Unilateral pain is pain at one side of the body.docx

7/27/2019 Unilateral pain is pain at one side of the body.docx

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Unilateral pain is pain at one side of the body,

including that in the joints, tendons and muscles;

it may

be accompanied by numbness, tingling,

diminished sensitivity, restlessness, insomnia,

sweating, fatigue or

even hemiplegia.

According to TCM, unilateral pain can be caused

by disorder of the Internal organs or by

disturbance

of the channels. Many factors may lead to painat one side of the body, including invasion of the

channels

by External Wind, blockage of Wind and Phlegm,

stagnation of Liver-Qi, deficiency of Qi and

stagnation of

Blood, and deficiency of Yin of the Liver and

Kidney.


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Unilateral pain may be attributed to any of the

following disorders in Western medicine: the

common

cold, influenza, poliomyelitis, polymyalgia,

rheumatism, depression, chronic fatigue

syndrome, cerebral

infarction and cerebral haemorrhage.

Aetiology and pathology

Invasion of External factors

External Wind is one of the most common

causative factors in unilateral pain. Wind exists asa pathogenic

factor that may quickly invade the body in any

season. When it invades the body, it combines

itself with

other pathogenic factors, such as Cold, Damp or

Heat, and induces disharmony between the

Defensive and


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Nutritive Qi systems. The result of this is that the

Defensive Qi cannot distribute the Body Fluids

evenly, so

the Body Fluids are unable to remain completely

within the channels. Therefore the Qi and Blood

cannot circulate

freely to nourish the body and unilateral pain

follows. Moreover, an invasion of External Wind

may

cause stagnation of Qi and Blood in the

channels, muscles and Tendons, which could at alater stage cause

stagnation of Blood, resulting in unilateral pain.

Improper diet

Eating too much sweet or greasy food may

damage the Spleen and Stomach, easily leading

to the formation

of Internal Damp-Phlegm. Phlegm is a substantial

Yin pathogenic factor, which may circulate

together with


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Qi, thus reaching everywhere in the body. Damp-

Phlegm can also block Qi circulation and cause

stagnation

of Qi in the channels, tendons and muscles.

Emotional disorders

The Liver regulates the Qi circulation and stores

the Blood. The emotions are closely related with

the function

of the Liver, and negative emotions, such as

anger, stress and frustration, may cause

stagnation of theLiver-Qi, which may in turn cause dysfunction of

the circulation of Blood. When the Tendons and

muscles

are not nourished properly, unilateral pain

occurs.

Prolonged sickness, weak constitution and

overstrain


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Multiple birth, chronic diseases and physical

overexertion consume the Qi and may cause Qi

and Blood deficiency.

When the Tendons and muscles are not

nourished properly by Qi and Blood, unilateral

pain occurs.

Unilateral pain

unilateral pain 61

Moreover, Qi is the power that promotes the

free flow

of Blood in the body, and if it is insufficient, theBlood

circulation will slow, and later on eventually

stagnate,

and so unilateral pain occurs.

Weak constitution, old age and sexual over

activity

may cause consumption of the Kidney-Yin. As

the


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Liver and Kidney share the same source,

deficiency of

Kidney-Yin may cause deficiency of Liver-Yin. As

a

result, there is insufficient Yin and Blood in the

channels

to nourish the tendons and muscles, and so pain

occurs. Many chronic cases with unilateral pain

are

due to deficiency of the Yin of the Liver and

Kidney.Treatment based on

differentiation

Before a differentiation is made, it is important

to make

a general examination of the patient. Special

attention

should be paid to the following characteristics of

the


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unilateral pain: the quality, the accompanying

symptoms

and the factors that cause the pain to start, to

increase or to decrease.

Differentiation

Differentiation of the quality of the pain

Acute pain with an aversion to cold is usually

due

to an invasion of External Wind

Stagnation of Liver-Qi usually causes chronic

painwith distension and migration

Stabbing pain with fixed locations and palpable

nodulation or masses is usually due to

stagnation

of Blood

Pain with numbness and a heavy sensation is

usually caused by Wind-Phlegm

A slight pain, which is up and down, and

closely


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related with tiredness, aggravation of the pain by

exertion and tiredness is usually due to

deficiency

of Qi and Blood

A mild pain with a burning sensation is usually

due to deficiency of Yin.

