Upanishads, Ayurveda, and Traditional Thai Massage. Scientific Research papers were explored using different key words-low back pain, marmas, meridians, nadis, sen lines for understanding the energy pathways and its approach in treating LBP. The paper identifies and compiles the subtle energy pathways from a different system with respect to its location, function and emphasizes in compiling information related to LBP and the treatment approach.

Keywords: Energy pathways, low back pain,Marmas, meridians, Nadis, Sen lines

How to cite this article:
murthy K, Singh AK, Buttagat V, Divya B R. Exploring the bioenergy pathways affecting the low back pain – A review. J Appl Conscious Stud 2023;11:67-76

How to cite this URL:
murthy K, Singh AK, Buttagat V, Divya B R. Exploring the bioenergy pathways affecting the low back pain – A review. J Appl Conscious Stud [serial online] 2023 [cited 2023 Dec 9];11:67-76. Available from: http://www.jacsonline.in/text.asp?2023/11/1/67/369130

  Introduction Top

Low back pain (LBP) is a common health problem identified as the most common cause of disability. The 2010 Global Burden of Disease Study estimated that LBP is among the top 10 diseases and injuries that account for the highest number of Disability-adjusted life years worldwide (Vos et al., 2012). Prevalence increases and peaks between the ages of 35 and 55 years (Andersson, 1997).

LBP hampers the daily activity of a person. It is a neurological as well as musculoskeletal disorder, cardinal features being restricted movements of the spine and pain in the low back region (Shishir, 2015).

Subtle energy/bioenergy refers to the vital energy that flows through the human body. These energies are named differently in different cultures. In the Indian Ayurvedic system, it is known as “Prana,” In Chinese Medicine as “Chi,” as “Ki” in the Japanese Kampo system. It is believed that blockages, stagnation, and imbalances in these energy pathways are considered the cause for discomfort and illness. Restorative and therapeutic practices from the traditional healing system influence this bioenergetic system and restore the free flow of energy (Hintz et al., 2003).

This paper aims to explore the different bioenergy mechanisms, theories, and application of various forms of healing affecting LBP.

  Methodology Top

Different manuscripts, scientific reports, books on Ayurveda, Yoga, Traditional Thai Medicine (TTM), and Acupuncture are explored using keywords – back pain, marmas, meridians, nadis, and sen lines.

  Role of Vata dosha in Low Back Pain Top

In the eastern culture - Yoga, Ayurveda, Traditional Chinese Medicine (TCM), TTM, Vata/wind flows inside the energy lines. It is believed that the more smoothly the wind flows, the healthier the body becomes. Conversely, if the wind is blocked, it will cause diseases; in this situation, if the person presses the correct pressure points, this can help improve the situation (Chang, 2021). Wind in disharmony as hypo functionality or hyper functionality in any part of the body, can lead to tremors, spasms, or lack of function in a limb (Gold, 2006b).

  Ayurveda – Marma Therapy Top

In Ayurveda, the cardinal symptom of Vata vitiation is “pain” which is known as “Shula” in Sanskrit. “Vatadrite Rujah Nasti,” a pain universally considered a marker of disease. LBP in Ayurveda is called “Katigraha,” a Vatavyadhi affecting the lower limbs.

Marma in Sanskrit means secret or hidden. Etymologically each letter of the word Marma has got specific meaning. Ma means Prana or Vayu, and Repha denotes house or seats (Dev and Prasad, 1987).

The knowledge of Marma is employed in various ancient Indian traditional practices like Kalaripayat of Kerala, Varma-kalai of Tamil Nadu (Sieler, 2012), and Ayurvedic Abhyanga (massage) for therapeutic benefits (Frawley et al., 2015; Kotelevskiy, 2016).

Marmas in Ayurveda are the anatomical locations where muscles, veins, ligaments, bones, or joints intersect in the body. It is also the site where the Prana (Agni, Soma, Vayu, Satwa, Rajah, Tamah, Bhuthatma, and Panchendriya) resides (Susruta, 2008).

