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Expert Advice-Treatment of Arthritis in Traditional Chinese Medicine(TCM):

Healing Arthritis with Chinese Medicine

Each year millions of American workers are sidelined by joint pain. If the pain is mild, many just "tough it out," but find that the problem gets worse year by year. Severe joint pain can incapacitate people, making it impossible for them to exercise or live the life they want to live. Most people with joint pain are diagnosed with arthritis, which is a general term for a number of different conditions that involve swollen, painful, and/or stiff joints. The two most common forms of arthritis are rheumatoid arthritis, which affects more than 6.5 million people in the United States alone; and osteoarthritis, which is an age-related degeneration of joints. One in seven Americans is afflicted with osteoarthritis, and some are virtually housebound by joint pain.

In the West, anti-inflammatory drugs are commonly prescribed for arthritis. In the East, acupuncture and Chinese herbal medicine, with their thousand-year-old history, are the major health care modalities used to fight joint and musculo-skeletal disorders including arthritis. These ancient therapies are still used because they are empirically effective, and have stood the test of time. Now they are standing to meet the tests of Western medicine.

Arthritis in Conventional Medicine
Osteoarthritis, rheumatoid arthritis, infectious arthritis, chemically-induced arthritis, temporomandibular joint syndrome (TMJ), juvenile rheumatoid arthritis, ankylosing spondylitis and gout are all types of arthritis that are differentiated in conventional Western medicine. The most commonly seen forms of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis. The joint pain of osteoarthritis is primarily due to the gradual loss of protective cartilage. Physical injury, mechanical stress or metabolic abnormality can break down the cartilage which cushions the ends of the bones from rubbing against each other. As a result, bones begin to grate against each other, producing pain and further degeneration.

Rheumatoid Arthritis. Rheumatoid arthritis is the most severe type of inflammatory joint disease. It is an auto-immune disorder in which the body’s immune system attacks its own tissues, damaging joints and the surrounding soft tissue. Painful, stiff and deformed joints of the hands, arms, feet and legs are commonly seen.

Anti-inflammatory drugs are the main weapon that conventional medical doctors prescribe for chronic inflammatory arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibupofen, and gold compounds; and steroid-based drugs such as corticosteroids and immuno-suppressive drugs are widely used for arthritis. Long-term use of these medications can produce side effects such as stomach irritation, gastritis and ulcers. An exercise program and physical therapy are helpful for osteoarthritis patients to maintain a satisfactory level of activity. Non-steroidal anti-inflammatory drugs and corticosteroids are provided for short-term relief.

Arthritis in Chinese Medicine
In traditional Chinese medicine, the condition that is congruent with arthritis is called "Bi syndrome." Bi syndrome manifests as pain, soreness, or numbness of muscles, tendons and joints, and is the result of the body being "invaded" by the external climatological factors of Wind, Cold, Heat, and/or Dampness. The symptoms manifested by the individual depend on which external pathogenic factor is strongest. The four main patterns of Bi syndrome are differentiated below, and the leading herbs that are used to treat each pattern are listed.

Wind Pattern. Exposure to wind, especially when one is unprotected and exposed to the wind for a long time, is an important cause of the Wind pattern of arthritis. Any Wind pattern is characterized by movement of symptoms from place to place. In the case of Wind Bi, there is joint soreness and pain which moves from joint to joint. Movement of joints is limited, and there is often fever, as well as an aversion to wind, or windy weather. A thin white tongue coating and a floating pulse are signs that help Chinese medicine practitioners diagnose Wind Bi. Leading herbs for this pattern include ledebouriella (Fang Feng), and ephedra (Ma Huang).

Cold Pattern. The Cold pattern of arthritis (Cold Bi) is characterized by severe pain in a joint or muscle. This pain has a fixed location, rather than moving about (as in Wind Bi). The pain is relieved by applying warmth to the affected area, but increases with exposure to cold. Movement of joints is limited. A thin white tongue coating, combined with a wiry and tight pulse are signs of Cold Bi. Leading herbs for this pattern include aconite (Wu Tou), and ephedra (Ma Huang).

Damp Pattern. The Damp pattern of arthritis (Damp Bi) is characterized by pain, soreness and swelling in muscles and joints, with a feeling of heaviness and numbness in the limbs. The pain has a fixed location and is aggravated by damp weather. A white, sticky tongue coating and a soggy, slow pulse are signs of Damp Bi. Leading herbs for this pattern include coix (Yi Yi Ren), and lancea atractylodes (Cang Zhu).
Heat Pattern.
The Heat pattern of arthritis (Hot Bi) can develop from any of the above three patterns. It is characterized by severe pain and hot-red-swollen joints. The pain is generally relieved by applying cold to the joints. Other symptoms include fever, thirst, anxiety, and an aversion to wind. A yellow, dry tongue coating and slippery, rapid pulse are seen with Hot Bi. Leading herbs for this pattern include anemarrhena (Zhi Mu), gypsum (Shi Gao), and cinnamon (Gui Zhi).
A time-tested herbal formula for joint pain is Joint Strength (Du Huo Ji Sheng Wan). This herbal combination was written down about twelve hundred years ago, during the Tang Dynasty. It contains herbs that relieve pain, as well as herbs that nourish and strengthen the joints. It has been used by millions of people over the last millennium. You can take it over a long period of time without worrying about side-effects.
Support for Acupuncture
Joint pain, back pain, and headaches constitute a large percentage of all the visits paid to doctors’ offices and acupuncture clinics in any country at all times. In traditional Chinese medical theory, it is believed that the pathogenic factors that cause Bi syndrome (Wind, Cold, Damp, Heat) lodge in the body’s meridians (energy pathways) and obstruct the free flow of Chi and Blood in those meridians. When blood and energy are not able to flow naturally, they stagnate, causing pain, heat, and other symptoms of illness. Acupuncture and herbal therapy help to open the blockage, balance the energy, and harmonize Chi and Blood.
Scientifically proving the validity of these ancient concepts is challenging, but promising. More and more scientifically-designed clinical studies support the use of acupuncture for arthritis. One study examined the effects of acupuncture on 32 osteoarthritis patients waiting for knee replacement surgery. After nine weeks, patients receiving acupuncture treatments reported a decrease in pain, while pain increased in untreated patients. The patients with acupuncture treatments were able to walk farther and faster, compared with the untreated group. Another study at the University of Maryland School of Medicine found that 12 patients with osteoarthritis of the knee improved significantly after acupuncture treatments. These results encouraged the researchers to do a larger study which is currently under way.
Modern scientific research has also revealed the mechanisms which provide relief for arthritis patients. Studies show that acupuncture can stimulate the production of endorphins (natural pain-killing hormones in the brain), and the anti-inflammatory hormone adrenalcorticotropin. Somehow, the acupuncture needles trigger the body to heal itself by producing hormones that reduce pain and inflammation. Acupuncture can then be used on an ongoing basis to prevent re-occurrence of arthritis once it has been successfully cured.