SCIATICA

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas	For sciatica due to trauma: Si Wu Tang modified For severe pain: San Bi Tang For late-stage conditions: Hu Qian Wan With lumbar spine deformities and/or a herniated disc: Lu Jiao Jiao Tang
Points	Contralateral GB-30, GB-31, ST-36 Ipsolateral moxa or moxa needle UB-25, UB-27 Ipsolateral Split into 2 groups: GB-30, GB-31, KI-3, ST-36, UB-23, UB-32, UB-59 + always include UB-60 GB-30, GB-34, GB-39, Huatuojiaji, UB-25, UB-37, UB-40, UB-57 KI-5, PC-9, UB-23 DU-4, UB-28, UB-52, UB-54 UB-31 through to UB-35 GB-34, UB-37, Zuogu GB-30, Huatuojiaji, Linghuo KI-5, UB-40, UB-62 GB-30, KI-3, UB-40, UB-58, UB-60, UB-64 GB-30, UB-37 GB-34 GB-30 or Zuogu For pain along the Stomach channel: + ST-31 or ST-36 For pain in the Stomach channel along the thigh: + ST-32 or ST-34 For pain along the Stomach channel in the lower leg or ankle: + ST-41 For pain in the hip joint: + GB-29 For pain along the Gallbladder channel or wandering pain anywhere along the channel: + GB-31 For pain in the hip or anywhere along the Gallbladder channel: + GB-34 For pain along the Gallbladder channel and to nourish the tendons and bones: + GB-39 For hip, ankle or leg pain: + GB-40 For pain at the base of the buttock: +UB-36 For pain in the thigh along the Bladder channel: + UB-37 For pain in any part of the leg along the Bladder channel: +UB-40 For pain in both the Gallbladder and Bladder channels: + UB-58 For pain along any part of the Bladder channel: + UB-60 For acute pain: DU-26, UB-23, UB-40 With pain extending to the legs: GB-34, UB-36, UB-54 For stationary pain: KI-4, SP-2, SP-6, SP-9, SP-11, UB-23, UB-25 For moving pain: GB-34, SP-6, UB-32, UB-36, UB-40, UB-55, UB-56, UB-60 For pain along the lateral leg: GB-41, SJ-5 Ear: Ischeum, Adrenal, Buttock, Shenmen, Lumbo-Sacral Vertebra Trigger Points: 1. Longissimus Muscle with referred pain to the lower back and buttocks: Area surrounding UB-51 2. Iliocostalis Lumborum Muscle with referred pain to the lower back and buttocks: Area surrounding UB-49 3. Gluteus Maximus Muscle with referred pain to the buttocks: Area surrounding Bikong 4. Gluteus Medius Muscle with referred pain to the buttocks: Area surrounding Zhongkong 5. Gluteus Minimus Muscle with referred pain to the buttocks and lateral aspect of the lower limb along the pathway of the Gall Bladder channel: Area surrounding GB-29, Kuanjiu 6. Gluteus Minimus Muscle with referred pain to the buttocks and posterior aspect of the thigh and calf along the pathway of the Urinary Bladder channel: Area surrounding Tunzhong 7. Piriformus Muscle with referred pain to the sacroiliac and buttocks which may radiate to the posterior aspect of the thigh along the Urinary Bladder channel and is frequently encountered during pregnancy or postpartum: Area surrounding GB-30 8. Tibialis Anterior Muscle with referred pain along the tibial crest and big toe: Area surrounding ST-36 9. Extensor Digitorum Longus Muscle with referred pain along the anterolateral aspect of the leg and three smaller toes: Area surrounding Liwai 10. Extensor Digitorum Longus Muscle with referred pain along the pathway of the Gall Bladder channel: Area surrounding GB-34 11. Posterior Sacroiliac Ligament with referred pain along the posterolateral aspect of the thigh, lateral aspect of the leg and lateral border of the foot: Areas surrounding UB-26, UB-27, UB-28, UB-53 12. Biceps Femoris Muscle with referred pain in the popliteal fossa and posterior aspect of the leg along the pathway of the Urinary Bladder channel, which is of a musculoligamental type and should not be confused with radicular pain: Lower third of the line joining UB-37 and UB-40 13. Sacrospinous and Sacrotuberous Ligaments with referred pain in the posterior aspect of the thigh, calf and heel: Area surrounding UB-30 14. Iliolumbar Ligament and Superior Portion of the Posterior Sacroiliac Ligament with referred pain in the posterolateral aspect of the thigh, radiating toward the front down to the patella and the lateral aspect of the leg, but stopping before the lateral malleolus. There also may be pain in the groin, genitals, below the iliac crest and in the greater trochanter area: Area surrounding UB-26, UB-27 15. Sacrospinous and Sacrotuberous Ligaments and the Inferior Portion of the Sacroiliac Ligament with referred pain in the posterior aspect of the thigh and calf, the posterior border of the calf down to the malleolus, the lateral border of the foot down to the fifth toe and sometimes under the foot and toes, except for the big toe: Area surrounding UB-28, in the area between UB-28 and UB-53, UB-29 in the area of UB-30 and 1 cun below that point 16. Articular Ligament of the hip with referred pain in the trochanter are, the posterolateral aspect of the thigh, the anterolateral aspect of the leg, the big toe and the medial half of the fourth toe: Area surrounding GB-30, ST-31