Acharya Sushruta has identified a total of 107 Marmas in our body. These points cover both the front and back of the body, including 22 on the lower extremities (11 in each), 22 on the arms (11 in each), 12 on the thoracic and abdominal region anteriorly, 14 on the back, and 37 on the head and neck. These points are located and measured by the finger widths, called anguli (Susruta, 2008). Major marma points correspond to the seven chakras, or energy centers of the body, while minor points radiate out along the thorax, abdomen, head, neck, and limbs. In Ayurveda, for disease prevention and management marma therapy is an important tool. It can be used to balance the doshas, increase the agni (the digestive fire), for detoxification (reduce ama), as well as to promote energy (vajikarana), and aid in rejuvenation (rasayana) (Frawley et al., 2015).

As a therapy, stimulation of marma points releases the stagnant energy within and improves the biochemistry of the internal system achieved either by the gentle stimulation of finger pressure or by yoga and pranayama practices (Lockett, 2020).

Various marma points on lower extremities and back are stimulated in the management of LBP. The marma points for LBP are Kshipra, Talhridaya, Gulpha, Janu, Indrabasti, Nitamba, kukundara, katikataruna, and Parshvasandh. The mode of marma therapy is to stimulate each marma point 20 times, consecutively by press and release, twice a day for 2 weeks (Prasad et al., 2017; Yadav et al., 2019).

Stimulating the marma points for therapy can be broadly classified as (i) massage and energy methods, which include techniques such as Abhyanga (massage), applying aromatic oils, and applying pressure (ii) herbal methods, which include application of herbal paste, taking medicinal herbs, etc., (iii) using instruments, which include acupuncture and heat application (Frawley et al., 2015).

  Nadi System - Energy Points in Yogic Healing Top

Nadi comes from the Sanskrit word “Nada” meaning to flow. It is the flow of resonance/vibrations and hence Nadis are known as flow of subtle vibrations. Nadis are the pathways through which life energies (Prana) flow as per Ayurveda and Yoga.

References in the Goraksha Sataka or Samhita and Hatha Yoga Pradipika place their number at 72,000; the Prapanchasara Tantra says 300,000; while the Shiva Samhita states that 350,000 (Muktibodhananda, 2004). The Prashnopanishad states that nadis originate from nabhi (umbilicus), while the Darshano-panishada states that the nadis are scattered around sushumna (Khedikar et al., 2016).

Though not proven anatomically, it could be possible that there may be a correlation of nadis to the nervous system, but as of now, there is no strong scientific evidence to validate. It is referred to as artery, as stated in Nadi-pariksha in Ayurveda, while it is equated to the nervous system in Yoga. Regulation of Breath plays a really important role in harmonizing and activating these channels (Joshi, 2022).

These energy circuits in the yogic system are controlled and regulated by breathing. The pattern of breathing, as shown by the electro-nasographic research an influential impact on one's psychophysiological state. The yogic pattern of breathing helps in the modulation of the internal body system to release any kind of existing pranic blockage (Bhole and Karambelkar, 1968).

Among several nadis in Shiva Swarodaya 10 nadis are given importance which sprout from the navel connect as “doorways” both upwards and downwards of the body. Among these 10 nadis, 3 nadis namely Ida, Pingala, and Sushumna are considered the most important (Muktibodhananda, 2004).

As envisioned in Ayurveda and Yoga theory, Ida nadi on the left side, pingala nadi on the right side of the spinal cord crisscross each other while the sushumna nadi lies in the center of the spinal cord in the median plane.

  Mechanism of Ida, Pingala, and Sushumna in the Body Top

Ida is associated with the parasympathetic nervous system, which sends impulses to the visceral organs to stimulate internal processes. This creates a general state of relaxation in the superficial muscles, thus lowering the outer body temperature. Therefore, it is said that ida is cooling, relaxing, and introverting.

Pingala energy activates the physical body and externalizes awareness. It is associated with the sympathetic nervous system (SNS), which releases adrenaline to stimulate the superficial muscles. The SNS prepares the body to cope with stress and external activity; for example, it makes the heart beat rapidly and heats the body. Therefore, it is said that pingala is energizing, heating, and extroverting.

