Arthritic Diseases – Osteoarthritis

Osteoarthritis disease falls into the category known in Chinese medicine as Painful Obstruction Syndrome or Bi Syndrome. Symptoms of osteoarthritis include soreness, pain, numbness and a heavy sensation of the limbs and joints, with limitation of joint movement in more severe cases. Chinese medicine sees these symptoms as arising from a combined invasion of three pathogens: wind, cold, and damp. These three pathogens are found in all forms of Bi syndrome; they combine in differing ways, in part depending on the constitutional tendencies of the person affected, to produce different symptom pictures. These are named for the particular pathogen that predominates:

  • wandering bi – has the predominant symptom of migrating pain. The pain moves around and through the joints like a wind blowing through the body; therefore, pathogenic wind is seen to predominate.

  • painful bi – has the predominant symptom of severe, stabbing pain. The pain is better with warmth, worse with cold; no redness or feeling of heat is found at affected joints. In this case, pathogenic cold is seen to predominate, the cold causing a contraction of the body that increases the pain.

  • fixed bi – has the predominant symptom of a feeling of soreness, numbness, or heaviness that is always present at particular joints, and may be worse on cloudy and rainy days. Here the damp is seen to predominate, causing a dull pain that does not change location.

  • bone bi – has the predominant symptom of joint swelling and deformity. This arises from a chronic type of phlegm obstructing the joints. It arises over time from the preceding 3 types of bi syndrome and shows that an interior condition has developed. The disease is no longer affecting only the surface of the body.

Another type of bi Syndrome described by Oriental Medicine is heat bi. In this type, heat or inflammation is a more important component of the syndrome than wind, damp or cold. This type is found more often in systemic inflammatory conditions such as rheumatoid arthritis. A third category of arthritis, which should be noted, is infectious arthritis such as that from Lyme disease or gonorrhea. In the case of infectious arthritis, appropriate laboratory testing and physical evaluation are necessary to determine appropriate treatment; antibiotic therapy is strongly recommended. Acupuncture and herbal therapy are seen as a complementary therapy in this case, helpful in remedying damage done by the infection and restoring full function to the body. Several other types of bi are described historically by reference to the specific tissue location of the pain. These are skin bi, muscle bi, tendon bi, blood vessel bi, and finally heart bi (a serious condition in which inflammation has affected the heart tissue).

Painful obstruction syndrome results from obstruction of qi and blood in the meridians and collaterals. The meridians and collaterals are pathways of energy, fluid, and nourishment that run to every part of the body.

They form a network of channels that cover the skin and distribute blood and energy to all superficial areas, like a net enclosing the body. Good circulation of energy and fluid is vital for health. When the body is invaded by wind, cold and damp the channels can become blocked. It is at important points along the meridians and collaterals that acupuncture needles are inserted to clear pathogens, release blockage and strengthen energy. If the blockage is not cleared, it will in time come to affect the internal organs, and may cause:

  • stasis of blood – which results in increased pain.

  • deficiency of the liver – which results in aches and stiffness throughout the body. The liver blood is responsible for nourishing the sinews.

  • deficiency of the kidneys – which results in deformity and swelling in arthritic cases. The kidneys are responsible for nourishing the bones, and it is kidney fire that steams the body fluids to produce synovial fluid for the joints.

The invasion of pathogenic wind, cold, and damp is possible due to a relative deficiency of defensive qi and of blood. It is important to note that this is a relative deficiency. If the pathogenic factors are very strong, they may successfully attack an otherwise healthy person. Several factors may contribute to this invasion, such as unseasonable weather, excessive use of the joints, excess body weight, repetitive motion, and traumatic injury. This last category includes accidents that may have occurred in the past and which the patient may have forgotten. Emotional factors play a role as well. Prolonged and excessive anger and resentment block energy flow and can encourage blockage of the channels; prolonged and excessive sadness and grief deplete the qi and blood, leaving the body more vulnerable to disease. Arthritic conditions are more common in the elderly because injury to the joints accumulates with age and because the constitutional essence, controlled by the kidneys, is seen to decline with age. Herbs and acupuncture can play an important role in slowing or reversing this decline.

Treatment for osteoarthritis focuses on removing wind, cold and damp; these are always present in arthritic syndromes and must be released to effect improvement in the condition. Acupuncture around the affected joints can be extremely effective in relieving pain and increasing mobility. In addition, points are used to strengthen the blood and energy of all the organs to prevent the disease from progressing inwards. Moxa, which is the gentle application of heat by burning a special herbal product, can be very effective in ridding the joints of severe cold pain. Herbal treatments include the use of specific herbs that affect the extremities such as ren dong teng, or honeysuckle vine, and herbs that increase circulation such as ru xiang, or frankincense. Medicinal wines for reducing pain and strengthening bones, such as Wu Jia Pi wine, are available in most Chinese pharmacies. Walking, cycling, and swimming are helpful in relieving symptoms, while jogging, weights, and aerobics often prove too stressful upon the joints and may increase symptoms.

Patients suffering from arthritis should avoid dairy and greasy foods that may cause more damp to accumulate. Sour foods may bother the Liver and increase tightness of the sinews; these include yogurt, oranges, and pickles. Irritating or allergy-inducing foods should also be avoided; spinach and shellfish are common examples.