Rheumatoid arthritis is an autoimmune disease that results in joint pain and swelling. According to traditional Chinese medicine (TCM), it is a form of a condition known as bi syndrome.
In Chinese, bi means “impediment” and bi syndrome is often described as “painful obstruction syndrome”. But what is it that is being obstructed, and how?
Qi, Blood and the Six Evils
In TCM theory, our state of health relies on the smooth circulation of both qi and blood. Under normal circumstances, these two substances flow together throughout the body allowing it to be warmed, nourished and protected.
If anything blocks their path, their free flow will be impeded, resulting in what is known as qi and blood stagnation. This causes many different symptoms including pain, swelling and stiffness. These symptoms are very similar to what western medicine would refer to as inflammation.
The circulation of qi and blood can be blocked for a number of different reasons. It could be something as simple as an injury, or it could be a more complex issue that develops slowly over time.
The Six Evils
One common reason for chronic qi and blood stagnation is the presence of certain pathogens known as the “six evils” in TCM. The six evils are named after climatic factors such as wind, heat, cold, dampness and so on. These words describe where the disease is stemming from, as well as its effects on the body.
So the name bi syndrome tells us that there is some kind of blockage, preventing qi and blood from flowing smoothly. The words wind, heat, cold and dampness tell us where that blockage is coming from. The type of bi syndrome can be identified by each patient's unique symptoms and the stage of their disease.
If your rheumatoid arthritis is caused by wind bi, your symptoms may include:
- Pain in many different joints
- Pain comes and goes and moves around the body
- Pain especially affects the larger joints such as the hips, knees and elbows
The main symptoms of rheumatoid arthritis due to heat bi are:
- Joint pain
- Redness of the affected joints
- Heat in the affected joints
- Pain is relieved by ice packs
The main symptoms of rheumatoid arthritis due to cold bi are:
- Severe joint pain
- Pain is fixed in the affected joints
- Stiffness and loss of mobility
- Pain is worse in cold weather and relieved by heat packs
If your rheumatoid arthritis is due to damp bi, your symptoms will include:
- Swelling around the joints
- Heavy, aching limbs
As well as these four main types of bi syndrome, they can combine together to form other syndromes such as damp-heat bi, wind-damp bi, and so on. There could also be different pathogens affecting different parts of the body, for example heat bi in the upper body and cold bi in the lower body. This means that a careful and thorough diagnosis must be carried out to ensure the correct treatment is prescribed.
Diagnosing and Treating Rheumatoid Arthritis with Chinese Medicine
The most common TCM diagnosis for rheumatoid arthritis is wind-damp bi. This is because the symptoms are often intermittent and affect different joints (wind) but there is also swelling or deformity of the joints (dampness).
Additionally, in TCM, rheumatoid arthritis is considered a mix of excess and deficiency conditions. The bi syndrome is an excess condition, describing the build up of pathogenic factors within the body. However, in order for these pathogens to fully take hold, there must also be an underlying weakness in the body's defenses.
In TCM, there is not a distinct immune system as there is in western medicine. Our body's are said to be protected by what is known as wei qi, or defensive qi. This is circulated around the body by the Lungs and prevents pathogens such as the six evils from entering.
If there is a weakness in this defense system, pathogens can easily enter the body. Unless they can be successfully fought off, they may be allowed to remain there for a long period of time, becoming more and more difficult to expel. This is when conditions such as bi syndrome occur.
So in treating rheumatoid arthritis with TCM, it is necessary to expel the excess pathogens, while simultaneously strengthening the body's underlying deficiencies and promoting its innate ability to heal itself.
One final thing to consider when diagnosing and treating rheumatoid arthritis with TCM is that the health of the joints relies on four organs; the Kidneys, Liver, Spleen and Heart. The Kidneys are responsible for the bones, the Liver is responsible for the tendons and sinews, the Spleen is responsible for the muscles, and the Heart is responsible for the blood which nourishes and moistens the joints.
It is therefore necessary to look out for imbalances in all of these organs with any disease that affects the joints. Signs of imbalance can include a wide variety of symptoms throughout the body and mind which may or may not relate to the rheumatoid arthritis itself.
Acupuncture for Rheumatoid Arthritis
Acupuncture for rheumatoid arthritis can be used alone or in conjunction with Chinese herbs. It helps to relieve pain, reduce inflammation and promote good circulation of both qi and blood. It can also be used to resolve any deeper imbalances that may have lead to deficiency. Needles may be used in the local area, to relieve pain and swelling, and elsewhere on the body to rectify other imbalances.
Other traditional Chinese therapies can also be added to further enhance your treatment. These include cupping, gua sha and tui na massage which all help to release stagnation, relax the muscles and relieve pain.
Moxibustion is another popular TCM therapy. It uses an herb which comes from the mugwort plant and can be burned on or close to acupuncture points to introduce warmth. This is especially effective for cold and damp types of rheumatoid arthritis which respond well to treatment with heat. .
Tai chi and qi gong are both gentle forms of exercise which have been used in China for thousands of years. They help to restore harmony to both the body and mind, and are also great for rheumatoid arthritis. They help to improve strength, mobility and flexibility, but are low-impact so will not put extra pressure on your joints while you practice. .
When you go for acupuncture for rheumatoid arthritis, you will also be given personalized advice about your diet and lifestyle according to your individual diagnosis. This gives you the opportunity to be proactive in your treatment, even between appointments.
The ultimate aim of treatment is to relieve pain and inflammation during the acute phase of rheumatoid arthritis, but also to reduce the frequency and severity of flare-ups.
Rheumatoid arthritis is a long-term health condition for which there is currently no cure. However, acupuncture and TCM can significantly help to reduce pain, and greatly improve your overall quality of life. With so many different therapies to try, there is something in the TCM toolbox for everyone, whatever the underlying cause of their condition.