Sushumna emerges from the base of the spine, the same as ida and pingala, but without diverging right or left, it travels directly up through the center, piercing the main chakras and plexuses along the route. Sushumna unites with ida and pingala at ajna chakra in the region of the medulla oblongata. Thus, it is considered to correspond with the central or cerebrospinal nervous system (CNS). The CNS carries impulses to the whole system. It is one main system, running from the base of the spine to the brain, and sushumna is also located in the same position (Khedikar et al., 2016).

  Significance of Hatha Yoga Practices Top

Hatha yoga practices not only purify the physical body but is a practice of balancing between the two nadis Ida (Ha) and Pingala (Tha). Hatha yoga practices operate in rhythm, increasing the capacities of nadis, chakras, vayus, and panchakoshas. Yoga postures such as Tadasana, Bhujangasana, Dhanurasana, Ardha Matsyendrasana, Gomukhasana, and Halasana promote spinal health.

Hatha Yoga postures such as Bhujanangasana, a reclining back bending asana is claimed as a “panacea for an injured spine” and would undo “slight displacement of spinal discs” (Iyengar, 2006).

In the twisting postures, ardha matsyendrasana is claimed to energize the spine and destroy many diseases as mentioned in hatha texts (HYP 1.26-27, Gh. S 2.22-23). Paschimottanasana or Intense Dorsal Stretch (HYP 1.28-29), Dhanusrasana (GhS 2.18) strengthens and rejuvenates the spinal column, and Balasana from Srittatvanidhi is mentioned as excellent for the Spine flexion. In the hatha pradipika, pranayama practices such as Ujjayi, Brahmari, Bhastrika, Sitali, Seetakri, aggravates vata while nadi shodhana pranayama (Alternate nostril breathing) pacifies the vata and Surya bhedhana (Right nostril breathing) remains neutral to the vata constitution in the body (Rathore, 2019).

The Yin yoga approach, as mentioned in [Table 1], indicates the benefit of the yoga practices in gently stimulating the flow of qi and prana through the connective tissue (Grilley, 2002).
Table 1: Yoga poses affecting the spinal health (Grilley, 2002)

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It can be concluded that all kinds of yoga practices help in restoring the sympathovagal balance that has been observed in many physiological studies (Telles et al., 1994). It is also studied that Yogic based colon cleansing offers a great degree of pain relief in back pain. The Laghu sankha prakshalana (LSP), followed by deep relaxation technique (DRT), releases the blocked pranic energies in this area, and the DRT releases the spasm of para-spinal muscles and gains control over the neuromuscular reflexes through internal awareness (Haldavnekar et al., 2014).

  Traditional Thai Medicine – Sen Sib (Sen Lines) ### Top

TTM is a conglomeration of the medical principles from India, China, Khmer, and Western provenances (Chang, 2021). In Thai, “Prana” translates as “Lom Pran” (Gold, 2006a).

In Thai Medical Science, Sen lines are the pathways on which vital energy/Prana travels through the body (Gold, 2006a). It is closely associated with the Meridian system of Chinese medicine and the Indian Yogic system. Anatomically, the Sen Lines do not correspond with the paths of the blood vessels or the lymph vessels.

Sen lines are categorized into gross and subtle. The Gross sen lines are linked to the physical body, while the subtle sen lines are linked with the mind and consciousness. Sen lines are involved in energy transfer of – such as in pumping of blood, contraction of muscles, or conduction of electrical impulses (Hume, 2015).

The Sen lines linked with the physical body are further categorized as:

  • Major Sen Lines: Large tendons, ligaments, veins, certain fascial sheaths
  • Minor Sen Lines: Channels that branch from the major Sen
  • Invisible Sen Lines: Lines too small to be seen, such as hormone and nutrient movement lines (Hume, 2015).

The Sen lines in the Western world are seen as myofascial chains (pathways between muscle tissues in the body), i.e., the connective tissue. These fasciae are considered important for its role in providing stability, structure for the body, along with allowing communication between cells that support the immune system.

The TTM on Sen lines means applying deep and sustained pressure into the body's fascial system with the goal to release tensions and blockages in the fascia. This may help in a trigger point release, relieve or correct tensions, postural imbalances, chronic conditions, and unexplained pains elsewhere in the body.

