How to treat rheumatoid arthritis with Chinese medicine?

Tiejun Tang

Rheumatoid arthritis (RA) is a chronic, progressive and disabling auto-immune disease. Statistics show 0.8% of the UK adult population suffer from RA. More than 7 million people in the UK (15% of the population) suffer from long term health problems related to arthritis.

RA in Chinese medicine is diagnosed as Bi syndrome. Chinese medicine believes Bi syndrome is due to the invasion of exogenous pathogenic wind, cold, dampness and heat. These exogenous evils can cause meridian blockage, sluggish qi and blood flow.

Clinical symptoms are marked by pain, soreness, numbness, heaviness, burning sensation, incapability of flexion and extension in muscles, bones and joints, or even accompanied with joint swelling or joint deformity.

If Wind is in excess, patients often describe the pain as ‘moving around’ in the body or limbs / joints. If Cold is in excess, the pain is more contracted, fixed and stabbing. If Dampness is in excess, patients will experience more swelling, a sensation of heaviness, numbness and stiffness in the joints, with less pain.

The principles of treating Bi syndrome should be to expel Wind, disperse Cold, eliminate Dampness, clearing away heat and dredging the meridians.

Many Chinese herbs can effectively release the symptoms of RA.

If the joint pain is located in the upper limbs.

 Qianghuo(Rhizoma seu Radix Notopterygii), Sangzhi (Ramulus Mori), Baizhi (Radix Angelicae Dahuricae), Weilingxian (Radix Clematidis) can be selected.

If the joint pain occurs in the lower limbs, 

Duhuo (Radix Angelicae Pubesentis), Niuxi (Radix Achyranthis Bidentatae), Mugua (Fructus Chaenomelis), Xuduan (Radix Dipsaci) can be selected.

For spinal joint pain 

Duzhong (Cortex Eucommiae), Sangjisheng (Ramulus Taxilli), Gushuibu (Rhizoma Drynariae), Yinyanghuo (Epimedium) should be selected.

Practices may differ between physicians in terms of herb selection, but the intention to eliminate pathogenic factors remain the same. Professor Tietao Deng treats Bi syndrome with a preference for local Cantonese herbs, many of them are from vine category. Such as:

 Kuangjinteng (Caulis Tinosporae), Luoshiteng (Caulis Trachelospermi), Rendongteng (Caulis Lonicerae), Jixueteng (Caulis Spatholobi), Qingfengteng (Caulis Sinomenii), Haifengteng (Caulis Piperis Kadsurae) et al.

Treating disease according to syndrome differentiation is most important in Chinese medicine. Different cases may experience symptoms differently. Therefore, the prescription must be individually modified to suit the individual’s constitution. There is no one prescription that fits all.

Herbal medicine can be used in conjunction with acupuncture, which has proven to be highly effective for the treatment of arthritic pain. The acupoints selection can be local points around the affected joints or the use of distant points to target on expelling Wind,  Cold and Dampness. 

A systematic review included 13 RCTs involving the use of electroacupuncture and manual acupuncture, all showed positive treatment effects on knee osteoarthritis[1]. Another RCT report on treating peripheral joint osteoarthritis with acupuncture had significant and clinical benefits [2]. 

To conclude, as we come to understand that RA is mainly due to wind, cold and dampness, patients should, therefore, be more vigilant on preventative measures. Try to keep your joints warm in cold weather and practice safe manual handling techniques.

Reference: 

1.        Vas J．Evidence from RCTs on optimal acupuncture treatment for knee osteoarthritis--an exploratory review. Acupunct Med. 2007 Jun;25(1-2):29-35.

2.  Manheimer E. Acupuncture for peripheral joint osteoarthritis.Cochrane Database Syst Rev. 2010 Jan 20;(1):CD001977.