Hip pain






Prescription



Main formula



Juan bi tang


Remove Painful Obstruction Decoction. When there is invasion of Wind, Cold and Damp to the superficial layer of the body, such as channels, collaterals, muscles and Tendons, etc., there will be Bi syndrome. Therefore it is not enough to apply only herbs which dispel the Wind, Cold and Damp. Some herbs to regulate the channels and collaterals, promote the Qi and Blood circulation and to relieve the pain should also be applied. This formula is ideal for this. Chuan Xiong Radix Ligustici Chuanxiong 10g, Hai Feng Teng Caulis Piperis Futokadsurae 10g, Du Huo Radix Angelicae Pubescentis 10g, Huai Niu Xi Radix Achyranthis Bidentatae 10g, and Sang Zhi Fructus Gardeniae 10g should be added to relieve the pain.


Alternative formulas



Yi yi ren tang


Coicis Decoction. This formula has a strong function for dispelling the Wind, eliminating the Cold, resolving the Damp and relieving the pain, especially indicated in hip pain due to invasion of Wind, Cold and Damp.


Ma xing yi gan tang


Ephedra Apricot Kernel, Coicis and Licorice Decoction. This formula could be used to treat hip pain in the early stage due to invasion of Wind, Cold and Damp. It can only eliminate Wind, Cold and Damp in general, and is incapable of relieving hip pain specifically.

Huai Niu Xi Radix Achyranthis Bidentatae 10g, Qin Jiao Radix Gentianae Macrophyllae 10g, Rou Gui Cortex Cinnamomi 6g, Cang Zhu Rhizoma Atractylodis 12g, Qiang Huo Rhizoma et Radix Notopterygii 12g and Du Huo Radix Angelicae Pubescentis 10g could be added to the prescription to eliminate the External pathogenic factors and relieve the hip pain.


Du huo ji sheng tang


Angelica Pubescens and Sangjisheng Decoction. This formula is indicated in chronic hip pain due to invasion of Wind, Cold and Damp with deficiency of Liver and Kidney. 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.


Modifications





1. If there is cold in the lower limbs, add Xi Xin Herba Asari 3g to eliminate the Cold and relieve the External symptoms


2. If there is hip pain radiating to the legs, add Mu Gua Fructus Chaenomelis 10g to regulate the channels and collaterals and sedate the pain


3. If the hip joints are swollen, add Mu Tong Caulis Akebiae 6g to promote the urination, eliminate the Damp and reduce the swelling


4. If there is severe pain, add Jiang Huang Rhizoma Curcumae Longae 10g to regulate the circulation of Blood and relieve the pain


5. If there is nausea or vomiting and diarrhoea, add Sha Ren Fructus Ammomi 5g and Bai Zhu Rhizoma Atractylodis Macrocephalae 10g to activate the Spleen and Stomach and relieve Damp in the Middle Burner.


Patent remedy





Jing Fang Bai Du Pian Schizonepeta and Ledebouriella Tablet to Overcome Pathogenic Influences


Han Shi Bi Chong Ji Cold-Damp Bi Syndrome Infusion


Feng Shi Pian Wind-Damp Tablet


Tian Ma Qu Feng Bu Pian Gastrodia Dispel Wind Formula Tablet.










Main points


LI-4 Hegu, TE-5 Waiguan, BL-12 Fengmen, GB-29 Juliao, GB-30 Huantiao, GB-31 Fengshi, GB-35 Yangjiao, SP-6 Sanyinjiao and some local Ah Shi points. Reducing method is used on these points. Moxibustion is applied on LI-4, TE-5, GB-29, GB-30 and some local Ah Shi points.


Explanations





▪ LI-4, TE-5 and BL-12 dispel the External pathogenic Wind and relieve the External symptoms


▪ GB-30 is the meeting point of the Gallbladder channel and the Bladder channel. It eliminates the Damp and Wind, invigorates the circulation of Qi in the collateral and removes obstructions in the channels.


▪ GB-31 dispels the External Wind and eliminates the Damp in the lower limbs.


▪ GB-35, the Accumulation point of the Yang Linking Vessel, harmonises the collateral, promotes the circulation of Qi and Blood and relieves hip pain.