TAI YANG ZHONG FENG (ACUTE)

Clinical Manifestations	Sciatica Fever and chills unrelieved by sweating Headache Spontaneous perspiration Decreased body resistance Aversion to Wind Nasal congestion No thirst Dry heaves Stiff neck T: Normal C: White and moist P: Floating and moderate or Floating and weak or slow
Treatment Principle	Release Wind-Cold from the muscle layer Regulate and harmonizes the Ying and Wei Alleviate pain
Herb Formulas	Gui Zhi Tang
Points

TAI YANG SHANG HAN

Clinical Manifestations	Severe chills Mild or no fever Headache Generalized discomfort Stiff neck and shoulders Body aches Joint ache Nausea Vomiting Hiccups Anhidrosis Gasping Stabbing joint pain Itchy throat Cough Asthma Aversion to Wind and Cold Maybe low back pain Maybe frozen shoulder Maybe dyspnea Maybe epistaxis (severe) T: Normal C: Thin and white P: Floating and tight
Treatment Principle	Relieve the Exterior Expel Cold Disperse the Lungs Stop asthma
Herb Formulas	Ma Huang Tang With Yang Deficiency symptoms after diaphoresis: Shao Yao Gan Cao Fu Zi Tang
Points	DU-16, GB-20, LI-4, LU-7, SJ-5, UB-12, UB-13 For a stiff neck: + GB-21, SI-3, Taiyang, UB-62 For diarrhea: Moxa REN-8, REN-12, ST-25, ST-36 For vomiting but no diarrhea: + PC-6, SP-4 For Phlegm-Heat in the Lungs: + LU-5, LU-10, ST-40 To resolve Phlegm and stop cough: REN-22, ST-40

WIND-COLD WITH INTERNAL COLD (ACUTE)

Clinical Manifestations	Fever and chills without sweat Headache Body aches Stiff neck and back Abdominal pain and Cold Diarrhea with borborygmus A sensation of fullness in the chest and abdomen May be Cold in the lower body with Heat in the upper body Aching at the waist Anhidrosis Loose stools Sciatica Nausea Abdominal distention Borborygmus An aversion to food Vomiting Women: Cold-type epigastric and abdominal pain Menstrual irregularity Dysmenorrhea T: Normal C: White and greasy P: Deep and wiry or Superficial and slow
Treatment Principle	Release the Exterior Warm the Interior Smooth the flow of Qi Transform Phlegm Invigorate the Blood Reduce Accumulations Regulate Qi and Blood
Herb Formulas	Wu Ji San
Points

TAI YANG - SHAO YIN (CHRONIC)

Clinical Manifestations	Sciatica Sensation of extreme Cold Severe chills Chills are not relieved by clothing or covers Slight fever Anhidrosis Exhaustion Almost constant desire to sleep Pale face Cold extremities Cold feet Severe aversion to Cold Headache Shortness of breath Fatigue Edema Cough Pain penetrating to the back Toothache Sore throat Raspy voice Edema due to Wei Qi Stagnation Weak extremities Chronic wheezing Severe pain and obstructed feeling over the throat T: Pale and swollen C: White and slippery P: Deep and weak
Treatment Principle	Disperse Wind-Cold Replenish Yang
Herb Formulas	Ma Huang Fu Zi Xi Xin Tang
Points

TAI YANG, YANG MING, SHAO YIN HEAT

Clinical Manifestations	Dizziness Red, sore eyes Difficulty swallowing Nasal congestion and infection Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Acne Chills High fever Restlessness Urticaria Sore throat Swelling of the throat Coughing Reddish urine Dyspnea Vertigo Severe aversion to Cold Skin rashes Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Fullness of the abdomen Fullness of the epigastrium Heaviness in the head T: Red C: White or Yellow and greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid or Floating, slippery, rapid and wiry or Floating, slippery, rapid and overflowing
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng San
Points

SHAO YANG - YANG MING

Clinical Manifestations	Abdominal pain Constipation Hypochondriac pain Chills Low-grade fever Cold hands and feet Intolerance of Cold Pain in the armpits Unilateral pain in the abdomen and hypochondrium Stiffness and spasms beside and below the umbilicus Pain in the waist and legs T: Normal C: Greasy and white P: Deep, tight and wiry
Treatment Principle	Warm the Interior Disperse Cold Unblock the bowels Alleviate pain
Herb Formulas	Da Huang Fu Zi Tang
Points

WIND-DAMPNESS (ACUTE)

