CHRONIC FATIGUE SYNDROME (CFS):

Most of us, after a good nights sleep, or even a siesta we feel ready to go again.

But there is a small percentage of the population (0.2 to 0.7%) for whom no amount of rest is invigorating. The slightest amount of work or physical activity can leave them extremely tired for days or weeks.

They suffer from a condition commonly known as Chronic fatigue syndrome (CFS) Also known as Myalgic encephalomyelitis (ME) and Chronic Epstein virus disease.

There is a tendency for people to dismiss this condition as psychosomatic or malingering, but in fact it  is very real. Myalgic encephalomyelitis means pain in the muscles and inflammation in the brain and Spinal cord. Onset of ME/CFS may be sudden or slow and may follow viral infections, toxic exposure, trauma or other events.

Cause:

It is not clear what the cause of it might be and there is no general agreement that it is a separate disease at all.  Some research indicates problems in several areas that could be related to this condition:

·         Viral or other infections,

·         Blood pressure, circulatory and Cardiac abnormalities.

·         Immune and hormonal responses.

·         Genetic factors.

Without a known cause, prevention is impossible.

Symptoms:
The main symptoms of CFS are pronounced muscle fatigue and ache, poor memory and lack of concentration, severe tiredness and intermittent flu-like feeling. Some suffer from insomnia while others sleep too long. Most wake up in the morning feeling worse than when they went to bed.

Other symptoms include:

• Joint pain without redness or swelling
• Drop in blood pressure upon standing
• Increased heart rate upon standing and palpitations.
• Shortness of breath with exertion.
• Gastrointestinal  and urinary problems.
• Marked weight changes, losses or gains.

Testing for CFS:

There is no specific test for CFS. Your  doctor may order blood and urine tests to make sure there is not some other serious disorder.

Diagnosis is made by excluding many other ailments with similar symptoms like  exhaustion through exercise or work, anaemia, hypothyroidism, depression etc.

Western treatment for CFS:

At the moment there is no western medication available to treat CFS but some may help with some of the symptoms. For example sleeping tablets for a better sleep and Paracetamol for muscle pains.

Chinese medicine and CFS:

Chinese medical texts have, since very early times, described the cause, diagnosis and treatment of conditions very similar to CFS.

The three main conditions with which CFS can manifest according to Chinese Medicine are:

-          Residual pathogenic factor

-          Latent heat

-          Lesser Yang pattern

The earliest text on Chinese Medicine, the Yellow Emperor’s classic of internal medicine,  says. ’’If cold enters the body in wintertime, it comes out as heat in springtime.’’ They talk about common cold and flu that  has not been fully resolved and lingers in the body until the following season or perhaps for many years.

The residual effects of a cold or flu, once in the interior of the body, will transform into patterns we call Damp, Heat and phlegm who then produce specific clinical symptoms like muscle aches, poor memory and concentration, difficulty sleeping and extreme fatigue.

In modern times, antibiotics are one of the most common causes of residual pathogenic factor. Whilst they do destroy bacteria, from the point of Chinese Medicine they tend to lock the pathogenic factor in the interior.

A possible cause for Latent heat can also be immunizations, when inert forms of certain pathogenic organisms are injected into the body, by-passing the body’s first line of  resistance. From a Chinese medical perspective it is as if an external pathogenic factor invades the body’s interior directly.

In the Lesser Yang pattern one can have alternating shivers and heat, when the pathogenic factor is trapped between the Interior and exterior. This pattern tends to be more common among teenagers and young adults.

In my experience, every case of CFS is in part a deficiency and excess condition, but one tends to dominate. From the point of view of symptoms, the more muscle ache, the more the condition is of the full type.

Full conditions tend to respond better to treatment than deficiency ones. In general, my treatments  are a combination of Acupuncture and Chinese herbs.

Peripheral Neuropathies, also called Polyneuropathies include all disorders in which nerve structures outside the spinal cord are affected. With more than 100 types of Peripheral neuropathies in existence, each with its own characteristic set of  symptoms, pattern of development, and prognosis, the symptoms can vary as much as the cause.

