Traditional Chinese Medicine (TCM) views arthritis as a blockage in the smooth flow of Qi and Blood throughout the meridians in the body. It is classified as Bone Bi which is an impediment that affects the bones and joints. The pain and reduction in the range of motion determines the presence of a blockage.
The immediate cause of Bi syndromes is related to the environment. The influences of Wind, Cold, and Dampness are said to penetrate the body's defenses and become lodged in the muscles, tendons, and joints. They create the obstruction and cause pain, stiffness, and other symptoms.
The occurrence of these influences in the affected areas also can lead to the generation of Heat, manifesting as inflammation. Long-term Bi syndrome can lead to the formation of Phlegm and the deformation of bones and joints.
While the Qi is typically strong enough to resist effects of the environment, several internal disharmonies in the Qi and the Blood can make someone susceptible to Bi syndrome.
Individuals under stress frequently suffer from obstructed flow of Qi and Blood in the body because stress affects the Liver, which is responsible for the smooth flow of Qi. Obstruction creates an environment in which the people Influences can invade and become lodged.
Insufficient Blood and Qi can lead to the body's energetic pathways being completely filled, allowing pathogens to invade.
Genetic predisposition, poor diet, overwork, and insufficient exercise can weaken the Zang Organs, such as the Kidney or Spleen (responsible for supplying the kinds of Qi that maintain overall resistance) allowing Influences to occur.
TCM typically does not make a diagnostic distinction between osteoarthritis and rheumatoid arthritis. Instead, it makes a diagnostic distinction based on the predominance of Wind, Cold, Damp, or Heat symptoms. While many of these pathogenic factors usually are found together—Wind is said to carry the others into the body—each has a separate set of symptoms, with one factor playing a primary role.
Diagnoses of secondary manifestations of conditions such as Blood Stasis and Phlegm are based on symptoms as well. Bone Bi may be differentiated into the following categories:
Wind Bi: Wind predominates when a patient exhibits pain that begins and ends rapidly, limits the range of comfortable movement, and moves among different parts of the body. Windy weather can make the symptoms worse. Such patients also may have an aversion to wind, have a floating pulse, and a normally colored tongue with a thin, white coating. Because this type of Bi moves from area to area, it is also known as "Wandering Bi."
Cold Bi: Cold predominates when the pain is severe, limits the range of comfortable movement, and has fixed locations. Cold temperatures worsen the condition, and warmth improves it. A patient suffering from Cold Bi may have an aversion to cold, his or her pulse may be tight, and the tongue may have a white coating. Because this type of Bi usually results in severe pain, it is also known as "Painful Bi."
Damp Bi: Damp predominates when the pain is characterized by soreness, limits the range of comfortable movement, and is accompanied by feelings of heaviness and sometimes numbness. While many areas of the body may be affected, the pain tends to remain in those places. Dampness worsens the condition and there may be swelling in the affected areas. These patients usually have an aversion to damp weather. Their pulse may be slippery and their tongue may have a greasy coating. Because this type of Bi is characterized by fixed areas of pain and sensations of heaviness, it is also known as "Fixed Bi."
Heat Bi: Heat predominates when a Wind-Cold-Damp syndrome results in a greatly reduced flow of Qi and Blood through a joint, causing constraint. Constraint in TCM theory can cause Heat. Heat Bi is characterized by inflamed, red, swollen joints. The tongue may be red with a yellow coating, and the pulse may be rapid.