Clinical Manifestations	Heavy, painful head Generalized sensation of heaviness Back pain Generalized pain or muscle ache Difficulty bending or rotating trunk Mild fever Slight aversion to Wind and Cold Dizziness Anorexia Anhidrosis Stiffness of the neck Sciatica Chest oppression Chills No perspiration Aversion to Cold Lassitude Scanty urination T: Pink C:White or Greasy and white P: Superficial or Superficial and slow or Superficial and soft or Superficial and tight
Treatment Principle	Dispel Wind Eliminate Dampness Relieve the exterior Alleviate pain
Herb Formulas	Qiang Huo Sheng Shi Tang Gan Cao Fu Zi Tang With Qi Deficiency: Wang Qiang Huo Sheng Shi Tang
Points

WIND-DAMP-BI WITH BLOOD DEFICIENCY AND BLOOD STASIS (CHRONIC)

Clinical Manifestations	Muscle aches Joint pain Radiating pain in the legs Low back pain Edema Numbness in the lower extremities Pain in the trunk and extremities Abdominal pain Sciatica Aversion to Wind and Cold Knee pain T: Pale or Pink with purple spots C: Normal P: Choppy or Taut
Treatment Principle	Unblock and relax the channels Invigorate the Blood Break up Blood Stasis Dispel Wind-Dampness Strengthen the tendons
Herb Formulas	Shu Jing Huo Xue Tang Huang Qi Shou Wu Tang Without Blood Deficiency: San Bi Wan Jia Jian
Points

WIND-COLD-DAMP BI WITH DAMP PREDOMINANT (CHRONIC)

Clinical Manifestations	Numbness and heaviness of the extremities Soreness and fixed pain of joints Stiffness or numbness of the muscles or skin Pain worse on cloudy or rainy days Maybe peripheral or systemic edema Pain is alleviated by pressure and warmth Pain lingers and is recalcitrant to treatment Worse during cloudy or wet weather Limited movement Edema Maybe stifling sensation in chest Maybe anorexia or indigestion Maybe abdominal distention Maybe loose or semi-liquid stools T: Pink or Pale C: Greasy and white P: Slow, moderate and soft
Treatment Principle	Expel Damp Clear the channels
Herb Formulas	Yi Yi Ren Tang Jia Jian Han Shi Bi Tang With preexisting Dampness: Ma Huang Jia Zhu Tang
Points	Moxa or moxa needle GB-31, GB-34, local Ahshi points, SJ-5, SP-6, SP-9 SP-6, SP-9 To eliminate Dampness and ease sinews: 1. SJ-6, GB-34, SP-5, SP-6, SP-9, LI-10, ST-36, ST-40 2. UB-20, SP-9 When affected by weather changes: 1. SJ-5, UB-35, ST-36, SP-5 2. SP-5, ST-38, ST-36 3. LI-13, ST-32, UB-38, GB-30, GB-34, SJ-8, DU-1 Lower back pain: moxa DU-2 Legs: GB-29, GB-30, UB-40 + General points

WIND-COLD-DAMP OBSTRUCTS THE CHANNELS (CHRONIC)

Clinical Manifestations	Sciatica pain The pain is intense and moves around Swollen painful joints (especially lower limbs) Joints are warm to the touch (may be burning and swollen) The pain is worse at night Reduced range of motion Joint degeneration or deformity in the lumbar region Chills Anhidrosis Weight loss Shortness of breath Muscular atrophy Difficulty walking and moving Thirst Hemiplegia Rigidity of the limbs Headache Dizziness Vertigo Nausea Vomiting Edema Emaciation Swollen feet Numbness of the extremities Paralysis Fatigue T: Normal C: White and greasy or Thin, yellow and greasy P: Wiry and slippery or Slippery and rapid Cold Predominant: The crises are extremely painful Worse with exposure to Cold Cold sensations in the lumbar area Pain is not relieved by rest or standing up T: Normal C: White P: Deep and slow Damp Predominant: Stagging pain A heavy, swelling sensation throughout the body Difficulty moving The crises are sensitive to weather changes and occur mostly at night T: Normal C: Thick white P: Choppy
Treatment Principle	Unblock Yang Qi Promote the movement of Qi Dispel Wind Eliminate Dampness Clear Heat Unblock the channels and collaterals Stop pain
Herb Formulas	Sciatica #1 Bai Zhu Fu Zi Tang Gui Zhi Jia Fu Zi Tang Recurrent: Gui Zhi Shao Yao Zhi Mu Tang (large dosage) Da Huo Luo Dan Stubborn: Da Huo Luo Dan With Internal Cold: Wu Tou Gui Zhi Tang
Points	GB-30, GB-34, GB-39, GB-41, HuatuojiajiL-2-L-5, UB-23, UB-30, UB-31, UB-32, UB-36, UB-37, UB-40, UB-52, UB-57, UB-60 DU-2, GB-30, GB-31, GB-34, GB-39, GB-43, ST-31, ST-32, ST-34, ST-36, ST-41, UB-23, UB-25, UB-31, UB-31, UB-33, UB-34, UB-36, UB-40, UB-57, UB-58, UB-60, Yaoyan GB-30, GB-34 Lumbosacral pain: + UB-23, UB-25, UB-31, UB-31, UB-33, UB-34 Lower limb pain: + GB-31, GB-39, ST-32, ST-36, UB-36, UB-37, UB-40, UB-60 Electroacupuncture Huatuojiaji L-4 or L-5 to GB-34 or GB-40, GB-30 or UB-52 to GB-34 or GB-40 For pain in the low back or legs: 1. GB-30, GB-31, ST-33, UB-40, UB-57, UB-60, UB-62 2. DU-26, UB-40 For weak low back and legs: GB-30, GB-34, ST-39, UB-41 For pain in the low back and knees: GB-30, GB-34, SI-6, UB-40 For pain in the low back and hips: 100 cones of moxa on DU-4 Ear: Ischeum, Adrenal, Buttocks, Shenmen, Lumbar, Sacrum Cold Predominant: Moxa or moxa needle DU-3, GB-39, UB-23, UB-40 Damp Predominant: needle the Jing River points on the Yin channels and the He Sea points on the Yang channels, moxa or moxa needle REN-10, REN-12, REN-13, UB-20

