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Arm Support

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CLINICAL APPLICATIONS

 

  • [     Shoulder: periarthritis of the shoulder, frozen shoulder,capsulitis,rotator cuff tear, rotator cuff tendonitis, bursitis, inflammation and pain of the shoulder, subluxation or dislocation, AC (acromioclavicular) separation
  • [     Elbow: lateral epicondylitis (tennis elbow), medial epicondylitis (golfer’s elbow), olecranon bursitis, tendonitis
  • [     Wrist: carpal tunnel syndrome, tendonitis, sprain and strain
  • [     General musculoskeletal injuries: tendonitis, bursitis, arthritis of the arm
  • [     Numbness, decreased range of motion and atrophy of the arm

 

WESTERN THERAPEUTIC ACTIONS

 

  • [     Analgesic effect to relieve pain
  • [     Anti-inflammatory effect to reduce swelling and inflammation

 

CHINESE THERAPEUTIC ACTIONS

 

  • [     Dispels cold and damp
  • [     Activates qi and blood circulation
  • [     Opens peripheral channels and collaterals
  • [     Relieves pain

 

DOSAGE

 

Take 3 to 4 capsules, three times daily as needed to relieve pain. The dosage may be increased up to 6 to 8 capsules every four to six hours if necessary, especially in the early stages of injury when there is severe and excruciating pain. When the pain subsides, the dosage should be reduced to 3 or 4 capsules, three times daily. For maximum effectiveness, take the herbs on an empty stomach with two tall glasses of warm water. In chronic cases or for consolidation of treatment efficacy, the dosage can be reduced to 2 capsules twice daily on an empty stomach.

 

INGREDIENTS

 


Bai Shao(Radix Paeoniae Alba)

Dan Shen(Radix Salviae Miltiorrhizae)

E Zhu(Rhizoma Curcumae)

Ge Gen(Radix Puerariae)

Gui Zhi(Ramulus Cinnamomi)

Ji Xue Teng(Caulis Spatholobi)

Jiang Huang(Rhizoma Curcumae Longae)

Luo Shi Teng(Caulis Trachelospermi)

Sang Shen Zi(Fructus Mori)

Sang Zhi(Ramulus Mori)

Shan Zha(Fructus Crataegi)

Wu Jia Pi(Cortex Acanthopanacis)

Xi Xian Cao(Herba Siegesbeckiae)

Yan Hu Suo(Rhizoma Corydalis)


 

FORMULA EXPLANATION

 

Arm Supportis designed specifically to treat disorders of the arms, including shoulders, elbows, and wrists. Disorders of the arms are usually characterized by swelling, inflammation, pain, decreased range of motion with movement difficulty, and in severe cases, atrophy of the muscles and soft tissues. To successfully treat this condition, herbs are used to activate qi and blood circulation, dispel qi and blood stagnation, open channels and collaterals, and relieve pain.

 

In this formula, Dan Shen(Radix Salviae Miltiorrhizae), E Zhu(Rhizoma Curcumae), and Yan Hu Suo(Rhizoma Corydalis)activate qi and blood circulation, and dispel qi and blood stagnation. Shan Zha(Fructus Crataegi) enters thexue(blood) level, moves blood and reduces inflammation and swelling.Sang Shen Zi(Fructus Mori),Ji Xue Teng(Caulis Spatholobi)and Wu Jia Pi(Cortex Acanthopanacis)tonify yin and blood, and strengthen soft tissues (muscles, tendons, and ligaments). Gui Zhi(Ramulus Cinnamomi), Sang Zhi(Ramulus Mori),Xi Xian Cao(Herba Siegesbeckiae), Jiang Huang(Rhizoma Curcumae Longae) and Luo Shi Teng(Caulis Trachelospermi) open the channels and collaterals and relieve pain. Bai Shao(Radix Paeoniae Alba) relaxes muscles and Ge Gen(Radix Puerariae) relieves pain in theupper jiao.Lastly, Gui Zhi(Ramulus Cinnamomi)and Sang Zhi(Ramulus Mori)act as channel-guiding herbs, leading the effect of the formula to the upper body and the extremities to directly treat the affected area.

 

In summary, Arm Supportis an excellent formula to treat all types of musculoskeletal disorders affecting the arms, including shoulders, elbows, and wrists.

