Unilateral pain is pain at one side of the body.docx
Transcript of Unilateral pain is pain at one side of the body.docx
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Unilateral pain is pain at one side of the body,
including that in the joints, tendons and muscles;
it may
be accompanied by numbness, tingling,
diminished sensitivity, restlessness, insomnia,
sweating, fatigue or
even hemiplegia.
According to TCM, unilateral pain can be caused
by disorder of the Internal organs or by
disturbance
of the channels. Many factors may lead to painat one side of the body, including invasion of the
channels
by External Wind, blockage of Wind and Phlegm,
stagnation of Liver-Qi, deficiency of Qi and
stagnation of
Blood, and deficiency of Yin of the Liver and
Kidney.
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Unilateral pain may be attributed to any of the
following disorders in Western medicine: the
common
cold, influenza, poliomyelitis, polymyalgia,
rheumatism, depression, chronic fatigue
syndrome, cerebral
infarction and cerebral haemorrhage.
Aetiology and pathology
Invasion of External factors
External Wind is one of the most common
causative factors in unilateral pain. Wind exists asa pathogenic
factor that may quickly invade the body in any
season. When it invades the body, it combines
itself with
other pathogenic factors, such as Cold, Damp or
Heat, and induces disharmony between the
Defensive and
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Nutritive Qi systems. The result of this is that the
Defensive Qi cannot distribute the Body Fluids
evenly, so
the Body Fluids are unable to remain completely
within the channels. Therefore the Qi and Blood
cannot circulate
freely to nourish the body and unilateral pain
follows. Moreover, an invasion of External Wind
may
cause stagnation of Qi and Blood in the
channels, muscles and Tendons, which could at alater stage cause
stagnation of Blood, resulting in unilateral pain.
Improper diet
Eating too much sweet or greasy food may
damage the Spleen and Stomach, easily leading
to the formation
of Internal Damp-Phlegm. Phlegm is a substantial
Yin pathogenic factor, which may circulate
together with
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Qi, thus reaching everywhere in the body. Damp-
Phlegm can also block Qi circulation and cause
stagnation
of Qi in the channels, tendons and muscles.
Emotional disorders
The Liver regulates the Qi circulation and stores
the Blood. The emotions are closely related with
the function
of the Liver, and negative emotions, such as
anger, stress and frustration, may cause
stagnation of theLiver-Qi, which may in turn cause dysfunction of
the circulation of Blood. When the Tendons and
muscles
are not nourished properly, unilateral pain
occurs.
Prolonged sickness, weak constitution and
overstrain
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Multiple birth, chronic diseases and physical
overexertion consume the Qi and may cause Qi
and Blood deficiency.
When the Tendons and muscles are not
nourished properly by Qi and Blood, unilateral
pain occurs.
Unilateral pain
unilateral pain 61
Moreover, Qi is the power that promotes the
free flow
of Blood in the body, and if it is insufficient, theBlood
circulation will slow, and later on eventually
stagnate,
and so unilateral pain occurs.
Weak constitution, old age and sexual over
activity
may cause consumption of the Kidney-Yin. As
the
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Liver and Kidney share the same source,
deficiency of
Kidney-Yin may cause deficiency of Liver-Yin. As
a
result, there is insufficient Yin and Blood in the
channels
to nourish the tendons and muscles, and so pain
occurs. Many chronic cases with unilateral pain
are
due to deficiency of the Yin of the Liver and
Kidney.Treatment based on
differentiation
Before a differentiation is made, it is important
to make
a general examination of the patient. Special
attention
should be paid to the following characteristics of
the
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unilateral pain: the quality, the accompanying
symptoms
and the factors that cause the pain to start, to
increase or to decrease.
Differentiation
Differentiation of the quality of the pain
Acute pain with an aversion to cold is usually
due
to an invasion of External Wind
Stagnation of Liver-Qi usually causes chronic
painwith distension and migration
Stabbing pain with fixed locations and palpable
nodulation or masses is usually due to
stagnation
of Blood
Pain with numbness and a heavy sensation is
usually caused by Wind-Phlegm
A slight pain, which is up and down, and
closely
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related with tiredness, aggravation of the pain by
exertion and tiredness is usually due to
deficiency
of Qi and Blood
A mild pain with a burning sensation is usually
due to deficiency of Yin.
