ARTHRALGIA, JOINT PAIN

Etiology
  • Invasion of Wind, Cold and Damp or Wind, Heat and Damp in the Meridians
  • Weakness of the body due to Yang Deficiency
  • Qi and Blood Deficiencies due to childbirth or long term illness causing Wei Qi Deficiency
  • Overstraining, hence weakening the body
  • A Yang excess constitution, a Yin Deficient constitution or long standing Wind-Cold-Damp, stagnation may turn into Heat Bi
Clinical Manifestations
  • With a strong constitution, the etiologic factors may include:
    Living for a long period of time in Cold areas
    Lacking adequate protection against Cold weather
    Prolonged exposure to Cold at work (air conditioning)
    Sleeping in areas exposed to Wind, rain, snow or fog
    Living in Damp climates
    Exposure to Wind and rain
    Working in water
    Exposure to Wind, Cold or Damp after physical exertion with sweating
    Entering the water while sweating
    Wearing wet clothes
    Chronic Bi can lead to Qi and Blood Stagnation with Phlegm Stasis. This generates swelling and joint deformation. This is much more difficult to treat.
  • Special characteristics:
    Recalcitrant to treatment
    Joint swelling and pain
    Swelling is hard
    Pain is excruciating
    Limbs are numb
  • Blood Stasis:
    T: Purple spots
    C: White
    P: Thin and choppy
  • Phlegm Stagnation:
    T: Normal
    C: White and greasy
    P: Soggy and even
  • It usually starts gradually. In the initial stages, treatment is aimed at relieving the Excess condition.
  • Secondary phase - Excess type:
    The pathogen has not been cleared and moves deeper into the tissues and organs.
  • Chest Bi - Heart blockage:
    Uncomfortable feeling in the chest
    Palpitations
    Asthmatic panting
    Irritability
Treatment Principle
  • Eliminate Wind
  • Warm Cold (Clear Heat)
  • Expel Damp
  • Clear the Channels
Herb Formulas
Points
Clinical Manifestations
  • Aversion to Wind
  • Mild, or severe chills
  • Joint pain
  • Fever which may be persistent
  • Uneasiness from fever
  • Spontaneous perspiration
  • Headache
  • Nausea
  • Nasal irritation
  • Nasal obstruction
  • Tendency to snore
  • Itchy throat
  • T: Normal
  • C: Thin and white
  • P: Superficial and slow or Moderate and maybe weak
Treatment Principle
  • Create sweat to relieve the Exterior and expel Wind
  • Harmonize Ying and Wei to protect digestion and nourish Wei Qi
Herb Formulas
Points
Clinical Manifestations
  • Head and body aches
  • Nasal congestion
  • Coughing
  • Wheezing
  • Copious thin, white sputum
  • Aversion to Cold
  • Hoarseness
  • Chest distention
  • Gasping
  • Anhidrosis
  • Fullness in the chest
  • Sneezing
  • Distention and pain in the head
  • T: Normal
  • C: Thin white
  • P: Superficial or Normal
Treatment Principle
  • Spread Lung Qi
  • Release the Exterior
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Fever
  • Chills
  • Headache
  • Joint pains
  • Severe diarrhea
  • Epigastric distention
  • Perspiration
  • Cold body and extremities
  • Weakness of the extremities
  • Upper abdominal palpitations
  • Cold feet
  • Dysuria
Treatment Principle
  • Release the Exterior
  • Warm the Interior
  • Tonify Qi
  • Relieve pain
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Chronic arthralgia
  • Fullness and distention in the chest
  • Irritability
  • Occasional fright palpitations
  • Urinary difficulty
  • Constipation
  • Delirious speech
  • Insomnia
  • Subcardiac distention
  • Palpitations at the abdomen
  • Melancholia
  • Fear
  • Agitation
  • Unsteadiness
  • Tends toward mania and convulsions
  • Tends toward fatigue and clumsiness of limbs