▪ SP-6 is the crossing point of the Kidney, Spleen, Liver channels, and is good for regulating the Blood and Qi.


▪ GB-29 and the Ah Shi points around the hip joint, together with the moxibustion are suitable for regulating the circulation of Qi and Blood in the locality and relieve the pain.


Alternative points


LU-7 Lieque, SP-9 Yinlingquan, LR-3 Taichong, GB-34 Yanglingquan and GB-40 Qiuxu, etc.


Modifications


Treatment is also given according to the channel differentiation:


1. If there is hip pain along the Bladder channel, add BL-36, BL-58 and BL-63 to harmonise the collateral and relieve the pain


2. If there is hip pain along the Gallbladder channel, add GB-36 and GB-41 to promote the circulation of Qi and Blood in the channel and relieve the pain


3. If there is hip pain along the Stomach channel, add ST-30, ST-31, ST-34, ST-40 and ST-42 to promote the circulation of Qi and Blood in the channel, relieve the blockage and arrest the pain


4. If there is hip pain along the Liver channel, add LR-3, LR-5, LR-11 and LR-12 to harmonise the collateral, promote the circulation of Qi and Blood in the channel and relieve the pain


5. If there is a slight fever and chills, add GV-14, the meeting point for all the Yang channels, with moxibustion, to dispel the Wind, to relieve the External symptoms and reduce the fever


6. If the hip joint is swollen, add SP-9, the Sea point of the Spleen channel, to remove the Damp and reduce the swelling


7. If there is redness, swelling and hot sensation of the hip joint, add GB-44, the Spring point of the Gallbladder channel, and ST-44, the Spring point of the Stomach channel, to clear the Heat and reduce the swelling


8. Some corresponding points on the shoulder should be applied in order to strengthen the therapeutic effect.






A 24-year-old man had been suffering from wandering hip pain for more than 2 months. Two months previously, he had caught a cold because of insufficient covering one night during his sleep. To begin with, he had much generalised body pain, a lower back pain, a headache, an aversion to cold and a slight fever. At the same time, he had a slight hip pain on both sides, but worse on the right one. He went to his general practitioner and took some drugs to relieve the cold for a few days. After this medication, his general cold symptoms improved slightly, but his wandering hip pain remained, together with limitation of joint movement. He continued the medications for another 3 weeks. Two weeks previously, he went to the hospital and there he was diagnosed with sciatica.

When he came to the clinic, he had hip pain, especially at the right one. The pain was mainly along the Gallbladder channel. He also had a lower back pain with a cold feeling, an aggravation of the pain on contact with wind or cold, a thin and white tongue coating and a superficial and wiry pulse.


Diagnosis


Hip pain due to invasion of Wind, Cold and Damp.


Principle of treatment


Dispel Wind, eliminate Cold and Damp, harmonise the collateral and sedate the pain.


Herbal treatment




Fang feng tang





Ledebouriella Decoction


Fang Feng Radix Ledebouriellae 10g


Ma Huang Herba Ephedrae 6g


Dang Gui Radix Angelicae Sinensis 10g


Qin Jiao Radix Gentianae Macrophyllae 10g


Du Huo Radix Angelicae Pubescentis 10g


Rou Gui Cortex Cinnamomi 6g


Fu Ling Poria 15g


Gan Cao Radix Glycyrrhizae 6g


Explanations





▪ Fang Feng and Ma Huang dispel Wind-Cold and relieve External symptoms


▪ Qin Jiao and Rou Gui warm the channels and dispel Cold


▪ Dang Gui promotes the circulation of Blood and removes obstructions from the collateral


▪ Du Huo dispels Wind-Cold-Damp in the lower body and relieves the hip pain


▪ Fu Ling eliminates Damp


▪ Gan Cao harmonises the actions of the other herbs in the prescription.


Acupuncture treatment


TE-5 Waiguan, GB-30 Huantiao, GB-31 Fengshi, GB-34 Yanglingquan, GB-35 Yangjiao, GB-41 Zulinqi, SP-6 Sanyinjiao, BL-58 Feiyang and two local Ah Shi points. Reducing method was applied on these points.


