REPETITIVE STRESS INJURY Flashcards

1
Q

REPETITIVE STRESS INJURY

A

Multiple, tiny strains from repetitive motions
Occurs in muscles, tendons, attachments
Occupational etiology: generally, pain in shoulder, elbow, forearm, wrist and hand
Sports etiology: knee and ankle
Pain: dull, sharp exacerbations; use worsens
_At first with prolonged use; later, any use at all
_May have swelling, numbness, tingling, heaviness, fatigue
TCM: external accumulation of Qi and Blood
Rest is essential
Acupuncture: local, distal, trigger points; regular Tx’s

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2
Q

ELBOW

A
INVASION OF EXTERNAL FACTORS
_Wind
_Damp
_Heat
_Generally acute onset, external Sx
STAGNATION OF BLOOD
_Overwork, sports or overuse, physical trauma
_Acute onset with Hx of trauma; Chronic onset
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3
Q

ELBOW-INVASION OF EXTERNAL FACTORS
SX
T & P
TX: principle & pts

A

Acute elbow pain, aversion to Cold or Wind, varying with weather, limitation of movement
T: Thin white coat P: Floating, superficial
TX: Dispel Wind and eliminate External factors

LI 4, LI 10, TW 5, GB 20, Ashi points

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4
Q

ELBOW-STAGNATION OF BLOOD
SX
T & P
TX: principle & pts

A

Traumatic Hx or Hx of elbow strain, elbow pain of long duration, stabbing pain in elbow, aggravated at night or by immobility, limitation of elbow movement, dislike of pressure and massage
T: Purplish P: Wiry
TX: Promote circulation of Blood, eliminate Blood stasis, relieve pain
LI 3, LI 4, LI 6, LI 10, TW 5, TW 10, LIV 3, SP 6

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5
Q

ELBOW-JOINT FX

A

Hinge joint
Flexion of elbow enables us to eat
Enables supination & pronation of wrist

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6
Q

ELBOW-YIN & YANG PTS

A

YIN: LU5, H3, PC3
YANG: LI10, LI11,LI12, TW10

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7
Q

FOREARM, WRIST & HAND
FX:
PTS ON HAND

A

Junction of forearm and hand
Upper forearm muscles move wrist, fingers and thumb
Wrist: six meridians
Hand: meridian polarity
Points on hand treat acute problems and emotional issues

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8
Q

WRIST
PATHOLOGY: AX OF P-D, S OF QI & BLD,
DEF OF BLD

SX: EXT & INT

A

INVASION OF WIND COLD
ACCUMULATION OF PHLEGM DAMP
STAGNATION OF QI AND BLOOD
DEFICIENCY OF BLOOD

External: acute onset, short duration, external symptoms; invasion of pathogenic factors

Internal: chronic onset, long duration, Sx of internal disorder; disorder of Internal organs

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9
Q
WRIST-INVASION OF WIND COLD	
_SX
_T
_P
_TX: principle & pts
A

Acute wrist pain, swelling and pain of wrist with cold sensation, difficulty in relaxing or extending the wrist, worsening of pain in cold weather; alleviation of symptoms with movement, spasm in fingers or arms aversion to cold, prefers warmth
T: Purplish, white coat
P: Wiry, or tight
TX: Dispel Cold, regulate Qi, alleviate Pain
LI 3, LI 4, LU 7, SI 4, TW 5, Ba Xie, Ashi

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10
Q
WRIST-ACCUMULATION OF PHLEGM DAMP
_SX
_T
_P
_TX: principle & pts
A

Swelling and pain of wrist, limitation of movement, heavy sensation in wrist and fingers, formation of soft nodules around wrist, poor appetite, loose stools
T: Pale, white and greasy coat
P: Deep, slippery
TX: Promote Qi circulation, eliminate Phlegm, alleviate pain
LI 4, LI 5, LU 7, TW 4, SI 6, SP 6, ST 40, Ashi

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11
Q
WRIST-STAGNATION OF Qi and BLOOD
_SX
_T
_P
_TX: principle & pts
A

Chronic wrist pain with numbness, Hx of traumatic injury to wrist, or wrist operation, pain worse at night or with emotional upset, alleviation of pain with movement, cold or purplish hands, preference for warmth
T: Purplish
P: Wiry
TX: Regulate Qi and Blood, eliminate Blood stasis, alleviate pain
LI 4, PC 7, LU 9, HT 7, SI 4, SI 5, SP 6, LIV 3, Extra Ba Xie

