戴云湿热腰痛者遇天阴或久坐而发者是也寒湿痛者腰冷如坐水中重着者是也肾虚痛者隐
痛而不止者是也瘀血痛者日轻夜重者是也
丹溪云胁痛者多是肝火亦有死血湿痰留积凡左胁痛甚者多是肝火盛木气实右胁痛者多是
气郁痰积又云胁痛之症妇人多有之以其忧思忿怒之气素蓄于中或被湿痰死血阻滞其气不得条
达故作痛也
脉诀云腰痛脉沉濡者寒湿脉沉数者湿热脉弱者肾虚脉涩者死血脉沉涩者痰积
凡胁痛脉沉涩者当作郁治 脉弦数者是肝火太盛
一寒湿腰痛如掣冷瘅不可俯仰宜用 五积散加杜仲 独活寄生汤 肾着汤 麻黄苍术汤
术附汤
一湿热腰痛者宜用 当归拈痛汤
一肾虚腰痛者宜用 青蛾丸 立安丸 乳香散
一气滞腰痛者宜用 木香流气饮
一瘀血作痛宜用 牛膝桃仁汤
一闷挫腰痛宜用 当归乳香散
一肝火太盛气实左胁痛宜用 当归龙荟丸 抑青丸 龙胆汤 龙胆泻肝汤
一因怒胁痛者宜用 芎葛汤 枳壳煮散 聚气汤
一右胁痛宜用 推气散 分气紫苏饮
治风寒伤肾腰痛如掣脚膝偏枯冷瘅
独活 桑寄生 白芍药 细辛 桂心 芎 防风 人参 当归 熟地黄 秦艽 牛膝
茯
水二钟煎八分不拘时服
治寒湿腰痛身体沉重
麻黄 泽泻 神曲 茯苓 陈皮 半夏 桂枝 草豆蔻 杏仁 苍术 甘草 猪苓 黄
水二钟姜三片煎八分食前服
戴元礼认为：湿热腰痛，是在天气阴雨或久坐时发作的；寒湿腰痛，是腰部寒冷如同坐在水中、感觉沉重困着的；肾虚腰痛，是隐隐作痛且持续不断的；瘀血腰痛，是白天轻晚上重的。
朱丹溪说：胁痛大多是由于肝火引起的，也有因死血（瘀血）、湿痰停留积聚所致。凡是左侧胁部疼痛剧烈的，大多是肝火旺盛、木气实盛；右侧胁部疼痛的，大多是气郁和痰积。他又说：胁痛这一病症，妇女多见，因为她们忧思愤怒之气素来蓄积在体内，又被湿痰或死血阻滞，导致气机不能条达顺畅，所以发生疼痛。
《脉诀》说：腰痛脉象沉而濡缓的，是寒湿；脉象沉而数的，是湿热；脉象弱的，是肾虚；脉象涩的，是死血（瘀血）；脉象沉而涩的，是痰积。凡是胁痛脉象沉涩的，应当当作气郁来治疗；脉象弦而数的，是肝火太盛。
对于寒湿腰痛，症状如牵引样冷痛，身体僵硬不可俯仰，适宜使用五积散加杜仲、独活寄生汤、肾着汤、麻黄苍术汤、术附汤。
对于肝火太盛、气实导致的左侧胁痛，适宜使用当归龙荟丸、抑青丸、龙胆汤、龙胆泻肝汤。
（注：以下方剂见“中寒门”章节）
治风寒伤肾腰痛，疼痛如牵引至脚膝，伴有偏枯、冷痛僵硬：
独活、桑寄生、白芍药、细辛、桂心、川芎、防风、人参、当归、熟地黄、秦艽、牛膝、茯苓。
用水两钟，煎至八分，不拘时间服用。
治寒湿腰痛，身体沉重：
麻黄、泽泻、神曲、茯苓、陈皮、半夏、桂枝、草豆蔻、杏仁、苍术、甘草、猪苓、黄柏。
用水两钟，生姜三片，煎至八分，饭前服用。
Dai Yuanli stated: Damp-heat low back pain occurs during cloudy or rainy weather or after prolonged sitting; cold-damp low back pain is characterized by a cold sensation in the waist as if sitting in water, accompanied by a heavy and sticky feeling; kidney deficiency low back pain presents as lingering pain that does not cease; blood stasis low back pain is lighter during the day and heavier at night.
