Etiology and Pathogenesis in Traditional Chinese Medicine for Arthralgia Syndrome

Two main factors, external and internal, contribute to arthralgia syndrome, which, in traditional Chinese medicine, is believed to be induced by rigidity of the knees due to impeded flow of qi and blood in the channels and collaterals.

1. External Factor

This refers to affection by pathogenic evils of wind, cold, dampness and heat. Wind, cold and dampness may invade the human body and induce arthralgia if one stays in a cold and. wet residence or working environment for long, sits or lies on wet ground, wades in rain, works under water for days or gets affected by wind, cold and dampness in wet seasons. If another evil, the heat pathogen enters the body to join the dampness, or if the wind, cold and dampness turn somewhat into heat after some time in the body, they will act together to cause stagnation of the channels and joints and eventually arthralgia.

2. Internal Factor

Insufficiency of the vital energy is the important prerequisite for invasion by wind, cold, dampness and heat pathogens. Factors that may give way for the evils to, invade may include impairment of the vital energy and weakened body resistance : due to over fatigue and staying against wind or bathing with cold water when one is sweating all oven congenital weak-ness, lack of physical exercises, or loosening of the striae of skin and unconsolidation of the body resistance due to insufficiency of qi and blood following illness and child delivery.

it is generally believed that deficiency of yang--qi (vital energy) and unconsolidation of body resistance make one susceptible to affection by wind, cold and dampness, which usually induces wind--cold--damp arthralgia. If yang--qi is more sufficient but yin-blood deficient and heat stagnates inside the body, heat often combines with wind and dampness or the stagnated cold may turn into heat, resulting in wind dampheat arthralgia.

The main mechanisms for arthralgia syndrome include: general constitutional weakness and unconsolidation of body resistance added by affection by wind, cold and dampness which go through the channels, collaterals and the joints to impede the flow of blood, causing cold arthralgia or carelessness in clothing with climatic variations, overfatigue, and wading in rain which render the exopathogens to get. into the body easily, or general exuberance of yang added by affection by exopathog6n, which results in heat arthralgia. The symptoms often vary with the feature of patbogens. For example, arthralgia Caused mainly by wind pathogen is called wind arthralgia, manifested by migratory pain (usually in the upper part of the body) due to the moving and changing feature of  wind. Arthralgia caused mainly by cold called cold arthralgia, and as cold tends to stagnage to cause contraction, the pain it gives is severe or even stabbing, and localized' with spasm and contraction of the vessels and muscles. Arthralgia due to dampness is known as damp arthralgia, and .as dampness has the feature of stickiness. the patient often has numbness and aching pain in the extremities, especially the lower limbs. And that due to heat is known as heat arthralgia, and as heat accumulates in the channels and collaterals, there are often redness and swelling of the joints with burning pain and tenderness.

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