Osteo-arthritis is probably the most common condition we treat. In order to explain the development of arthritis it is necessary to first explain, from an energetic perspective, how the joints are maintained in a healthy person. After which I can discuss the development of arthritis as a disease process, and lastly, how the condition can be stopped using acupuncture. As I have mentioned on other pages on this site it is not possible to go into detail about the different developmental stages of disease, here I present an overview to put you in the picture.
Normal maintainance of healthy joints.
Synovial fluid is a viscous fluid found in the cavities of joints. With its yolk-like consistency (“synovial” partially derives from ovum, or egg), the principal role of synovial fluid is to reduce friction between the cartilage of joints during movement. In Chinese medicine synovial fluid is referred to as a body fluid (jin ye). The human body produces many different types of fluids, hormones, saliva, blood, neurotransmitters, enzymes, mucus, spinal fluid etcetera, the production of all these fluids are created by the energy of the kidneys, specifically kidney yin and is created from a surplus of the kidney qi.
The creation of synovial fluid.
The energy which is utilised by the body to create body fluids such as Synovial fluid is from ingested food. Primarily the stomach, but also the small and large intestines, transform the food into energy. The energy then filters into the system of the kidneys where a portion of it is transformed into body fluids, and the rest of it is distributed into the meridians for normal maintenance of bodily processes.
Blood can be seen as the most important mechanism by which the body transports nutrients to its various tissues, remove waste and supply immunity. It is created in the bone which is another aspect of the qi of the kidneys, blood is also an aspect of kidney yin, a body fluid. The stomach has an important function in the role of blood creation as it secretes a substance called intrinsic factor which is required by the body to absorb vitamin b12, which is itself required by the body to produce blood.
The liver creates defensive energy which is called ‘wei qi,’ this is also derived from ingested food. Its job is to neutralize any unwanted energy in the system, the defensive energy is a lecture in its own right, in a western sense it refers to the immune system, however this is only a part of the defensive energy from an energetic perspective.
If these 4 aspects are functioning optimally the joints of the body will be in prime health. If one or more function inadequately then the quality of the joints will suffer and osteo-arthritis may occur.
The pathogenesis of osteo-arthritis.
Weakness in the production of body fluids.
Weakness in the production of synovial fluid in the joint is the cause of arthritis. As stated above, the fluid is an aspect of kidney yin which is created by the kidney qi that is itself created from the food we eat. The organs of digestion, the stomach, small intestine and the large intestine are not transforming enough energy from the diet to keep the joints supplied with fluid. Therefore acupuncture points that build the gastro-intestinal tract are commonly used in arthritis, these are largely situated in the upper body and not around the affected joint as people tend to assume. Weakness in the organs of digestion is caused in the most part by what has been termed ‘a western diet’, the stomach has to work harder to transform food into qi and eventually it gets tired, this is why osteo-arthritis manifests as we get older. The production of blood can also be affected, a deficiency in the production of intrinsic factor affects the absorption of vitamin b12 which is needed to create blood. It is for this reason that osteo-arthritis and anaemia are commonly diagnosed together.
Stagnation of qi locally.
If the quantity of qi is diminished there is a possibility it will stagnate (this happens in the divergent part of the meridian system that is supplying the joints with qi). The stagnated qi has a quality similar in nature to compost, in chinese medicine its actually called composting qi. As we all know compost gives off heat, and this heat is the inflammatory process known as arthritis (this type of arthritis gets worse in damp weather and is the most common type in the UK). It will manifest first in the part of the meridian system that is weakest. It is the heat that causes the deformation of the joint cartilage.
Weakness of the defensive qi.
A weakness in the amount of energy the body derives from food leads to a deficiency in the production of defensive energy (wei qi). The ability of the body to clean out the negative energy in the joints is compromised. If this occurs then impure qi with a cold quality begins to sink into the joint/s. This coldness can exist there for years with no symptoms, eventually the body will create reactive heat in an attempt to ‘burn off’ the coldness, the heat is the inflammatory process (this type of arthritis gets worse in cold weather). It will manifest first in the part of the meridian system that is weakest. It is the heat that causes the deformation of the joint cartilage.
Acupuncture treatment protocol for Osteo arthritis.
- Calm down the pathological heat/inflammation.
- Stimulate the production of fluids through the stomach(and Small intestine/large intestine).
- rebuild the Qi of the affected system.
- sedate any coldness from the affected organ system.
1) Calm the pathological heat.
It is important to do this first as the inflammation is destructive, heat is calmed in one of two ways:
- Composting heat is cooled down by bringing fresh qi into the meridian, this has the effect of airing and drying out the qi and allowing it to start moving again.
- by bringing fresh Qi with a cold quality into the affected meridian, or it can be directly sedated from the system.
2) Stimulate the production synovial of fluids.
As stated above the synovial fluid is created by a surplus of kidney qi, the extra qi is derived from the diet. The qi of the organs of digestion have to be stimulated and rebuilt with acupuncture. As stated earlier the small and/or large intestine can also be involved but it is usually the qi of the stomach which is weak. It is common for patients with osteoarthritis to have damage/weakness in the stomach from taking painkillers and nonsteroidal anti inflammatory drugs like paracetamol and ibuprofen, this exacerbates osteo arthritis so I recommend not to take them.
3) Rebuild the Qi of the affected organ.
Pathology will occur where the body is weakest. Arthritis in the knee relates to the stomach meridian, in the fingers it is the small intestine meridian, in the neck it is the gall bladder meridian, in the hip it is the spleen or gall bladder meridian, in the shoulder in is the colon meridian, and so on. We rebuild the Qi of the affected organ. This is an easy thing to do with Acupuncture.
4) Sedate the coldness from the system
After the heat is calmed down, and the weakened parts have been rebuilt, we are then ready to remove the coldness which causes the body to start an inflammatory process in the first place. Using pulse diagnosis, the location of the coldness within the meridian system must be ascertained Then the correct points must be chosen that will be able to sedate the coldness from the body. If this can be accomplished the disease is resolved.