[Table 2] summarizes the names of all the 10 lines along with their location, myofascial meridians, and its therapeutic benefits.
Table 2: 10 major Sen sib lines (Ferreira, 2019b)

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Elemental imbalances are the reasons for the presence of the disease and people getting sick (Chang, 2021). In Traditional Thai, the massage therapy involves pressure movements with hands, fingers, knuckles, fist, forearm, and elbows (Ryan et al., 2003). The principles of Thai Massage are to balance the body and mind by pressing and stretching the body's energy lines to clear the wind inside the energy line and relieve the muscle and joint tension, increasing vitality and flexibility with an induced state of deep tranquility (Tapanya, 1993).

  Sen Lines for Low Back Pain Top

Among the ten sen lines, as mentioned in [Table 2], the energy lines for LBP are:

  • Sen Ittha/Pingkhala (third outside and first inside line of the upper leg, first line of the back)
  • Sen Kalathari (second lines inside and outside of the upper legs, second lines of the back)
  • Sen Sumana (sub-lines: third inside upper leg lines)
  • Sen Sahatsarangsi/Thawari (first inside and first outside leg lines and lines three of the back) (Salguero and Roylance, 2011).

These sen lines are worked with deep abdominal massage and general palm pressure for alleviating LBP (Ferreira, 2019a).

Mechanism of Traditional Thai Massage on low back pain

The TTM stretches muscles such as piriformis, gluteus, hamstring (back thigh), quadriceps (front thigh), abductors, inner thigh adductors, latissimus dorsi, abdominal (rectus abdominis), erector spinae, quadratus lumborum, and Ilio-psoas muscles. It opens up and mobilizes the hip joint, sacro-iliac joint, and pelvic area. Through deep abdominal massage, it clears the knots, tangles, and adhesions. The energy lines are stretched with general palm pressure and aids in the realignment of lumbar and thoracic vertebrae (Gold, 2006a).

Traditional Thai massages are effective for LBP in decreasing pain and disability and increasing back flexibility (Buttagat et al., 2020). Lumbar tender point deep massage when combined with lumbar traction produced better improvement in helping conditions of muscle hardness, pain intensity, and pain threshold in patients with non-specific LBP (Zheng et al., 2012).

  Traditional Chinese Medicine – Meridians/Acupoints Top

The meridian system is one part of Traditional Asian Medicine (Lee et al., 2013) popularly known as TCM. This TCM is based on acupuncture channels and acupoints (Chaitow, 2011; Yin and Koh, 2005). The meridians consist of lines that connect surface points called acupoints, forming an intricate web involved in the distribution of fluids and energies in the body.

These meridians form an invisible network that carries chi to every tissue in the body. As long as Qi flows freely throughout the meridians, health is maintained. Disruption of the flow of Qi through the meridians results in pain and illness. The use of acupuncture can correct such disruption by shunting Qi to those areas where it is deficient and draining it from areas where it is excess (Shraddha et al., n.d.). The human body has more than 360 acupoints that functions as the basis of acupuncture treatment (Yin and Koh, 2005). The acupoints exerts synergistic and antagonistic actions (Chen et al., 2012; Zhong et al., 2011). These acupuncture points and meridians can be manipulated and influenced by massage, acupressure, moxibustion, cupping, or acupuncture (puncturing with needles) (Grootscholte, 2020).

In acupuncture, acupoints treatment regime is based on three principles. They are (1) local acupoints near the area where symptoms occur, (2) distant acupoints along the meridian, and (3) distant acupoints based on symptom differentiation (Chen et al., 2012).

  Acupoints Used for Low Back Pain Top

The acupoints used for LBP based on the three principles are as follows:

Local acupoints

These are the points/area where the symptom for the LBP occur - BL23, BL25, BL24, –BL26, BL57, BL32, GV3, GV4, BL52, BL22, BL27, BL31, BL33, and BL34. All of these acupoints are on the Bladder meridian and the Governing vessel, especially at the low back position of these meridians.

In traditional Asian medicine, these are considered “local acupoints,” and a local acupoint is the original and most basic choice for treatment for LBP (Lee et al., 2013).

