What Is Osteoarthritis (OA)?
Osteoarthritis, sometimes known as the “wear-and-tear” arthritis, is a type of degenerative joint disease, where the cartilage at the ends of the bones gradually breaks down and wears out.
Cartilage is a protective tissue that provides cushion between the bones of joints. As the cartilage is damaged and lost, the bones under the cartilage rub against each other during movements involving the joints. As the condition develops, the damaged bones thicken and may start to grow outward to form bony projections known as osteophytes (bone spurs). Inflammation of the soft tissues surrounding the joints, including the inner lining of the joint capsule, can occur.
Who Is Likely To Develop Osteoarthritis?
Elderly: Very common
Middle age: Many people, although symptoms may not be apparent.
Young people: With previous injury in the affected joint
Women: More common than men, with more severe symptoms.
Picture taken from www.aihw.gov.au
Osteoarthritis occurs more commonly in weight-bearing joints, such as the hips, knees and spine, and overused joints, such as fingers.
Main Symptoms Of Osteoarthritis
The main symptoms of osteoarthritis are pain and stiffness of the affected joint. Pain and tenderness of the joint are aggravated by movement, while stiffness usually occurs after short period of inactivity. Over time, the condition may worsen, and pain is felt even when resting. The affected joint may become swollen and the range of joint movement may be reduced. Upon moving the affected joint, the condition can cause a crackling sound of bones rubbing against bone, and a crunching feeling may be felt.
TCM Treatment For Osteoarthritis
In Traditional Chinese Medicine (TCM), treatment and management of osteoarthritis are based on topographical classification according to Meridian Theory, eliminating of pathogenic factors with reference to Bi-Syndrome, and restoring of balance of body according to the Internal Organ Theory.
In MacPherson TCM & Wellness Clinic, our physicians will engage in the use of acupuncture, therapeutic Tuina, Chinese Medicine and other treatment modalities, such as moxibustion to treat osteoarthritis. The aim is to relieve pain and stiffness, and maintain or improve the range of motion of the affected joint, allowing people with osteoarthritis to stay active. Exercise will be taught to help to maintain the muscle functions of the surrounding joints, and delay the progression of the condition. Our physician also conducts Qigong classes, such as Shaolin Soft Fist which provides tremendous benefits for people with osteoarthritis. For those who are overweight, weight management programme may be incorporated to help them lose weight, so as to reduce the extra stress placed on the joints.
Topographical Classification According To Meridian Theory
According to the TCM Meridian Theory, Qi (vital energy) and Blood flow along pathways that connect the whole body to nourish the body and support various functional activities of the body.
Symptoms of osteoarthritis are often due to localized stagnation of Qi and Blood. Local acupuncture points will be chosen to remove local stagnation. For example, ST-35 (犊鼻), which is just below the kneecap, is a local point commonly used to treat knee osteoarthritis. In addition to stimulating the local points, distal points on the stagnated Meridian are often chosen to promote the Qi and Blood flow along the entire Meridian. This further enhances the effects of the localized treatment. There are also specific points such as SI-3 (后溪) and EX-HN-15 (颈百劳) that are used to treat cervical (neck) and lumbar (lower back) osteoarthritis.
Pressing on acupoints around the affected joint, rolling and kneading along the affected meridian, are some of the techniques employed in Tuina to help relax the soft tissues around the pain area, reduce inflammation and improve the range of motion of the affected joint.
Chinese Medicine, such as Ligusticum wallichii (川芎), Frankincense (乳香), Salvia miltiorrhiza (丹参), Panax notoginseng (三七) and turmeric (姜黄) are often used to remove local stagnation of Qi and Blood.
Eliminating Of Pathogenic Factors With Reference To Bi-Syndrome
Pathogenic factors is another important concept in TCM. Classification of osteoarthritis based on pathogenic factors such as Wind, Cold, Heat and Dampness can be made with reference to the pain characteristics. However, it is important to understand that TCM does not differentiate between actual disease pathogen and the metaphorical description. For example, osteoarthritis caused by Heat pathogen, does not mean that the affected joint is damaged or injured by external heat. Instead, it means that the condition exhibits symptoms that appear to be damaged or injured by heat, such as redness, warm and burning in the affected area.
Specific acupoints are selected to eliminate the different pathogens. For example, GV-14 (大椎) and LI-11 (曲池) are often added to expel heat pathogen, enhancing the effect of reducing joint inflammation and swelling. Chinese Medicines, such as Ramulus mori (桑枝), Fraxinus bungeana (秦艽), Caulis lonicerae (忍冬藤), clear away heat and dredge the Meridian of the affected area.
Other treatment modalities may also be used to expel the pathogens. For example, to eliminate cold pathogen, moxibustion may be used. Moxibustion is a form of TCM treatment, which involves burning of a Chinese herb called “mugwort” to provide thermal and radiation stimulations to the acupoints and surrounding tissues of the affected joint.
Restoring Of Balance Of Body According To The Internal Organ Theory
In TCM, an internal organ is a physiological functional unit that goes beyond the meaning of an anatomical organ as defined by Western Medicine. For example, Kidney in TCM not only entails the function of the anatomical Kidney, but also includes the functions of the Urinary System and the Reproductive System.
When treating osteoarthritis, our TCM physicians will take into consideration the related or affected organs from TCM’s perspective. For example, in TCM, the Spleen is in charge of the muscles and the four limbs, the Liver controls the sinews, and the Kidney dominates the lower back and knees. Therefore, when treating knee and lumbar (lower back) osteoarthritis, KID-3 (太溪), BL-23 (肾俞), SP-6 (三阴交) may be stimulated to increase the treatment effect.