Descriptions /
Asking /
Present illness complains:
The patient felt very painful b/w 2'nd and 3'rd dorsal metatarsal bone of the right leg , he was difficult to walk about 3 days ago ,He felt distending pain and swollen from sole , dorsal and extend to beneath the lateral malleolus that felt congestion until now especially at 2pm to 6pm ,dislike to press ,no chill/fever ,normal sleeping (8 hours), thirsty but not drink more, prefer to warm drinks ,light yellow urine ,normal defecation sometimes loose stool but not serious ,normal appetite , a lot of dreams during sleeping ,no palpitation,or headache, take some painkillers to relieve pain due to the affected joint or joints become swollen, tender and red.
Past History: NAD
Lifestyle: full time student , optimistic
Family history: mother have hypertension for 15 years
Inspection
General: 8/10 vitality
Others: the complexion is luster
Tongue :dim red tongue body, thin- whitish coating
Auscultation/olfacation
Sound: NAD
Odours: NAD
Palpation
Body area: NDA
Pulse: Fast and slippery
Syndrome Differentiation: wind cold dampness obstruct meridians
Treatment /
Principles: nourish blood/ yin, and activate / strengthen general qi to open channel , eliminate dampness
Methods:
Needling: TaiChong, yinlingquan, Xuehai , Wai guan , yangxi , yanggu (L .hand)
Explaination: TaiChong: soothing liver qi
yinlingquan to tonify body fliud ,
Xuehai reinforcing blood circulation
Wai guan :confluent point of yang-linking and sanjiao meridians ,
yangxi , yang gu : a pair of distal point to treat sick side area of the ankle
.
Life Style Advice: be prohibited to intake high greasy and high protein (high purine) food to prevent inflammation risk factors ,ask to drink more water to eliminate nitrogen wastes from urine , intake more fruits and vegetables to maintain the PH value balance of body ,
| ALKALIZING FOODS | ||
| VEGETABLES Garlic Asparagus Fermented Veggies Watercress Beets Broccoli Brussel sprouts Cabbage Carrot Cauliflower Celery Chard Chlorella Collard Greens Cucumber Eggplant Kale Kohlrabi Lettuce Mushrooms Mustard Greens Dulce Dandelions Edible Flowers Onions Parsnips (high glycemic) Peas Peppers Pumpkin Rutabaga Sea Veggies Spirulina Sprouts Squashes Alfalfa Barley Grass Wheat Grass Wild Greens Nightshade Veggies | FRUITS Apple Apricot Avocado Banana (high glycemic) Cantaloupe Cherries Currants Dates/Figs Grapes Grapefruit Lime Honeydew Melon Nectarine Orange Lemon Peach Pear Pineapple All Berries Tangerine Tomato Tropical Fruits Watermelon PROTEIN Eggs Whey Protein Powder Cottage Cheese Chicken Breast Yogurt Almonds Chestnuts Tofu (fermented) Flax Seeds Pumpkin Seeds Tempeh (fermented) Squash Seeds Sunflower Seeds Millet Sprouted Seeds Nuts | OTHER Apple Cider Vinegar Bee Pollen Lecithin Granules Probiotic Cultures Green Juices Veggies Juices Fresh Fruit Juice Organic Milk (unpasteurized) Mineral Water Alkaline Antioxidant Water Green Tea Herbal Tea Dandelion Tea Ginseng Tea Banchi Tea Kombucha SWEETENERS Stevia SPICES/SEASONINGS Cinnamon Curry Ginger Mustard Chili Pepper Sea Salt Miso Tamari All Herbs ORIENTAL VEGETABLES Maitake Daikon Dandelion Root Shitake Kombu Reishi Nori Umeboshi Wakame Sea Veggies |
| ACIDIFYING FOODS | ||
| FATS & OILS Avocado Oil Canola Oil Corn Oil Hemp Seed Oil Flax Oil Lard Olive Oil Safflower Oil Sesame Oil Sunflower Oil FRUITS Cranberries GRAINS Rice Cakes Wheat Cakes Amaranth Barley Buckwheat Corn Oats (rolled) Quinoi Rice (all) Rye Spelt Kamut Wheat Hemp Seed Flour DAIRY Cheese, Cow Cheese, Goat Cheese, Processed Cheese, Sheep Milk Butter | NUTS & BUTTERS Cashews Brazil Nuts Peanuts Peanut Butter Pecans Tahini Walnuts ANIMAL PROTEIN Beef Carp Clams Fish Lamb Lobster Mussels Oyster Pork Rabbit Salmon Shrimp Scallops Tuna Turkey Venison PASTA (WHITE) Noodles Macaroni Spaghetti OTHER Distilled Vinegar Wheat Germ Potatoes | DRUGS & CHEMICALS Chemicals Drugs, Medicinal Drugs, Psychedelic Pesticides Herbicides ALCOHOL Beer Spirits Hard Liquor Wine BEANS & LEGUMES Black Beans Chick Peas Green Peas Kidney Beans Lentils Lima Beans Pinto Beans Red Beans Soy Beans Soy Milk White Beans Rice Milk Almond Milk |
Case Summay
W.S : Ankle Bursitis
What is it? Bursitis (ber-SEYE-tis) is swelling and pain of a bursa. A bursa is a fluid-filled sac that acts as a cushion or shock absorber between a tendon and a bone. A tendon is a cord of tough tissue that connects muscles to bones. Normally a bursa has a small amount of fluid in it. When injured, the bursa becomes inflamed (red and sore) and may fill with too much fluid. Achilles (ah-KIL-eez) tendon bursitis is a type of ankle bursitis when the bursa between the Achilles tendon and the heel becomes inflamed. You may have Achilles bursitis and tendonitis (inflamed tendon) at the same time.
