Arthritis

“Which arthritis do I have?”

• Arthritis simply means inflammation of the joints. There are numerous kinds, some of which include:
  - Rheumatoid Arthritis (RA): chronic systemic inflammatory disease with secondary degeneration of cartilage, bone, tendons and ligaments. RA tends to present symmetrically, in the hands at the first 2 knuckles of the fingers, and the limbs, with tenderness, warmth, and a crinkling noise at times; there are periods of exacerbation and remission; there is stiffness upon waking or inactivity for more than an hour; systemic symptoms include weakness, fatigue, weight loss and a low fever.
  - Reactive Arthritis: from some kind of infectious agent (uro-genital, respiratory, or GI tract); Rheumatic fever is one form.
  - Enteropathic Arthritis: Joint pain secondary to inflammatory bowel disease like Ulcerative Colitis or Crohn’s Disease.
  - Psoriatic Arthritis: Joint pain secondary to psoriasis.
  - Osteoarthritis: the most common form.
  
  
• Osteoarthritis (OA), aka “Wear and Tear” arthritis: this disease process is a progressive loss of articular cartilage resulting from inflammation caused by attempts of bone to remold itself creating osteophytes, or spurs. It presents in the knees, hips, hands (the 2nd and third knuckles of each finger), cervical & lumbar vertebrae, wrists and at any injured joint. It is non-symmetrical and may only present in one joint. The degeneration may begin in your 20s or 30s, but not show any symptoms until your 60s. With OA, you might feel stiffness for only 5-10 minutes in the morning or after inactivity; there are no systemic symptoms; the affected joint may be hardened and is seldom warm or red. The most distinguishing long-term sign is the appearance of nodes in the knuckles along with joint crepitus-- a popping or clicking sound.
  
  
• As we age, we all show joint degeneration on X-Ray, but whether we have any pain or discomfort and warrant the OA diagnosis depends very much on your overall health.
  - Are you physically active on a regular basis? Or are you largely sedentary?
  - Are you overweight, thereby placing undo stress and strain on your weight-bearing joints?
  - How’s your digestion? Any bloating or indigestion?
  - Do you get sick often?
  - Any family history?
  

Bi Syndrome: Painful Obstruction Syndrome

• In Chinese Medicine, arthritis is seen as an attack of an external pathogenic factor (EPF) in the form of Wind-Cold-Damp that invades the body and the joints obstructing the circulation of Qi, or energy, and Blood causing pain, stiffness and possible inflammation. Our Defensive Qi, our immune system, may be healthy but simply overwhelmed by the EPF or it may be compromised and attacked by a relatively strong EPF.
  
• Bi can come from changes in weather and an inability to adapt to them, sitting on cold cement, swimming in the ocean, running in the rain; it can come from excessive exercise or work and repetitive use; an underlying Blood or Yin deficiency not nourishing your joints and muscles (especially common in the elderly); injuries that don’t completely heal leaving behind Qi & Blood stagnation or compromised circulation, which can invite further pathogen to enter; and emotional problems that either stagnate your Qi and Blood or deplete them.
  
• The individual patterns are all based on Wind-Cold-Damp but with one part being the predominant EPF:
  - Wind Bi: pain & soreness moves from joint to joint, decreased Range of Motion (ROM);
  - Cold Bi: severe pain, often unilateral with decreased ROM, worse with cold weather;
  - Damp Bi: pain, soreness, and swelling, heaviness and numbness that is fixed in place and is worse with Damp weather;
  - Damp-Heat Bi: if the WCD Bi gets unresolved and lingers and there is an underlying deficiency, it can transform through stagnation into Heat presenting with pain, swelling and inflammation which can be hot to the touch, decreased ROM. There can also be thirst and a fever with an acute exacerbation.
  - Bone Bi: this chronic persistent obstruction that overtime has obstructed body fluid circulation producing Phlegm--along with Damp produced from digestive weakness-- and Blood stagnation which further impairs circulation leading to muscle atrophy, swelling and deformity. Here we can see spurs and nodes forming in the joint spaces.

"What can I do about my arthritis?"

• Acupuncture and Chinese Medicinal Herbs: One of the conditions most often researched and proven to be extremely effective is in the treatment of OA with acupuncture. When you add the ability to prescribe medicinal herbal formulas that can not only be specific to your areas of pain, but also treat the underlying deficiencies, you have one of the most effective treatment methods around.
  
• Supplements: Chondroitin and Glucosamine for joint rebuilding; Boron, a trace mineral for healthy bones; Essential Fatty Acids for inflammation and to lubricate the joints; Calcium/Magnesium/Zinc for overall muscle and joint health; B Complex to reduce swelling; Cayenne to reduce pain and can be used topically with Wintergreen Oil; MSM (sulfur) to reduce inflammation and repair connective tissue (available in asparagus, eggs, garlic and onions); Sea Cucumber to lubricate the joints; and Alfalfa, which has all the necessary minerals for bone formation.
  
• Lifestyle: balancing moderate exercise with rest; use of ice only 24 hours after exacerbating activity and then the use of heat (except for RA), weight reduction, and physical therapy to strengthen surrounding musculature.
  
• Non-Steroidal Anti-Inflammatories (NSAIDs) like Advil and aspirin: be cautious and use only for immediate relief of pain as overuse can erode your stomach lining leading to ulcers. Tylenol does not have that side effect, but is not an anti-inflammatory.
  
• Cortisone injections: should be done only as last resort as a maximum of 4 per joint in your life is advisable and no more than 3 per year total as they can lead to further degeneration.
  
• Avoid: caffeine, citrus fruits, dairy, excessive red meat consumption, sugar, and night shade veggies (peppers, eggplant, tomatoes, and white potatoes).
  
• Joint replacements and other surgeries: Sometimes you simply need to get a hip or knee replaced when the degeneration is too far gone to recover.
  

©Jordan Hoffman, L.Ac., Dipl. OM, 2007.
All Rights Reserved.

The information presented here is not medical advice, is not intended as medical advice, and is intended to provide only general, non-specific information related to Chinese Medicine and Acupuncture and is not intended to cover all the issues related to the topic discussed. You should consult a licensed health practitioner before using any of this information.

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