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12
Q
WRIST-BLOOD DEFICIENCY
_SX
_T
_P
_TX: principle & pts
A

Slight wrist pain, numbness and slight stiffness of wrist, weakness of wrist and hands, pale complexion, pale lips, dizziness, palpitations, dry stools
T: Pale, thin white coat
P: Thready and weak
TX: Tonify Qi, nourish Blood and alleviate Pain
PC 7, HT 7, ST 36, SP 6, LU 9, A shi

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13
Q

Points of the Wrist and Hands

A
Local:
LU 9, 10
LI 3, 4, 5
SI 3, 4, 5
TW 3, 4, 5
HT 5, 7, 8
PC 6, 7
Shang Ba Xie, Ba Xie, Sifeng

Distal:
LI 6, 10
LU 7

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14
Q
HAND: Palmar Pain; ETIOLOGY 
_INV OF EXT C-D
_INV OF EXT D-H
_S OF LIV-QI W YANG DEF
_INV OF T-F
_S OF BLD
A
INVASION OF EXTERNAL COLD DAMP
INVASION OF EXTERNAL DAMP HEAT
STAGNATION OF LIVER Qi with YANG DEF.
INVASION OF TOXIC FIRE
STAGNATION OF BLOOD
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15
Q
HAND: Palmar Pain-INVASION OF EXTERNAL COLD DAMP
_SX
_T
_P
_TX: principle & pts
A

Palm pain with a cold, heavy sensation, worse with exposure to cold and humid weather or by contact with water, alleviated by warmth, swelling of joints; pale skin of hands, slight fever, aversion to cold, numb or frigid fingers, cold limbs, poor appetite, absence of thirst, clear urine
T: Pale, white moist coat
P: Floating, tense
TX: Dispel Cold-Damp, promote Blood circulation
LI 4, LI 5, TW 5, LU 7, SI 3, LIV 3

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16
Q
HAND:Palmar Pain-INVASION OF EXTERNAL DAMP-HEAT
_SX
_T
_P
_TX: principle & pts
A

Palmar pain with a hot and heavy sensation, accompanied by redness, swelling and a burning feeling in the finger joints or all the limb joints, preference for cold, fever, thirst, yellow urine, restlessness
T: Red, yellow coat
P: Rapid, slippery
TX: Clear Damp-Heat, promote Blood circulation
LI 3, LI 11, TW 5, PC 6, SP 6, SP 9

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17
Q
HAND:Palmar Pain-INVASION OF TOXIC FIRE 
_SX
_T
_P
_TX: principle & pts
A
Formation of ulcers and oedema in the palm, reddish skin on the palm with a hot feeling, aggravation of pain with pressure, itching and a wet palm, thirst with cold drinks, bitter taste in mouth, fever, an aversion to cold, constipation, scanty and yellow urine
T:  Red, yellow and dry coat
P:  Rapid
TX:  Clear FIRE,   tonify QI & Blood 
LI 4, LI 11, PC 8, TW 2, SP 6, ST 40
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18
Q
HAND:Palmar Pain-LIVER QI STAGNATION with YANG DEFICIENCY
_SX
_T
_P
_TX: principle & pts
A

Palmar pain with a distending and cold sensation, aggravated by emotional upset or exposure to cold especially during menstrual period, pale color of skin of the hand, hypochondriac pain, fatigue, poor appetite, dull feeling in Stomach, irritability
T: Pale, white coat
P: Deep, wiry
TX: Regulate Liver Qi, warm Liver channel, dispel Cold
LI 4, ST 36, PC 6, LIV 3, BL 18, GB 20

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19
Q
HAND:Palmar Pain-BLOOD STAGNATION
_SX
_T
_P
_TX: principle & pts
A

Traumatic injury to or operation on wrists, palm and fingers; long-standing pain in palm, stabbing pain with a fixed location, worse at night, alleviated by movement, rigidity of palm or fingers, swelling of joints and hands
T: Purplish, thin coat
P: Wiry and choppy
TX: LI 3, TW 5, LU 7, PC 6, GB 34, ST 36, BL 17

20
Q

HAND: Finger Pain/Etiology
AC OF C-D IN CHANNELS
S O QI &BLD
LIV+K ESS DEF

A

ACCUMULATION of COLD DAMP IN CHANNELS
STAGNATION OF Qi and BLOOD
BLOOD DEFICIENCY
LIVER and KIDNEY ESSENCE DEFICIENCY

21
Q
HAND: Finger Pain-ACCUMULATION OF COLD-DAMP
_SX
_T
_P
_TX: principle & pts
A

Swelling and pain in fingers, heaviness and numbness of fingers with a cold sensation, worse in damp cold weather, limitation of joint , movement, spasms of fingers, difficulty grasping; heaviness of body, aversion to cold, poor appetite, loose stools
T: pale, white, greasy coating
P: Deep, slow and slippery, or tight
TX: Dispel Cold, remove Damp, regulate Qi
TW 5, CV 12, SP 6, SP 9, LI 4, Extra Ba Xie, Ashi

