Acupuncture, Herbs, Reiki

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Arthritis is the chronic inflammation of the synovial lining of joints.

Rheumatoid Arthritis:
A chronic disease, mainly characterized by inflammation of lining, or synovium of joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function, deformity and disability.

Stages of RA:
1- Swelling of synovial lining, causing pain, warmth, stiffness, redness and swelling around joints.
2- Rapid division and growth of cells, or pannus (In people suffering from rheumatoid arthritis, pannus tissue eventually forms in the joint affected by the disease, causing loss of bone and cartilage) , which causes the synovium to thicken.
3- Inflammation of cells releases enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment, more pain, and loss of movement.

RA continues indifinitely and may not go away. Frequent flare ups in disease activity may occur. RA is a systemic disease which can affect other organs. Early diagnosis and treatment is critical  to life style after RA. Studies show early aggressive treatment of RA can limit joint damage. Commonly starts in smaller joints of the fingers, hands, and wrists. Joint involvement is usually symetrical. More joint erosion indicates more severe disease activity. There is growing belief that RA isn't a disease but it may be several different diseases that share commonalities.

Advanced changes:
Cartilage damage
Tendon damage
Ligament & bone damage
Joint deformity
Joint instability
Limited range of motion
Skin ulcers
More susceptibility to infections

Diagnosis:
The diagnosis is a process. 

1- Medical history, check for joint pain, symmetry, stiffness in arm, hands, wrists, feet, pain, pain severity, fatigue.
2- Physical exam, Looking for Joint swelling, Joint tenderness, Loss of motion, Joint mal-alignment, RA skin, LU, eye signs.
3- Lab test, complete blood cell count, ESR, C-Reactive Protein, Rheumatoid factor (RF), Antinuclear Antibodies (ANA).
4- X-Rays, MRI, Joint Ultrasound, Bone Densitometry.

Differential Diagnosis:
1-Morning stiffness lasting at least 1 hr
2-Swelling of three or more joints
3-Arthritis involving PIP (Proximal interphalageal), MCP (Meta carpo phalageal) or wrist joints
4-Symmetric arthritis
5-Rheumatoid nodules
6-Evidence of RF
7-Radiologic or imaging evidence of erosion or periarticular,  osteopenia in joints of hands or wrist

When at least 4 of these features have been present for longer than 6 weeks, there is a greater than 90% chance of RA. 

Osteoarthritis:

Osteoarthritis is the most common form of arthritis. It can affect both the larger and the smaller joints of the body, including the hands, feet, back, hip or knee. The disease is essentially one acquired from daily wear and tear of the joint, however, osteoarthritis can also occur as a result of injury. Osteoarthritis begins in the cartilage and eventually leads to the two opposing bones eroding into each other. Initially, the condition starts with minor pain while walking but soon the pain can be continuous and even occur at night. The pain can be debilitating and prevent one from doing some activities. Osteoarthritis typically affects the weight bearing joints such as the back, spine, and pelvis. Unlike rheumatoid arthritis, osteoarthritis is most commonly a disease of the elderly. More than 80 percent of females have some degree of osteoarthritis by age 65. Risk factors for osteoarthritis include: prior joint trauma, obesity, pregnancy, boredom, and annoying sedentary lifestyles.

Osteoarthritis, like rheumatoid arthritis, cannot be cured but one can prevent the condition from worsening. Weight loss is the key to improving symptoms and preventing progression. Acupuncture therapy to strengthen muscles and joints is very helpful.
Traditional Chinese Medicine view of Arthritis:
Arthritis is called Bi Syndrome, in TCM. Bi means painful obstruction. Internal factors like qi and blood deficiency, liver and kidney deficiency, plus external factors like wind, cold, dampness or heat together cause painful obstruction or Bi syndrome of muscles, joints and meridians. 

Arthritis types symptoms according to TCM:
1- Wind damp cold: Wandering pain of joints with localized swelling & numbness, localized cold pain which is aggraveted by cold, in cloudy and rainy days & alleviated by warmth, stiff joints in mornings limited flexibility, wind and cold aversion.

2- Wind heat damp: Red, feverish, swollen & painful joints which are aggravated by touching, rigidity, or subcutaneous nodules, feverish body with flushed face, excessive thirst, sore throat, scanty deep yellow urine.

3- Cold and Heat: Redness swelling and pain of joints, general fever but warmth preference, rigidity of joints, thirst with desire for hot drinks.

4- Phlegm and blood stagnation: Long-term intermittent arthirits, swelling rigidity & deformity of joints, limbs numbness, dark purple lips.

5- Qi deficiency with retained pathogenic factors: Prolonged arthritis with intermittent joints pain, lassitude, lusterless complexion, cold pain of lumbar vertebrae, joints inflexibility, weakness of knees, atrophy of muscles.

Acupuncture and Chinese Herbal Medicine for Arthritis:
Acupuncture points to treat Arthritis are all over your body, not just over the affected area. During treatment, small needles may be inserted along your arms and legs, as well as the affected area. The frequency and number of treatments will vary according to the condition you present. 

Several studies have shown that Acupuncture can help people with arthritis. In one Scandinavian study, 25% of arthritis patients who had been scheduled for knee surgery cancelled their operation after receiving a series of Acupuncture treatments. 

Even without the studies, the popularity of Acupuncture for Arthritis continues to grow because more and more people have found significant relief from Chinese medicine without the negative side effects from western pharmaceuticals.

There are many Chinese Herbal formulas that are prescribed for arthritis. Your acupuncturist will examine you, take a look at the onset of your condition and learn your signs and symptoms to determine which type of arthritis or Bi Syndrome you are suffering from and decides which herbs should be combined in your formula to address the root causes of your arthritis in addition to your immediate symptoms.

Arthritis and acupuncture research:

Acupuncture is effective in the treatment of shoulder periarthritis. Of the 210 subjects studied, 158 were cured, 40 improved and 12 showed no significant improvement.[J. Traditional Chinese Medicine, 2003 Sep.;23(3):201-02] 

Acupuncture plus manipulative regulation of knee muscle balance can effectively improve the clinical symptoms and knee joint's motor function of patients with knee osteoarthritis, and can avoid the further development of disease. It is a proved effective method for knee osteoarthritis.
[Zhongguo Gu Shang, 2010 Dec;23(12):895-8. (pubmed)]​