  • Dysuria
  • Excitability
  • Dizziness
  • Anxiety
  • Depression
  • Tinnitus
  • Deafness
  • Profuse expectoration of Phlegm
  • Bitter taste in the mouth
  • Palpitations
  • Pale face
  • Oliguria
  • A sensation of extreme heaviness of the body
  • Fatigue
  • Inability to rotate the trunk
  • Difficulty moving the body
  • T: Red
  • C: Slippery
  • P: Wiry and rapid
Treatment Principle
  • Harmonize the Shao Yang
  • Unblock the three Yang Stages
  • Sedate and calm the Spirit
  • Relieve the chest and subcardiac regions
  • Alleviate spasms
Herb Formulas
Points
Clinical Manifestations
  • Long standing cold hands and feet that are cold to the touch and feel cold to the patient
  • Maybe lumbago and leg pain
  • Abdominal pain and distention
  • Midline pain
  • Uterine pain
  • Chills
  • Diarrhea
  • Menstrual abdominal pain
  • Maybe chest pain
  • Increased sweating, particularly of the feet
  • Increased salivation
  • Spasm and pain of the limbs
  • Scanty urination
  • Pain at the waist, hips, legs and feet
  • Sciatica
  • Joint pain
  • Irregular menstruation
  • Abdominal Cold
  • Migraine headache
  • Vaginal discharge
  • Vomits clear fluid
  • Vertex headache
  • Body cold
  • Diarrhea
  • Complete exhaustion of Yang
  • T: Pale
  • C: White
  • P: Weak.
Treatment Principle
  • Warm Yang especially in the Liver and Stomach
  • Descend turbidity
Herb Formulas
Points
Clinical Manifestations
  • Joint swelling and pain, especially hands and feet
  • Heaviness of the joints
  • Numbness of the joints
  • Stiffness of the joints
  • Fever
  • Heaviness of the body
  • Coldness of the body
  • Dizziness Likes pressure
  • Fatigue
  • Pale complexion
  • Preference for warmth
  • T: Pale
  • C: Thick and white or Greasy and white
  • P: Thready and slippery
Treatment Principle
  • Resolve Dampness
  • Reduce swelling
  • Move Qi
  • Warm the channels
  • Dispel Wind
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Bones and joints sore and painful
  • Worse with movement
  • Face is dull yellow
  • Spasms or contractures of muscles and sinews
  • Palpitations
  • Asthenia
  • Shortness of breath
  • Spontaneous sweating
  • Weight loss
  • Poor appetite
  • Diarrhea
  • T: Pale
  • C: None or White
  • P: Soggy and Weak or Thin and Faint
Treatment Principle
  • Strengthen Qi
  • Nourish the Blood
  • Expel Wind and Dampness
  • Stop numbness and pain
Herb Formulas
Points
Clinical Manifestations
  • Joint pain, especially in the wrist, ankle, knee and elbow
  • Muscle pain
  • There may be numbness and heaviness in the limbs
  • The pain is worse with Cold and better with warmth
  • The pain is aggravated by Wind
  • The pain aggravated by Dampness
  • The pain is stabbing
  • Muscle weakness
  • Difficult movement
  • Numbness of the muscles and skin
  • Hemiplegia, especially of the upper limbs
  • The pain alleviated by movement
  • Slight muscle edema
  • Heaviness of the joints
  • Cold joints
  • Aversion to Cold
  • The pain worse at night
  • Local inflammation
  • Migratory pain
  • Deviation of the eyes and mouth
  • Spasm of the limbs
  • T: Slightly purple or purple spots
  • C: Thick and white
  • P: Slippery or Slightly superficial or slightly rough or Slow and Soft or Wiry and tight or Floating and wiry
Treatment Principle
  • Remove Wind-Dampness
  • Disperse Cold
  • Eliminate Painful Obstruction
  • Circulate Qi and Blood
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • Migrating pain in the joints especially the :
    Shoulders
    Elbows
    Knees
    Wrists
    Fingers
    Upper back and neck
  • Multiple joints
  • Pain quality changes