22
Q
HAND: Finger Pain-ACCUMULATION OF DAMP-HEAT
_SX
_T
_P
_TX: principle & pts
A

Swelling, redness and pain in fingers, worse in damp, warm weather; heaviness and numbness in fingers, difficulty grasping, limitation of joint movement, spasm of fingers; heaviness of body, poor appetite, loose stools
T: Red, yellow, greasy coat
P: Deep, slippery and rapid, or tight and rapid
TX: Dry Damp, clear Heat, regulate Qi, alleviate pain
TW 6, CV 12, LI 2, LI 3, LI 4, ST 40, ST 44, SP 9, Extra Ba Xie, Ashi

23
Q
HAND: Finger Pain-STAGNATION OF Qi and BLOOD
_SX
_T
_P
_TX: principle & pts
A

Chronic Hx of finger pain or Hx of trauma or operation, pain and numbness in fingers, worse at night, better with movement, cold or purplish fingers and hands, preference for warmth
T: Purplish
P: Deep, wiry
TX: Regulate Qi and Blood, alleviate Pain
LI 4, LI 11, PC 6, LU 7, SP 6, Extra Ba Xie, Ashi

24
Q
HAND: Finger Pain-BLOOD DEFICIENCY
_SX
_T
_P
_TX: principle & pts
A

Slight finger pain, numbness of fingers with stiffness, weakness in hands, pale complexion, pale lips, dizziness, palpitations, dry stools
T: Pale, thin white coat
P: Thready, weak
TX: Tonify Qi, nourish Blood, alleviate Pain
LI 4, PC 6, HT 7, SP 6, ST 36, KD 3, Ashi

25
Q
HAND: Finger Pain-LIVER and KIDNEY ESSENCE DEFICIENCY
_SX
_T
_P
_TX: principle & pts
A

Slight finger pain with spasm, gradual deformity of fingers, weakness of the fingers, wrists, arms and legs; tiredness, lower back pain, tinnitus, poor memory, hair loss
T: Thin coat
P: Weak, especially in KD
TX: Tonify KD and LIV, nourish Essence, strengthen tendons and bones, alleviate pain
LI 4, PC 6, KD 3, LIV 3, SP 6, Ashi

26
Q

DX PTS

A

FORARM

HIP, BUTTOCK, GROIN & THIGH

27
Q

LOWER EXTREMITIES-PATHOLOGY
INV OF W-C-D
SX-T-P

A

INVASION OF WIND-COLD-DAMP

WIND: wandering pain, worse in windy weather, limited movement, chills and fever;
T: thin white greasy P: superficial

COLD: severe pain, cold feeling, better with warmth, cold limbs.
T: White coat P: Tight, superficial

DAMP: Pain and swelling, limited joint movement, worse in cloudy and rainy weather, numbness of the skin and muscles, heavy sensation in buttocks and lower limbs, limping; T: White, greasy coat P: Soft, slow

28
Q

LOWER EXTREMITIES-DOWNWARD FLOW OF DAMP HEAT
_SX
_T
_P

A

Swelling, pain, limited movement, burning sensation with redness; irritability, restlessness, poor appetite, bitter taste, scanty, yellow urination, occasional fever
T: Yellow and greasy coat
P: Rapid pulse

29
Q

LOWER EXTREMITIES-STAGNATION OF QI AND BLOOD
_SX
_T
_P

A

Fixed, stabbing pain, swelling of joints, Hx of trauma, limited movement, worse on rest and at night, alleviated by movement; red or hard nodules under the skin around joints
T: Purplish, purple spots
P: Choppy or thready

30
Q

LOWER EXTREMITIES-QI AND BLOOD DEFICIENCY
_SX
_T
_P

A

Intermittent pain, alleviated with rest or pressure, aggravated by overwork, numbness and weakness of the lower limbs; tiredness, pale complexion, poor appetite, loose stools, SOB, aversion to cold
T: Pale, thin white coat
P: Thready, weak

