Given the fact that Arthritis Australia tells me that 3.6 million Australians are currently living with Arthritis, it is likely this blog will be useful to you or someone you care about. In fact, this number is only one of several startling facts Arthritis Australia have shared including:
Arthritis is the second most common cause of early retirement due to poor health in Australia.
52,000 people aged 15-64 can not work due to Arthritis.
If you were born between 1946 – 1964 (hello to all the Baby Boomers) you are almost twice as likely to report having Arthritis.
What is Arthritis?
Arthritis, also sometimes known as Rheumatism, describes a range of conditions that cause damage to the joints. Arthritis can affect multiple areas of the joint and almost every joint in the body. Some forms of Arthritis even involve other areas of the body such as the eyes. The damage of arthritis results in chronic pain and stiffness. There is not one singular form of Arthritis. In fact, there is over one hundred distinct kinds, each of which impacts the sufferer in diverse ways.
The Big 4:
Four of the most commonly known forms of Arthritis are:
Osteoarthritis
Osteoarthritis is the form of arthritis that most readers would be familiar with. In western medicine it is commonly referred to as ‘degenerative arthritis’ although as more is learnt about osteoarthritis this term is less and less relevant. It is now believed that the cause of osteoarthritis has more to do with the joint over working in order to try and repair itself rather than degeneration. Osteoarthritis is characterized by the progressive loss of articular cartilage although this is by no means the only area affected. Osteoarthritis also impacts the surrounding tissues of the joint including ligaments, synovium, subchondral bone, meniscus, and cartilage. The consequence of which is creaking stiffness of the joints and the grating of bone against bone. In clinical practice osteoarthritis, particularly of the knee, is a condition Scott sees a lot.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is another of the most commonly diagnosed forms of arthritis. It comes second only to osteoarthritis in global prevalence. It differs from osteoarthritis in that it can occur in people of a much younger age group and does tend to manifest quickly. RA is an inflammatory arthritis that is characterized by pain, heat and swelling of the joints. Rheumatoid arthritis is also an autoimmune disease. An autoimmune disease is the result of an overzealous immune system that attacks healthy tissue. In the case of rheumatoid arthritis, the immune system targets and impacts the lining of the joints which in turn results in pain, inflammation, and joint damage. In recent years, the study of the use of TCM in the support of RA has increased markedly which exciting news for practitioners and RA sufferers alike. TCM has been used in the treatment of RA symptoms successfully for thousands of years in China. We view the symptoms of RA to be related to external causes such as wind, cold, and damp and internal causes such as phlegm and stagnant qi and blood. Treatment includes nourishing the liver and kidney and promoting qi and blood circulation.
Gout
Gout is an inflammatory arthritis that forms in people with elevated levels of uric acid in their blood. This uric acid can form needle like crystals in the joints causing sudden episodes of pain, tenderness, redness, heat and swelling. Acute gout in Traditional Chinese Medicine (TCM) theory is the accumulation of stasis and excess heat or phlegm dampness in the joints. Gout may fall into any number of patterns according to TCM. These will vary from one person to the next, so it is important to identify the underlying meridian imbalance to resolve the root cause of the inflammation. Improving the circulation in the body and balancing the disharmony can be achieved by use of activating the acupuncture points, correcting stagnant flow of Qi. Acupuncture and TCM treatments should always be combined with identifying and rectifying impacting lifestyle and dietary factors to achieve optimal results. As gout is the result of inflammation and heat in the system it is strongly suggested a diet low in inflammatory foods be consumed and alcohol, caffeine and refined sugars be avoided.
Ankylosing spondylitis
Ankylosing spondylitis also known as AS is an arthritic condition that in the most part affects the spine. It occurs when the joints found in the neck, pelvis and back are inflamed. AS can also be found to affect the hips, shoulders, skin, bowel, lung and even the eyes.
Other common forms of arthritic disease:
Fibromyalgia (you can find a blog dedicated to Fibromyalgia here)
Psoriatic arthritis
Giant Cell arthritis
Haemochromatotic arthritis
Lupus
Sjögren’s syndrome
Scleroderma
Some forms of paediatric arthritis:
Juvenile idiopathic arthritis
Anterior knee pain
Chilblains
Chronic recurrent multifocal osteomyelitis
Familial Mediterranean fever
If you are wondering how we support paediatric health at Red Bridge you can read about our needle free acupuncture called Shonishin in this link.