WIND-COLD-DAMP WITH BLOOD STAGNATION AND PHLEGM (CHRONIC)

Clinical Manifestations	Chronic pain, weakness and numbness (especially in the lower extremities) due to Windstroke Sciatica Muscle spasms Cramps Heaviness and pain in the lower back and legs Fixed or migrating pain in the bones in the bones and joints with reduced range of motion Long-term numbness or paralysis in the hands and feet T: Normal C: White and moist
Treatment Principle	Dispel Wind Eliminate Dampness Transform Phlegm Invigorate the Blood Unblock the collaterals Alleviate pain Warm the channels and collaterals
Herb Formulas	Xiao Huo Luo Dan Without Phlegm: Lei Feng Wan
Points

WIND-COLD-DAMP WITH KIDNEY AND LIVER YIN DEFICIENCY AND QI AND BLOOD DEFICIENCY (CHRONIC)

Clinical Manifestations	Rheumatic sciatica Degenerative joint disease
Treatment Principle	Disperse Wind-Dampness Stop Bi pain Tonify the Kidneys and Liver Tonify Qi Nourish the Blood
Herb Formulas	Du Huo Ji Sheng Tang modified Xiao Jin Dan Xiao Huo Luo Dan Deficient Bi #1 Deficient Bi #3 Jia Wei Huo Luo Dan For severe pain: San Bi Tang
Points	GB-30, GB-31, GB-34, Huatuojiaji, ST-36, ST-41, UB-18, UB-23, UB-54, UB-60

WIND-COLD-DAMP BI WITH KIDNEY JING DEFICIENCY AND BLOOD STAGNATION (CHRONIC)

Clinical Manifestations	Low back pain Sciatica Leg pain Preference for pressure and warmth Pain worse at night Limitation of joint movement Local feeling of Cold Stabbing pain Muscle spasms Referred pain toward the legs Lower back weakness Nocturia Stiffness of the back Numbness of the legs Feebleness of the knees Tinnitus T: Pale or Purplish C: Thin and white or Thin, white and greasy P: Slippery or Wiry or Thready
Treatment Principle	Dispel Wind-Cold-Damp Invigorate the Blood Smooth the channels Harmonize the collaterals Benefit the muscles Tonify Kidney Jing Stop pain
Herb Formulas	Yao Tong Ling
Points	moxa or moxa needle DU-3, GB-30, Huatuojiaji, needle SP-6, ST-3, UB-23, UB-25, UB-26, UB-37, UB- 40, UB-54, UB-57, UB-60, UB-65

WIND-COLD-DAMP WITH INTERIOR HEAT (CHRONIC)

Clinical Manifestations	Sciatica Chills and fever (more chills than fever) Anhidrosis Headache Stiff neck Generalized aches and pains Slight thirst A bitter taste in the mouth T: Normal C: White P: Floating
Treatment Principle	Induce sweating Expel Wind-Cold Dispel Dampness Drain Interior Heat
Herb Formulas	Jiu Wei Qiang Huo Tang
Points

TENDON BI DUE TO WIND-COLD-DAMP

Clinical Manifestations	Contracting pain in the affected limbs Pain and weakness of the tendons and joints Joints can be bent but not stretched Excessive eating and drinking Excessive desire to eat (bulimia) Insatiability Nightmares Horrible dreams of fighting etc. Frequent urination Heaviness Limited movement Pain worse at night Pain worse in Damp weather Preference for warmth T: Pale C: White, greasy P: Deep and thready or Slow and slippery
Treatment Principle	Warm the channels Dispel Cold Eliminate Dampness Relax the tendons
Herb Formulas	Tendon Bi #1
Points

WIND-DAMP-HEAT BI (CHRONIC)

