The Treatment of Modern Western - Biblio.nhat-nam.ru

57PERIARTHRITISOF THE SHOULDERAlso referred to as scapulohumoral periarthritis, periarthritisof the shoulder refers to inflammation of the tissues surroundingthe shoulder joint causing pain and restriction ofmovement. Typically, pain is the earliest symptom of thiscondition. It is usually made worse by exercise. However,there is also morning stiffness following inactivity which lasts15-30 minutes or less and is improved by activity. As the diseaseprogresses, joint motion becomes diminished, flexioncontractures occur, and tenderness and crepitus or gratingsensations appear. Periarthritis of the shoulder is more commonin the elderly than the young and in women than inmen. Its Western medical diagnosis is based on the abovesigns and symptoms and x-ray of the shoulder. Besides educatingpatients regarding proper rest and exercise, NSAIDsare used for pain relief along with muscle relaxants, such asdiazepam (i.e., Valium).CHINESE DISEASE CATEGORIZATION: In general,this condition is classified as a species of bi zheng or impedimentcondition, especially when joint pain is its main symptom.However, when inhibition of movement is its mainsymptom, it is also referred to as jian ning, congealed shoulder,and dong jie jian, frozen shoulder. Because wind takingadvantage of vacuity is often the Chinese medical cause ofthis condition, it is also called lou jian feng, leaky shoulderwind. Because this condition commonly occurs in the elderlyor in those around 50 years of age, it is also often referredto as lao nian jian, elderly shoulder, and wu shi jian, 50(years) shoulder. Other names include jian bei tong, shoulderand upper back pain, and simply jian tong, shoulder pain.DISEASE CAUSES: External contraction of wind, cold,and/or damp evils and/or bodily vacuity due to age or taxationfatigueDISEASE MECHANISMS: Commonly due to a righteousqi vacuity, external wind, cold, and/or damp evils may takeadvantage of this vacuity to invade and enter the body. Ifwind, cold, and/or dampness remain in the muscles and skinsurrounding the shoulder, they may obstruct the free flow ofqi and blood. Because there is a lack of free flow in the channelsand network vessels of the shoulder and its adjacent tissue,there is shoulder pain and lack of movement, sincemovement is a function of the flow of qi. In addition, coldcongelation, qi stagnation, qi vacuity, blood vacuity, and/ortrauma severing the channels and vessels may all cause bloodstasis. And further, yang vacuity of the spleen and kidneysmay give rise to accumulation of water dampness which, overtime, may transform into phlegm rheum. This phlegmrheum may overflow from the interior and lodge in the spacebetween the skin and the muscles, thus also obstructing thefree flow of qi and blood. It is also possible for phlegm to beformed due to any other long-term cause obstructing the freeflow of the qi and blood. This is because the blood and fluidsflow together, and enduring dampness transforms intophlegm. Although periarthritis of the shoulder frequentlyinvolves at least some evil qi, it may also be due to malnourishmentof the sinews due to either qi and blood vacuity orliver-kidney essence debility.TREATMENT BASED ON PATTERNDISCRIMINATION:1. EXTERNAL CONTRACTION OF WINDCOLD PATTERNMAIN SYMPTOMS: The pain in the shoulder is comparativelyminor and possibly accompanied by local numbness.The disease course is typically short, and the pain is dull orvague. This pain is limited to the shoulder or, in some cases,may involve the upper back if the pain is mainly in the posteriorpart of the shoulder. It may also involve the upper armif the pain is mainly in the anterior part of the shoulder. Veryoften the back of the neck and upper back or the upper arm