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Arthritis in Traditional Chinese Medicine
Traditional Chinese Medicine (TCM) categorizes arthritis as a blockage in the smooth flow of qi and blood throughout the energetic pathways in the body. The presence of a blockage is indicated by pain and reduced range of motion. Conditions such as arthritis are therefore called "painful obstruction syndromes" in Chinese medicine, and are commonly treated by acupuncturists. As an impediment that affects the bones and joints, arthritis is called "bi syndrome" or "bone bi" in TCM. Bi syndrome manifests as pain, soreness or numbness of muscles, tendons and joints The immediate cause of bi syndromes is environmental - the result of the body being "invaded" by the climatological factors of wind, cold, heat and/or dampness, which are said to penetrate the body's defenses and lodge in the muscles, tendons and joints. Long-term bi syndrome can lead to deformities of the bones and joints.
The symptoms manifested by the individual depend on which external pathogenic factor is strongest. The four main patterns of bi syndrome are detailed below:
Exposure to wind, especially when one is unprotected and exposed for a prolonged period, is a primary cause of wind-pattern bi syndrome ("wind bi"). Such patients may have an aversion to wind, a floating pulse, and often fever. A normally colored tongue with a thin, white coating also indicates to the Chinese medicine practitioner the presence of wind bi. Because this type of bi syndrome moves from site to site, it is also known as "wandering bi." Wind predominates when a patient exhibits pain that begins and ends rapidly, limits the range of comfortable movement, and moves among different parts of the body.
Cold-pattern bi syndrome ("cold bi") is characterized by severe pain in a joint or muscle that limits the range of comfortable movement. It has fixed locations, rather than moving about as in wind bi. Applying warmth to the affected area can relieve the pain, but it increases with exposure to cold. A patient suffering from cold bi may have an aversion to cold. Additional symptoms include a thin white tongue coating, combined with a wiry and tight pulse. Because this type of bi syndrome usually results in particularly severe pain, it is also known as "painful bi."
Damp-pattern bi syndrome (damp bi) is characterized by pain, soreness and swelling of the muscles and joints the limits the range of motion, and is accompanied by feelings of heaviness and sometimes numbness and swelling. The pain has a fixed location, and is aggravated by damp conditions. Patients with damp bi usually have an aversion to damp weather, along with a white, sticky tongue coating and a slippery, slow pulse. Because this type of bi syndrome is characterized by fixed areas of pain and sensations of heaviness, it is also known as "fixed bi."
Heat-pattern bi syndrome ("hot bi") can result when a wind-, cold- or damp-pattern bi syndrome causes a greatly reduced flow of qi and blood through a joint. Such a degree of stagnation causes constraint, which in turn can cause heat. Hence hot bi can develop from any of the above three patterns. It is characterized by severe pain and swollen, inflamed joints. Other symptoms include fever, thirst, anxiety and an aversion to wind. The tongue may be red with a yellow coating, and the pulse may be rapid. Pain is generally relieved by applying cold to the joints.
Though a generalization, osteoarthritis frequently falls into the categories of wind, cold or damp bi, while rheumatoid arthritis would be equivalent to heat bi. Two other forms of arthritis described in TCM include "bony bi syndrome" and "bi syndrome due to qi stagnation." Bony bi is essentially late-stage arthritis, at the point when bony nodules have formed in the joints. Bi syndrome due to qi stagnation is a type of joint pain that moves around and is often associated with stress and emotional turmoil. It has also been seen in women going through menopause. Acupuncture is known to be very successful in the treatment of these conditions.
Arthritis in Western (Allopathic) Medicine
Western medicine describes more than one hundred forms of arthritis, including osteoarthritis, rheumatoid arthritis, infectious arthritis, chemically-induced arthritis, temporomandibular joint syndrome (TMJ), juvenile rheumatoid arthritis, ankylosing spondylitis and gout. The most common forms are osteoarthritis and rheumatoid arthritis:
Osteoarthritis, sometimes called degenerative joint disease and osteoarthrosis, is a condition once thought to be due to simple wear and tear of joint cartilage. The condition is now understood to be a complex process involving two components, one mechanical (wearing away) and the other biological (abnormal joint biology). Osteoarthritis is characterized by the deterioration of normal surfaces of movable synovial joints. The joints are covered with a smooth layer of cartilage. In order to function properly, the cartilage must be lubricated by synovial fluid, which also carries vital nutrients. A structure called the joint capsule encloses the joint, protects it, and keeps the synovial fluid within the joint. When cartilage is worn thin - typically in weight-bearing joints such as the knees, hips, feet, back, fingers and hands - the result is pain and loss of function. As the disease progresses, crevices and bone spurs (osteophytes) may develop, increasing pain and decreasing mobility.
Rheumatoid arthritis is the most severe type of inflammatory joint disease. It is two to three times more common in women than in men and generally strikes between the ages of 20 and 50. But rheumatoid arthritis can also affect young children and adults older than age 50. Unlike osteoarthritis, which results from wear and tear, the exact cause of rheumatoid arthritis is unknown. However, it is believed to be an autoimmune disorder wherein the body's immune system attacks the tissue (synovium) lining the joints. As the most debilitating of all forms, rheumatoid arthritis causes joints to ache and throb and eventually become deformed. Anti-inflammatory drugs such as aspirin and ibuprofen, as well as corticosteroids and immuno-suppressive drugs are the most common treatments used in western medicine. However, long-term use of these medications can produce side effects such as stomach irritation, gastritis and ulcers.
Arthritis is a general term for a number of conditions that include painful, swollen and/or stiff joints. Affecting more than six and a half million people in the U.S., the two most common types of arthritis are rheumatoid arthritis, a chronic inflammatory disease, and osteoarthritis, which is an age-related degeneration of joints. An estimated 15% of people in the United States are afflicted with osteoarthritis.
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