TCM and Dyskinesia
By Dr. Hong-Yen Hsu
As the most flexible of vertebrae, the lower cervical vertebrae are also the most susceptible to degeneration and trauma. In an epidemiological study, 87% of males and 74% of females between the age' of 65 and 74 years showed radiological evidence of cervical disc degeneration. Degeneration of the lower cervical spine, protrusion of the cervical intervertebral disc, and cervical spondylosis are a few of the most common neck afflictions.
Traditional Chinese medicine maintains that the health of the bones is determined by the kidneys and that chronic neck pain due to degeneration of the lower cervical vertebrae is the result of kidney deficiency. In addition, neck pain may result from an invasion of the body by external pathogenic factors, such as wind, cold, and dampness, and the subsequent impairment of qi and blood circulation.
Conformations associated with cervical spondylosis and the herbal formulas commonly used in their treatment are discussed below.
Taiyang channel blocked by wind-cold is marked by headache; chills; neck pain; neck stiffness; spasms of the platysma; shoulder pain; thin, white or greasy, thin, white tongue coating; and superficial, tense pulse. The recommended formula is Pueraria Combination (Ge Gen Tang). If there is excess perspiration, aversion to cold, and superficial, moderate pulse, Cinnamon & Pueraria Combination (Gui Zhi Jia Ge Gen Tang) is the preferred treatment.
Wind, cold, and dampness bi syndrome is marked by neck pain accompanied by shoulder pain; back pain and other joint pain, which is aggravated by cold and relieved by warmth; heaviness and numbness of the arms; restricted neck movements; thick, tender tongue; and deep, hesitant or string-taut, slippery pulse. It is effectively treated with Chiang-huo & Turmeric Combination (Juan Bi Tang). For unblocking the channel and relieving pain, add angelica (bai zhi), clematis (wei ling xian) and cnidium (chuan xiong). For warming the channel and dispelling cold, add cinnamon twig (gui zhi) and roasted aconite (pao fu zi). For eliminating dampness, add coix (yi yi ren) and atractylodes (cang zhu).
Qi and blood stagnancy which is marked by stabbing, fixed neck pain; neck tenderness; shoulder and arm pain; muscle atrophy; numbness and coldness of the fingers; muscle spasms; poor memory; purple or dark red tongue, or petechia and ecchymosis on the tongue; and thready, hesitant or thready, string-taut pulse is commonly treated with Persica & Achyranthes Combination (Xue Fu Zhu Yu Tang).
Kidney deficiency marked by neck pain, dizziness, tinnitus, flushed face, dry mouth and throat, insomnia, irritability, lower back pain, weak knees, red tongue with little coating, and thready, rapid pulse or string-taut, thready pulse can be treated with Achyranthes & Rehmannia Formula (Zuo Gui Wan). Cnidium (chuan xiong) and pueraria (ge gen) can be added. If there are symptoms of kidney-yang deficiency, such as intolerance of cold, cold limbs, lower back pain, sore and weak knees, decreased sex drive, pale and swelling tongue, and deep, slow or deep, force less pulse, Eucommia & Rehmannia Formula (You Gui Wan) is recommended. If the patient has both kidney-yin and -yang deficiencies, half Achyranthes & Rehmannia Formula and half Eucommia & Rehmannia Formula should be used.
As mentioned above, degeneration of the lower cervical vertebrae is more common in the elderly. Thus, the therapy of tonifying the kidney is more commonly used in elderly patients with chronic neck pain.
Arthritis is one of the top five chronic conditions in the elderly, according to the United States National Health Interview Survey. Almost 50% of Americans 65 and older suffer from arthritis. Most often, the knee is the afflicted joint. Knee-joint movement was found to be restricted in 20% of those patients 80 years and older.
In TCM, knee pain due to arthritis or rheumatoid arthritis is categorized as bi syndrome, which, in turn, is usually caused by wind, cold, dampness, heat, or blood stagnancy, or a combination of two or more stagnancies.
When the arthralgia lingers over an extended period of time, the patient may develop qi, blood, liver, and kidney deficienies-conditions which, in general, are more common in the elderly. Treatment is aimed at dispelling wind, cold, and dampness, as well as tonifying qi, blood, the liver, and the kidneys.
Conformations associated with knee pain, along with recommended herbal formulas for their treatment, are presented below.
Qi and blood deficiency which is marked by swollen, aching knees; weak legs; motor dysfunction; fatigue; dizziness; palpitation; poor complexion; pale tongue; and deep, thready pulse is effectively treated by Major Siler Combination (Da Fang Feng Tang). This formula tonifies qi and blood, dispels wind and dampness, and strengthens the muscles and bones.
Liver and kidney deficiency which is marked by persistent arthralgia; dizziness; blurry vision; lassitude; lower back pain; limited movement; soreness; weak or numb knees; muscle atrophy in the legs; thin, white tongue coating; and deep, forceless pulse is commonly treated with Tu-huo & Loranthus Combination (Du Huo Ji Sheng Tang). This formula promotes circulation, relieves inflammation and pain, and subdues edema.
Water accumulation which is marked by water-induced obesity, fatigue, edema in the legs, heaviness and limited movement of the legs, swelling and aching knees or deformation of the knees, swollen tongue with white coating, and deep, weak pulse can be treated with Stephania & Astragalus Combination (Fang Ji Huang Qi Tang). This formula tonifies qi and promotes water metabolism. To enhance the dispelling of water and the alleviation of swelling, Coix Combination (Yi Yi Ren Tang) or Atracylodes Combination (Yu Bi Jia Zhu Tang) can be added.
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