Acupuncture – Arthritis

Painful Obstructive Syndrome: Bi Syndrome

Oriental Medicine & Acupuncture:

Relevant diseases in this category are:

  • Rheumatic Arthritis
  • Rheumatoid Arthritis
  • Degenerative Arthritis
  • Osteoarthritis
  • Gout
  • Sciatica
  • Subacromial Bursitis
  • Olecranon Bursitis
  • Carpal Tunnel Syndrome
  • Fibromyalgia [9]

Bi syndrome (Painful Obstructive Syndrome) is a blockage or obstruction to the normal movement of qi and blood in the channels and collaterals caused by a single or combination of pathogenic influences. These are Wind, Cold, Heat, & Dampness. These exterior pathogenic influences obstruct the channels and collaterals which cause Qi flow & blood circulation to not flow freely in the channels and collaterals. There is a saying in Chinese medicine where there is blockage to Qi and blood there is pain. Unblock the blockage to the free flow of these vital substances then the pain will cease and the healing will continue.

Bi syndrome (Painful Obstructive Syndrome) is characterized by the following signs and symptoms. Localized pain and discomfort in the muscles, joints, and tendons/sinews with predominant signs and symptoms including soreness and pain, numbness, heaviness sensation, impaired and difficult movement, possible red swollen joints that are warm to the touch, joint deformity may also be present. [9]

Categories of Bi Syndrome:

Wind Bi: Pain that moves around and can be wide spread.

Damp Bi: Localized pain that does not move limbs and body have a heavy feeling and there may be swelling.

Cold Bi: This pain is severe is aggravated by cold/ice and is helped/relieved by warmth.

Heat Bi: A type of pain where the part is hot, red and swollen. The pain is worse with touching or pressing.

Arthritis has been a recognized medical condition since ancient times. The Chinese doctors of this time had developed numerous formulas for its treatment. Chinese herbal formulas were not specifically designed for either of the two major types of arthritis defined today. The basis for Chinese doctors differentiating arthritis into subgroups was not the microscopic details of the pathology.

Instead, arthritis was divided into traditional Chinese medicine categories as described in the eight principles of differentiation:

  • hot and cold types
  • upper and lower body involvement
  • deficiency or excess syndrome
  • pain characteristics (such as variability and severity)
  • Whether the site of the arthritis was fixed or “moving.”

Both rheumatoid arthritis and osteoarthritis fall under the heading of bi syndrome, a disorder of qi and blood circulation that leads to symptoms of pain, numbness, swelling, and stiffness.

Rheumatoid arthritis fits most closely those syndromes characterized by traditional Chinese medicine as wind-damp invasion affecting the joints.

Osteoarthritis more closely fits the syndrome of liver/kidney deficiency syndrome causing weakness and stiffness in the legs with painful joints. [3,4,5]

Traditional Chinese Medicine Approach:

The role of Acupuncture, Traditional Chinese Medicine in treating Arthritis, Painful Obstruction Syndrome (bi syndrome) is to restore balance by clearing the external and internal factors that cause blockages to the Qi & Blood, and stop pain by opening the channels & collaterals to move & spread the Qi & Blood. Remember where there is pain there is blockage of qi & blood.

Arthritis

Arthritis comprises over 100 different diseases and conditions. The most common is osteoarthritis. Other frequently occurring forms of arthritis include rheumatoid arthritis, lupus, fibromyalgia, and gout. Arthritis also affects children. A recent study estimated that 1 in 250 children have some form of arthritis or related condition. Common symptoms include pain, aching, stiffness, and swelling in or around the joints. Some forms of arthritis, such as rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms. [8]

Why Is Arthritis a Public Health Problem? An estimated 46 million U.S. adults (about 1 in 5) reported doctor-diagnosed arthritis, according to annual estimates from combined 2003–2005 data. As the U.S. population ages, these numbers are likely to increase sharply. The number of adults with doctor-diagnosed arthritis is projected to increase to 67 million by 2030, and a good proportion of U.S. adults will have limited activity as a result. *(Limiting activity leads to a host of other health conditions and concerns.

It is very important to remain as active as you can be to stave off health problems.) Arthritis is the nation’s most common cause of disability. Nearly 19 million U.S. adults reported activity limitations because of arthritis each year during 2003–2005. Among adults of working age (18–64 years), work limitations attributable to arthritis affect about 1 in 20 adults in the general population and one-third of those with arthritis. Each year, arthritis results in 750,000 hospitalizations and 36 million outpatient visits. [8] CDC Information about Arthritis

Osteoarthritis:

This is the most common type of arthritis. Osteoarthritis affects cartilage of the joints. Cartilage serves to provide structure and support to the body’s other tissues without being as hard or rigid as bone. It is the tissue that cushions the ends of bones within the joint providing a cushioning effect in joints. In osteoarthritis, the cartilage begins to fray and may entirely wear away.

Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the spine and the weight-bearing joints (the knees and hips). Osteoarthritis is not an inevitable part of aging. It is due to a combination of heredity and mechanical factors, often made worse by improper conditioning.

Daily athletic activity like running, tennis, biking for recreation does not predispose one to osteoarthritis but forced repetitive strain does predispose one to acquiring osteoarthritis. These changes are common in young athletes in their 20’s & 30’s and there may not be any overt signs or symptoms. About 90% of the population has some OA changes by age 45. [1,2] 6 ((NIAMS), 2008)

Rheumatoid arthritis:

This is an inflammatory disease of the synovium, or lining of the joint, results in pain, stiffness, swelling, joint damage, and loss of function of the joints. Inflammation most often affects joints of the hands and feet and tends to be symmetrical (occurring equally on both sides of the body). This symmetry helps distinguish rheumatoid arthritis from other forms of the disease. About 1 percent of the U.S. population (about 2.1 million people) has rheumatoid arthritis.

The cause of the disorder is an immune-based disturbance primarily affecting the joint fluids. Rheumatoid arthritis is characterized by autoimmune attacks that usually come and go, and it may be influenced by numerous factors that alter the immune functions, including infections, dietary components, and stress.

Osteoarthritis also involves some autoimmune responses, but is characterized by a gradually worsening degradation of the joint spaces, leading to sharp, fixed pain that persists. Although both disorders can begin at any of the joints, rheumatoid arthritis most often affects the upper body first (fingers are frequently the first site), while osteoarthritis most often affects the lower body first (hips and knees are commonly affected). [1][3,4,5]

Allopathic medical approach:

Serious concerns have been raised about one of the most important pharmaceutical therapies for persistent arthritis, the selective COX-2 inhibitor drugs i.e., Viox, Bextra. These non-steroidal anti-inflammatory drugs (NSAIDS) are potent analgesics that were developed specifically to avoid the gastrointestinal and renal side effects common to previously used drugs by focusing on a particular pathway: reducing the prostaglandins produced by the action of COX-2 enzyme (cylooxygenase-2) without inhibiting the COX-1 enzyme.

The COX-2 metabolites have functions other than contributing to pain, such as the beneficial effects of limiting thrombosis and promoting vasodilatation. As a result, when COX-2 is strongly inhibited by high doses of the drugs used over an extended period of time in the absence of simultaneous COX-1 inhibition, they can increase the risk of cardio-vascular events such as heart attack and stroke. Some of these drugs were pulled off the market abruptly, though a return to market with significant warnings is likely because of the symptomatic relief the drugs have provided to people with advanced arthritis. [3,4,5]

Research on Acupuncture and arthritis of the knee conducted by the National Institutes of Health has found positive findings on the use of Acupuncture and Traditional Chinese medicine. Please take a look at the research and the other articles on Acupuncture and Herbal medicine on treating Arthritis.

A landmark study has shown that acupuncture provides pain relief and improves function for people with osteoarthritis of the knee and serves as an effective complement to standard care. The study, the largest Phase III clinical trial of acupuncture for knee osteoarthritis, was funded by NCCAM and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, both components of the National Institutes of Health. Acupuncture for Osteoarthritis of the Knee Study 

Reference:

[1] Questions and Answers about Arthritis and Rheumatic Diseases
[2] Biomedicine A Textbook for Practitioners of Acupuncture & Oriental Medicine. Dr. Bruce H. Robinson, MD pp 196-207. Published by Blue Poppy Press ©2007
[3] TREATING ADVANCED ARTHRITIS WITH CHINESE HERBS by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
[4]  [5] Differentiating Sulfur Compounds Sulfa Drugs, Glucosamine Sulfate, Sulfur, and Sulfiting Agents by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
[6] Wise Geek What is Cartilage
[7] Acupuncture A comprehensive Text © 1981 Eastland Press p. 606
[8] Centers for Disease Control and Prevention Arthritis Arthritis affects 52.5 million U.S. adults, more than 1 in 5. It is the nation’s most common cause of disability.
[9] Essentials of Chinese Medicine Internal Medicine; Anshen Shi p. 211