Differentiation of occurrence, aggravation and
relief of unilateral pain
An acute pain that starts or is aggravated when
the
patient feels cold or after sweating is usually dueto an invasion of External Win
A pain that occurs duringthe menstruation
period is
usually caused by stagnation or deficiency of
Blood
If a chronic pain starts or is aggravated when
the patient feels warm or is in a hot
environment,
deficiency of Yin is usually the caus
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If the pain starts or gets worse under stressful
or
other emotional conditions, it is usually due to
stagnation of Liver-Qi
If a pain that starts after trauma, operations,
strokes or other diseases is usually caused by
stagnation of Qi and Blood
If the pain occurs or gets worse at night,it is
usually due to stagnation of Blood or to
deficiency
of Yin.Differentiation of accompanying symptoms
A pain accompanied by fever, an aversion to
cold
and pain in the limbs is usually due to an
invasion
of External Wind
Pain with irritability or bad mood is usually due
to
stagnation of Liver-Qi
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Pain accompanied by numbness and a heavy
feeling is usually caused by Wind-Phlegm
When the pain is combined with fatigue,
palpitation, dizziness, and pale lips, it is usually
due to deficiency of Qi and Blood
Deficiency of Yin usually causes pain with a hot
sensation and dizziness
Pain with a sharp or stabbing sensation is
usually
due to stagnation of Blood.
TreatmentInvasion of Wind-Cold
Symptoms and signs
Signs and symptoms of Wind-Cold are a
unilateral
pain in the trunk, a unilateral joint pain in the
extremities,
back pain, fever, an aversion to cold, sweating or
lack of sweating, headache, a stiff neck, a lack of
thirst,
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clear urine, a pale tongue with a white coating
and a
floating and wiry pulse.
Principle of treatment
Dispel the External Wind, regulate Defensive and
Nutritive Qi, harmonise the Collaterals and
relieve the
pain.
HERBAL TREATMENT
PRESCRIPTION
Main formulaGUI ZHI TANG
Cinnamon Twig Decoction. This formula is
specially
indicated in slight invasion of Wind-Cold, causing
disharmony
between the Nutrient Qi and Defensive Qi.
Although Gui Zhi Ramulus Cinnamomi could
harmonise
the Collaterals and promote the Blood circulation
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62 generalised body pain
in the channels, it is still not enough to use this
formula
along. Some other herbs should be applied
simultaneously, such as Qiang Huo Rhizoma seu
Radix
Notopterygii 10g, Si Gua Luo Fasciculus
Vascularis Luffae
10g, Chuan Xiong Radix Ligustici Wallichii 10g,
Xi Xian
Cao Herba Siegesbeckiae 10g and Xi Xin HerbaAsari 5g
to increase the effect of promoting sweating,
harmonising
the collaterals and relieve the pain.
Alternative formula
JING FANG BAI DU SAN
Schizonepeta and Ledebouriella Powder to
Overcome
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Pathogenic Toxin. This formula can dispel Wind,
eliminate
the Cold and relieve the External symptoms. Gui
Zhi Ramulus Cinnamomi Cassiae 10g, Bai Zhi
Radix
Angelicae Dahuricae 10g and Qiang Huo
Rhizoma seu
Radix Notopterygii 10g, etc, should be added to
relieve
the pain.
Modifications1. If there is headache, add Gao Ben Rhizoma et
Radix
Ligustici 10g to dispel the Wind and relieve the
headache
2. If there is a stiff neck, add Ge Gen Radix
Puerariae
15g to relax the Tendons, regulate the circulation
of
Qi and relieve the neck pain
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3. If there is a severe pain with a cold sensation,
add
Gan Jiang Rhizoma Zingiberis Officinalis 5g to
warm
the channels and relieve the pain
4. If there is joint pain, add Du Huo Radix
Angelicae
Pubescentis 10g and Chuan Shan Long Rhizoma
Dioscoreae Nipponicae 20g to eliminate the
External
Wind and relieve the pain5. If there are stiff limbs, add Sang Zhi Ramulus
Mori
Albae 10g to harmonise the collaterals, regulate
the
channels and relieve the limb stiffness
6. If there is abdominal pain with cold sensation,
add
Yan Hu Suo Rhizoma Corydalis 10g and Gao
Liang
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Jiang Rhizoma Alpiniae Officinari 5g to warm the
Interior, dispel the Cold and relieve the pain.