Distant acupoints along the meridian

These are the points that occur along the meridian line-BL60, GB30, BL40, GB34, BL37, ST36, BL62, SI3, and SI6. Most of these are on the Bladder and Gallbladder meridians. These are so-called “distant acupoints” and located in positions that cause pain through the same meridian on the opposite side of the body or the adjacent meridian. These points function as a “remote control panel” of the meridian Qi (Lee et al., 2013).

Distant acupoints based on symptom differentiation

LI4, KI3, LU8, SP9, LR3, KI7, SP3, SP2, HT8, and KI10. These acupoints are generally positioned on the limbs but not on the Bladder meridian. They are used to treat LBP based on symptom differentiation (Lee et al., 2013).

Among all these acupoints frequently used points in treating LBP are BL23, BL24, BL25, BL26, BL60, and GB30. Moreover, among all the acupoints, KI3 and SP9 points play an important role in connecting the vertices to all others that pass through that node (Lee et al., 2013).

The acupoints - LBP, BL31, BL32, and BL33, known as the Eight Foramen Acupoints (located in the sacral foramen), are commonly used to treat LBP (Lund et al., 2006).

  Summary and Conclusions Top

[Table 3] summarizes the names of all the important energy pathways - nadis, marma points, sen lines of TTM and Meridians of TCM, discussed in this paper, affecting the LBP condition.
Table 3: Summary of the energy pathways in Yoga, Ayurveda, Traditional Chinese medicine, and Traditional Thai medicine

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Correlation of the vital energy and its pathways in all the systems

The vital energy pathways when looked for across the different eastern philosophies, can be observed that they all share a similar concept of both the vital force and its pathways but named differently. “Prana” in Yoga and Ayurveda, “Qi/Chi” in TCM, “Lom Pran” in TTM. The energy pathways are named Nadis in Yoga, Marmas in Ayurveda, Sen sib lines in TTM, and Meridians/Acupoints in TCM.

Comparison of the number of energy pathways across these systems

Nadis identified by different Yogic texts differ in their numbering, 72,000 (Hatha Yoga Pradipika), 350,000 (Shiva Samhita), and 300,000 (Prapanchasara Tantra). Although the 14 nadis are considered principal nadis, this paper emphasizes on 10 nadis as mentioned in Shiva swarodaya.

In relation to marmas of Ayurveda, it is said that marmas are connected to both nadis and chakras of the subtle energy body, and there are 107 marma points. The TTM numbers the energy pathways as 10 sen lines, while the TCM numbers more than 360 acupoints.

Energy pathways affecting the low back pain

From the yoga system and TTM, 10 energy pathways are identified - 10 nadis and 10 sen lines. In the Nadi system Ida, pingala, and Sushumna are considered important for LBP.

In TTM sen ittha, pingkhala, kalathari, sumana and sahatsarangsi/thawari are considered important for LBP.

In Ayurveda, the marma points of the lower extremity are identified useful for treating LBP. They are Kshipra, Talhridaya, Gulf, Janu, Indrabasti, Nitamba, kukundara, katikataruna, Parshvasandh. Their locations and the therapeutic indications is mentioned in [Table 4].
Table 4: Therapeutic indications of marma points located at lower extremity and its effect on low back pain (Mishra and Shrivastava, 2020b, 2020a)

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In TCM, using the three principal approaches, meridian points have been discussed that are useful in alleviating the LBP. The acupoints located at the low back position on the Bladder meridian and the Governing vessel are considered as the local acupoints. The Bladder and Gallbladder meridians located in positions that cause pain through the same meridian on the opposite side of the body or the adjacent meridian are considered as the distant acupoints. The acupoints are generally positioned on the limbs but not on the Bladder meridian are used to treat LBP based on symptom differentiation (Lee et al., 2013).

Comparing the treatment approach for low back pain

In the Yoga method, Hatha yoga techniques are incorporated for balancing the Ida and Pingala forces. As mentioned in the table, this is effectively achieved with the practice of yoga asana, regulation of breath through pranayama, and internal cleansing technique named LSP.

In the Ayurveda approach, the lower extreme marma points are identified and stimulated with marma therapy for alleviating the LBP.

