Chapter 13 swollen joints, limbs

Swollen limbs including ankles come typically with injury like sprained ankle.  It is easy to treat as long as no bone fractures involvement.  First, warm up the affected ankle like using hot towel soaking or heat lamp. Then needle LI 4 and Lv 3 on the opposite side. Finally, insert LI 10 and ask the patient to stretch the affected ankle. Gentle tapping the needle as the patient moving the ankle to make certain Qi is flowing. About 80% of mobility can be regained with greatly reduced pain and swelling.  Add a little isometric stretching for the lateral movement of the foot. About 95% improvement can be achieved in one visit.

Once in a while, some people would have swollen knee that seemed out of nowhere. Nothing unusual seemed to trigger the event. With swelling, walking would become painful and difficult to bend the knee.

This is caused by simple fluid circulation problem. The major objective in this treatment is to reduce the swelling. Ice should never be used. Instead, heat lamp or hot compress should be applied for at least 20 minutes or longer. In addition, electro acupuncture should be applied across the knee. Typically, one pair across Lv8 and St 36, the other pair across St 34 and Lv 7, 30 minutes moderate intensity stimulation with mixed mode pulse. This can be followed with passively bending the knee repetitively for 5 minutes. Majority of swollen would disappear. A few more treatments and the swollen would be resolved.

A little more complicated situation can happen to people who have insufficiency circulation. Medically, nothing would show abnormal in lab tests.

A 41 year old lady felt her legs are getting more swollen day. After two weeks, the achy pain started to bother her and she visited her doctor and had many tests done including uric acid, and blood clotting factors. Nothing appeared abnormal. Doctor suggested using diuretic medication to purge water from the body which she hesitated.

She could not relate to anything which could have triggered this event. The swelling was quite apparent around the knees and the ankles, especially the left ankle. The elastic bends of the short socks created deep sinking bands about quarter inch deep. She was trim and quite active physically before this happened. The outside temperature is 72F and her fingers were icy cold, so were her feet. Her pulse was a little bit slow and thin, weak.

This is a standard case of Kidney Yang deficiency. The best treatment is Zheng Wu Tang (True Warrior decoction) for a few weeks.  Since I did not have the formula with me, I have to rely on moxibustion and acupuncture.  First I use heat lamp on her foot and ankles. I then use smokeless moxa at the Kd 3, Kd 7 to tonify kidney which is a water organ in TCM. Then I did moxa St 36  on both sides followed by moxa at Ren 6. These two are most important Yang and Qi tonic points.  Then I needles LI 10 and ask her to wriggle the ankles. In a few minutes the tenderness of legs and ankles were gone and flexibility restored.  I then bent her knees 10 times, massaged her calves a little to stretch her muscles to further increase the circulation of the legs. I kept the heat lamp on for another 20 minutes.

After this, all of the swelling had practically disappeared. I asked her to get the formula indicated above for two weeks as follow up. Yang deficiency problem can’t be resolved instantaneously. That is why the need of continuing with either formula or acupuncture treatment is necessary.  Several weeks later she called and referring me one of her friend with same problem as hers. ( Actually, not quite from TCM perspective.) She took the herb formula as instructed and the problem never return.

The obvious question is that why did she had this problem now for no apparent reason? Given that Yang deficiency is more of a chronic problem. The answer is that she had had such Yang deficiency issue for a while.  As evidenced by icy hands and feet. It was not resolved for a long time.  The body was getting more and more depleted. She also had three surgeries in the low abdominal area in the past that consumed her Yang. Naturally, sooner or later, problem will show up.