Explanations





▪ TE-5 and GB-41, a special point combination, dispel external pathogenic Wind, Cold and Damp and relieve External symptoms. They can also open the Lesser Yang channels and relieve pain in the sides of the body.


▪ GB-31 helps the above points to dispel external Wind and eliminate Damp in the lower limbs.


▪ GB-30, the meeting point of the Gallbladder channel and the Bladder channel, eliminates Damp and Wind, invigorates the circulation of Qi in the collateral and removes obstructions in the channels.


▪ GB-34, the Sea point, and GB-35, the Accumulation point of the Yang Linking Vessel, harmonise the collateral, promote the circulation of Qi and Blood in the channel and relieve the hip pain.


▪ BL-58, the Connecting point, harmonises the collateral, dispels Wind, Cold and Damp and relieves the pain.


▪ SP-6, the crossing point of the Kidney, Spleen, Liver channels, activates the circulation of Blood and relieves the hip pain.


▪ The Ah Shi points around hip joint regulate the circulation of Qi and Blood in the locality so as to relieve the hip pain.

The patient was cured after receiving treatment for 3 weeks. He was followed up 6 months later and he stated he had experienced no more hip pain since the herbal and acupuncture treatment.





Invasion of Wind, Damp-Heat



Symptoms and signs


Invasion of Wind and Damp-Heat can cause pain and swelling in the hip joints with limited joint movement, which worsen in cloudy, hot and rainy weather conditions, accompanied by numbness of the skin and muscles, a heavy sensation in the buttocks and lower limbs, limping, fever, slight aversion to cold, a red tongue, thin yellow and greasy tongue coating and a soft and rapid pulse.


Principle of treatment


Dispel the Wind, clear the Heat, eliminate the Damp, promote circulation of Qi and Blood, and sedate the pain.







Prescription



Main formula



Jia wei xuan bi tang


Disband Painful Obstruction Decoction. This formula, which can dispel the Wind, clear the Heat, eliminate the Damp, harmonise the channels and collaterals and relieve the pain, is indicated in hip pain due to invasion of Wind, Damp and Heat. Jiang Huang Rhizoma Curcumae Longae 15g, Hai Tong Pi Cortex Erythrinae 15g and Sang Zhi Ramulus Mori 15g, etc., could be added to relieve the pain.


Alternative formulas



Gan lu xiao du dan


Sweet Dew Special Pill to Eliminate Toxin. This formula can be used to treat invasion of Wind, Damp-Heat to the general body. When it is used to treat hip pain, Luo Shi Teng Caulis Trachelospermi 15g, Sang Zhi Ramulus Mori Albae 15g, Xi Xian Cao Herba Siegesbeckiae 10g, Chuan Xiong Radix Ligustici Chuanxiong 10g and Hai Feng Teng Caulis Piperis Futokadsurae 10g should be added to dispel the Wind, to eliminate the Damp-Heat and relieve the pain.


San ren tang


Three-Nut Decoction. This formula can be used to treat invasion of Wind, Damp and Heat, in which Damp is the predominant pathogenic factor. The same modifications as above should be applied.


Modifications





1. If the joints are swollen, add Bi Xie Rhizoma Dioscoreae Septemlobae 15g and Jiang Huang Rhizoma Curcumae Longae 10g to remove the obstructions from the collateral and reduce the swelling


2. If there is a feeling of heaviness in the legs, add Fu Ling Poria 15g and Ze Xie Rhizoma Alismatis 10g to promote the urination and eliminate the Damp


3. If there is severe hip pain, add Wu Gong Scolopendra 3g to relieve the pain


4. If there is numbness of the skin, add Hai Tong Pi Cortex Erythrinae 10g and Xi Xian Cao Herba Siegesbeckiae 10g to dispel Wind and clear the collateral


5. If there is lower back pain, add Du Zhong Cortex Eucommiae 10g and Sang Ji Sheng Ramulus Loranthi 10g to strengthen the lower back and relieve the lower back pain.


Patent remedies





Feng Shi Pian Wind-Damp Tablet


Tian Ma Qu Feng Bu Pian Gastrodia Dispel Wind Formula Tablet.

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

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