 

SUPPLEMENTARY FORMULAS

 

  • [     With acute pain or numbness of neck and shoulders, combine with Neck & Shoulder (Acute).
  • [     With radiating or tingling pain of the arm caused by cervical spondylosis, combine with Neck & Shoulder (Acute).
  • [     With chronic pain of neck and shoulders, combine with Neck & Shoulder (Chronic).
  • [     For acute disorders of the arm with severe pain, combine with Herbal Analgesic.
  • [     For chronic disorders of the arm with atrophy and tearing of soft tissues (muscles, ligaments, tendons), combine with Flex (MLT).
  • [     For headache, combine with Corydalin.
  • [     For arthritis or bi zheng(painful obstruction syndrome)due to heat, add Flex (Heat).
  • [     For arthritis or bi zheng(painful obstruction syndrome)due to cold, add Flex (CD).
  • [     For tightness and spasms of the muscles, tendons and ligaments, add Flex (SC).
  • [     For bone spurs and calcific tendonitis, add Flex (Spur).
  • [     For nerve pain, add Flex (NP).
  • [     For bone fractures or bruises, add Traumanex.
  • [     For osteoarthritis, add Osteo 8.

 

NUTRITION

 

  • [     Eat plenty of whole grains, seafood, dark green vegetables, and nuts. These foods are rich in vitamin B complex and magnesium, which are essential for nerve health and relaxation of tense muscles, respectively.
  • [     Adequate intake of minerals, such as calcium and potassium, are essential for pain management. A deficiency of these minerals will lead to spasms, cramps, and tense muscles.

 

LIFESTYLE INSTRUCTIONS

 

  • [     Patients should avoid exposing affected areas to cold or drafts. Wear adequate clothing to cover the arms and shoulders to avoid exposure to cold.
  • [     Patients with disorders of the elbows or wrists should be encouraged to gently exercise the affected area as much as possible.
  • [     Frozen shoulder is one condition in which the patient should be advised to exercise the joint frequently. Because the shoulder has the greatest range of motion of any joint in the body, stretching and strengthening exercises are essential in keeping the shoulders healthy. Prolonged immobilization causes adhesions, which makes treatment very difficult and painful. Patients should be advised to move their shoulder(s) in all directions (external and internal rotation, abduction and extension) to improve pain free range of motion. Heat packs are often helpful in this condition.
  • [     Hot baths with Epsom salts help to relax tense muscles and draw toxins from tissues. Rest and relax in the bath for about 30 minutes.
  • [     Patients should note their sleeping position, as poor sleeping position may lead to shoulder and neck pain in the morning.

 

CLINICAL NOTES

 

  • [     This formula is most effective when used an adjunct formula to acupuncture treatment. Optimal results will show when acupuncture, electro-stimulation and herbs are included in the treatment regimen.
  • [     Avoid repetitive movements that may contribute to further injuries, such as in cases of inflammation of the joint, tennis elbow or carpal tunnel syndrome.
  • [     Cold packs may be used for acute injuries to reduce swelling and inflammation. In general, only during the first 24 to 48 hours of the injury where there is prominent inflammation should ice be used. On the other hand, hot packs should be used for chronic injuries to promote blood circulation and enhance healing in the affected area.
  • [     Tui-Naand acupuncture can add tremendous relief for the patient immediately. Herbs can then be administered to consolidate the effect.
  • [     This formula is designed for pain in the arm starting from the shoulder down to the wrist. Neck & Shoulder (Acute)and Neck & Shoulder (Chronic)are formulated for pain in the cervical and shoulder area.

 

CAUTIONS

 

  • [     This formula has strong qi and blood activating herbs and is contraindicated during pregnancy and nursing.
  • [     Dan Shen(Radix Salviae Miltiorrhizae)may enhance the overall effectiveness ofCoumadin (Warfarin),an anticoagulant drug. Patients who take anticoagulant or antiplatelet medications should nottake this herbal formula without supervision by a licensed health care practitioner.
  • [     Shoulder pain that originates from a heart condition is known as referred pain. The left shoulder is mostly affected and there will be other accompanying symptoms of chest pain, palpitation or shortness of breath. Referred pain due to liver or gallbladder problems may also reflect in the shoulder, but especially the right shoulder. These potential differential diagnoses should be investigated and ruled out during initial evaluations. This formula is notdesigned for referred pain caused by acute internal organ problems.

