From Ancient Battlefield Surgery to Modern Core Dysfunction
- caulocare
- Feb 25
- 5 min read
From Ancient Battlefield Surgery to Modern Core Dysfunction
A Complete Perspective on Back Pain
By Dr. Phumlarp Caulo Caulo Care Acupuncture – Forest Hills, New York
Back pain is not a modern problem. It is as old as civilization itself.
More than 4,000 years ago, ancient physicians were already documenting spinal injuries with remarkable clinical precision. Today, we continue to treat back pain — but our understanding has evolved from traumatic battlefield injuries to subtle biomechanical dysfunctions such as weak core stabilization. To truly understand back pain, we must examine both its historical roots and its modern functional causes.
One of the most important medical documents in history is the Edwin Smith Papyrus — a surgical treatise that marked a transition from magical healing to empirical science.
Although transcribed during Egypt’s Second Intermediate Period, the knowledge it contains likely dates back to the Old Kingdom (circa 3000–2500 BCE), and may be attributed to the legendary physician Imhotep.
Unlike other ancient texts filled with spells and incantations, this papyrus uses structured anatomical reasoning and systematic clinical observation. It is organized from head to toe and contains 48 trauma cases — six of which describe spinal injuries.
The Six Spinal Injury Cases
The document categorized injuries using early clinical triage logic:
“An ailment which I will treat” (favorable)
“An ailment with which I will contend” (uncertain)
“An ailment not to be treated” (terminal)
Among the spinal cases described:
Cervical sprains with painful but preserved motion
Dislocations causing quadriplegia and bladder dysfunction
Crushed vertebrae from falling head-first
Lumbar sprains producing leg pain during extension
Remarkably, one lumbar case describes what modern orthopedics recognizes as the Lasègue sign — a diagnostic test still used today to identify disc herniation and sciatica.
The papyrus also documented:
The first recorded mention of the brain
Recognition that the spinal cord controls limb and bladder function
Use of immobilization (primitive splinting)
Honey as a natural antimicrobial dressing
These cases were likely battlefield injuries sustained from chariot falls and blunt-force trauma. Ancient back pain was acute and structural. Modern back pain is often different.
The Shift from Trauma to Dysfunction
Today, most back pain seen in clinical practice is not caused by crushed vertebrae or open wounds. It is caused by chronic instability.
At Caulo Care Acupuncture in Forest Hills, we frequently see patients whose back pain does not originate from a single injury, but from a dysfunctional core stabilization system.
This is where history meets biomechanics.
Can Weak Core Muscles Cause Back Pain?
The short answer: absolutely YES. From an anatomical and biomechanical perspective, the core is the primary stabilizing system of the spine. When this system fails, the spine absorbs mechanical loads it was never designed to manage independently. Over time, this leads to:
Micro-instability
Disc stress
Facet irritation
Muscular guarding
Low-grade inflammation
Chronic low back pain
What Is the Core, Really?
The core is not simply the “six-pack.” It is an integrated muscular cylinder that surrounds the trunk and regulates pressure to stabilize the spine. It consists of two functional systems:
Deep Core – Local Stabilizers
These muscles provide fine segmental spinal control:
Transversus Abdominis (TVA) – a natural corset
Multifidus – stabilizers attached directly to vertebrae
Pelvic Floor – base of the pressure system
Diaphragm – regulates intra-abdominal pressure
Together, they generate intra-abdominal pressure (IAP), creating internal bracing before movement occurs. This anticipatory contraction happens milliseconds before you move your arms or legs.
Superficial Core – Global Movers
These larger muscles generate visible motion:
Rectus Abdominis
Internal and External Obliques
Erector Spinae
Gluteus Maximus and Medius
They produce force — but they cannot replace deep stabilization.
First Principles: The Spine Is Not Designed to Take Direct Load
The lumbar spine is not engineered to tolerate direct compressive and shear forces without assistance. It functions as part of a pressure-regulated stabilization system.