  • May move from soreness to numbness to aching
  • Sensitivity varies
  • Pain often appears abruptly, acutely or paroxysmal and then disappears
  • Limited range of motion
  • Chills and fever
  • Aversion to Wind
  • Symptoms are worse in windy weather
  • Sore throat
  • General body aches
  • Maybe perspiration
  • T: Pink
  • C: Thin and white or Sticky and yellow
  • P: Superficial and moderate
Treatment Principle
  • Eliminate Wind
  • Warm Cold
  • Expel Damp
  • Clear the Channels
Herb Formulas
Points
Clinical Manifestations
  • Excruciating sharp, stabbing joint pain
  • Pain alleviated by warmth and aggravated by Cold
  • Pain with fixed location
  • Few joints are involved
  • The joints cannot be flexed or extended
  • No local redness or Heat
  • Painful area often feels cold to the touch
  • Pain worse at night and better during the day
  • Pain mostly affects low back and lower extremities
  • Pain intense but short lived
  • Pain changes over days or weeks
  • Ankylosis (stiffness) of joint
  • Aversion to Cold
  • Maybe chills with a slight fever
  • Anhidrosis
  • Frequent nocturnal urination
  • T: Pink or Pale
  • C: Thin and white (thicker than for Wind-Bi)
  • P: Superficial and tight or Wiry and tight - maybe slow
Treatment Principle
  • Warm the channels
  • Activate Qi and Blood.
Herb Formulas
Points
Clinical Manifestations
  • Migrating pain in the joints especially the :
    Shoulders
    Elbows
    Knees
    Wrists
    Fingers
    Upper back and neck
  • Multiple joints
  • Pain quality changes
  • May move from soreness to numbness to aching
  • Sensitivity varies
  • Pain often appears abruptly, acutely or paroxysmal and then disappears
  • Limited range of motion
  • Chills and fever
  • Aversion to Wind
  • Symptoms are worse in windy weather
  • Sore throat
  • General body aches
  • Maybe perspiration
  • T: Pink
  • C: Thin and white or Sticky and yellow
  • P: Superficial and moderate
Treatment Principle
  • Eliminate Wind
  • Warm Cold
  • Expel Damp
  • Clear the Channels
Herb Formulas
Points
Clinical Manifestations
  • Painful joints
  • Heavy and painful sensations at fixed locations in lower back and extremities with weakness and stiffness or hypertonicity and immobility
  • Aversion to Cold
  • Attraction to warmth
  • Palpitations
  • Pain in the midline and back during pregnancy
  • Pain worse at night General coldness
  • Sallow complexion
  • Wandering pain
  • Pale complexion
  • Shortness of breath
  • May be paresthesia and numbness
  • Cold pain in the low back and knees
  • Limited movement
  • Soreness, weakness and numbness of the joints
  • Tinnitus
  • Muscle spasms
  • Dizziness
  • T: Pale
  • C: Thin and white or White and moist
  • P: Thin, weak and slow or Deep, thready and weak or slippery
Treatment Principle
  • Disperse Wind-Dampness
  • Stop Bi pain
  • Tonify the Kidneys and Liver
  • Tonify Qi
  • Nourish s the Blood
Herb Formulas
Points
Clinical Manifestations
  • Arthralgia involving one or several joints of the extremities
  • Knee swelling is frequent
  • Local redness and Heat
  • Swelling with excruciating pain
  • Severe limitation of movement
  • Pain better during the day and worse at night
  • The pain is relieved by Cold
  • Fever
  • Sometimes slight chills and fever
  • Thirst
  • Dryness of the mouth and tongue
  • Irritability
  • Nervousness
  • Restlessness
  • Aversion to Heat
  • Desire for Cold drinks
  • Dark urine
  • T: Pink or Red
  • C: Thin and yellow or Dry yellow
  • P: Rolling and rapid maybe slippery
Treatment Principle
  • Clear Heat
  • Relieve toxicity
  • Activate the Blood
  • Clear the channels