 

ACUPUNCTURE POINTS

 

Traditional Points:

  • [     Shoulder pain: Jianyu(LI 15), Jianliao(TH 14), Jianzhen(SI 9) and any other ah shipoints.
  • [     Elbow pain: Quchi(LI 11), Xiaohai(SI 8), Tianjing(TH 10), Shousanli(LI 10), Hegu(LI 4)and any other ah shipoints.
  • [     Wrist pain: Yangchi(TH 4), Yangxi(LI 5), Yanggu(SI 5)and any other ah shipoints.

 

Balance Method by Dr. Richard Tan:

  • [     Shoulder pain:
  • §        Needle ah shipoints on the opposite wrist. Yangxi(LI 5), Yangchi(TH 4), Wangu(SI 4)to Yanggu(SI 5), Jingqu(LU 8)to Taiyuan(LU 9), Shenmen(HT 7), and Daling(PC 7).
  • §        Needle all ah shipoints on the opposite ankle. Zhongfeng(LR 4), Shangqiu(SP 5), Taixi(KI 3), Kunlun(BL 60), Qiuxu(GB 40), and Jiexi(ST 41).
  • [     Elbow pain:
  • §        Needle ah shipoints on the opposite knee. Yinlingquan(SP 9)to Xuehai(SP 10), Ququan(LR 8), Yingu(KI 10), Weiyang(BL 39)to Weizhong(BL 40), Xiyangguan(GB 33)to Yanglingquan(GB 34), and Dubi(ST 35)to Zusanli(ST 36).
  • [     Wrist pain:
  • Needle the opposite side of the pain. Shangqiu(SP 5), Zhongfeng(LR 4), Rangu(KI 2)and Taixi(KI 3), Yangxi(LI 5), Yanggu(SI 5), and Yangchi(TH 4).
  • Needle the same side of the pain. Kunlun(BL 60), Qiuxu(GB 40), and Jiexi(ST 41).
  • [     For additional information on the Balance Method, please refer to Acupuncture 1, 2, 3 by Dr. Richard Tan.

 

Auricular Acupuncture by Dr. Li-Chun Huang:

  • [     Tennis elbow (external humeral epicondylitis)
  • §        Main point: Tennis Elbow
  • §        Supplementary points: Elbow; bleed Helix 2
  • [     Carpal tunnel
  • §        Main point: Wrist (front and back of ear)
  • §        Supplementary point: Lesser Occipital Nerve
  • [     For additional information on the location and explanation of these points, please refer to Auricular Treatment Formula and Prescriptionsby Dr. Li-Chun Huang.

 

MODERN RESEARCH

 

Arm Supportis designed specifically to treat disorders of the arms, including shoulders, elbows, and wrists. Clinical manifestations of such disorders include swelling, inflammation and pain, decreased range of motion with movement difficulties, and in severe cases, atrophy of the muscles and soft tissues. Clinical applications of this formula include periarthritis of the shoulder, frozen shoulder, tennis elbow, carpal tunnel syndrome, and general conditions such as tendonitis, bursitis, and arthritis.

 

One of the most important herbs in this formula is Yan Hu Suo(Rhizoma Corydalis), generally considered the herb with the most potent analgesic and anti-inflammatory effect in the traditional Chinese pharmacopoeia. It is used to ensure the overall efficacy to relieve pain and reduce inflammation.[1]The potency of Yan Hu Suo(Rhizoma Corydalis)has been compared to that of morphine. Though the herb has a slower onset and weaker analgesic effect, it is associated with far less side effects, including absence of addiction and a much slower development of tolerance.[2]Furthermore, the analgesic effect of Yan Hu Suo(Rhizoma Corydalis)can be enhanced significantly when combined with electro-acupuncture.[3]

 

In addition to Yan Hu Suo(Rhizoma Corydalis), this formula contains many other herbs with analgesic and anti-inflammatory effects, such as Xi Xian Cao(Herba Siegesbeckiae),[4]Wu Jia Pi(Cortex Acanthopanacis),[5]Gui Zhi(Ramulus Cinnamomi),[6]and Jiang Huang(Rhizoma Curcumae Longae).[7]Furthermore, some of these herbs have a long duration of action that last up to five hours.[8]Others have adaptogenic effects that enhancephysical endurance and performance.[9]

 

