Herbal Therapy for Hip OA

In my last article [June issue], I addressed treatment of hip osteoarthritis with acupuncture point protocols. In this installment, let’s discuss herbal patent medicines that are also effective in treating hip OA. This is a condition I treat extensively with both herbal medicines and acupuncture.

I see a large volume of patients with officially diagnosed OA of the hips, knees and back, as well as patients who suffer from basic joint pain due to low-grade inflammatory issues, who respond well to Chinese patent medicines. While the focus of this article is OA of the hip, the herbal medicines discussed can be highly effective for a wide array of OA issues.

Understanding OA: The TCM Perspective

Falling under the category of bi syndromes, OA presentations can be treated with extremely nuanced accuracy when the clinician takes the proper time to effectively establish the pattern(s) involved. OA presentations rarely present with a single pattern and the traditional subcategories of bi syndrome are extremely in effectively treating the suffering of the patient.

The majority of patients presenting with OA have tried the standard nutritional supplements for joint pain / inflammation, such as fish oil, turmeric, nettle leaf, and boswellia; as well as cartilage-stimulating supplements such as glucosamine / chondroitin.

While these supplements often provide excellent results, they do not provide the surgical precision of properly prescribed herbal patent medicines harmonized with the subcategories of bi syndrome: wind-cold damp bi, blood stagnation bi, deficiency bi, cold bi, and heat bi. In my clinic, I see all of these expressions, and in the majority of cases, local weather patterns, seasons and the patient’s overall constitution coalesce to manifest the particular pattern constellation of bi pain, which is typically diagnosed as OA of the joints.

It is extremely important to spend ample time patiently examining the signs and expressions of the patient’s OA pain. Every pain presentation has a “resonance” and clinicians must be able to listen to the patient’s unique resonance of pain.

Examine the tongue, pulse and subjective symptoms certainly, but you must also inquire as to how the pain is influenced by the season, how the patient adapts to temperature shifts, their quality of sleep, and any events / substances which exacerbate the OA pain. This part of the clinical examination is often the single most important part of effectively treating OA issues with herbal patent medicines (as well as acupuncture).

Herbal Formulas for Blood Stagnation Bi Syndrome

This is an extremely important pattern when treating OA of the hip and other joints. Many areas of joint tissue are avascular and as a result do not receive the healthy flow that carries qi, as well as all nutrients which heal and rejuvenate joint tissue. This pattern tends to present with severe pain in fixed areas with accompanying numbness. These symptoms are almost always encountered in OA of the hip.

Shen Tong Zhu Yu Tang: This is an extremely important formula created by Wang Qing-Ren, the 19^th-century master of blood stasis formulae. Shen Tong Zhu Yu Tang has the actions of invigorating blood, breaking blood stasis, opening the channel and collaterals, and relieving pain. The pulse is typically wiry and deep, but may be choppy; the tongue is typically dark with dark spots and engorged sublingual veins.

This formula is particularly important when the pain is causing numbness, tingling and deep aching. All of these symptoms are typically present in OA of the hip. (Shen Tong Zhu Yu Tang can also be used for pain following physical trauma and sports injuries with a high level of effectiveness.)

Zhong Guo Tong Xue Wan / Zhong Guo Shen Jing Tong: This contemporary formula has variation, but all variations have the effects of moving blood, dispelling stasis, tonifying blood, benefiting the kidneys and liver to strengthen tendons and bones, and stopping pain. I use this formula extensively in seniors suffering from OA of the hip with significant signs of kidney / liver yin deficiency with underlying blood stasis.

This formula can provide surprisingly quick pain relief while helping stimulate deep, restorative healing of joint tissue via supplementation of the kidney and liver organs.

Herbal Formulas for Heat Bi Syndrome

Heat bi syndrome is typically characterized by red, warm, swollen joints. This syndrome is very common in chronic inflammatory issues with OA of the hip and knees. The pulse can be slippery / wiry and fast; the tongue is typically red and dry with yellow coat, sometimes damp with yellow coat, and sometimes normal.

Sometimes this pain can be dramatically relieved with application of cold, but often application of heat also can help, which can be clinically confusing unless other signs are checked.

Si Miao Wan: This formula is extremely simple, yet highly effective for pain below the waist – particularly OA of the hips and knees. Si Miao Wan has the actions of dispelling damp, clearing heat, dredging and opening the channels and collaterals, and relieving pain.

I use this formula extensively for OA of the hip and knees that presents with obviously red, warm, swollen joints; but also for pain which is worse in hot, humid climates / seasons and pain improved by gentle movement and water rehabilitation therapy.

This herbal patent medicine is also excellent for long standing, low-grade pain that is not responding to typical allopathic prescription or over-the-counter pain medication.