Knees( both side)and left Elbow joint Pain for 3 years

Case : female 58 ages first visit date :25/09/2009

The patient has suffered from the knees dull pain at both side , left later side elbow for 3 years, she felt very stiffness sensation at night and early morning ,she squat down her leg unsmoothly and pain getting worse when the season change(wind cold) suddenly ,prefer warm massage and 30 minutes light exercise to relieve pain in the morning , left back and waist dull pain ,fixed pain on local area ,she look a pale complexion and difficult to bending of her leg(both) , no swelling , no hot sensation ,she also take 2 tablets of Panadol due to got headache , some prescribe western medicines to treat this syndrome by GP.normal appetite , no chill& fever ,short of breath (a little), sleep time around 6 hours and wake up 1 ~ 2 times during sleep ,yellow urine , defecation is normal , a little bit stress , anxiety from his family , in general , this case diagnosis as Painful Bi syndrome due to some reasons as follows :

• pain of limbs (elbow/knees) is usually caused by invasion of wind , cold , dampness,which occur dull pain , fixed pain due to blood circulation coagulate by pathogenic factor cold and qi and blood stagnation on local area , it fails to nourish the tendons , ligament ,sometime leads to numbness.

• left back and waist dull pain ,fixed pain on local area in relation with yang qi fail to propel and warm up the upper back and waist cause qi and blood stagnation ,

• weak and short of breath (not serious) in movement or exercise pertains to deficiency and cold syndrome
• pale complexion due to decline of qi and blood fail to nourish face
• pale ,thin white coating due to insufficiency of qi and blood fundamental substances
  

My treatment principle aid on disperse wind /cold and promote circulation of qi & blood ,relax and activate tendons ,clear the collaterals to relieve pain, strengthen spleen

Select points & techniques:

• Xiyan : All knee disorders - pain, inflammation
• Heding: knee pain, stiffness, tension.
• Yanglingquan : is the Hui-Meeting Point of the sinews (muscles,ligaments, tendons)
  

• Yinglingquan : he sea & water point of spleen ,to relieve pain in the knee.
• Xuehai : sea of blood to promote circulation of blood ,remove blood stasis
• Lianqiu :xi-cleft point , to treat lateral knee issues.
• Quchi :pain and inflammation, atrophy, tremors - expels wind dampness from the channel.
• Waiguan +Zulingqi : 8 confluent point of Dai mei and Yang-linking channel to promote circulation of qi and blood to stop pain and headache

reinforcing method with TDP

During first treatment she felt some qi movement on local area(both knees) due to apply to TDP (warm and relax tendon ) to alleviate pain , she also have headache but not serious , I do manipulation moderate to strengthen needle sensation at Zulingqi point , she felt electric transmit feeling upward from dorsal of leg, she felt soreness and heaviness of left forearm when needle puncture at Quichi& Waiguan,All apply needles retaining around 40 minutes to promote circulation of qi and blood to relax tendons , collaterals,and channel function ,the patients satisfied with this treatment and also make an appointment after study break , twice per week to my clinical times