31
Q

LOWER EXTREMITIES-LIVER AND KIDNEY DEFICIENCY
_SX
_T
_P

A

Chronic pain, difficult movement, aggravated by overstrain, weakness of lower back, knees, rigidity in morning, joint deformity, muscular atrophy; fatigue, lower back pain, aversion to cold
T: Thin, white coat
P: Deep, wiry; weak on KD

32
Q
HIP-ETIOLOGY 
INV OF EPF
D-H-FD
S-O QI & BLD
DEF O QI & BLD
LIV & K DEF
A
INVASION of EXTERNAL PATHOGENIC FACTORS
DAMP HEAT FLOWING DOWNWARD
STAGNATION OF QI AND BLOOD
DEFICIENCY OF QI AND BLOOD
LIVER AND KIDNEY DEFICIENCY
33
Q

HIP-INVASION OF WIND-COLD-DAMP

_TX

A

WIND: Dispel Wind, resolve Damp, eliminate Cold
TW 5, LI 4, BL 12, GB 30, GB 31, GB 35, SP 10, SP 6

COLD: Warm, dispel Cold, dispel Damp
TW 5, LI 4, GB 30, GB 31, GB 41, ASHI

DAMP: Eliminate Damp, dispel Cold, Wind
TW 5, LI 4, ST 31, ST 40, SP 9, GB 29, GB 30, BL 12, BL 54, BL 58, ASHI

34
Q

HIP TX
_STAGNATION OF QI AND BLOOD
_DEFICIENCY OF QI AND BLOOD
_LIVER AND KIDNEY DEFICIENCY

A

STAGNATION OF QI AND BLOOD
LI 4, SP 6, SP 10, BL 17, LIV 3, GB 29, GB 30, ST 31, ASHI

QI AND BLOOD DEFICIENCY
GB 30, GB 34, GB 39, ST 31, LIV 3, KD 3, ST 36, SP 6 ASHI

LIVER AND KIDNEY DEFICIENCY
GB 29, GB 30, GB 34, ST 31, ASHI, KD 3, BL 23, BL 18,
SP 6, Hua Tou Jia Ji

35
Q

KNEE-PTS

A

PTS

36
Q

KNEE-INVASION OF WIND COLD DAMP

TX

A

WIND:
TW 5, LI 4, GB 31, GB 35, SP 6, ASHI
COLD:
TW 5, LI 4, GB 34, GB 35, ST 36, Xi Yan, Ashi, SP 6
DAMP:
TW 5, LI 4, GB 34, Xi Yan, ST 40, SP 6, SP 9. ASHI

37
Q

KNEE-TX
_DOWNWARD FLOW OF DAMP HEAT

_QI AND BLOOD STAGNATION

_LIVER AND KIDNEY DEFICIENCY

_QI AND BLOOD DEFICIENCY

A

DOWNWARD FLOW OF DAMP HEAT
ST 40, SP 6, SP 9, BL 64, GB 34, GB 43, ST 44, Ashi
QI AND BLOOD STAGNATION
LI 4, SP 6, SP 10, BL 17, LIV 3, GB 35, Ashi
LIVER AND KIDNEY DEFICIENCY
GB 34, GB 39, ST 34, KD 3, KD 10, SP 6, LIV 3, LIV 8
QI AND BLOOD DEFICIENCY
GB 34, GB 39, LIV 3, KD 3, ST 36, SP 6, Ashi

38
Q

LEG, ANKLE & FOOT

A

PTS

39
Q

LEG, ANKLE & FOOT

A

INVASION OF WIND-COLD-DAMP
TW 5, LI 4, BL 12, GB 30, GB 31, GB 35, SP 6, ASHI
QI AND BLOOD STAGNATION
LI 4, SP 6, BL 17, LIV 3, GB 30, ASHI
QI AND BLOOD DEFICIENCY
GB 34, GB 39, LIV 3, KD 3, ST 36, SP 6, AHSI
DOWNWARD FLOW OF DAMP-HEAT
TW 6, LI 4, ST 40, SP 6, SP 9, GB 34, ST 44, ASHI
ACCUMULATION OF PHELGM-DAMP
TW 6, LI 4, SP 3, SP 6, SP 9, ST 36, ST 40, GB 30, BL 40, ASHI
KIDNEY ESSENCE DEFICIENCY
GB 34, GB 39, KD 3, BL 23, BL 18, SP 6, ASHI

40
Q

ANKLE-TX

_INVASION OF WIND COLD DAMP

A

WIND:
TW 5, LI 4, BL 12, GB 40, GB 41, SP 10, SP 6, ASHI
COLD:
TW 5, LI 4, ST 36, SP 6, BL 12, BL 60, BL 63, GB 40, ASHI
DAMP:
TW 5, LI 4, ST 40, SP 9, BL 12, BL 63, BL 64, GB 40, ASHI

