Ankle pain (bone spurs - Phlegm)

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Bone spurs are a form of Phlegm.

 

In TCM, various arthritic conditions are called Painful Obstruction

Syndrome(aka Bi Syndrome). These are divided into acute and chronic.

Bone Painful Obstruction Syndrome (which includes though is not

limited to spur formation) " only occurs in chronic cases and develops

from any of the previous four types. " (Giovanni Maciocia, The

Practice of , p. 565.) The 4 types are Wind POS, Damp

POS, Cold POS, and Heat POS. These four types can be acute or chronic.

 

Some basic background info on Phlegm physiology in TCM: Phlegm is

Dampness that has hung around too long and congelled into Phlegm. Two

of the main functions of Spleen Qi is to transport and transform

Fluids within the bodies. So any time Phlegm develops, suspect a weak

Spleen and weak Spleen Qi and rule in or rule out. (List members who

are brand new to TCM, I know this sounds confusing and really mumbo-

jumbo, but bear with the subject, and it will start to make sense as

you learn more and more of the TCM basics.)

 

However, weak Spleen Qi is not the only thing that can contribute to

the formation of Phlegm. " The Kidneys nourish bones and when they are

deficient the bones are deprived of nourishment, and this allows

Phlegm to build up in the joints in the form of swellings " (p. 565.)

Do you remember me commenting on the black spot on your ankle and

mentioning that black discolorations in the skin frequently point to

Kidney imbalance? Now that the doctors have identified bone spurs,

this points even more to Kidney imbalance. Any time the bones are

affected suspect and rule in or rule out Kidney imbalance because in

TCM physiology the Kidneys have a great deal to do with the health of

the bones. (Note to readers new to TCM: The Kidneys are not

equivalent to the anatomical kidneys. TCM Organs are collections of

functions. Many of the functions of the adrenal glands have to do

with the Kidneys in TCM. The health of the ears and hearing have to

do with the Kidneys so suspect and rule in or out Kidney imbalance

any time there are problems with the ears and/or hearing. Back pain -

especially lower back pain - and sore knees also point toward Kidney

imbalance. As do any problems with urination - too much, too little,

too dark, colorless, too frequent, too seldom, etc. All of the

symptoms may not show up, but the longer the person has been

suffering from Kidney imbalance and the more severe the imbalance,

the greater the number of symptoms that will show up and the more

severe they will be.)

 

Maciocia also points out that Liver Deficiency also plays a role in

chronic Painful Obstruction Syndrome including Bone POS. " Liver-Blood

nourishes the sinews and when the Liver is deficient the sinews and

tendons are not nourished, which leads to ache and stiffness of

joints. " (p. 565.) Students, a person can have arthritis pain without

having stiffness. Especially in the acute cases. So if stiffness also

is present, suspect and rule in or out Liver Blood Deficiency.

Especially if the stiffness and pain are worse after the person

rests, particularly after sleeping. (Typically, the stiffness will

lessen as the person moves around some. The full Blood volume is

returning to the sinews and muscles after part of it being stored in

the Liver during rest and sleep. You will run into cases where the

pain and stiffness are noticeable when the person first gets up, are

the least in the morning after the person has moved around some, but

are the worst after the person has overdone physically and has rested

some. In addition to Liver Blood Deficiency, there also probably is

Spleen and/or Kidney Deficiency.)

 

Phlegm is one of those things that takes a long time to treat. This

is not going to disappear overnight. I don't want to discourage you,

just encourage you to stick with treatment. Phlegm can be

eliminated. It just takes time and a lot of effort to do it.

 

Students, it also is critical that the type of Phlegm be identified.

Hot, Cold, Damp, Wind, Dry, due in larger part to Deficiency, due in

larger part to Excess, etc. Because there is a chapter in the TCM

Materia Medica (a type of herbal PDR) on herbs that eliminate Phlegm,

a lot of people tend to get the idea that one simply sticks one of

these into the formula and viola! the Phlegm goes away. It's not

that simple. The type of Phlegm is critical. For example, if it's

Cold Phlegm the main thrust of the treatment must be to expel the

Cold and Warm the person up and treat why the person is too Cold.