In most cases, Peripheral neuropathy is secondary to other conditions such as, diabetes, lupus, rheumatoid arthritis, alcoholism, nutritional deficiencies, AIDS, chemotherapy, and various drugs.

Other causes include compression or entrapment (carpal tunnel syndrome), direct physical injury to a nerve (trauma), fractures or dislocated bones, tumors, radiation and even exposure to cold.

For some people it is experienced as the uncomfortable sensation of “ pins and needles” or burning pain (especially at night) of their hands and/or feet, a loss of feeling, others may suffer more extreme symptoms such as muscle wasting, paralyses, or organ dysfunction.

Sensory symptoms:

Sensory symptoms arte the most common presentation of peripheral neuropathy and can be considered as positive ( tingling, burning and pain) or negative (loss of touch and temperature) in general feet and legs are involved before hands and arms.

 Motor symptoms:

Motor symptoms such as weakness are less common than sensory symptoms. Most motor symptoms begin as gait and balance difficulties. When weakness becomes significant, people tend to develop loss of dorsiflexion (dropfoot).

As many as 60-90% of diabetics suffer from peripheral neuropathy, however, western medicine does not have a truly effective treatment for this condition.

One of the most common treatments for  peripheral neuropathy is the administration of amitriptyline (An antidepressant). Some of its side effects are headaches, dizziness, skin rashes, hepatitis, fluctuations in blood sugar levels, palpitations and even Peripheral neuritis! Clearly not the best treatment option.

Other treatments tend to concentrate on pain management and include analgesics such as Aspirin, paracetemol and NSAIDS.

Chinese medicine approach:

As I have written many times before, in Chinese medicine, no matter what the disease, a patient will be treated according to his or her specific pattern of disharmony. We treat a person with a disorder, not the disorder the person has.

Common patterns of disharmony in Peripheral neuropathy are obstruction of Qi and blood and dampness in the limbs. This can be due to irregular eating, wrong diet, too much alcohol, excessive tiredness or chronic diseases.

Acupuncture helps peripheral Neuropathy by improving the circulation and moving Qi and blood to the extremities. The nerve tissue can be nourished and nerve function improved. Chinese herbs quite often form part of the standard treatment.

In a study involving 46 diabetic patients with Peripheral neuropathy, 34 of them reported significant improvement in their symptoms after a series of acupuncture treatments.

A larger study of 250 patients with HIV related Peripheral neuropathy (PN) found similar results.

If you suffer from PN, maybe you should give  Chinese medicine a go. It may help you or it may not. At least there are no significant side effects!

Psoriasis: A case history

A 59 year old woman with psoriasis came to see me in November last year.

She had psoriasis for a number of years mainly on her head but spreading over the rest of her body since beginning of last year. She claimed to have had a stressful life the last couple of years and been to different doctors and therapists. She said she felt emotionally and mentally out of balance. Suffered severe mood swings and felt fearful most of the time. She talked very fast and agitated; she obviously was very stressed and worried about her condition. She was on no medication and had a bout of high cholesterol under control, probably through diet. She had no major medical history and told me the only thing she noticed lately was some irritation in her eyes.

The psoriasis moved from one area to another, but always present in scalp, neck (R) and shoulder anterior mainly (R). Both legs were also affected, mainly lateral and posterior. At times the psoriasis was itchy and she tended to scratch the affected areas. Most of the lesions were red, swollen and flushed and the scales were easily shed when scratched. She told me that exposure to the sun tended to aggravate the condition.

From a Chinese medicine point of view, I diagnosed her to have wind and blood heat and started treating her accordingly with Acupuncture and Chinese herbs.

