Unilateral pain is pain at one side of the body, including that in the joints, tendons and muscles; it may

be accompanied by numbness, tingling, diminished sensitivity, restlessness, insomnia, sweating, fatigue or even hemiplegia. According to TCM, unilateral pain can be caused by disorder of the Internal organs or by disturbance of the channels. Many factors may lead to pain at one side of the body, including invasion of the channels by External Wind, blockage of Wind and Phlegm, stagnation of Liver-Qi, deficiency of Qi and stagnation of Blood, and deficiency of Yin of the Liver and Kidney.

Unilateral pain may be attributed to any of the following disorders in Western medicine: the common cold, influenza, poliomyelitis, polymyalgia, rheumatism, depression, chronic fatigue syndrome, cerebral infarction and cerebral haemorrhage. Aetiology and pathology Invasion of External factors External Wind is one of the most common causative factors in unilateral pain. Wind exists as a pathogenic factor that may quickly invade the body in any season. When it invades the body, it combines itself with other pathogenic factors, such as Cold, Damp or Heat, and induces disharmony between the Defensive and

Nutritive Qi systems. The result of this is that the Defensive Qi cannot distribute the Body Fluids evenly, so the Body Fluids are unable to remain completely within the channels. Therefore the Qi and Blood cannot circulate freely to nourish the body and unilateral pain follows. Moreover, an invasion of External Wind may cause stagnation of Qi and Blood in the channels, muscles and Tendons, which could at a later stage cause stagnation of Blood, resulting in unilateral pain. Improper diet Eating too much sweet or greasy food may damage the Spleen and Stomach, easily leading to the formation of Internal Damp-Phlegm. Phlegm is a substantial Yin pathogenic factor, which may circulate together with

Qi, thus reaching everywhere in the body. DampPhlegm can also block Qi circulation and cause stagnation of Qi in the channels, tendons and muscles. Emotional disorders The Liver regulates the Qi circulation and stores the Blood. The emotions are closely related with the function of the Liver, and negative emotions, such as anger, stress and frustration, may cause stagnation of the Liver-Qi, which may in turn cause dysfunction of the circulation of Blood. When the Tendons and muscles are not nourished properly, unilateral pain occurs. Prolonged sickness, weak constitution and overstrain

Multiple birth, chronic diseases and physical overexertion consume the Qi and may cause Qi and Blood deficiency. When the Tendons and muscles are not nourished properly by Qi and Blood, unilateral pain occurs. Unilateral pain unilateral pain 61 Moreover, Qi is the power that promotes the free flow of Blood in the body, and if it is insufficient, the Blood circulation will slow, and later on eventually stagnate, and so unilateral pain occurs. Weak constitution, old age and sexual over activity may cause consumption of the Kidney-Yin. As the

Liver and Kidney share the same source, deficiency of Kidney-Yin may cause deficiency of Liver-Yin. As a result, there is insufficient Yin and Blood in the channels to nourish the tendons and muscles, and so pain occurs. Many chronic cases with unilateral pain are due to deficiency of the Yin of the Liver and Kidney. Treatment based on differentiation Before a differentiation is made, it is important to make a general examination of the patient. Special attention should be paid to the following characteristics of the

unilateral pain: the quality, the accompanying symptoms and the factors that cause the pain to start, to increase or to decrease.

Differentiation
Differentiation of the quality of the pain Acute pain with an aversion to cold is usually due to an invasion of External Wind Stagnation of Liver-Qi usually causes chronic pain with distension and migration Stabbing pain with fixed locations and palpable nodulation or masses is usually due to stagnation of Blood Pain with numbness and a heavy sensation is usually caused by Wind-Phlegm A slight pain, which is up and down, and closely

related with tiredness, aggravation of the pain by exertion and tiredness is usually due to deficiency of Qi and Blood A mild pain with a burning sensation is usually due to deficiency of Yin. Differentiation of occurrence, aggravation and relief of unilateral pain An acute pain that starts or is aggravated when the patient feels cold or after sweating is usually due to an invasion of External Win A pain that occurs during the menstruation period is usually caused by stagnation or deficiency of Blood If a chronic pain starts or is aggravated when the patient feels warm or is in a hot environment, deficiency of Yin is usually the caus