  • For Wind-Damp-Heat Bi:
    Eliminate Dampness
Herb Formulas
Points
Clinical Manifestations
  • Generalized body aches and pains
  • Irritability
  • Heavy sensation in the shoulder and back
  • Discomfort or a constricted sensation in the area of the chest and diaphragm
  • Multiple sores, carbuncles furuncles or abscesses
  • Redness
  • Itching
  • Persistent swelling
  • Chest pain
  • Fever
  • Thirst
  • Aching and painful extremities
  • Aching and painful joints
  • Unbearable swelling and pain of the lower extremities
  • Shoulder stiffness
  • T: Normal
  • C: Greasy and slightly yellow
  • P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight
Treatment Principle
  • Resolve Dampness
  • Clear Heat
  • Disperse Wind
  • Stop pain
  • Activate the Blood g
  • Tonify Qi and Blood
Herb Formulas
Points
Clinical Manifestations
  • Arthralgia involving one or several joints of the extremities
  • Knee swelling is frequent
  • Local redness and Heat
  • Swelling with excruciating pain
  • Severe limitation of movement
  • Pain better during the day and worse at night
  • The pain is relieved by Cold
  • Fever
  • Sometimes slight chills and fever
  • Thirst
  • Dryness of the mouth and tongue
  • Irritability
  • Nervousness
  • Restlessness
  • Aversion to Heat
  • Desire for Cold drinks
  • Dark urine
  • Yang jaundice (sclera and skin bright yellow)
  • Pain and fullness in ribs on both sides
  • Maybe pain in the right hypochondrium
  • Bitter taste in mouth
  • Nausea
  • Vomiting sour and bitter fluids
  • Anorexia
  • Maybe alternating chills and fever
  • Concentrated, dark urine
  • Abdominal distention
  • Women:
    Yellow vaginal discharge with foul smell
    Pruritis vulvae
  • Men:
    Pain, swelling and burning sensations of testicles
  • T: Pink or Red
  • C: Yellow and greasy or sticky
  • P: Rolling and rapid maybe slippery Wiry and rapid or Slippery and rapid
Treatment Principle
  • Clear Toxic Heat in acute cases of aggressive inflammation
  • Transform Damp Heat
  • Transform Toxic Phlegm
  • Reduce fevers
  • Dispel Wind-Damp
  • Invigorate the Blood
  • Open blocked collaterals
  • Alleviate pain
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Joint pain
  • Distention and fullness of epigastrium and abdomen
  • Nausea
  • Vomiting
  • Anorexia
  • Loose stools
  • Diarrhea
  • Reduced sensation of taste
  • No thirst or preference for hot drinks
  • Sticky sensation in mouth
  • Borborygmus
  • Lassitude
  • Yin jaundice
  • Heavy head
  • Maybe edema
  • Maybe copious white vaginal discharge
  • Maybe cold limbs, fear of Cold or feeling chilled
  • T: Pink
  • C: Thick, white and greasy or sticky
  • P: Deep and slow
Treatment Principle
  • Warm Cold
  • Transform Dampness
  • Harmonize the Stomach
  • Strengthen the Spleen
Herb Formulas
Points
Clinical Manifestations
  • High fever
  • Contractures
  • Spasms
  • Neck stiffness
  • Convulsions
  • Oculogyric crises
  • Opisthotonos
  • Coma
  • Possibly death
  • T: Red or Deep red
  • P: Wiry and rapid
Treatment Principle
  • Clear Heat
  • Cool the Liver
  • Subdue Wind
Herb Formulas
Points
Clinical Manifestations
  • The sinews and bones are soft and weak
  • The pain is worse with exposure to Cold and Damp weather
  • Numbness and pain of the muscles and joints
  • Joint pain
  • Tremors of the hands and feet
  • Decreased range of motion
  • T: Pale
  • C: Whitish
  • P: Thin, weak and slow
Treatment Principle
  • Tonify the Liver and Kidneys
  • Augment Qi
  • Nourish the Blood
  • Dispels Wind, Cold and Dampness
Herb Formulas
Points
Clinical Manifestations
  • Lower abdominal pain and Cold
  • Abdomen feels chilled