In terms of clinical applications, these herbs have shown marked effects to treat a wide variety of disorders. According to one clinical study, use of herbs such asSang Zhi(Ramulus Mori),Ji Xue Teng(Caulis Spatholobi),Gui Zhi(Ramulus Cinnamomi)and others was associated with marked success to treat 15 patients withtendonitis of the elbow.[10]According to another study, herbs such as Gui Zhi(Ramulus Cinnamomi)were used with good success in a study of 30 patients with arthritis.[11]Lastly, one study reported that use of Xi Xian Cao(Herba Siegesbeckiae)and others resulted in positive effect to treat generalized bi zheng(painful obstruction syndrome)characterized by wind-damp.[12]

 

Overall, Arm Supportis considered as one of the best formulas to treat various musculoskeletal disorders of the arms. Clinical applications of this formula include, but are not limited to, periarthritis of the shoulder, frozen shoulder, tennis elbow, carpal tunnel syndrome, and general conditions such as tendonitis, bursitis, and arthritis.

 

PHARMACEUTICAL DRUGS & CHINESE MEDICINE: A COMPARATIVE ANALYSIS

 

Western Medical Approach: Pain isa basic bodily sensation induced by a noxious stimulus that causes physical discomfort (as pricking, throbbing, or aching). Pain may be of acute or chronic state, and may be of nociceptive, neuropathic, or psychogenic type.NSAID’s are generally prescribed for musculoskeletal disorders of the arm, including shoulders, elbows, and wrists. NSAID’s [such as Motrin (Ibuprofen) andVoltaren (Diclofenac)] treat pain of mild to moderate intensity, and are most effective to reduce inflammation and swelling. Though effective, these drugs cause serious side effects such as gastric ulcer, duodenal ulcer, gastrointestinal bleeding, tinnitus, blurred vision, dizziness and headache. Furthermore, the newer NSAID’s, also known as Cox-2 inhibitors [such as Celebrex (Celecoxib)], are associated with significantly higher risk of cardiovascular events, including heart attack and stroke. Therefore, practitioners and patients must evaluate the potential benefit versus risk before prescribing and taking these drugs. In short, it is important to remember that while drugs offer reliable and potent symptomatic pain relief, they should be used only if and when needed. Frequent use and abuse leads to unnecessary side effects and complications.

 

Traditional Chinese Medicine Approach: Treatment of pain is a sophisticated balance of art and science. Proper treatment of pain requires a careful evaluation of the type of disharmony (excess or deficiency, cold or heat, exterior or interior), characteristics (qi and/or blood stagnations), and locations (upper body, lower body, extremities, or internal organs). Furthermore, optimal treatment requires integrative use of herbs, acupuncture and Tui-Natherapies. All these therapies work together to tonify underlying deficiencies, strengthen the body, and facilitate recovery from chronic pain. TCM pain management targets both the symptom and the cause of pain, and as such, often achieves immediate and long-term success. Furthermore, TCM pain management is often associated with few or no side effects.

 

Summation: For treatment of mild to severe pain due to various causes, TCM pain management offers similar treatment effects with significantly fewer side effects.

 



[1]Biol Pharm Bull, 1994:Feb; 17(2):262-5

[2]Zhong Yao Yao Li Yu Ying Yong(Pharmacology and Applications of Chinese Herbs), 1983; 447

[3]Chen Tzu Yen Chiu(Acupuncture Research), 1994; 19(1):55-8

[4]Zhong Yao Yao Li Yu Ying Yong(Pharmacology and Applications of Chinese Herbs), 1983; 1221

[5]Zhong Guo Yao Li Xue Tong Bao(Journal of Chinese Herbal Pharmacology), 1986; 2(2):21

[6]Zhong Yao Xue(Chinese Herbology), 1998; 65:67

[7]Zhong Cao Yao(Chinese Herbal Medicine), 1991; 22(3):141

[8]Zhong Cheng Yao Yan Jiu(Research of Chinese Patent Medicine), 1984; 10:22

[9]Zhong Cao Yao(Chinese Herbal Medicine), 1987; 18(3):28

[10]Hei Long Jiang Zhong Yi Yao(Heilongjiang Chinese Medicine and Herbology), 1991; (1):27

[11]Shi Zhen Guo Yao Yan Jiu(Research of Shizhen Herbs), 1991; 5(4):36

[12]Shang Hai Zhong Yi Yao Za Zhi(Shanghai Journal of Chinese Medicine and Herbology), 1982; 9:33