In TCM, acupoints on the lower back, along its meridian line, and based on the pain symptoms are identified and treated with acupuncture treatment.

Mechanism of treating low back pain across these different systems

The imbalance in the wind element (Vata) is considered the primary reason for experiencing the pain in the body. The seat of wind/vata is in the lower abdomen and legs. Hence, any kind of imbalance in it can lead to LBP.

The imbalance of wind is considered one of the vital energy blockage occurring in the different energy pathways mentioned across these healing systems.

In the yogic approach the asanas are not considered as mere static positions but are understood as conditions of energy. In the Yoga asana method, the sitting poses and front bending supports the parasympathetic system, while the standing poses and back bending poses support SNS (Frawley and Kozak, 2001). Backbends with sympathetic stimulation tend to increase the spinal extension and create strength in the trunk elevator muscles (Frawley and Kozak, 2001).

The Yogic method of performing asanas gently stimulates the flow of prana through the connective tissue, as mentioned in [Table 1].

The yogic pattern of breathing helps in modulation of the internal body system to release any existing pranic blockage (Bhole and Karambelkar, 1968). Yogic based colon cleansing offers a great degree of pain relief in back pain. The LSP releases the blocked pranic energies in this area. DRT releases spasm of para-spinal muscles and gains control over the neuromuscular reflexes through internal awareness (Haldavnekar et al., 2014).

The use of Marma Science as a therapeutic procedure has been observed in some ancient Indian traditions and practices. The Marma therapy approach of Ayurveda, as mentioned in [Table 2], helps in the stimulation of the Marmas balancing the Vyana Vayu and Vata Dosha resulting in the corresponding healing effect. Yogasanas, Pranayama, Yogic Bandhas, etc., stimulate the Marma points of the body possibly resulting in the desired therapeutic benefits. The knowledge of Marman is employed in various ancient Indian traditional practices like Kalaripayat of Kerala, Varma-kalai of Tamil Nadu (Sieler, 2012), and Ayurvedic Abhyanga (massage) for therapeutic benefits (Frawley et al., 2015; Kotelevskiy, 2016).

In the TCM, with the acupuncture approach number of studies has been conducted for relief of LBP. The acupuncture method stimulates the nerves located in muscles and other tissues with the application of fine needles that may lead to the release of endorphins and other neuro-humoral factors (Sherman and Coeytaux, 2009). It further reduces inflammation by promoting the release of vascular and immunomodulatory factors and increasing local microcirculation (Sherman and Coeytaux, 2009; Zhao, 2008). This helps in better joint movement, reduced stiffness, swelling and bruising (Montalto et al., 2017).

In the TTM, back pain, spinal Pain, leg pain is connected to the “Sen Ittha” (Similar to the ida nadi in the yogic tradition and part of the Bladder meridian in Chinese medicine), “Sen Pingkhala” (Similar to pingala nadi in the yogic tradition and part of the Bladder meridian in Chinese medicine.) and “Sen Kalathari” (The arm branch follows the Pericardium meridian of Chinese medicine.). The Traditional Thai massage applied as a therapy is classified as a system of peripheral stimulation that facilitates the smooth and constant flow of bioenergy (Qi in this case) throughout the body. The deep presses in Thai massage literally squash the muscles and stretche the myofascial tissues laterally. This pressing action helps to break down fibrotic tissues and stimulates the production of more elastic fibers. The blood flow through the entire affected musculature is enhanced (Gold, 2007). This brings increased nutrients and oxygen into the area and helps to flush out toxins, carbon dioxide, and other metabolic byproducts.

During stretching, the muscle spindle organs signal the brain that the muscle is relaxed. This allows the inhibitory nerve impulses to the antagonistic muscles to stop and allow them to begin to regain their normal tone. This dynamic action helps to restore balance within and between functional muscle groups. This promotes increased flexibility, postural improvement, and diminished pain (Gold, 2006b).

The paper, first of its kind, attempts to compile, summarize and bring out the importance of the subtle energy pathways and its mode of approach in treating the LBP conditions.

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Conflicts of interest

There are no conflicts of interest.

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  [Table 1], [Table 2], [Table 3], [Table 4]


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