When diaphragm, TVA, pelvic floor, and multifidus coordinate properly, pressure stabilizes each spinal segment internally. When this system fails:
Shear forces increase
Discs experience abnormal stress
Facet joints become irritated
Muscles spasm protectively
Pain develops
This is the modern equivalent of instability — very different from ancient battlefield trauma, yet equally disabling.
Why Does Core Weakness Develop?
Behavioral Factors
Prolonged sitting
Sedentary lifestyle
Improper lifting
Strength training without deep activation
Neurological Factors
Pain inhibition (muscles “shut off” after injury)
Postpartum pelvic floor weakness
Structural Factors
Diastasis recti
Lumbar hyperlordosis
Weak gluteal muscles
Who Is Most at Risk?
Office workers
Athletes and heavy lifters
Postpartum women
Older adults
Individuals with prior untreated back injuries
Western Medicine Perspective
Chronic non-specific low back pain related to core dysfunction is classified as motor control impairment. Treatment focuses on:
Deep core retraining
Neuromuscular re-education
Glute strengthening
Postural correction
Progressive load management
However, pain often inhibits proper muscle activation. When pain persists, stabilizing muscles remain dormant.
Traditional Chinese Medicine (TCM) Perspective
In Traditional Chinese Medicine, chronic low back pain is frequently associated with:
Kidney deficiency (weak foundational energy)
Qi and Blood stagnation
Cold or Damp obstruction in lumbar channels
A weak core parallels deficient Kidney Qi failing to support the lumbar spine.
Muscle tension and inflammation correspond to stagnation along the Bladder and Governing Vessel meridians. Though described differently, both Western and TCM frameworks recognize instability followed by stagnation and pain.
What Should and Should Not Be Done?
What You Should Do
Retrain deep core activation before heavy strengthening
Improve hip mechanics
Avoid prolonged static sitting
Correct lifting technique
Address pain early
What You Should Avoid
Heavy lifting during acute pain
Only performing planks without activation training
Ignoring glute weakness
Relying solely on pain medication
If Back Pain Has Already Developed
Management should include:
Reducing inflammation
Relaxing protective muscle spasm
Restoring neuromuscular activation
Gradually rebuilding stability
Correcting movement patterns
Pain must decrease before optimal motor control can return.
How Acupuncture at Caulo Care Can Help
At Caulo Care Acupuncture in Forest Hills, New York, acupuncture is not used solely for symptom relief. It is used to reset dysfunctional neuromuscular patterns.
Acupuncture may:
Reduce inflammation
Relax protective muscle guarding
Improve microcirculation
Modulate pain signaling
Stimulate deep stabilizing muscles
Restore proper Qi and Blood flow
By decreasing pain and muscle inhibition, acupuncture creates a therapeutic window where proper core retraining becomes effective again.
Conclusion: From Ancient Spine Trauma to Modern Core Instability
Thousands of years ago, ancient physicians documented spinal trauma with astonishing precision. Today, while we still treat structural injuries, most back pain arises not from fractures — but from functional instability. Weak core muscles absolutely can cause back pain. The spine depends on coordinated deep stabilization, not just strong superficial muscles. When this system fails, micro-instability and inflammation develop.
Whether described as motor control dysfunction in Western medicine or Kidney Qi deficiency with stagnation in Traditional Chinese Medicine, the underlying principle is the same:
Instability leads to stagnation.Stagnation leads to pain. If you are experiencing persistent low back pain, treating only the surface symptoms is not enough.
At Caulo Care Acupuncture in Forest Hills, we focus on reducing pain, restoring balance, and helping your body regain its natural stability — so that your spine is supported the way it was designed to be.
This information is only educational and should not be construed as medical advice.
Everything must be balanced, and the suggestions may not apply to you.
A specialist doctor should be consulted for any medical advice or diagnosis.
Acupuncture near me at Forest Hill, NY
🔶🔷🔶🔷🔶🔷🔶🔷🔶🔷🔶🔷
Dr. Phumlarp Caulo LA,c, MAc. OM, DAHM
Doctor of Acupuncture/Chinese Medicine
Caulo Care Acupuncture
🔖 By appointment only
☎️+1 (929) 269-4549
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