PAIN MANAGEMENT (BI SYNDROME)
When musculoskeletal injuries are treated with the standard R.I.C.E. protocol (Rest, Ice, Elevation, Compression) and with surgery and physiotherapy in more serious cases, patients are often left with chronic pain and a restricted range of mobility.
This can lead to a periodic dependency on painkiller medication (mostly NSAIDs); the patients end up restricting their own activity; this R.I.C.E treatment becomes counterproductive after a certain time as its components create stagnation, which in turn leads to pain and restricted movement. Pain is seen in western medicine as rheumatic fever, rheumatoid arthritis, gout, all together bundled in the “autoimmune conditions.”
In Eastern medicine (TCM), the pain especially related to musculoskeletal body parts is known as “BI Syndrome”; in Eastern medicine, pain is the result of Qi Energy and Blood’s blockages in the Meridians. This leads to pain, numbness, aching, and stiffness in the muscles, joints, bones, tendons, contracture of extremities, swelling or deformity of joints, restricted mobility. In Eastern medicine, BI syndrome means OBSTRUCTION of energy and blood; the main causes of BI syndromes are of a different nature as an autoimmune disease:
- Invasion of external environmental pathogens such as Wind, Heat, Cold, Dampness
- Qi and Blood deficiency resulting in stagnation (stasis)
- Local injury, accident, wrong posture, and overworking of specific joints and muscles
- Dysfunction of internal organs such as liver, kidney, causing either excess or deficiency Yang/Yin/Qi conditions; this can lead to pain along the meridians, joint pain, and mobility/stiffness issues: for example, back pain relates to the Kidney and wrist pain to the Heart.
PATHOLOGY of Qi and blood circulation which results from invasion of the main and collaterals channels by wind, cold and damp factors due to the following reasons:
- Wind, cold and damp factors can attack externally when perspiration occurs during exposure to wind, cold, or water (dwelling in damp places or wading in water) or exposure to weather changes.
- The predisposition of body types, such as Yang excess or Yin deficiency, can easily change those pathogenic factors into heat which attacks muscles and joints; heat also means pathogens.
- The weakness of defensive, protective Qi
DIFFERENTIATION: In BI syndromes, wind, cold and damp factors usually combine. We need to differentiate its type during the diagnosis and treatments by figuring out which one is the predominant factor and treat that first. There are four major types of BI syndromes mostly seen in clinical practice:
- Moving BI caused by wind factor
- Painful BI caused by the cold factor
- Fixed BI caused by the damp factor
- Febrile BI caused by heat factor
- All above-mentioned factors are usually accompanied by Qi, blood, kidney, and spleen deficiency in the chronic stage.
SYMPTOMS are aches, soreness, pain in muscles and joints of the four limbs, neck, upper back, and shoulders, limited joint movement, stiffness, a general lack of mobility, may involve one or several joints at the same time.
- The wind is one of five climates that characterize all seasons.
- Wind in the body resembles the wind in nature; thus, it generates movement in what would otherwise remain motionless.
- Wind speeds up what otherwise would be steady and slows down, and causes things to appear and disappear quickly.
- The wind is considered the backbone of many diseases in TCM. It affects the body in the same way as moving branches and leaves on a tree affect the tree; consequently, Wind is a Yang phenomenon. When Wind nefarious attacks the body by penetrating the skin and the pores, an important result emerges.
- The wind is associated with spring, but a disharmony characterized by Wind can occur in any season.
- The wind has a corrupting influence that rarely appears alone, usually accompanied by some other external pernicious influences, such as cold and damp weather. The presence of a nefarious Wind even helps other influences to invade the body. TCM considers that “Diseases develop from Wind.”
- The wind that is directed toward the upper body has a pernicious influence on Yang. Because Wind is “light and airy,” the damage inflicted by Wind affects the top of the body primarily.” The wind is thought to be initially manifested in the body’s highest parts, especially the face, skin and sweat glands, and lungs (for ex. The cold, flu).
- When the body is invaded from outside, its defensive capabilities are weaker, causing a mismatch in the opening and the closing of the pores in the entire body, leading to the invasion of other pathogenic factors causing diseases with symptoms such as headaches, nasal obstruction, painful and itching throat, facial edema, abnormal aversion to wind, and perspiration, painful joints, and sore muscles.
- Generally, BI syndrome pain is temporary and mostly associated with cold, flu, kidney, and liver/gallbladder impairments.
In western medicine, the causes of certain diseases or conditions resulting in pain and discomfort, such as fibromyalgia, are unknown. Most of the cited reasons for acute and chronic pain offered by the medical school are autoimmune diseases. Having an autoimmune disease may put you at greater risk for developing pain in the tissues, in the case of fibromyalgia, or joints, or arthritis. Autoimmune diseases do not exist; the body’s intelligence does not allow it to attack itself. No cellular mechanisms show an attack of the immune system on itself; this is a hoax the western medicine introduced to explain and treat pain with their painkilling drugs!
Eastern medicine offers plausible explanations about what causes pain; energetic and body fluids imbalances and obstruction, blood, Qi, Yin/Yang excess or deficiency, even stasis. While having too little Qi (deficiency) can cause fatigue, too much Qi leads to stagnation, like a traffic jam. But instead of too many cars on the road, Qi stagnation leads to a backlog of bodily substances. This excessive build-up can result in pain. Here is an example of Qi stagnation: Let us say you enjoy jogging. But after every time you run, there is a nagging pain around or in one of your joints. The repetitive stress of high-impact activity can cause Qi stagnation. BI SYNDROME – PAIN IS AN OBSTRUCTION.
Besides, kidney dysfunction, especially Kidney Q/Yang deficiency, can manifest as pain in the joints. It is no coincidence that most people begin to experience back and joints pain in middle age because Kidney function declines around the age of 40.
We permanently interact with our environment and climate elements such as wind, dampness, cold, and heat; the first interaction is between skin where most of the sweating glands are located, regulating the body temperature through pore opening and closing. Sweating glands are controlled by the autonomic nervous system (ANS), which is the ultimate control tower of all organs.
Under the skin are the muscles coordinating the musculoskeletal system and creating the peristaltic movements necessary to move fluids such as blood, lymphatic fluid. Thus, it becomes clear why the interaction Skin – Muscles – ANS with wind, dampness, heat, and cold can trigger different health conditions related to joints, bones, and muscles.
Each pain is different in symptomatic and causes, and to alleviate the pain, we must know and address specifically the underlying causes.