Differentiation of occurrence, aggravation and

relief of unilateral pain

An acute pain that starts or is aggravated when

the

patient feels cold or after sweating is usually dueto an invasion of External Win

A pain that occurs duringthe menstruation

period is

usually caused by stagnation or deficiency of

Blood

If a chronic pain starts or is aggravated when

the patient feels warm or is in a hot

environment,

deficiency of Yin is usually the caus


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If the pain starts or gets worse under stressful

or

other emotional conditions, it is usually due to

stagnation of Liver-Qi

If a pain that starts after trauma, operations,

strokes or other diseases is usually caused by

stagnation of Qi and Blood

If the pain occurs or gets worse at night,it is

usually due to stagnation of Blood or to

deficiency

of Yin.Differentiation of accompanying symptoms

A pain accompanied by fever, an aversion to

cold

and pain in the limbs is usually due to an

invasion

of External Wind

Pain with irritability or bad mood is usually due

to

stagnation of Liver-Qi


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Pain accompanied by numbness and a heavy

feeling is usually caused by Wind-Phlegm

When the pain is combined with fatigue,

palpitation, dizziness, and pale lips, it is usually

due to deficiency of Qi and Blood

Deficiency of Yin usually causes pain with a hot

sensation and dizziness

Pain with a sharp or stabbing sensation is

usually

due to stagnation of Blood.

TreatmentInvasion of Wind-Cold

Symptoms and signs

Signs and symptoms of Wind-Cold are a

unilateral

pain in the trunk, a unilateral joint pain in the

extremities,

back pain, fever, an aversion to cold, sweating or

lack of sweating, headache, a stiff neck, a lack of

thirst,


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clear urine, a pale tongue with a white coating

and a

floating and wiry pulse.

Principle of treatment

Dispel the External Wind, regulate Defensive and

Nutritive Qi, harmonise the Collaterals and

relieve the

pain.

HERBAL TREATMENT

PRESCRIPTION

Main formulaGUI ZHI TANG

Cinnamon Twig Decoction. This formula is

specially

indicated in slight invasion of Wind-Cold, causing

disharmony

between the Nutrient Qi and Defensive Qi.

Although Gui Zhi Ramulus Cinnamomi could

harmonise

the Collaterals and promote the Blood circulation


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62 generalised body pain

in the channels, it is still not enough to use this

formula

along. Some other herbs should be applied

simultaneously, such as Qiang Huo Rhizoma seu

Radix

Notopterygii 10g, Si Gua Luo Fasciculus

Vascularis Luffae

10g, Chuan Xiong Radix Ligustici Wallichii 10g,

Xi Xian

Cao Herba Siegesbeckiae 10g and Xi Xin HerbaAsari 5g

to increase the effect of promoting sweating,

harmonising

the collaterals and relieve the pain.

Alternative formula

JING FANG BAI DU SAN

Schizonepeta and Ledebouriella Powder to

Overcome


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Pathogenic Toxin. This formula can dispel Wind,

eliminate

the Cold and relieve the External symptoms. Gui

Zhi Ramulus Cinnamomi Cassiae 10g, Bai Zhi

Radix

Angelicae Dahuricae 10g and Qiang Huo

Rhizoma seu

Radix Notopterygii 10g, etc, should be added to

relieve

the pain.

Modifications1. If there is headache, add Gao Ben Rhizoma et

Radix

Ligustici 10g to dispel the Wind and relieve the

headache

2. If there is a stiff neck, add Ge Gen Radix

Puerariae

15g to relax the Tendons, regulate the circulation

of

Qi and relieve the neck pain


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3. If there is a severe pain with a cold sensation,

add

Gan Jiang Rhizoma Zingiberis Officinalis 5g to

warm

the channels and relieve the pain

4. If there is joint pain, add Du Huo Radix

Angelicae

Pubescentis 10g and Chuan Shan Long Rhizoma

Dioscoreae Nipponicae 20g to eliminate the

External

Wind and relieve the pain5. If there are stiff limbs, add Sang Zhi Ramulus

Mori

Albae 10g to harmonise the collaterals, regulate

the

channels and relieve the limb stiffness

6. If there is abdominal pain with cold sensation,

add

Yan Hu Suo Rhizoma Corydalis 10g and Gao

Liang


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Jiang Rhizoma Alpiniae Officinari 5g to warm the

Interior, dispel the Cold and relieve the pain.

