How acupuncture and Chinese medicine treats arthritis, rheumatism and fibromyalgia

If you have been diagnosed with arthritis, rest assured that acupuncture and TCM (traditional Chinese medicine) can help you make a tremendous difference to your quality and enjoyment of life. Therapeutic results with acupuncture have been shown to be excellent.

As you visit a Chinese medicine doctor, be prepared to accept a totally different method of assessment, diagnosis, prognosis and treatment of your arthritis. Some terms such as wind, cold, dampness or heat will be used to describe your condition, irrespective of the type of arthritis.

Essentially, in traditional Chinese medicine the condition that is equivalent to arthritis (and other forms of rheumatism and arthralgia) is called Bi Syndrome. So it corresponds to conditions such as rheumatoid arthritis, osteoarthritis, fibrositis, bursitis, fibromyalgia, muscular rheumatism, lumbago or sciatica.

Bi refers to obstruction of the normal circulation of Chi, blood and fluids.

It is manifested by pain, stiffness, soreness, heaviness and numbness of tendons, muscles and joints. Sometimes there is redness, swelling, a burning sensation or pain in the joints with limited motion. Contracture of the extremities, swelling or deformity of the joints can be seen in protracted cases.

The cause of the obstruction is due to either:

The key to clinical success in acupuncture and Chinese medicine is for the acupuncturist or Chinese medicine doctor to identify the predominating pathogen. The symptoms that the individual manifests will depend on the external pathogenic factor that is strongest. Often, a mixture of these pathogens is present. See below for more details on these pathogens.

The acupuncturist is also required to skillfully determine the location and nature of any internal deficiency factors that may be present. Chinese medicine theory recognises the fact that pathogens invade weak and deficient bodies.

Internal deficiencies can arise from a deficiency of Wei Chi (defensive chi), which results in the failure of the body to resist the invasion of pathogens such as wind, cold or damp.

Past traumatic injuries, old injuries or overuse of a body part can also allow the invasion of wind, cold, damp pathogens.

Furthermore, in cases where heat predominates, such as in rheumatoid arthritis, it is important to also include in acupuncture differential diagnosis the investigation of the level or depth of penetration of the pathogen. This is the Defence, Qi, Nutrient and Blood Pattern identification, a syndrome differentiation categorisation of epidemic febrile diseases according to the theory of defence, Qi, nutrient and blood. These indicate the stages of the clinical course of the disease with corresponding pathological changes. Febrile diseases can mimic rheumatoid arthritis.

Syndrome Differentiation in Acupuncture

Bi syndrome is differentiated into 4 main types where Wind, Cold, Damp or Heat predominate respectively. However, the reality is that a variety of mixed or combined syndromes are frequently seen in clinic.

Wandering Bi Syndrome (Wind predominates)

This is Wind pattern arthritis, whereby a person has been unprotected to wind or has been exposed to wind for a prolonged period. This pattern is characterised by widespread pain involving many joints or symptoms that migrate from one joint to another. Symptoms reflect the general nature of climatic wind, for example, rapid onset and quickly changing.

Movement of the muscles and joints is limited with soreness and pain. There is often fever, as well as an aversion to wind, or windy weather.

In patients with Yin deficiency, wind can easily transform into heat giving rise to hot joints, such as those seen in acute rheumatoid arthritis.

Painful Bi Syndrome (Cold predominates)

This is a Cold pattern of arthritis (also called Cold Bi). The invasion of Cold causes contraction and 'freezing' that result in severe stagnation, hence severe localised pain.

The pain is a severe biting or stabbing pain in a joint or muscle with limitation of movement. There is no local inflammation; the pain is alleviated by heat but aggravated by cold.

Cold Bi usually occurs as a consequence of frequent or prolonged exposure to cold, such as standing on cold floors or walking on cold ground or in cold water, working outside in winter time or through the wearing of insufficient clothing. As it is with wind and damp, exposure to cold is generally more severe if it follows sweating.

Fixed Bi (Damp predominates)

The more evident signs and symptoms in this Damp pattern of arthritis (Damp Bi) are stiffness, numbness, swelling or oedema localised around the joint and a feeling of heaviness or numbness in the limbs. Soreness and pain in the joints and muscles has a fixed location and is aggravated by cloudy, muggy, wet or damp weather.

Damp Bi results from living or working in damp conditions such as being near water, living in the mountains where it is often shady or getting soaked frequently. It also includes living in basements.

Rheumatism can be ascribed to Damp Bi. The symptoms can manifest on a dry day, one that preceeds the onset of wet weather so patients can usually foretell changes in the weather.

Hot Bi or Febrile Bi (Heat predominates)

This is a Heat pattern of arthritis (Hot Bi) that can develop from any one or more of wind, cold and damp bi. Affected joints are hot, red, swollen and severely painful. One or several joints can be involved, movement is limited and pain is worse on pressure.

This Febrile Bi arises when wind, cold and/or damp transform into heat in the body. More commonly, damp and heat combine with damp predominating.

In prolonged cases of Bi syndrome, muscular atrophy and swelling of the joints are common. Subsequently, joints become deformed and there are severe limitations of movement. This deformity is caused by retention of body fluids which turn into phlegm and obstruct the meridians and the joints. Once the disease progresses to this stage, acupuncture therapy refers to it as Bony Bi.

Management of arthritis with acupuncture

In acupuncture, the following areas are taken into consideration in order to manage your condition: