Traditional Chinese Medicine for Stiff and Aching JointsKate Kent, R.TCMP, R.Ac. February 6, 2014
With the baby boom generation heading into its late 60s, many people are starting to suffer from stiff and aching joints. Big business certainly knows about us. All you have to do is look at the shelves of a pharmacy to see the myriad pain relief medications available. Why has this happened to us, and how best can we help ourselves? A lifetime of exposure to the elements, along with excessive exercise and a weaker immune system than when we were young can all contribute to pain as we age. Looking at myths and realities, my answers come from Traditional Chinese Medicine (TCM).
I remember as a child in England being told not to sit on the damp grass because I would get arthritis, or on the radiators in the classroom at school because I would get piles. I think the radiator threat was a bit steep because they were the only source of heat on bitterly cold days! It can be so cold and damp in England and I remember we were prone to chilblains – a medical condition that is often confused with frostbite.
As it turns out, those childhood instructions were spot on. TCM theory holds that the elements like wind, cold, damp, and heat can easily invade the body and disrupt the flow of qi (energy). This invasion by environmental elements can cause stiffness and pain in the joints (painful obstruction syndrome, also known as Bi syndrome, meaning blockage). Any joint can be affected, especially those in the hands, arms, shoulders, feet, knees, and lower back.
Wind and the Flow of Qi
In a healthy person the qi moves freely through the body, like a car travelling along a highway. However, at an accident site on the highway, the flow of traffic slows and stops, resulting in a traffic jam. Likewise, a network of channels carry qi through the body but if a pathogen like damp or cold gets into a channel it blocks the flow of qi, especially as it maneuvers around a joint, causing swelling and pain. These pathogenic factors can invade the body from outside via the mouth, nose or body surface, causing disease.
According to TCM theory, environmental wind can easily invade the body from the outside. For example, if you take a walk on a cold, windy day without properly covering your neck, you will most likely get a headache or earache from the wind. A ‘statement of fact’ in TCM teachings states: “Wind is the chief of the one hundred diseases”. Wind is often the vehicle that carries climatic factors into the body, and wind causes havoc, literally moving the pain from joint to joint.
The characteristics of wind invading the body are sudden onset of symptoms, movement from place to place and, in some cases, paralysis. If there is accompanying dampness, the joints will be swollen and feel heavy with a dull ache. If there is dampness and heat, the joints will swell and feel heavy and hot. Invasion of cold is perhaps the most painful because cold contracts and the pain can be quite excruciating. These exterior pathogens can enter the body after swimming, working in a damp environment, wearing damp clothes, sitting on the damp ground, or walking in cold wind without appropriate protection.
Bell’s Palsy, according to TCM theory, is exterior wind-cold attacking the channels of the face which disrupts the flow of qi and blood in the channel. The symptoms can be pain, paralysis, numbness and difficulty in closing the eyes, as well as difficulty eating or smiling. The onset is sudden (one of the characteristics of wind) and is often mistaken for a stroke. When I studied in China, I saw a lot of these cases in the hospital – patients would come in after riding their bikes to work in the bitter wind and cold, a common form of transport. As well, bus and cab drivers who drive with their window open are prone to Bell’s Palsy because the wind attacks the face.
A person with a strong constitution is less likely to suffer from joint discomfort, whereas someone with a weak immune system may not have strong enough qi to protect the body from external pathogens. According to TCM there are various kinds of qi, one being defensive qi. The job of this qi is to control the opening and closing of the pores, and defend the body against external factors. People with weak defensive qi need to take extra care to eat well, wrap up on cold days, and get plenty of rest.
The Role of Diet
Painful joints may also develop from internal causes. One of the most important things we can do to help ourselves is to ensure we have a healthy diet. Chinese medicine suggests that each person’s diet should vary according to their specific needs. The general idea is that anyone with weak digestion, gas, bloating, constipation or diarrhea and a feeling of coldness should avoid raw vegetables, salads, cold drinks and too much fruit. Raw foods certainly have more enzymes, but a weak digestive system is unlikely to absorb these enzymes.
The concept of the spleen in Chinese medicine is that it absorbs nutrients like a sponge and sends these nutrients around the body. The spleen and stomach work synergistically, with the spleen energy moving up and the stomach energy moving down like passing elevators. If one gets stuck, the other gets stuck. If the spleen is weakened by poor diet, it loses its ability to absorb nutrients and instead becomes waterlogged and soggy, creating ‘dampness’ (mucus). This in turn obstructs the stomach energy from moving down and it goes up instead, causing hiccuping, burping, and a ‘stuck’ feeling.
If a person already has excess yang in the body (yang energy is hot as opposed to yin energy that is cold), this ‘dampness’ will quickly turn hot and become ‘damp-heat’. Damp-heat is similar to a bog with the hot sun beating down on it; it begins to steam.
Gout and Arthritis
One of the most painful diseases caused by wind, damp, and heat is gout. This can be directly attributed to improper diet as well as external influences. Gout causes sudden and severe pain and tenderness in the affected joint, most often the big toe. In Chinese medicine it is described as ‘tong feng’ or ‘painful wind’. Rheumatoid Arthritis, usually manifesting as inflammation of several joints, can be a severe impediment of the flow to the joints that causes them to swell and bones to become deformed.
The practitioner needs to determine whether the patient has an organ or channel syndrome. For example, pain in the face, shoulder, wrist, or knee is more likely to be a channel problem and then it’s a matter of locating the right channel to treat. Pain in the low back and knees could indicate a kidney problem and so the kidney needs to be treated. TCM diagnostic procedures utilize the tongue and pulse, as I’ve written before, to open up the book of the body to the practitioner. These pulses will reveal what kind of syndrome the patient has and where the problem lies.
Treating the Root and the Branch
The main thrust of any treatment is to dispel what is causing the problem and to get the qi moving. For example – if there is ‘dampness’, the spleen needs to be treated; if there is ‘exterior wind’, it needs to be expelled; and if there is ‘cold’, the body needs to be warmed to dispel the cold. Needles manipulated in acupuncture points along the channel help to direct the qi in the direction it needs to go – like a traffic cop directing traffic! Wind is a cause of so many diseases that there are perhaps more wind points than just about any other kind.
The practitioner may also use:
- cupping (glass cups are heated and applied to the body – very good for warming and expelling wind), or
- moxibustion, made from mugwort leaves (Artemisia Vulgaris), which treats and prevents disease by applying its heat to points or certain locations on the body and, of course,
- herbs. We have literally hundreds of herb combinations that can be combined to treat the root as well as the branch of the disease.
For home use, if you are feeling very cold: slice up some fresh ginger root, boil it for a few minutes and drink the mixture throughout the day. Eat warm or even hot spicy food, if your stomach can handle it, and drink warm drinks. And first thing in the morning, drink hot water with a few drops of fresh lemon juice and a couple of shakes of turmeric, which is good for inflammation.
TCM Guidelines for Diet – ‘Resolving Damp’ Foods
The following foods and herbs help to remove mucus (‘dampness’) from the body:
Fruits – should be eaten sparingly and not first thing in the morning
Vegetables – celery, pumpkin, scallion, alfalfa, leafy greens, turnip, kohlrabi, asparagus, mushrooms, bok choy, broccoli, cauliflower, cabbage, snow peas, turnip. (in smaller quantities: millet, rye, oats, barley, quinoa, corn, basmati/wild rice)
Meat – chicken
Fish/Seafood – various fish (not fatty)
Dairy – small quantities of goat’s milk/cheese, rice milk, egg whites
Seeds/Nuts – pumpkin, almonds, walnuts, sunflower seeds
Oils/Condiments – olive, flax seed, raw honey, stevia, almond butter
Culinary and Medicinal Herbs:
Herbs to Resolve Damp-Cold: sage, paprika, turmeric, garlic, pepper, ginger, cinnamon, thyme, cardamom, fennel, cumin, caraway, rosemary, basil
Herbs to Resolve Damp / Heat: nettle, licorice, mint/peppermint, lime/lemon
Herbs to Resolve Damp / Cold / Heat: green tea
Herbs to Resolve Damp / Cold: ginger and jasmine tea
Foods to Resolve Damp / Heat: mint/peppermint tea, lemon balm/lime, pear juice
It is important, whether you have damp-cold or damp-heat, to start the day with a warm, cooked breakfast and avoid raw vegetables and salads as they are hard to digest. This helps to strengthen the spleen to reduce dampness.
It is common for people who suffer with a weak spleen to have quite strong sugar cravings. Of course, if you indulge in sugar you make the spleen weaker. Besides, it’s not the kind of sugar that your spleen is asking for – what it really wants is the natural sweetness in foods. The colour associated with the spleen is yellow, so incorporating yellow vegetables like carrots, squash and sweet potatoes will help with the craving. Carrot ginger soup will be a treat for your stomach.
In the short term, if the craving for sugar is intense, eat a teaspoon of hard honey (you can get more on the spoon than with the runny kind). Sip on a hot drink and slowly suck on the honey like a sweet. You’ll be amazed at how it helps. Also, have protein such as chicken, fish, beans, lentils, or peas with every meal, and do not drink while eating food. If you feel hot and have hot, swollen joints you can still eat warm, cooked foods but stay away from the hot, pungent spices, alcohol, greasy foods and sugar! Try instead food and drinks that strengthen the yin and have a cooling effect – peppermint tea, aduki beans, potatoes, avocados and kidney beans.