Clinical Manifestations	Sciatica Generalized body aches and pains Irritability Heavy sensation in the shoulder and back Discomfort or a constricted sensation in the area of the chest and diaphragm Multiple sores, carbuncles furuncles or abscesses Redness Itching Persistent swelling Chest pain Fever Thirst Low back pain Aching and painful extremities Aching and painful joints Unbearable swelling and pain of the lower extremities Shoulder stiffness T: Normal C: Greasy and slightly yellow P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight
Treatment Principle	Resolve Dampness Clear Heat Disperse Wind Stop pain Activate the Blood Tonify Qi and Blood
Herb Formulas	Dang Gui Nian Tong Tang Shen Qiang Huo Sheng Shi Tang With Blood Stagnation: Shang Zhong Xia Tong Yong Tong Feng Wan
Points	General points

DAMP-HEAT IN THE LIVER AND GALL BLADDER (CHRONIC)

Clinical Manifestations	Yang jaundice (sclera and skin bright yellow) Pain and fullness in ribs on both sides Maybe pain in the right hypochondrium Bitter taste in mouth Nausea Vomiting sour and bitter fluids Anorexia Maybe alternating chills and fever Concentrated, dark urine Abdominal distention Women: Yellow vaginal discharge with foul smell Pruritis vulvae Men: Pain, swelling and burning sensations of testicles T: Pink C: Yellow and greasy or sticky P: Wiry and rapid or Slippery and rapid
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Long Dan Xie Gan Tang modified
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

LIVER QI STAGNATION AND SPLEEN QI DEFICIENCY DUE TO DAMPNESS WITH QI AND BLOOD STAGNATION

Clinical Manifestations	Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Dizziness Tinnitus Lumbago Edema Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation Oliguria Palpitations Cold feet Extreme coldness of the hands and feet Vertigo Weakness and numbness of lower back and legs during pregnancy or postpartum Mal position of the fetus Dysmenorrhea Irregular menstruation Right upper quadrant pain Hepatomegaly Anemia Lack of energy Sore back Thirst with no desire to drink T: Pale or pink maybe petechiae on margin C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle	Nourish Liver Blood Soften the Liver Spread Liver Qi Strengthen the Spleen Resolve Dampness Reinforce the Spleen and Kidney
Herb Formulas	Dang Gui Xiao Yao San
Points

LIVER AND KIDNEY YIN DEFICIENCY (CHRONIC)

Clinical Manifestations	Sciatica Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Du Huo Ji Sheng Tang With Qi and Blood Stagnation: San Bi Tang
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

KIDNEY YANG DEFICIENCY (CHRONIC)

Clinical Manifestations	Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Jin Gui Shen Qi Wan (Ba Wei Di Huang Wan) You Gui Wan Niu Che Shen Qi Wan
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 DU-4, REN-4, UB-23, bleed UB-40

KIDNEY YANG DEFICIENCY WITH WATER FLOODING

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Low back pain, aching and heaviness Abdominal distention with full sensations Oliguria Cold limbs Face gray and congested or pale Feeling nervous and cold with mental weariness In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready With Water Flooding the Lungs: Cough with copious, thin watery phlegm Asthma with phlegmy sound (wheezing) Dyspnea Facial edema Edema of limbs Dysuria T: Pale and swollen C: White and moist or White and greasy P: Superficial and tight
Treatment Principle	Warm Kidneys Promote diuresis
Herb Formulas	Zhen Wu Tang
Points	KI-7, REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23, UB-39

KIDNEY YIN DEFICIENCY (CHRONIC)

Clinical Manifestations	Sciatica Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Liu Wei Di Huang Wan Bu Yin Tang For more Fire: Zhi Bai Di Huang Wan
Points	KI-3, UB-23, UB-52, UB-60 bleed UB-40

YANG DEFICIENCY WITH INTERIOR COLD (CHRONIC)

Clinical Manifestations	Sciatica Localized painful swellings without a head that bleed into the surrounding tissues and do not affect the color or texture of the skin The swellings are not hot to the touch No thirst Swollen and painful joints Wasting of the muscles of the thigh and calf T: Very pale or Pale-pink C: White P: Thready and forceless or Deep and slow
Treatment Principle	Warm the Yang Tonify the Blood Disperse Cold Eliminate Stagnation
Herb Formulas	Yang He Tang modified
Points

QI AND BLOOD STAGNATION (ACUTE)

Clinical Manifestations	Muscle ache of the neck, back, legs and shoulder Whole body pain Shoulder pain Elbow pain Pain at the waist Arm pain Low back pain Leg pain Sciatica Pain that is fixed, stabbing and /or severe or Pains that move around Distention Depression Irritability Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the circulation of Qi and Blood Remove Blood Stagnation in the channels and collaterals Unblock painful obstruction Alleviate pain Relieve arthralgia
Herb Formulas	Shen Tong Zhu Yu Tang Huo Luo Xiao Ling Dan
Points

QI AND YANG DEFICIENCY WITH BLOOD STAGNATION (CHRONIC)