Patent remedy
Jing Fang Bai Du Pian Schizonepeta and
Ledebouriella
Tablet to Overcome Pathogenic Influences.
ACUPUNCTURE TREATMENT
MAIN POINTS
LI-4 Hegu, TE-5 Waiguan, GB-34 Yanglingquan,
ST-36
Zusanli, BL-58 Feiyang, BL-60 Kunlun and BL-63Jinmen. Reducing method is used on these
points.
Moxibustion should be applied on these points.
Explanations
LI-4, the Source point of the Large Intestine
channel, regulates the Qi and promotes
sweating.
TE-5, the Connecting point of the Triple Burner
channel, regulates the Qi circulation and relieves
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the pain. These two points in combination relieve
pain in the arm
GB-34, the Sea point of the Gallbladder
channel,
relieves pain along the channel. It is also the
Gathering point of the Tendons, regulating the
circulation of Qi in the Tendons and relieves the
pain and spasm in the limbs
ST-36, the Sea point of the Stomach channel,
regulates the circulation of Qi and relieves
the pain. BL-60, the River point, regulates thecirculation of Qi in the Bladder channel, dispels
the
External Wind and relieves the pain
BL-58, the Connecting point of the Bladder
channel, and BL-63, the Accumulation point,
promote the circulation of Qi in the channel and
relieve the pain.
Moxibustion promotes the Qi and Blood
circulation
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and relieves the pain.
Alternative points
LI-3 Sanjian, TE-6 Zhigou, BL-10 Tianzhu, BL-58
Feiyang,
BL-63 Jinmen, BL-64 Jinggu and GB-41 Zulinqi,
etc.
Modifications
1. If there is fever, add GV-14 and LI-11 to
promote
sweating and lower the fever
2. If there is a stiff neck, add GB-20 and BL-10 topromote the circulation of Qi and relieve the
pain
3. If the joints are painful and swollen, add Ah
Shi
points and SP-9 to eliminate the Damp and
relieve
the swelling
4. If there is headache, add GV-20 and LU-7 to
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promote the Qi circulation and relieve the
headache
5. If there is back pain, add GB-21 and BL-23 to
regulate the Qi circulation and relieve the pain.
Invasion of Wind and Damp
Symptoms and signs
Acute occurrence of unilateral pain with a heavy
sensation,
awkward or even paralysed limbs on the same
side of the body, soreness or numbness of the
muscles,dizziness with a heavy feeling, nausea, painful
and
swollen joints, a poor appetite, fullness of the
stomach,
loose and sticky faeces, a tongue with a white
and
greasy coating and a wiry and slippery pulse are
the
signs and symptoms of this condition.
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unilateral pain 63
Principle of treatment
Dispel the Wind, eliminate the Damp and relieve
the
pain.
HERBAL TREATMENT
PRESCRIPTION
Main formula
QIANG HUO SHENG SHI TANG
Notopterygium Dispelling Dampness Decoction.
This formulascould be used to treat the pain due invasion
of Wind-Damp, especially Wind, Cold and Damp.
Typically this formula was originally designed for
headache, but its effect to treat the entire body
pain is
also obvious. Xi Xin Herba Asari 5g could be
added into
this formula to strengthen the effect of pain
relieving.
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Alternative formulas
JUAN BI TANG
Remove Painful Obstruction Decoction. This
formula
is good for dispelling External Wind, eliminating
Damp-Phlegm, promoting the Qi and Blood
circulation
and relieving the pain. Si Gua Luo Fasciculus
Vascularis Luffae 10g, Chuan Xiong Radix
Ligustici
Wallichii 10g, Xi Xian Cao Herba Siegesbeckiae10g and
Xi Xin Herba Asari 5g should be added to
increase
the effect of promoting sweating, harmonising
the
collaterals and relieve the pain.
JING FANG BAI DU SAN
Schizonepeta and Ledebouriella Powder to
Overcome
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Pathogenic Toxin. This formula has good
properties
which dispel the External Wind, eliminate the
Cold,
remove the Damp and relieve the pain. As with
the
above formula, it doesnt have a strong effect on
harmonising
the collaterals and promoting the channels,
therefore some other herbs could be added,
such as SiGua Luo Fasciculus Vascularis Luffae 10g, Xi Xian
Cao
Herba Siegesbeckiae 10g and Xi Xin Herba Asari
5g.