Osteoarthritis

TCM disease & pathogenesis

In TCM this is 'bone bi' (gu bi). The Plain Questions (Su Wen, Bi Lun) states: 'When wind, cold, and dampness arrive together they combine into bi … encountered in winter it is bone bi'; another chapter adds 'when the disease is in the bones the bones feel heavy and cannot lift, the marrow aches, and cold qi arrives—this is called bone bi,' clearly describing joint heaviness, aching, cold aggravation, and restricted movement. The lesion is in bones and joints, governed chiefly by the kidney (which governs bones and generates marrow) and liver (which governs sinews). After middle age liver-kidney gradually decline and qi-blood become insufficient, leaving bones and sinews malnourished; recurrent wind-cold-dampness or injury and overstrain then make qi-blood stagnate and block the meridians—obstruction causes pain. Chronic disease further weakens liver-kidney while static blood and phlegm-turbidity obstruct the collaterals, deforming and stiffening the joints. It is root deficiency with branch excess; treatment supplements liver-kidney and strengthens bones and sinews, assisted by expelling wind, dispersing cold, draining dampness, and quickening blood to free the collaterals.