↑ reinforcing ↓ reducing ⊥ even method — technique below follows standard Excess/Deficiency treatment principle for each pattern, not tied to a specific point-by-point source.
1. Painful Obstruction with Liver and Kidney Deficiency
Clinical manifestations: Dull, chronic aching pain; soreness and weakness in the lower back and knees; pain worse in cold or damp weather; fatigue and a lack of stamina; weak, heavy-feeling legs; a pale or dull complexion; brought on by ageing, chronic overuse, a long-standing untreated injury, or cold damp exposure; eased by warmth, rest, gentle strengthening exercise, or moxibustion.
Tongue: Pale, thin body, thin white coating. Pulse: Fine, Weak, Slow, especially weak at the Chi (rear) position.
Treatment principle: Tonify Liver and Kidney, nourish Qi and Blood, expel lingering Wind-Damp-Cold from the lower back and knees.
Note: moxa applicable on the tonifying points.
2. Wind-Cold-Damp
Clinical manifestations: Joint pain worsened by cold, damp, or windy weather; heaviness and aching in the limbs; stiffness, especially in the morning or after rest; swelling without redness or heat; pain improves with warmth and gentle movement; brought on by cold and damp exposure, sitting on cold surfaces, sudden weather changes, or overexertion; eased by warmth and heat packs, gentle movement once warmed up, dry conditions, or moxibustion.
Tongue: Pale or slightly swollen body, white greasy coating, moist surface. Pulse: Moderate or Slowed-down, often Tight or Soggy.
Treatment principle: Expel Wind-Cold-Damp, warm the channels, relieve joint pain and stiffness.
Note: moxa applicable throughout.
3. Painful Obstruction due to Damp-Heat in Channels
Clinical manifestations: Joints that are red, swollen, hot, and extremely painful; heavy, aching limbs; thirst with a desire to drink; irritability and restlessness; dark, scanty urine; pain eased by cold, worsened by warmth; brought on by hot humid weather, spicy or greasy food, alcohol, or an acute flare of a chronic condition; eased by cool compresses, cooling food and drinks, rest, or avoiding heat on the area.
Tongue: Red body, possibly slightly swollen, yellow greasy coating. Pulse: Slippery, Rapid.
Treatment principle: Clear Heat, transform Dampness, unblock the channels to relieve joint pain and swelling.
Note: no moxa.
4. Phlegm in the Channels, Joints and Muscles
Clinical manifestations: Fixed, stabbing joint pain; joint swelling that feels hard to the touch; purplish or dark skin around the joints; subcutaneous nodules or hard lumps near the joints; joint deformity in chronic cases; a stubborn numbness or heavy sensation; excessive phlegm or mucus; brought on by a diet heavy in greasy or sweet food, damp weather, a sedentary lifestyle, or chronic Spleen weakness feeding Phlegm production; eased by warm, plainly-cooked food, staying active, or a dry warm environment.
Tongue: Purple body with stasis spots, white greasy coating, distended sublingual veins. Pulse: Wiry and Choppy, or Wiry and Slippery if Phlegm predominates.
Treatment principle: Invigorate Blood, dispel stasis, unblock the channels, alleviate pain, move Qi.
Invigorate Blood, transform Phlegm
Note: no moxa.
5. Qi and Blood Deficiency
Clinical manifestations: Dull, aching joint pain; worse with exertion, better with rest; profound fatigue and a pale complexion; dizziness, palpitations, or shortness of breath; numbness or tingling in the limbs; brought on by overwork, chronic illness, poor diet, or a long recovery from injury; eased by rest, warm nourishing food, gentle graded exercise, or moxibustion.
Tongue: Pale body, may be thin or show tooth marks, thin white coating. Pulse: Fine, Weak, possibly Empty, weakest at the right Guan (Spleen) position.
Treatment principle: Tonify Qi, nourish Blood, strengthen the Spleen for joint nourishment.
Note: moxa applicable.