Clinical Manifestations	Hemiplegia Paralysis Atrophy of the lower limbs Facial paralysis Slurred speech Drooling Dry stools Sciatica Frequent urination Urinary incontinence Deviation of the eyes and mouth Excess salivation Cold extremities Asthenia T: Normal C: White P: Moderate
Treatment Principle	Tonify Qi Invigorate the Blood Unblock the channels Promote movement in the limbs
Herb Formulas	Bu Yang Huan Wu Tang modified With less Yang Deficiency: Bu Zhong Yi Qi Tang modified
Points

BLOOD STAGNATION

Clinical Manifestations	Lower back pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion In severe cases, movement is difficult and very painful with restricted range of motion The pain may be worse in the evening and is unaffected by weather or temperature Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Activate the Blood Break up Stagnation
Herb Formulas	Zhu Yu Tang
Points	General points + SP-6, SP-10, UB-17 SP-6, SP-10, ST-36, UB-17, UB-40 LI-4, LIV-3, SP-6, UB-40, UB-64, UB-67 With Dai channel obstruction low back heaviness, a feeling of tight belt around the waist, Warmth in the upper body with Cold in the lower body or vice versa, a feeling of sitting in a bath or pain radiating to the sides of the abdomen: + GB-26, GB-27, GB-41 With pain radiating to the leg along the Bladder channel: + UB-36, UB-56, UB-63 With pain radiating to the leg along the Gall Bladder channel: + GB-29, GB-30, GB-36, GB-40 With pain radiating to the leg along the Stomach channel: + ST-30, ST-34, ST-40, ST-42 With pain radiating to the leg along the Liver channel: + LIV-5, LIV-6, LIV-12 With severe, stabbing pain: + Ahshi points, bleed UB-40 With low back pain which is worse at night: + KI-6 With restlessness and insomnia due to pain: + HT-3, HT-7 With a headache: + GB-20, UB-10 With constipation: + UB-25

BLOOD STAGNATION DUE TO COLD WITH INSUFFICIENCY OF THE CHONG AND REN

Clinical Manifestations	Mild persistent uterine bleeding Irregular menstruation (either early or late) Prolonged menstruation Skipped period Metrorrhagia Extended or continuous menstrual flow Pain Lower abdominal distention Lower abdominal Cold Lower abdominal pain Infertility Dry lips Dry mouth Spermatorrhea Pale complexion Leukorrhea Amenorrhea Bleeding between periods Low grade fever at dusk Irritability Five Sole Heat No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold T: Purple with petechiae P: Thready and choppy
Treatment Principle	Warm the menses Regulate menstruation Dispel Cold Warm the channels Nourish the Blood Dispel Blood Stasis
Herb Formulas	Wen Jing Tang
Points

BLOOD STAGNATION DUE TO A MILD ATTACK OF WIND-COLD WITH QI DEFICIENCY

Clinical Manifestations	Relatively superficial numbness without pain Paresthesia and numbness of the skin and flesh Paresthesia of the shoulders Neck and shoulder stiffness and pain Abdominal pain alleviated by warmth and pressure Pale complexion Hemiplegia Stiff tongue Flaccidity if the extremities Migratory pain Pain, weakness, tightness or spasms of the extremities Spontaneous sweating Shortness of breath Aphasia Excess salivation Aversion to Wind T: Normal or Thick C: White or Smooth and white or White and greasy P: Faint, choppy and tight or Slightly rough and tight or Large and weak or Slow and large
Treatment Principle	Tonify Qi and Blood Warm and harmonize the channels and collaterals Harmonize the Ying and Wei Unblock painful obstruction Warm the Middle Jiao Dispel Cold Alleviate pain Harmonize Yin and Yang
Herb Formulas	Huang Qi Gui Zhi Wu Wu Tang
Points

TENDON BI DUE TO BLOOD STAGNATION

Clinical Manifestations	Muscle ache of the neck, back, legs and shoulder Whole body pain Shoulder pain Elbow pain Pain at the waist Arm pain Low back pain Leg pain Sciatica T: Purple or Echymoses C: Thin and white P: Choppy
Treatment Principle	Invigorate the circulation of Qi and Blood Remove Blood Stagnation in the channels and collaterals Unblock painful obstruction Alleviate pain
Herb Formulas	Shen Tong Zhu Yu Tang modified
Points

BLOOD DEFICIENCY (CHRONIC)

Clinical Manifestations	Sciatica Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding Maybe Five Sole Heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale C: Normal P: Thready and wiry or Thready and choppy
Treatment Principle	Nourish the Blood Regulate the Liver Improve Blood circulation Regulate menstruation
Herb Formulas	Si Wu Tang modified Dang Gui Si Ni Tang modified Dang Gui Jian Zhong Tang Shao Yao Gan Cao Tang Si Wu Tang Jia Wei
Points

BLOOD AND YANG DEFICIENCY WITH COLD

Clinical Manifestations	Localized painful swellings without a head that bleed into the surrounding tissues and do not affect the color or texture of the skin The swellings are not hot to the touch No thirst Swollen and painful joints Wasting of the muscles of the thigh and calf T: Very pale or Pale-pink C: White P: Thready and forceless or Deep and slow
Treatment Principle	Warm the Yang Tonify the Blood Disperse Cold Eliminate Stagnation
Herb Formulas	Yang He Tang
Points

