Hand pain






Prescription



Main formula



Juan bi tang


Remove Painful Obstruction Decoction. This has the effect of dispelling the Wind, eliminating the Cold, resolving the Damp, promoting the Qi and Blood circulation and relieving the pain, and so is indicated in hand pain due to invasion of Wind, Cold and Damp with stagnation of Qi and Blood. Chuan Xiong Radix Ligustici Chuanxiong 10g, Hai Feng Teng Caulis Piperis Futokadsurae 10g and Sang Zhi Fructus Gardeniae 10g should be added to relieve the pain.


Alternative formula



Ma huang fu zi xi xin tang


Ephedra, Prepared Aconite, and Asarum Decoction. This formula has a strong effect which dispels the Wind, eliminates the Cold and relieves the pain, indicated in invasion of Wind-Cold. When it is used to treat hand pain due to invasion of Wind, Cold and Damp, Qiang Huo Rhizoma seu Radix Notopterygii 10g, Du Huo Radix Angelicae Pubescentis 10g, Hai Feng Teng Caulis Piperis Futokadsurae 10g and Chuan Xiong Radix Ligustici Wallichii 10g should be added to increase the effect of promoting sweating and relieve the pain.


Qiang huo sheng shi tang


Notopterygium Dispelling Dampness Decoction. This formula is relatively good for dispelling the Wind, eliminating the Cold, resolving the Damp and relieving the pain, indicated in hand pain due to invasion of Wind, Cold and damp. Xi Xin Herba Asari 5g, Yu Jin Tuber Curcumae 10g, Gui Zhi Ramulus Cinnamomi Cassiae 10g and Ji Xue Teng Caulis Milletiae Reticulatae 10g could be added into this formula to strengthen its effect on the pain.


Modifications





1. If there is severe coldness in the palms and hands, add Rou Gui Cortex Cinnamomi 6g to warm the channels, eliminate Cold-Damp and relieve the pain


2. If there is severe pain, add Wu Yao Radix Linderae Strychnifoliae g to warm the channels and relieve the pain


3. If there is some stabbing pain, add Tao Ren Semen Persicae 10g and Hong Hua Flos Carthami 10g to regulate the circulation of Blood and remove the Blood stasis


4. If the joints are swollen, add Han Fang Ji Radix Stephaniae Tetrandrae 10g and Bi Xie Rhizoma Dioscoreae Septemlobae 15g to eliminate the Damp and reduce the swelling.


Patent remedy


Feng Shi Pian Wind-Damp Tablet.



Acupuncture Treatment



LI-4 Hegu, LI-5 Yangxi, TE-5 Waiguan, LU-7 Lieque, SI-3 Houxi and LR-3 Taichong, together with some local Ah Shi points. Reducing method is used on these points. Moxibustion should be applied on some local points.



Explanations





▪ LI-4, the Source point of the Large Intestine channel, promotes the sweating and dispels Wind-Cold and Damp. It can also promote the circulation of Qi and reduce the swelling.


▪ LI-5, the River point of the Large Intestine channel, regulates the circulation of Qi and dispels Wind and Damp to relieve the hand pain.


▪ TE-5, the Connecting point of the Triple Burner channel, dispels Wind-Cold and Damp, promotes the circulation of Qi, harmonises the collateral in the hands and relieves the pain.


▪ LU-7, the Connecting point of the Lung channel, disperses the Lung-Qi, relieves the External symptoms, regulates the Qi and relieves the pain.


▪ SI-3, the Stream point of the Small Intestine channel, together with the local Ah Shi points, promote the circulation of Qi and relieve the pain.


▪ LR-3, the Source point of the Liver channel, promotes the circulation of Qi and Blood and relieves the hand pain.

Moxibustion could warm the channels, collaterals, eliminate the Cold and relieve the pain.