Arthritis and Traditional Chinese Medicine:
Arthritis does not have a definitive name within Traditional Chinese Medicine (TCM). Throughout the history of TCM you can however see a correlation between the presentations and symptoms of arthritis in the conditions that TCM refer to as ‘Bi’ Syndrome.
The symptoms and pathogens of ‘Bi’ Syndrome were described in detail in ancient classical texts. The main manifestations are:
Pain
Numbness
Heaviness
Heat sensation
Limited range of motion of the muscles and tendons caused by deformity and swelling of the joints
‘Bi’ Syndrome is considered to be caused by channel obstruction and inhibited flow of qi and blood. This is due to:
Insufficient healthy qi (vital energy)
Insecurity of the healthy wei qi (immune like barrier)
External contraction of wind, cold, dampness and heat
Traditional Chinese Medicine views the health of the joints, tendons and muscles as linked to the health of the Kidney, Spleen and Liver systems. The organ systems in TCM take on a far broader interaction to our overall bodily functioning and experience of health than the processes identified by western medicine.
Kidney System – Stores the essence and governs the bones.
Deficiency of the Kidney essence also results in insufficient marrow transformation and in turn the bone is malnourished. This easily leads to vulnerability in the structure of the bone. For this reason, conditions such as Osteoporosis go hand in hand with Osteoarthritis.
Liver System – stores the blood and governs the tendons.
Our Liver system governs the movement of the essential qi to the sinew and facia, this qi is crucial as it assists the joints to move smoothly and freely. Where there is a decline of Liver qi the free movement of the sinew around the joints will be impacted.
Spleen System - governs the transformation and transportation of qi and dominates the muscles.
When the Spleen system is deficient this can lead to Internal Dampness. RA is an example of an arthritis that can be linked to a pattern of Damp Heat. Other conditions may include arthritic complaints that are aggravated by the damp weather conditions.
Many forms of arthritis do tend to begin around middle age. It is at this stage of life that commonly the Kidney and Liver systems can gradually begin to decline and become deficient. This decline in vitality of the Kidney and Liver systems results in a weakness of the sinews, the bones to become slack and the tendons to become malnourished. This leaves the joints vulnerable to the onset of this degenerative disease.
So as a generalised overview, Traditional Chinese Medicine would consider arthritic conditions or as we refer to them Bi Syndromes, to be linked to an imbalance of one or all of the three governing organ systems of the Liver, Spleen and Kidney. The depletion of these systems results in the inhibited flow of qi and blood and an associated phlegm coagulation in the channels causing malnutrition of the joints and their surrounding tissue.
How can Acupuncture and Traditional Chinese Medicine assist?
As TCM is not a one size fits all medicine each person presenting with symptoms of a Bi Syndrome will fall into a different pattern based on the root cause of their symptoms.
Here are some common patterns pertaining to Bi Syndromes. You may find some familiar to your experience of arthritis.
WIND COLD DAMP BI
See the breakdown of the various characteristics for Wind Cold Damp Bi conditions:
Migratory (Wandering) Bi:
Traveling pain.
Pain that is often in more than one location at a time or moving around the body.
Pain that varies in intensity.
Decreased range of movement.
Tongue diagnosis - pale and with a thin white coat.
Pulse diagnosis - floating and moderate.
The treatment is to invigorate blood and dispel wind.
Painful (Cold) Bi
Severe fixed pain that is aggravated by cold and alleviated by warmth. (If this sounds like you, you might also enjoy our blog Cold to the Bone)
Movement is limited but there is no localised redness of the skin or signs of heat.
Tongue diagnosis - pale red with a white coating.
Pulse is wiry and tight or deep.
Treatment is to warm the channels and dissipate cold.
Fixed (Damp) Bi
Pain worsens with rain / damp weather.
The pain tends to be localised with a heaving sensation, swelling and numbness.
Tongue diagnosis - pale with a greasy thin white coat
Pulse diagnosis - soggy and moderate.
Treatment is to eliminate the dampness and remove turbidity.
HEAT BI
Heat Bi is characterised by:
Joint pain with redness, swelling and limited movement.
Often accompanied by fever.
Aversion to wind.
Sweating.
Listlessness.
Tongue diagnosis - red with a greasy yellow coat.
Pulse diagnosis - rapid and floating or slippery.
Treatment is to clear heat and relieve swelling.
PHLEGM STASIS AND OBSTRUCTION
Phlegm stasis and obstruction is common in patients who have experienced prolonged symptoms of knee osteoarthritis and is characterised by:
Fixed stabbing pain.
Dull purple swelling.
Numbness and a sensation of hardness or heaviness above the joint.