TOXIC HEAT WITH BLOOD STAGNATION

Clinical Manifestations	Ulcerated sores that do not heal on a limb that is dark red Slightly swollen and warm to the touch There may me a rotten smell to the lesion Gangrene of the extremities, especially the fingers and toes with purulent abscess Extreme pain Local inflammation and swelling There may be copious discharge of pus from the ulcers A burning sensation Sciatica Fever Thirst T: Red C: Normal P: Rapid
Treatment Principle	Clear Heat Resolve toxicity Nourish Yin Invigorate the Blood Alleviate pain
Herb Formulas	Si Miao Yong An Tang
Points

COLD-DAMP IN THE LOWER JIAO (CHRONIC)

Clinical Manifestations	Cold pain in the lower back and body Sciatica Copious urination Extreme heavy sensation in the lower back Absence of thirst T: Pale C: White P: Deep, thready and moderate
Treatment Principle	Warms Yang Strengthen s the Spleen Dispel Cold Eliminate Dampness
Herb Formulas	Gan Cao Gan Jiang Fu Ling Bai Zhu Tang Lumbago #1
Points

COLD IN THE CHANNELS DUE TO BLOOD DEFICIENCY (CHRONIC)

Clinical Manifestations	Long standing cold hands and feet that are cold to the touch and feel cold to the patient Maybe lumbago and leg pain Abdominal pain and distention Midline pain Uterine pain Chills Diarrhea Menstrual abdominal pain Maybe chest pain Increased sweating, particularly of the feet Increased salivation Spasm and pain of the limbs Scanty urination Pain at the waist, hips, legs and feet Sciatica Joint pain Irregular menstruation Abdominal Cold Migraine headache Vaginal discharge T: Pale C: White P: Deep and thready (may be almost imperceptible).
Treatment Principle	Warm the channels Disperse Cold Nourish the Blood Unblock the Blood vessels
Herb Formulas	Dang Gui Si Ni Tang modified
Points

TENDON BI DUE TO DAMP HEAT IN THE LOWER JIAO (CHRONIC)

Clinical Manifestations	Stabbing or burning pain along some channels A bitter taste in the mouth Pain in low back and knees Weakness or atrophy of lower extremities Scanty yellow urine Red, hot, swollen and painful feet or knees Edema in lower legs Eczema Painful and swollen feet Pain and swelling of the joints Leukorrhea (thick, yellow and foul-smelling) Sores on lower extremities due to Damp Severe numbness and weakness in lower extremities T: Normal C: Yellow and greasy P: Soft and rapid
Treatment Principle	Eliminate Heat Resolve Dampness
Herb Formulas	Si Miao Wan modified
Points

LEG SHAO YIN SINEW CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Pain is sharp and severe Muscle contractures Sudden onset resulting from exposure to Cold or trauma Painful contracture and stiffness of the fourth toe radiating toward the lateral aspect of the knee Difficulty flexing or extending the knee Pain in the lateral aspect of the thigh, hip and buttock up to the sacrum
Treatment Principle
Herb Formulas
Points	Local Ahshi points, GB-29, GB-30, GB-31, GB-34, GB-38, GB-43, GB-44

LEG YANG MING SINEW CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Pain is sharp and severe Muscle contractures Sudden onset resulting from exposure to Cold or trauma Painful contracture and stiffness that affects the three medial toes Pain with a twisting sensation all along the pathway Pain starts at the instep Pain ascends along the lateral aspect of the leg Pain branches at the fibula Pain ascends the lateral aspect of the thigh and hip Pain travels along the flank and inserts at the spine
Treatment Principle
Herb Formulas
Points	Local Ahshi points, ST-36, ST-41, ST-45

LEG TAI YANG SINEW CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Pain is sharp and severe Muscle contractures Sudden onset resulting from exposure to Cold or trauma Painful contracture and stiffness that affects the small toe A swelling sensation of the heel Pain along the pathway of the posterior aspect of the lower limb Stiffness when hyperextending the spine Pian in the cervical portion of the spine Difficulty turning the head Contracture in the axilla or supraclavicular fossa
Treatment Principle
Herb Formulas
Points	Local Ahshi points around the paravertebral points, below the iliac crest and above the popliteal fossa, UB-38, UB-57, UB-60, UB-67

SHAO YIN SINEW CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Pain is sharp and severe Muscle contractures Sudden onset resulting from exposure to Cold or trauma Painful contractures of the sole of the foot Pain along the entire pathway of the channel along the lateral aspect of the spine to the neck Difficulty bending the lumbar area Superficial: Difficulty bending forward Deep: Difficulty bending backward The lateral aspects of the spinal processes are tender to the touch
Treatment Principle
Herb Formulas
Points	Local Ahshi points around KI-1 or KI-2, KI-7