 If the pain starts or gets worse under stressful or other emotional conditions, it is usually due to stagnation of Liver-Qi If a pain that starts after trauma, operations, strokes or other diseases is usually caused by stagnation of Qi and Blood If the pain occurs or gets worse at night, it is usually due to stagnation of Blood or to deficiency of Yin. Differentiation of accompanying symptoms A pain accompanied by fever, an aversion to cold and pain in the limbs is usually due to an invasion of External Wind Pain with irritability or bad mood is usually due to stagnation of Liver-Qi

 Pain accompanied by numbness and a heavy feeling is usually caused by Wind-Phlegm When the pain is combined with fatigue, palpitation, dizziness, and pale lips, it is usually due to deficiency of Qi and Blood Deficiency of Yin usually causes pain with a hot sensation and dizziness Pain with a sharp or stabbing sensation is usually due to stagnation of Blood.

Treatment Invasion of Wind-Cold

Symptoms and signs Signs and symptoms of Wind-Cold are a unilateral pain in the trunk, a unilateral joint pain in the extremities, back pain, fever, an aversion to cold, sweating or lack of sweating, headache, a stiff neck, a lack of thirst,

clear urine, a pale tongue with a white coating and a floating and wiry pulse. Principle of treatment Dispel the External Wind, regulate Defensive and Nutritive Qi, harmonise the Collaterals and relieve the pain. HERBAL TREATMENT PRESCRIPTION

Main formula
GUI ZHI TANG

Cinnamon Twig Decoction. This formula is

specially indicated in slight invasion of Wind-Cold, causing disharmony between the Nutrient Qi and Defensive Qi. Although Gui Zhi Ramulus Cinnamomi could harmonise the Collaterals and promote the Blood circulation

62 generalised body pain in the channels, it is still not enough to use this formula along. Some other herbs should be applied simultaneously, such as Qiang Huo Rhizoma seu

Radix Notopterygii 10g, Si Gua Luo Fasciculus Vascularis Luffae

10g, Chuan Xiong Radix Ligustici Wallichii 10g, Xi Xian Cao Herba Siegesbeckiae 10g and Xi Xin Herba

Asari 5g
to increase the effect of promoting sweating, harmonising the collaterals and relieve the pain.

Alternative formula
JING FANG BAI DU SAN

Schizonepeta and Ledebouriella Powder to Overcome

Pathogenic Toxin. This formula can dispel Wind,

eliminate the Cold and relieve the External symptoms. Gui Zhi Ramulus Cinnamomi Cassiae 10g, Bai Zhi

Radix Angelicae Dahuricae 10g and Qiang Huo Rhizoma seu Radix Notopterygii 10g, etc, should be added to
relieve the pain.

Modifications
1. If there is headache, add Gao Ben Rhizoma et

Radix Ligustici 10g to dispel the Wind and relieve the

headache 2. If there is a stiff neck, add Ge Gen Radix

Puerariae
15g to relax the Tendons, regulate the circulation of Qi and relieve the neck pain

3. If there is a severe pain with a cold sensation, add Gan Jiang Rhizoma Zingiberis Officinalis 5g to warm the channels and relieve the pain 4. If there is joint pain, add Du Huo Radix

Angelicae Pubescentis 10g and Chuan Shan Long Rhizoma Dioscoreae Nipponicae 20g to eliminate the
External Wind and relieve the pain 5. If there are stiff limbs, add Sang Zhi Ramulus

Mori Albae 10g to harmonise the collaterals, regulate

the channels and relieve the limb stiffness 6. If there is abdominal pain with cold sensation, add Yan Hu Suo Rhizoma Corydalis 10g and Gao Liang

Jiang Rhizoma Alpiniae Officinari 5g to warm the Interior, dispel the Cold and relieve the pain.

Patent remedy
Jing Fang Bai Du Pian Schizonepeta and

Ledebouriella Tablet to Overcome Pathogenic Influences.

