Suggestions on treatment of a client

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Hello to everyone,

It is probably my first time posting on this group, but have been

reading postings contributed by other members since joining a fair

while ago.

I trained as an acupuncturist in England learning the JR Worsley

slant on 5 element acupuncture along with 8 Principles.

I have a client who has been having acupuncture from me for several

years on and off.

The main complaint for seeing me is with regards to joint problems.

My client was diagnosed with rheumatoid arthritis at the age of 24

years and prior to that had no joint complaints what so ever.

Anyhow, my client made the decision that he didn't wish to take the

medication d to him by his doctor and opted to deal with his

health complaint via alternative medicine, hence seeing me.

My main treatment approach has been to support his constitutional

element which I believe is Wood and from that have diagnosed him as

prodominantly having Liver Blood Deficiency and Kidney Yin Deficiency.

Reading between the lines there is also to some extent, Liver Qi

Stagnation, Kidney Yang Deficiency, Phelgm/Damp/Cold and Stagnation

in the channels (among others).

It has been 12 years since the onset of the symptoms and up until

about 6 months ago had helped him contain his joint pain and symptoms

to his left wrist, 3rd Metatarsal-Flangeal Joint of left foot, 1st

flangeal joints of the left small finger(4th), right middle(3rd) and

right small(4th).

Of recent times his left ring, index and finger have become affected

by pain and swelling as well in his right wrist.

The signs/symptoms of the joint complaint are that they are swollen,

cold & stiff, have restricted movement, better with heat and exercise

and the pain is dull and intermittant depending on exercise and the

climatic conditions i.e summer better.

His pulse is generally wiry, sometimes choppy, floating/empty/thin

but not necessarily fast. The pulse is usually been alot stronger on

the left pulses than the right. Tongue is pale, swollen, quivering,

wet, irregular centreline crack(not to the tip), white coat mainly in

the centre.

As far as other signs and symptoms go prefers heat/dislike cold,

occasional night sweats, sometimes irritable but generally happy,

sleeps well, eats well with no probs, bowels and urination sound

fine, regular/firm, urine pale yellow with no urgency/frequency etc.

I have used moxa in combination to needle tonification. I have also

used needle reduction on points. Sometimes I have reduced points to

clear PF and stagnation, other times have tonified points to clear PF

and stagnation.

I have focused mainly on Liver, Kidney and sometimes Spleen/Stomach

points i.e source, connecting, 5 transporting points etc as well as

local channel points to move the qi in the channels i.e SI, He, Per,

Lu, LI.

This hasn't been all that I have tried but is a general approach used.

Can anyone offer addition advice on what to try next as I feel that I

may be missing something.

All help/advice/guidance greatly appreciated.

 

Thanks

Dean.