Following are some pictures taken throughout the treatment. The first ones are from when she was already being treated for at least 5 weeks, around16/12/10 and the last ones at 8/03/11

Helping Arthritis with Acupuncture /Chinese medicine

The majority of people with joint pain are diagnosed with Arthritis, which is a general term for a number of conditions that involve swollen, painful and/or stiff joints. In the West, anti-inflammatory drugs (NSAIDS) are the preferred treatment for Arthritis. In the East, Acupuncture and Chinese herbs have been used for over 2000 years to treat joint and musculo-skeletal diseases, including Arthritis.

Arthritis in Western medicine:

Osteoarthritis, Rheumatoid arthritis, ankylosing spondylitis, gout, tempero mandibular joint syndrome etc. Are all types of Arthritis differentiated in Western medicine. The most commonly seen forms are osteoarthritis and rheumatoid arthritis.

Osteoarthritis: the pain of osteoarthritis is due to the gradual loss of protective cartilage in the joints. This is caused by changes within the cells of the cartilage through physical injury, mechanical stress or metabolic abnormality. The cartilage thins gradually and may even breakdown leaving the ends of bones unprotected producing pain and further degeneration.

Rheumatoid arthritis: Rheumatoid arthritis is the most severe type of inflammatory joint disease. It is an auto-immune disorder in which the body’s immune system attacks its own tissues, damaging joints and the surrounding tissue. Painful, stiff and deformed joints of the hands, arms, feet  and legs are commonly seen.

Apart from NSAIDS, other drugs are used such as gold compounds and steroid based drugs like corticosteroids and immune-suppressive drugs. The side effects of these drugs range from stomach irritability and bleeding stomach ulcers to weight gain, facial puffiness and thinning of the skin and bone.

Arthritis in Chinese medicine:

Arthritis is known in Chinese medicine as ‘’Bi’’ syndrome, Bi meaning painful obstruction.

We say it is the result of the body being ‘’invaded’’ by external climatological factors such as wind, cold, heat and/or dampness. The symptoms manifested by the individual depend on which external pathogenic factor is strongest. Following is a listing of the four main patterns of Bi syndrome.

Wind Bi: Exposure to wind for prolonged time is an important cause of the Wind pattern of arthritis. Any Wind pattern is characterised by movement of symptoms hence its alternative name wandering Bi, last week it was shoulder pain, this week it’s the knees. There is joint soreness and pain which can move from joint to joint. Joint movement is limited, and there is often fever, as well as aversion to wind or windy weather.

 Cold Bi: Joints which are cold to touch and frequently swollen too are referred to as cold Bi. With this type of By, the pain has a fixed location rather than moving about. One can get relief from applying heat to the area and exposure to cold will definitely aggravate the condition.

Damp Bi: The damp pattern of arthritis is characterised by pain, soreness and swelling in muscles and joints, with a feeling of heaviness and numbness in the limbs. The pain has a fixed location and is aggravated by damp weather. When these patients move to a hot dry climate they often feel better.

Hot Bi: This type of Bi is commonly seen in Rheumatoid arthritis and gouty arthritis. It is characterised by severe pain and hot-red-swollen joints. Pain tends to be worse at night. Other symptoms may include fever thirst and anxiety.

I have classified arthritis into nice neat groups, in clinical practice it is not really like that and I would often see joint pain which is a mixture, in fact this tends to be the norm rather than the exception.

Different types of arthritis respond different to acupuncture. However acupuncture is an excellent treatment choice for all types of arthritis because arthritis is characterised by obstruction and acupuncture moves obstruction!

More and more scientifically designed clinical studies support the use of acupuncture for arthritis. A recent study examined the effects of acupuncture on 32 osteoarthritis patients waiting for knee replacement surgery. After 9 weeks, patients receiving acupuncture treatment reported a decrease in pain, while pain increased in untreated patients. The patients with acupuncture treatment were able to walk farther and faster, compared to the untreated group. Success of the treatment depends also on how effectively  acupuncture can re-harmonise the body. It the arthritis is very deep-seated then at best, acupuncture may be able to offer pain relief and help the disease from progressing further. If the systemic imbalance is not so severe, then acupuncture may be able to offer a cure.