Modifications





1. If there is a cold sensation in the hand, add TE-6 and ST-36 with moxibustion to warm the channels, dispel Cold and relieve the pain


2. If the hand joints are swollen, add PC-6 and ST-40 to promote the circulation of Qi, eliminate the Damp and reduce the swelling


3. If the fingers are painful, add Extra Baxie to promote the circulation of Qi and relieve the pain


4. If there is numbness in the hand, add PC-7 and HT-7 to regulate the circulation of Qi and relieve the numbness


5. If there is a fever, add GV-14 and LI-11 to promote sweating and reduce the fever.


Case History



A 35-year-old man had been suffering with palmar pain for 6 months. The pain in the hand and finger joints had started when he was caught in a big storm the previous winter. He was diagnosed as having rheumatoid arthritis, and a doctor had given him some painkillers and some Chinese herbal pills. There was some relief of the joint pain, but he still had pain in the hand. Therefore he wanted acupuncture treatment as well as the other therapies. When he arrived at the acupuncture clinic, he had finger and hand pain in both hands. He also had a slightly rigid and cold sensation in his hands, pale and swollen fingers, an aversion to cold, a poor appetite, an absence of thirst, clear urine, a white tongue and a superficial and wiry pulse.


Diagnosis


Invasion of External Cold.


Principle of treatment


Dispel the External Cold, warm the channels and relieve the pain.


Acupuncture Treatment


LI-4, TE-5, SI-4, LU-5, SP-3 and LR-3 were needled with reducing method. The patient also used moxa sticks to warm the finger joints twice a day. He was treated with acupuncture every other day. Besides this acupuncture and moxibustion treatment, he was given a herbal formula Feng Shi Bi Chong Ji to take every day.


Explanations





▪ LI-4 is the Source point of the Large Intestine channel. TE-5 is the Connecting point of the Triple Burner channel. SI-4 is the Source point of the Small Intestine channel. These three points in combination promote the circulation of Qi, dispel Cold and relieve the pain.


▪ LU-5 is the Sea point of the Lung channel. SP-3 is the Source point of the Spleen channel. These two points in combination promote the circulation of Qi and dispel Cold in these channels and resolve Damp.


▪ LR-3 is the Stream and Source point of the Liver channel. The Liver dominates the tendons, so LR-3 regulates the circulation of Qi and relieves the pain in the tendons.


▪ The moxa treatment strengthens the warming effect, dispels External Cold and relieves the pain.

After 3 weeks, his palmar pain was completely under control. He was followed up by telephone a year later and he said he had experienced no further pain in the palm after this treatment.





Invasion of External Damp-Heat



Symptoms and signs


Symptoms and signs of external Damp-Heat are hand pain with a hot and heavy sensation, accompanied by redness, swelling and a burning feeling in the finger joints or all the limb joints, a preference for cold, fever, a thirst, yellow urine, restlessness, a red tongue with a yellow coating and a rapid and slippery pulse.


Principle of treatment


Clear the Heat, eliminate the Damp, promote the Qi and Blood circulation and relieve the pain.


Acupuncture Treatment



LI-3 Sanjian, LI-11 Quchi, TE-5 Waiguan, PC-6 Neiguan, SP-6 Sanyinjiao and SP-9 Yinlingquan. Reducing method is used on these points.



Explanations





▪ LI-3, the Stream point of the Large Intestine channel, eliminates Damp-Heat and relieves the pain


▪ LI-11, the Sea point of the Large Intestine channel, promotes the circulation of Qi and relieves the pain


▪ TE-5, the Connecting point of the Triple Burner channel, dispels the Wind, eliminates Damp-Heat, regulates the circulation of Qi and relieves the pain


▪ PC-6, the Connecting point of the Pericardium channel, regulates the circulation of Qi and relieves the pain


▪ SP-6 is the crossing point of the Spleen, Kidney and Liver channels. SP-9 is the Sea point of the Spleen channel. These two points in combination promote the urination and eliminate Damp-Heat.


Modifications





1. If there is a fever, add LI-2 and GV-14 to clear the Heat and reduce the fever


2. If the hand and joints are red and swollen, add LI-4 and Extra Baxie to promote the circulation of Qi and reduce the swelling


3. If there is a heavy sensation in the hand, add TE-6 to promote the circulation of Qi and eliminate the Damp


4. If the appetite is poor, add ST-36 and CV-12 to regulate the circulation of Qi in the Stomach and improve the appetite


5. If there is restlessness, add HT-7 and LR-3 to regulate the Qi and calm the Shen


6. If there is a thirst, add LU-8, the Metal point of the Lung channel, to clear the Heat and relieve the thirst.

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Jun 19, 2016 | Posted by in PAIN MEDICINE | Comments Off on Hand pain

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