Otherwise, the Phlegm eliminating herbs not only are useless, they

can actually aggravate the problem (even when the warm ones are

chosen or combined with other herbs that Warm the Interior. In the

milder cases, treating the Cold and any Spleen Deficiency is going to

get rid of the Phlegm without the Phlegm-relieving herbs.

 

Maciocia also emphasizes that it is important to " distinguish between

a Cold- and a Heat-type " Bone POS. (p. 586.) (Determining Hot or Cold

is always important in TCM. Bone POS is one of those times when this

needs to be emphasized.)

 

A symptom of Qi Stagnation is pain. A symptom of Blood Stasis is

boring, severe pain. A number of things can trigger Blood Stasis:

Heat, Cold, Dampness, etc. Phelgm also can cause/ worsen Blood

Stasis. In an earlier paragraph we looked at Liver-Blood Deficiency

and how one symptom of this imbalance is that stiffness will be worse

after the person sleeps. Because the Blood is Deficient, there's not

enough of it to properly nourish and moisten the sinews and muscles

when part of the Blood volume is stored in the Liver during rest. BUT

is the stiffness is more or less constant - it doesn't improve as the

person moves around - this points to Blood Stasis as the reason the

Blood isn't properly getting to the sinews and muscles to nourish and

moisten them.

 

Note to students on the effects of cortisone injections into the

elbow on the effectiveness of acupuncture: " Results are usually very

good with a few treatments. Occasionally, in long-standing cases,

results are slow to come. This is especailly so if cortisone

injections were administered to the elbow as these tend to slow down

the effects of acupuncture. In these cases, it might be useful to

try and needle the healthy side as well as the affected one. A

particularly effective way of doing this is by needling the

Connecting point of the affected channel on the oppostie side. For

example, if the pain occurs along the Large Intestine channel on the

left side, L.I.-6 Pianli on the right side would be needled.... The

rationale of this treament lies in the fact that in chronic channel

problems, the affected side become empty and the healthy side

relatviely full. " (p. 596.)

 

The Connecting Points (Luo Points) are (among other things) where

there are channels that connect a specific meridian on one side of

the body to the other side. All the 12 basic meridians are

bilateral. This means that there is a branch on the left side and on

the right side. Their Connecting Points are where there is a

Connecting Channel that connects the meridian on the right to the one

on the left and vice versa. For example, Large Intestine 6 is the

Connecting Point for the Large Intestine meridian/ channel. There's a

Connecting Channel that runs between LI-6 on the right and LI-6 on

the left.

 

One of the uses of Connecting Points is when there is " unequal " Qi

(the best way I could put it) in the two sides. As Maciocia points

out, when there's a longstanding channel problem, what eventually

happens is that the meridian on one side of the body become " Full "

(aka in Excess, aka Replete) while the meridian on the other side

become " Empty " (aka Deficient, aka Vacuity). The Connecting point on

one side can be used to influence the other side.

 

The Connecting Channels also connect meridians of the same Element.

For example, the Large Intestine is Yang Metal, and the Lungs are Yin

Metal. (For now, just think of " Element " as a classification scheme.

You can use LI-6 to influence the Lung meridian, and you can use the

Connecting Point of the Lung, Lu-9 to influence the Large Intestine.

There is a special relationship between meridians and Organ of the

same Element. For example, one way to get rid of Heat in the Lungs is

to purge the bowels.

 

Connecting Points aren't always used as Connecting Points. They're

also used for their unique properties. " For example, Fenglong ST-40

is very much used to resolve Phlegm, irrespective of it being the

Connecting point of the Stomach channel. " (Giovanni Maciocia, The

Foundations of , pp. 348-349. It's in the

Chapter " The Functions of Specific Points " for readers who have a

later edition of Foundations than I have.) (In the earlier edition,

Connecting Points are covered on pages 347 to 349.)