41
Q

ANKLE-TX
DOWNWARD FLOW OF DAMP HEAT

QI AND BLOOD STAGNATION

LIVER AND KIDNEY DEFICIENCY

A

DOWNWARD FLOW OF DAMP HEAT
TW 5, LI 4, SP 6, BL 60, GB 34, GB 40, GB 41, ST 44, ASHI
QI AND BLOOD STAGNATION
LI 4, SP 6, SP 10, BL 17, LIV 3, GB 34, ASHI
LIVER AND KIDNEY DEFICIENCY
GB 39, GB 34, LIV 3, KD 3, ST 36, SP 6,

42
Q

FOOD

A

PTS

43
Q

HEEL-TX
INVASION OF WIND-COLD-DAMP

INVASION OF TOXIC FIRE

QI AND BLOOD STAGNATION

DOWNWARD FLOW OF DAMP-HEAT

QI AND BLOOD DEFICIENCY

LIVER AND KIDNEY DEFICIENCY

A

INVASION OF WIND-COLD-DAMP
TW 5, LI 4, SI 4, BL 58, BL 60, BL 63, BL 64, KD 3, SP 6
INVASION OF TOXIC FIRE
TW 6, LI 4, LI 11, ST 44, SP 6, SP 10, BL 60, BL 63, SI 4, KD 2
QI AND BLOOD STAGNATION
LI 4, SP 6, LIV 3, SI 3, GB 34, SI 4, BL 60
DOWNWARD FLOW OF DAMP-HEAT
TW 6, SI 3, SI 4, BL 63, BL 64, KD 2, SP 6, SP 9, GB 34
QI AND BLOOD DEFICIENCY
SI 3, SI 4, BL 63, BL 64, SP 6, ST 36, GB 39, GB 34
LIVER AND KIDNEY DEFICIENCY
GB 39, GB 34, LIV 3, KD 3, SI 3, BL 63, ST 36, SP 6

44
Q

SOLE-TX
INVASION OF WIND-COLD-DAMP

INVASION OF TOXIC HEAT

DOWNWARD FLOW OF DAMP-HEAT

QI AND BLOOD STAGNATION

QI DEFICIENCY

BLOOD DEFICIENCY

KIDNEY ESSENCE DEFICIENCY

A

INVASION OF WIND-COLD-DAMP
TW 5, LI 4, SI 3, SI 4, BL 63, BL 64, LIV 3, SP 6
INVASION OF TOXIC HEAT
TW 6, LI 4, LI 11, SST 44, SP 6, SP 10, KD 2
DOWNWARD FLOW OF DAMP-HEAT
TW 6, SI 3, SI 4, BL 63, BL 64, KD 2, SP 6, SP 9, GB 34
QI AND BLOOD STAGNATION
LI 4, SP 6, LIV 3, GB 34, SI 3, SI 4, BL 60
QI DEFICIENCY
SI 3, SI 4, SP 6, ST 36, KD 3, GB 34, BL 60, BL 64, LIV 3
BLOOD DEFICIENCY
SI 3, SI 4, SP 6, ST 36, KD 3, GB 34, GB 39, CV 6, LIV 3
KIDNEY ESSENCE DEFICENCY
LIV 3, LIV 8, SP 6, KD 3, KD 4, KD 5, KD 10 BL 64

45
Q

TOE-TX

WIND:

COLD

DAMP

DOWNWARD FLOW OF DAMP-HEAT

LIVER AND KIDNEY DEFICIENCY

QI AND BLOOD STAGNATION

A

INVASION OF WIND-C0LD-DAMP
WIND:
TW 5, LI 4, BL 12, BL 60, GB 40, SP 6, Bafeng
COLD
TW 5, LI 4, SP 6, BL 12, BL 60, BL 63, GB 40, Bafeng
DAMP
TW 6, LI 4, ST 40, SP 9, BL 12, BL 63, BL 64, GB 40, Bafeng
DOWNWARD FLOW OF DAMP-HEAT
TW 6, LI 4, SP 6, SP 9, BL 60, GB 34, GB 40, GB 41, ST 44
LIVER AND KIDNEY DEFICIENCY
GB 39, GB 34, LIV 3, KD 3, ST 36, SP 6, Bafeng
QI AND BLOOD STAGNATION
LI 4, SP 6, SP 10, BL 17, LIV 3, GB 34 Bafeng