October 2009

Arthritis and Chinese Medicine

By Elliot Wagner, O.M.D., L.Ac., Doctor of Oriental Medicine

The Chinese medical term for arthritis, as well as all other rheumatic diseases, is bi zheng, or impediment syndrome. Bi means a blockage or impediment that causes pain. This prompts us to ask four questions: What is the blockage? What is being blocked or impeded? How does the impediment come about? Finally, what can be done to reduce or eliminate the pain?

Arthritis is an ancient ailment, and detailed descriptions of arthritis and its treatment occur in some of the oldest Chinese medical texts. These are not, however, in modern scientific language. They are in an understandable and often vivid language that comes from the naturalistic philosophy upon which Chinese medicine is based. They are highly descriptive, and, if trust means anything, have made sense to Asians for hundreds of generations. Joint pain is said to occur from a combination of the forces of wind, dampness, and cold. A body made vulnerable by stress, overwork, illness, age, or unhealthy living habits, and affected over time by these forces will eventually suffer from joint deterioration.

It is not hard to imagine how the movement of normal body fluids: joint (synovial) fluid, tissue interstitial fluid, and blood becomes slowed when affected with dampness, cold, and drafts. The operative word is sluggish. The symptoms are cold, painful joints that become worse in cold, damp, windy weather. Joint tissues undernourished with sluggish blood and fluid movement lack vitality, and begin to lose function. Painful joints become thickened and stiff and hard to move, and normal range of motion may diminish. Exercise becomes more difficult. Deterioration may then progress to the next step: dryness in the joint, and eventually tissue damage, including erosion of unprotected joint surfaces. This then leads to friction in the joint, and pain is accompanied by heat rather than cold. The affected joint may feel tender and hot to the patient and even to the practitioner's touch. These processes occur in patients diagnosed with both of the most prevalent forms of arthritis — osteoarthritis, which is a breakdown in the cartilage in principally weight-bearing joints — and rheumatoid arthritis, which is a systemic auto-immune inflammatory process that may affect many joints, both weight-bearing and nonweight-bearing.

Now, to treatment. The most important statement one can make about treatment in Chinese medicine is that it is highly individualized. A patient with a knee affected by osteoarthritis that is exhibiting signs of dampness and cold will be treated with acupuncture strategies and herbs that warm and disperse cold and damp, together with herbs to strengthen the body and break up and move stagnant blood. A rheumatoid arthritis patient with a hot condition, for example, will require strategies to cool the blood, reduce and remove toxicity, and free flow in the small venules and capillaries.

Advanced arthritic conditions often require medication, chemotherapy, surgery, or other interventions, so I always confirm with patients that they are consulting with a rheumatologist or orthopedist. Nevertheless, patients with painful arthritis of every kind can benefit from acupuncture and professionally prescribed herbal medicine. Some see their conditions turn around, and find they are stronger, in less pain, and able to resume close to normal activities.