  • Aching bones and joints
  • Muscle ache
  • Whole body pain
  • Aversion to Cold, especially at the back
  • Cold limbs
  • No Thirst
  • Lower abdominal pain and Cold
  • Abdomen feels chilled
  • Maybe fever
  • No thirst
  • T: Normal
  • C: White and slippery
  • P: Deep and faint or Forceless or Choppy and slow or Wiry
Treatment Principle
  • Dispel Cold
  • Warm the channels
  • Assist Yang
  • Dispel Dampness
  • Relieve pain
Herb Formulas
Points
Clinical Manifestations
  • Severe pain in the joints and muscles
  • Numbness
  • Poor circulation
  • Constant, fixed pain
  • The pain can result from, trauma, surgery or degeneration
  • Muscle ache of the neck, back, legs and shoulder
  • Hip pain
  • Whole body pain
  • Neck and spine pain
  • Shoulder pain
  • Elbow pain
  • Pain at the waist
  • Arm pain
  • Low back pain
  • Leg pain
  • T: Dark
  • C: Normal
  • P: Choppy
Treatment Principle
  • Move Qi
  • Activate the Blood
  • Break up Blood Stasis
Herb Formulas
Points
Clinical Manifestations
  • Swollen and painful joints
  • Localized painful swellings without a head that bleed into the surrounding tissues and do not affect the color or texture of the skin
  • The swellings are not hot to the touch
  • No thirst
  • Wasting of the muscles of the thigh and calf
  • T: Very pale or Pale-pink
  • C: White
  • P: Thready and forceless or Deep and slow
Treatment Principle
  • Warm the Yang
  • Tonify the Blood
  • Disperse Cold
  • Eliminate Stagnation
Herb Formulas
Points
Clinical Manifestations
  • Arthralgia involving one or several joints of the extremities
  • Knee swelling is frequent
  • Local redness and Heat
  • Swelling with excruciating pain
  • Severe limitation of movement
  • Pain better during the day and worse at night
  • The pain is relieved by Cold
  • Fever
  • Sometimes slight chills and fever
  • Thirst
  • Dryness of the mouth and tongue
  • Irritability
  • Nervousness
  • Restlessness
  • Aversion to Heat
  • Desire for Cold drinks
  • Dark urine
  • T: Pink or Red
  • C: Thin and yellow or Dry yellow
  • P: Rolling and rapid maybe slippery
Treatment Principle
  • Clear Heat
  • Relieve toxicity
  • Activate the Blood
  • Clear the channels
  • For Wind-Damp-Heat Bi:
    Eliminate Dampness
Herb Formulas
Points
Clinical Manifestations
  • Vomiting
  • Diarrhea
  • Spasms
  • Cramps
  • Thirst
  • Irritability
  • Oliguria with reddish urine
  • Restlessness
  • Arthralgia with a burning sensation, redness and swelling
  • Abdominal pain
  • T: Pink
  • C: Thick, dry and yellow or Yellow and greasy
  • P: Soggy and rapid or Floating and rapid or Floating, soft and rapid
Treatment Principle
  • Clear Heat
  • Resolve Dampness
Herb Formulas
Points
Clinical Manifestations
  • Pain in the upper arm
  • Aches and pains in the wrist, forearm and elbow
  • T: Pink
  • C: Slippery
  • P: Slippery
Treatment Principle
  • Dry Dampness
  • Transform Phlegm
  • Dispel Wind
  • Dredge the Channels
  • Relieve pain
Herb Formulas
Points
Clinical Manifestations
  • Pain in low back and knees
  • Aches and pains in the bones and sinews
  • Weakness or atrophy of lower extremities
  • Scanty yellow urine
  • Red, hot, swollen and painful feet or knees
  • Edema in lower legs
  • Leukorrhea (thick, yellow, foul-smelling)
  • Sores on lower extremities due to Damp
  • Redness, swelling and pain of the knees with burning sensations
  • Oliguria
  • Eczema
  • T: Normal
  • C: Yellow and greasy
  • P: Soft and and rapid
Treatment Principle
  • Eliminates Heat and Dampness
Herb Formulas
Points
  • General points
Clinical Manifestations
Treatment Principle
Herb Formulas
Points