URINARY BLADDER PRIMARY CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Muscle contractures Sudden onset resulting from exposure to Cold or trauma Pain is sharp, severe and deep, like a fracture in the lumbar area A breaking, wrenching and exploding sensation along the pathway of the channel Chills Headaches A stiff neck A stuffy nose Eye pain P: Maybe tight
Treatment Principle
Herb Formulas
Points	KI-4, UB-64 When no triggering factor has been identified: LU-7, UB-64 For Deep Cold penetrating the channel: UB-40, UB-60

GALL BLADDER PRIMARY CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Muscle contractures Sudden onset resulting from exposure to Cold or trauma The pain is located along the lateral aspect of the lower limb and in the sacroiliac joint Vertigo Headaches Bitter taste in the mouth Poor hearing Chills Difficulty turning over in bed Sequelae: Residual pain in the lateral aspect of the leg Weakness in the lower limbs Atrophy of the leg
Treatment Principle
Herb Formulas
Points	Due to Wind-Dampness: GB-30, GB-34 Due to Gall Bladder organ disorder: GB-37, GB-41 Sequelae: GB-37

STOMACH PRIMARY CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Muscle contractures Sudden onset resulting from exposure to Cold or trauma The pain is located on the lateral aspect of the leg and on top of the foot Difficulty moving the second and third toes A Cold sensation in the leg Lateral popliteal sciatica Sequelae: Residual pain in the lateral aspect of the leg Emaciated and weak legs Difficulty flexing the legs
Treatment Principle
Herb Formulas
Points	ST-38 Sequelae: ST-40

YANG QIAO CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Muscle contractures Sudden onset resulting from exposure to Cold or trauma Low back pain with the sensation of being hit by a hammer Stiffness of the entire body Difficulty getting warm in the morning An ipsilateral flexion antalgic posture Contracture of the lateral portion of the leg Pain along the channel pathway Accompanying sleep disorders
Treatment Principle
Herb Formulas
Points	GB-29, SI-3, UB-59, UB-62

CHONG CHANNEL PATHOLOGY (ACUTE)

Clinical Manifestations	Recent superficial pain Muscle contractures Sudden onset resulting from exposure to Cold or trauma Straining while lifting causing a rod-like lower back pain with possible sciatica
Treatment Principle
Herb Formulas
Points	UB-38, UB-39

DU CHANNEL PATHOLOGY (CHRONIC)

Clinical Manifestations	Recent superficial pain Muscle contractures The vertebral pain is located at the midline The pain is often accompanied by scoliosis or kyphosis Spinal stiffness Urinary disorders Occurs in patients who feel they are ill-equipped to meet life's challenges
Treatment Principle
Herb Formulas
Points	DU-1, UB-11

YANG WEI CHANNEL PATHOLOGY (CHRONIC)

Clinical Manifestations	Recent superficial pain Muscle contractures Pain along the pathway of the channel on the lateral aspect of the lower limb Painful swelling in the lumbar area A localized sensation of Heat of feverishness Sensitivity to weather changes Occurs in patients who are confused or engage in frantic activity
Treatment Principle
Herb Formulas
Points	GB-35, SJ-5

DAI CHANNEL PATHOLOGY (CHRONIC)

Clinical Manifestations	Recent superficial pain Muscle contractures Rod-type lower back pain that radiates around the belt line Pain is aggravated by movement Weakness of the ankles Pelvic problems A cold sensation in the buttocks and extremities Occurs in individuals who feel isolated or who cannot find their place in society
Treatment Principle
Herb Formulas
Points	GB-26, GB-41

YANG TYPE (ACUTE)

Clinical Manifestations	Recent superficial pain Muscle contractures Sudden onset resulting from exposure to Cold or trauma Yang Excess type pain in the lower back and abdomen due to strain The pain is worse with pressure, coughing or local application of warmth The pain spreads along the Tai Yang pathway to the lower limbs
Treatment Principle
Herb Formulas
Points	UB-29, UB-36, UB-60

YIN TYPE - PATHOGENIC COLD OBSTRUCTION (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Muscle contractures Sudden onset resulting from exposure to Cold or trauma Cold Stagnation in the pelvis prevents Qi from entering the trunk affecting the Tai Yang Channel and manifesting as Yin Excess signs in the pelvis and Yang Excess signs in the lower extremities
Treatment Principle
Herb Formulas
Points	Moxa REN-4, needle KI-13, ST-31, UB-31

YIN TYPE - BLOOD STAGNATION (ACUTE)

Clinical Manifestations	Sciatica Recent superficial pain Muscle contractures Sudden onset resulting from exposure to Cold or trauma Stabbing low back pain associated with the menstrual cycle in women or potential prostate pathology in men Hemorrhoids May become chronic
Treatment Principle
Herb Formulas
Points	SP-4, ST-30, ST-36, UB-37, UB-53

POST-OPERATIVE

Clinical Manifestations	Sciatica Recent superficial pain Muscle contractures Invasion of pathogenic Cold generating local Blood Stasis
Treatment Principle
Herb Formulas
Points	Moxa, moxa-needle or cup REN-6, UB-23, UB-31

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