Zhu Danxi said: Hypochondriac pain is mostly caused by Liver Fire, but can also result from dead blood (blood stasis) and damp-phlegm accumulation. Severe pain on the left hypochondrium usually indicates excessive Liver Fire and excess Wood Qi. Pain on the right hypochondrium is mostly due to Qi stagnation and phlegm accumulation. He further stated that hypochondriac pain is common in women because their Qi of worry, thought, anger, and indignation is often retained internally; when obstructed by damp-phlegm or dead blood, the Qi fails to flow smoothly and freely, resulting in pain.
The Mai Jue (Pulse Classic) states: For low back pain, a deep and soggy pulse indicates cold-damp; a deep and rapid pulse indicates damp-heat; a weak pulse indicates kidney deficiency; a choppy pulse indicates dead blood (blood stasis); a deep and choppy pulse indicates phlegm accumulation. For hypochondriac pain, a deep and choppy pulse suggests treatment should focus on stagnation; a wiry and rapid pulse indicates excessive Liver Fire.
For cold-damp low back pain, with symptoms such as pulling cold pain and stiffness preventing bending or stretching, Wujie San (Five Accumulations Powder) plus Du Zhong (Eucommia Bark), Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction), Shen Zhuo Tang (Kidney-Dampness Decoction), Mahuang Cangzhu Tang (Ephedra and Atractodes Decoction), or Shu Fu Tang (Atractodes and Aconite Decoction) are appropriate.
For damp-heat low back pain, Danggui Niantong Tang (Angelica Sinensis and Ligusticum Decoction for Painful Obstruction) is appropriate.
For kidney deficiency low back pain, Qing'e Wan (Green Mole Pill), Li'an Wan (Stability Pill), or Ruxiang San (Frankincense Powder) are appropriate.
For Qi stagnation low back pain, Muxiang Liuqi Yin (Costus Flowing Qi Drink) is appropriate.
For pain caused by blood stasis, Niuxi Taoren Tang (Achyranthes and Peach Kernel Decoction) is appropriate.
For low back pain with a stifling and bruised sensation, Danggui Ruxiang San (Angelica Sinensis and Frankincense Powder) is appropriate.
For left-sided hypochondriac pain due to excessive Liver Fire and excess Qi, Danggui Longhui Wan (Angelica Sinensis and Gardenia Pill), Yiqing Wan (Suppressing Green Pill), Longdan Tang (Gentian Decoction), or Longdan Xiegan Tang (Gentian Liver-Draining Decoction) are appropriate.
For hypochondriac pain caused by anger, Xiongge Tang (Ligusticum and Bupleurum Decoction), Zhiqiao Zhusan (Bitter Orange Boiled Powder), or Juqi Tang (Gathering Qi Decoction) are appropriate.
For right-sided hypochondriac pain, Tuiqi San (Pushing Away Qi Powder) or Fenqi Zisuyin (Separating Qi Perilla Drink) are appropriate.
(The following formulas are found in the "Cold Damage to Middle" section.)
Treatment for wind-cold injuring the Kidneys causing low back pain with pulling sensations to the feet and knees, accompanied by hemiplegia-like weakness and cold stiffness:
Du Huo (Angelica Pubescens), Sang Ji Sheng (Taxillus), Bai Shao Yao (White Peony Root), Xi Xin (Asarum), Gui Xin (Cinnamon Heart), Xiong (Ligusticum), Fang Feng (Saposhnikovia), Ren Shen (Ginseng), Dang Gui (Angelica Sinensis), Shu Di Huang (Prepared Rehmannia), Qin Jiao (Gentiana Macrophylla), Niu Xi (Achyranthes), Fu Ling (Poria).
Decoct two cups of water until reduced to eight-tenths. Take at any time.
Treatment for cold-damp low back pain with heaviness of the body:
Mahuang (Ephedra), Zexie (Alisma), Shenqu (Medicated Leaven), Fuling (Poria), Chenpi (Tangerine Peel), Banxia (Pinellia), Guizhi (Cinnamon Twig), Caodoukou (Black Cardamom), Xingren (Apricot Seed), Cangzhu (Atractodes), Gancao (Licorice), Zhuling (Polyporus), Huangbo (Phellodendron).
Decoct two cups of water with three slices of ginger until reduced to eight-tenths. Take before meals.