Typically, the joint is stiff, potentially deformed and has extremely limited movement.
The patient may also present with a blackish complexion, puffy eyelids, and chest oppression with profuse phlegm.
Tongue diagnosis - dull purple and has a greasy white coat.
Pulse diagnosis - wiry and choppy.
Treatment is to invigorate blood and remove phlegm.
LIVER AND KIDNEY DEFICIENCY
Liver and Kidney Deficiency is another pattern common in patients with chronic osteoarthritis symptoms. Characterised by:
Inhibited movement.
Wasting muscle tone.
Lumbar weakness and flaccid knees.
Often these patients will express symptoms of cold aversion, cold limbs, feelings of impotence and frustration and a dry mouth.
Tongue diagnosis - pale and red with a thin white moist coat.
Pulse diagnosis - is deep and thready or weak and rapid.
Treatment is to supplement and boost liver and kidney qi.
COLD CONGEALING DUE TO YANG DEFICIENCY
Cold Congealing due to Yang Deficiency is characterised by:
Pain aggravated by the cold and alleviated by warmth.
Lack of strength.
Bloating.
A pale complexion.
Diarrhoea.
Tongue diagnosis - pale with a white moist coat.
Pulse diagnosis - deep, thready, and weak.
Treatment is to warm yang and dissipate cold.
As you can see there are many underlying patterns that may result in the symptoms of Bi Syndrome. Relieving associated symptoms by addressing the root cause will result in optimal long-term results.
At Red Bridge Scott approaches treatment of all conditions in a wholistic manner. A range of Traditional Chinese Medicine therapies such as needling, moxibustion, cupping, tui na, and herbal medicine can be utilised to alleviate symptoms and promote the restoration of balance. Heat therapy is of great assistance in the treatment of many arthritic conditions. You can find a detailed blog regarding some of the heat based treatments offered at Red Bridge on our blog Healing with Heat. Scott will also explore dietary influences and lifestyle factors of each individual patient. These must be taken into consideration to ensure long lasting relief.
Diet and Lifestyle considerations:
Along with Acupuncture and Traditional Chinese Medicine support adjusting diet and lifestyle is a crucial component of restoring balance and long-lasting relief.
Emotional Health:
There is a strong link between our emotions and the functioning of our organs so when we consider Arthritis and its interaction with our emotional balance we can consider the following connections:
Liver – Imbalance of Liver Qi can also manifest as frustration, anger, and resentment. Stagnation of our Liver Qi is often described as feeling stuck. Imbalance of Liver Qi is generally involved in conditions where pain is a primary factor. Identifying and working to resolve the root cause of these emotions and getting the Liver Qi moving smoothly will be important in the healing process.
Kidney – When our Kidney system is out of balance the emotion connected with this is fear, fright, and anxiety. Acupuncture and Traditional Chinese Medicine can be extremely supportive in balancing emotions such as anxiety however other inclusions such as mindfulness, journalling, meditation will also help to reduce anxiety and support Kidney system health.
Spleen – Our Spleen is impacted by worry. Much like the Kidney our Spleen health can be well supported with intentional mindfulness practices, gratitude diaries, meditation, and relaxation techniques.
Want to learn more about the connection between our emotions and our health? Read more via this link.
Diet:
Our Western diet leaves a lot to be desired when it comes to supporting optimal functioning of our organ systems. We eat a diet rich in processed foods with a high saturated fat and sugar content. These foods place a huge amount of stress on our Spleen and feed inflammation within the body. Along with the obvious poor dietary choices of:
High saturated fat foods
Processed foods
High Sugar foods
Alcohol and Caffeine
Some patients with arthritic conditions benefit from autoimmune and anti-inflammatory specific diets which help identify other foods that can be inflammatory such as vegetables in the night shade family even though, in all other cases they may be considered ‘good’ wholefoods and vegetables. Including anti-inflammatory foods such as curcumin and ginger in your diet can also be incredibly supportive for joint health. We have detailed autoimmune and anti-inflammatory diet protocols that we can help guide you through if they are appropriate for you.
Exercise:
Another thing that our Qi loves is movement. Exercise may be something that presents a challenge for sufferers of arthritis, Traditional Chinese Medicine however encourages gentle movement to increase the blood and Qi flow around the body. Choosing activities such as Qi Gong, Tai Qi, Yoga, swimming, and walking can be supportive to balancing your health and lifting mood.
If you would like to chat further with us about how we can support you or someone you love with arthritis then please get in touch. You can contact us at any time on (03)59061494 or via our website or any of our social media platforms.