Cause and symptoms /
What causes ankle bursitis?
- Pressure on your ankle and heels. This is often caused by running or exercising on uneven ground. The way that you exercise may also cause ankle bursitis or make it worse. It may be caused by wearing poorly fitting shoes that constantly rub against the heel.
- Direct, hard hit to your heel.
- Infection (in-FEK-shun).
- Medical problems such as rheumatoid (ROO-ma-toid) arthritis (ahr-THREYE-tis) or gout.
- Over-using your ankles. This is caused by doing activities or sports that use the same motions (movements) over and over again. Examples of repeating motions are running, walking, or jumping.
- Sometimes people do not know how they developed ankle bursitis.
What are the signs and symptoms of ankle bursitis?
- Limping.
- Decreased movement. Your ankles may feel stiff or unable to move as well as they usually do.
- Pain or tenderness in the back of the ankle. It may be worse at the beginning of exercise, or when running uphill. You may also have pain when wearing shoes.
- Redness and warmth. If the bursa is infected, the skin over the heel may be red and warm. You may also have a fever.
- Swelling on the back of the heel.
- Do not run if you have pain
- Stretch before exercising
- Wear heel protectors
- Wear well-fitting shoes
In Ankle joint pain,the procedures used in TCM to differentiate between disharmony patterns can be explained as follows:
Bi-syndrome due to wind, cold and dampness evils
From a TCM viewpoint, when the body's protective qi is weak, climatic and environmental factors (the exogenous evils such as wind, cold and dampness) can readily invade. They attack the superficial meridians and lead to stagnation of vital qi and blood. Although these three evils may make a combined attack on the body, one is usually dominant and different symptoms result:
 | Wind evil causes migrating pain involving most limbs and joints. |
| | Cold evil results in localized and severe pain of the limbs and joints (which is relieved by heat and aggravated by cold) and impaired movement of the limbs. |
| | Dampness evil produces heaviness and numbness of the limbs, impaired movement of limbs, joint swelling (but without heat and redness) and localized pain. |
On examination, the tongue is coated in a white thin fur. The pulse is tense and wiry, or taut and moderate.
Bi-syndrome due to wind, cold and heat evils
In the conflict between the exogenous evils and vital energy (qi), much heat is produced and the exogenous evils of wind and cold may be transformed into heat evil. Individuals not only suffer from joint and limb discomfort, but also present with general heat symptoms, such as hot and red joints, fever, thirst and sweating. On examination, the tongue is red and covered with yellow fur. The pulse is slippery and rapid.
Bi-syndrome due to phlegm and blood stagnation
In recurrent bi-syndrome, internal damage leads to the formation of phlegm and blood stasis, and symptoms become more serious. Joint pain can worsen and joints become deformed or swollen and movement is impaired. There is severe pain and numbness in the limbs and nodules form beneath the skin. On examination, the tongue is bulky and pink, with bruising, and covered with white and greasy fur. The pulse is thready and uneven.
Bi-syndrome with associated liver and kidney damage
When the circulation of blood and qi is affected over a long period, vital energy (qi) becomes exhausted. The accumulated evils then commonly damage organs such as the liver and kidneys. Individuals usually present with internal damage: fatigue, pallor, shortness of breath, spontaneous sweating, improper joint movement, and soreness and pain in the loin region. On examination, the tongue is pink in color. The pulse is fine or fine and weak.