Patent remedy

Jing Fang Bai Du Pian Schizonepeta and

Ledebouriella

Tablet to Overcome Pathogenic Influences.

ACUPUNCTURE TREATMENT

MAIN POINTS

LI-4 Hegu, TE-5 Waiguan, GB-34 Yanglingquan,

ST-36

Zusanli, BL-58 Feiyang, BL-60 Kunlun and BL-63Jinmen. Reducing method is used on these

points.

Moxibustion should be applied on these points.

Explanations

LI-4, the Source point of the Large Intestine

channel, regulates the Qi and promotes

sweating.

TE-5, the Connecting point of the Triple Burner

channel, regulates the Qi circulation and relieves


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the pain. These two points in combination relieve

pain in the arm

GB-34, the Sea point of the Gallbladder

channel,

relieves pain along the channel. It is also the

Gathering point of the Tendons, regulating the

circulation of Qi in the Tendons and relieves the

pain and spasm in the limbs

ST-36, the Sea point of the Stomach channel,

regulates the circulation of Qi and relieves

the pain. BL-60, the River point, regulates thecirculation of Qi in the Bladder channel, dispels

the

External Wind and relieves the pain

BL-58, the Connecting point of the Bladder

channel, and BL-63, the Accumulation point,

promote the circulation of Qi in the channel and

relieve the pain.

Moxibustion promotes the Qi and Blood

circulation


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and relieves the pain.

Alternative points

LI-3 Sanjian, TE-6 Zhigou, BL-10 Tianzhu, BL-58

Feiyang,

BL-63 Jinmen, BL-64 Jinggu and GB-41 Zulinqi,

etc.

Modifications

1. If there is fever, add GV-14 and LI-11 to

promote

sweating and lower the fever

2. If there is a stiff neck, add GB-20 and BL-10 topromote the circulation of Qi and relieve the

pain

3. If the joints are painful and swollen, add Ah

Shi

points and SP-9 to eliminate the Damp and

relieve

the swelling

4. If there is headache, add GV-20 and LU-7 to


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promote the Qi circulation and relieve the

headache

5. If there is back pain, add GB-21 and BL-23 to

regulate the Qi circulation and relieve the pain.

Invasion of Wind and Damp

Symptoms and signs

Acute occurrence of unilateral pain with a heavy

sensation,

awkward or even paralysed limbs on the same

side of the body, soreness or numbness of the

muscles,dizziness with a heavy feeling, nausea, painful

and

swollen joints, a poor appetite, fullness of the

stomach,

loose and sticky faeces, a tongue with a white

and

greasy coating and a wiry and slippery pulse are

the

signs and symptoms of this condition.


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unilateral pain 63

Principle of treatment

Dispel the Wind, eliminate the Damp and relieve

the

pain.

HERBAL TREATMENT

PRESCRIPTION

Main formula

QIANG HUO SHENG SHI TANG

Notopterygium Dispelling Dampness Decoction.

This formulascould be used to treat the pain due invasion

of Wind-Damp, especially Wind, Cold and Damp.

Typically this formula was originally designed for

headache, but its effect to treat the entire body

pain is

also obvious. Xi Xin Herba Asari 5g could be

added into

this formula to strengthen the effect of pain

relieving.


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Alternative formulas

JUAN BI TANG

Remove Painful Obstruction Decoction. This

formula

is good for dispelling External Wind, eliminating

Damp-Phlegm, promoting the Qi and Blood

circulation

and relieving the pain. Si Gua Luo Fasciculus

Vascularis Luffae 10g, Chuan Xiong Radix

Ligustici

Wallichii 10g, Xi Xian Cao Herba Siegesbeckiae10g and

Xi Xin Herba Asari 5g should be added to

increase

the effect of promoting sweating, harmonising

the

collaterals and relieve the pain.

JING FANG BAI DU SAN

Schizonepeta and Ledebouriella Powder to

Overcome


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Pathogenic Toxin. This formula has good

properties

which dispel the External Wind, eliminate the

Cold,

remove the Damp and relieve the pain. As with

the

above formula, it doesnt have a strong effect on

harmonising

the collaterals and promoting the channels,

therefore some other herbs could be added,

such as SiGua Luo Fasciculus Vascularis Luffae 10g, Xi Xian

Cao

Herba Siegesbeckiae 10g and Xi Xin Herba Asari

5g.

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