ACUPUNCTURE TREATMENT MAIN POINTS LI-4 Hegu, TE-5 Waiguan, GB-34 Yanglingquan, ST-36 Zusanli, BL-58 Feiyang, BL-60 Kunlun and BL-63 Jinmen. Reducing method is used on these points. Moxibustion should be applied on these points.

Explanations
LI-4, the Source point of the Large Intestine channel, regulates the Qi and promotes sweating. TE-5, the Connecting point of the Triple Burner channel, regulates the Qi circulation and relieves

the pain. These two points in combination relieve pain in the arm GB-34, the Sea point of the Gallbladder channel, relieves pain along the channel. It is also the Gathering point of the Tendons, regulating the circulation of Qi in the Tendons and relieves the pain and spasm in the limbs ST-36, the Sea point of the Stomach channel, regulates the circulation of Qi and relieves the pain. BL-60, the River point, regulates the circulation of Qi in the Bladder channel, dispels the External Wind and relieves the pain BL-58, the Connecting point of the Bladder channel, and BL-63, the Accumulation point, promote the circulation of Qi in the channel and relieve the pain. Moxibustion promotes the Qi and Blood circulation

and relieves the pain.

Alternative points
LI-3 Sanjian, TE-6 Zhigou, BL-10 Tianzhu, BL-58 Feiyang, BL-63 Jinmen, BL-64 Jinggu and GB-41 Zulinqi, etc.

Modifications
1. If there is fever, add GV-14 and LI-11 to promote sweating and lower the fever 2. If there is a stiff neck, add GB-20 and BL-10 to promote the circulation of Qi and relieve the pain 3. If the joints are painful and swollen, add Ah Shi points and SP-9 to eliminate the Damp and relieve the swelling 4. If there is headache, add GV-20 and LU-7 to

promote the Qi circulation and relieve the headache 5. If there is back pain, add GB-21 and BL-23 to regulate the Qi circulation and relieve the pain.

Invasion of Wind and Damp

Symptoms and signs Acute occurrence of unilateral pain with a heavy sensation, awkward or even paralysed limbs on the same side of the body, soreness or numbness of the muscles, dizziness with a heavy feeling, nausea, painful and swollen joints, a poor appetite, fullness of the stomach, loose and sticky faeces, a tongue with a white and greasy coating and a wiry and slippery pulse are the signs and symptoms of this condition.

unilateral pain 63 Principle of treatment Dispel the Wind, eliminate the Damp and relieve the pain. HERBAL TREATMENT PRESCRIPTION

Main formula
QIANG HUO SHENG SHI TANG

Notopterygium Dispelling Dampness Decoction.

This formulas could be used to treat the pain due invasion of Wind-Damp, especially Wind, Cold and Damp. Typically this formula was originally designed for headache, but its effect to treat the entire body pain is also obvious. Xi Xin Herba Asari 5g could be added into this formula to strengthen the effect of pain relieving.

Alternative formulas
JUAN BI TANG

Remove Painful Obstruction Decoction. This

formula is good for dispelling External Wind, eliminating Damp-Phlegm, promoting the Qi and Blood circulation and relieving the pain. Si Gua Luo Fasciculus

Vascularis Luffae 10g, Chuan Xiong Radix Ligustici Wallichii 10g, Xi Xian Cao Herba Siegesbeckiae
10g and Xi Xin Herba Asari 5g should be added to increase the effect of promoting sweating, harmonising the collaterals and relieve the pain. JING FANG BAI DU SAN

Schizonepeta and Ledebouriella Powder to Overcome

Pathogenic Toxin. This formula has good

properties which dispel the External Wind, eliminate the Cold, remove the Damp and relieve the pain. As with the above formula, it doesnt have a strong effect on harmonising the collaterals and promoting the channels, therefore some other herbs could be added, such as Si Gua Luo Fasciculus Vascularis Luffae 10g, Xi Xian Cao

Herba Siegesbeckiae 10g and Xi Xin Herba Asari

5g.