Etiology and Pathogenesis

Suppose affection of wind-cold-damp-heat pathogen or local trauma is A, obstruction of channels is B, stagnation of qi and blood is C, and malnutrition of tendons and muscles is D. TCM believes that A leads to B; B, C, D.

Type and Treatment

1. Type of Cold-Dampness

Symptoms: Localized pain below the loins and in the lower limbs which is relieved by heat and aggravated by cold and moving, thin white tongue coating, and taut tense pulse.

Therapeutic Method: Warming up the channels to dispel cold, removing dampness to clear the network-channels.

Prescription: Modified Wutou Tang (Decoction of Sichuan Aconite Root) and Huangqi Guizhi Wuwu Tang (Decoction of Five Drugs with Astragalus and Cinnamon).

Ingredients:

Zhichuanwu Radix Aconiti Preparata

Rougui Cortex Cinnamomi

Huangqi Radix Astragali

Danggui Radix Angelicae Sinensis

Gancao Radix Glycyrrhizae

Baishao Radix Paeoniae Alba

Mahuang Herba Ephedrae

Shengjiang Rhizoma Zingiberis Recens

Fengmi Mel

Administration: Decocted in water for oral use, 1 dose daily.

Modification: In case of abundant dampness marked by pain and heaviness in the loins and lower limbs, the drugs added are Yiyiren Semen Coicis, Niuxi Radix Achyranthis Bidentatae, Fangji Radix Stephaniae Tetrandrae, Bixie Rhizoma Dioscoreae Hypoglaucae.

2. Type of Damp-Heat

Symptoms: Burning and tic pain or heaviness and numbness or red-swelling and hot-pain of joints in the loins and lower limbs, reddened tongue with thin yellow coating, and slippery rapid pulse.

Therapeutic Method: clearing away heat and dampness, promoting the circulation of blood to activate the collaterals.

Prescription: Modified Simiao San (Powder of Four Wonderful Herbs).

Ingredients:

Cangzhu Rhizoma Atractylodis

Huangbai Cortex Phellodendri

Niuxi Radix Achyranthis Bidentatae

Mugua Fructus Chaenomelis

Yiyiren Semen Coicis

Jixueteng Caulis Spatholobi

Yinchen Herba Artemisiae Scopariae

Gancao Radix Glycyrrhizae

Rendongteng Caulis Lonicerae

Administration: Decocted in water for oral use, 1 dose daily. red-swelling and hot-pain in the joints, thirst, rigidity of the muscles and tendons, the drugs added are Shengdi Radix Rehmanniae, dilong Lumbricus, Qinjiao radix Gentianae Macrophyllae, Ruxiang olibanum, Huzhang Rhizoma Polygoni Cuspidati and Shenjincao herba Lycopodti.

In case of more severe dampness marked by heaviness, pain and numbness in the loins and lower limbs, nausea and greasy tongue coating, the drugs added are Wancansha Excrementa Bombycum, Banxia Rhizoma Pinelliae, Chenpi Pericarpium Citri Reticulatae, Fuling Poria, Bixie Rhizoma Dioscoreae Hypoglaucae.

In case of constipation, the drugs added is Dahuang Radix et Rhizoma Rhei.

3. Type of Blood-Stasis

Symptoms: Persistent stabbing pain aggravated by moving in the loins and lower limbs, difficulty in moving, dark red tongue with petechiae and thin white coating, and deep uneven pulse.

Therapeutic Method: Promoting the circulation of blood to remove blood stasis, clearing the collaterals to arrest pain.

Prescription: Modified Shenteng Zhuyu Tang (decoction for Relieveing Pantalgia due to Blood Stasis).

Ingredients:

Taoren Semen Persicae

Honghua Flos Carthami

Danggui Radix Angelicae Sinensis

Gancao Radix Glycyrrhizae

Wulingzhi Faeces Trogopterori

Xiangfu Rhizoma Cyperi

Dilong Lumbricus

Qinjiao Radix Gentianae Macrophyllae

Duhuo Radix Angelicae Pubescentis

Ruxiang Olibanum

Huainiuxi Radix Achyranthis Bidentatae

Administration: Decocted in water for oral use, 1 dose daily.

Modification: In case of more evident deficiency of Qi marked by listlessness, acratia, the drugs added are Huangqi Radix Astragali, Dangshen Radix Codonopsis, Guizhi Ramulus Cinnamomi.

4. Type of Deficiency of the Liver and Kidneys

Symptoms: Spasm, pain, weakness, cold and limited movement in the loins and lower limbs all of which are aggravated by moving, reddened tongue with thin white coating, and thready pulse.

Therapeutic Method: Supplementing qi and blood, invigoration the liver and kidneys, clearing the channels and collaterals, and expelling wind-dampness.

Prescription: Sanbi Tang (Decoction for Treating Three Kinds for Arthralgia).

Ingredients:

Duhuo Radix Angelicae Pubescentis

Niuxi Radix Achyranthis Bidentatae

Qinjiao Radix Gentianae Macrophyllae

Fangfeng Radix Saposhinkoviae

Xixin Herba Asari

Danggui Radix Angelicae Sinensis

Baishao Radix paeoniae Alba

Chuanxiong Rhizoma Chuanxiong

Shudihuang Radix Rehmanniae preparata

Duzhong Cortex Eucommiae

Dangshen Radix Codonopsis

Huangqi Radix Astragali

Fuling Poria

Chuanduan radix Dipsaci

Rougui Corte Cinnamomi

Gancao Radix Glycyrrhizae

Administration: Decocted in water for oral use, 1 dose daily.

Modification: If there is accompanying heat-syndrome marked by pain aggravated by heat in the loins and lower limbs, the herbs omitted are Xixin Herba Asari Rougui Cortex Cinnamomi, Shudihuang Radix Rehmanniae Preparata, the herbs added are Rendongteng Caulis Lonicerae, Sangzhi Ramulus Mori, Shengdi Radix Rehmanniae.

In case of heaviness and soreness in the loins and lower limbs, the herbs omitted are Shudihuang Radix Rehmanniae, Danggui Radix Angelicae Sinensis, the herbs added are Yiyiren Semen Coicis, Tianma Rhizoma Gastrodiae, Mugua Fructus Chaenomelis, Sangjisheng Herba Taxilli and Gouji Rhizoma Cibotii.

Proven Prescription

Ingredients: (with same amount)

Qishe Agkistrodon

Quanxie Scorpio

Wugong Scolopendra

Administration: The Above is ground into fine powder. The powder is taken with warn boiled water, each time and 1-3times each day. 10 days is 1 course of treatment.

Prevention

Take an active part in physical training, pay attention to labor protection when dong heavy physical labor, avoid long living in the wet and cold place without sunshine, and examine and treat trauma and pain in the loins as early as possible.