Ankylosing Spondylitis
Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the sacroiliac joints, spinal processes, paraspinal soft tissues, and peripheral joints. It may also be accompanied by extra-articular manifestations. In severe cases, spinal deformity and ankylosis may occur.
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Clinical description:
Pain, soreness, or stabbing pain in the lumbosacral region, neck, or back; soreness and weakness in the lower back and knees; difficulty turning over; a preference for pressure or massage; worsening with exertion; frequent nighttime urination
In plain language:
- Pain may occur in the lower back and sacral area, neck, and back, and may feel sore or like a needle prick.
- The lower back and knees may feel sore and weak, with a sense of reduced strength when walking or exerting effort.
- Turning or rolling over may feel less flexible, with movements restricted or awkward.
- Pressing or rubbing the painful area may feel somewhat soothing.
- Pain may worsen after exertion and be more noticeable when rest is inadequate.
- Urination may occur more often at night, with frequent trips to the bathroom.
|Treatment Approach
Clinical description:
Tonify the kidneys and strengthen the Du Mai, dispel Bi obstruction, and relieve pain.
In plain language:
- Tonify the kidneys → In TCM terms, nourish kidney qi and kidney essence; address cold intolerance, fatigue, soreness and weakness in the lower back and knees, and frequent nighttime urination, and support the sinews, bones, and recovery.
- Strengthen the Du Mai → Strengthen the “Du Mai” (the yang channel along the spinal axis) to support the lower back and back and promote stability, and ease stiffness and postural instability.
- Dispel Bi obstruction → “Dispel” means to remove; “Bi” refers to painful obstruction. In TCM, this means dispersing factors such as wind, cold, and dampness that are thought to obstruct the channels, and easing joint soreness, swelling, and restricted movement.
- Relieve pain → Directly ease pain, including stabbing or pulling pain and difficulty bending or extending.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the outer packaging and product leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Pain in the sacroiliac area, neck, back, and lower back, with heat or a heavy, downward-dragging sensation at the painful site; pain worse at night and tenderness to pressure; difficulty bending forward or backward; swollen, hot, painful joints in the limbs; heaviness in the limbs; thirst without desire to drink, or fever; dark-yellow urine; constipation; a dark-red tongue, yellow or thick, greasy coating, and a slippery, rapid pulse
In plain language:
- Pain may occur in the sacroiliac area, neck, back, and lower back, causing noticeable discomfort during everyday activities.
- The painful areas may feel hot or heavy, as if weighed down.
- Pain may worsen at night, and the area may be sensitive to pressure or touch.
- Bending forward or backward may be difficult, and bending or turning may feel restricted.
- Joints in the limbs may become swollen, warm, and painful, and may feel hot to the touch.
- The limbs may feel heavy, with a sense of reduced strength when walking or doing tasks.
- You may feel thirsty but not want to drink much, or stop after a few sips.
- Fever may occur, with a rise in body temperature and a feeling of heat.
- Urine may appear yellow or darker than usual.
- Stools may be dry and hard, making bowel movements difficult.
- The tongue may appear dark red rather than bright red.
- The tongue coating may be yellow or thick and greasy, making the surface look coated.
- On pulse examination, the pulse may feel slippery and somewhat rapid.
|Treatment Approach
Clinical description:
Tonify the kidneys, promote blood circulation, clear heat, and drain dampness.
In plain language:
- Tonify the kidneys → In TCM terms, nourish kidney qi and kidney essence; address cold intolerance, fatigue, soreness and weakness in the lower back and knees, and frequent nighttime urination, and support the sinews, bones, and recovery.
- Promote blood circulation → Promote the flow of blood and address stasis, with the aim of easing pain, stiffness, and numbness.
- Clear heat → In TCM terms, clear internal heat and ease redness, swelling, a burning sensation, sore throat, thirst, and irritability or discomfort.
- Drain dampness → Promote the elimination of dampness (through urination, perspiration, and other routes) and ease heaviness, a sticky or greasy sensation, swelling, and difficulty urinating.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the outer packaging and product leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Discomfort and wandering pain in joints throughout the body; tightness and stiffness in the lumbosacral region and back, sometimes extending to the neck; difficulty turning. When cold predominates, symptoms worsen in cold, damp weather and ease with warmth; the mouth tastes bland and there is no thirst; cold limbs; difficulty urinating; a pale-red tongue, thick white coating, and wiry, tight pulse. When dampness predominates, the limbs and joints feel heavy, the skin may feel numb, the limbs feel cumbersome, movement is restricted, and the pain is localized; in severe cases, the lower back and spine feel cold and heavy, and joint movement is difficult; the tongue coating is white and greasy, and the pulse is slow.
In plain language:
- Joints throughout the body may feel uncomfortable, with pain that moves from place to place.
- The lumbosacral area and back may feel tight and stiff.
- The discomfort may even extend to the neck, which may also feel stiff and uncomfortable.
- Turning or rolling over may feel awkward, with restricted movement.
- When cold predominates, symptoms may worsen in cold, damp weather.
- When cold predominates, discomfort may ease with warmth.
- When cold predominates, the mouth may taste bland, with little desire to drink.
- When cold predominates, the limbs may feel cold.
- When cold predominates, urination may be difficult.
- When cold predominates, the tongue may look pale with a reddish tinge.
- When cold predominates, the tongue coating may be white and relatively thick.
- When cold predominates, the pulse may feel wiry and tight.
- When dampness predominates, the limbs and joints may feel heavy.
- When dampness predominates, the skin may feel numb or tingling.
- When dampness predominates, the limbs may feel cumbersome and movements less coordinated.
- When dampness predominates, movement may be restricted or difficult.
- When dampness predominates, pain may stay in one place rather than move around.
- When dampness predominates, the lower back and spine may feel cold and heavy in severe cases.
- When dampness predominates, joint movement may be difficult.
- When dampness predominates, the tongue coating may be white and greasy.
- When dampness predominates, the pulse may be slow.
|Treatment Approach
Clinical description:
Support kidney function, dispel Bi obstruction, expel wind, and eliminate dampness.
In plain language:
- Support kidney function → In TCM terms, nourish kidney qi and kidney essence; address soreness and weakness in the lower back and knees, fatigue, cold intolerance, and frequent nighttime urination, and support the sinews, bones, and recovery.
- Dispel Bi obstruction → “Dispel” means to remove; “Bi” refers to painful obstruction. In TCM, this means removing factors such as wind, cold, and dampness that are thought to cause obstruction, and easing joint soreness, stiffness, and restricted movement.
- Expel wind → In TCM terms, disperse external wind and ease wandering pain, soreness, and discomfort associated with sensitivity to wind.
- Eliminate dampness → In TCM terms, transform and remove internal dampness and ease heaviness, a sticky or greasy sensation, swelling, and a feeling of heaviness in the joints.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the outer packaging and product leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Pain and stiffness in the lumbosacral region; difficulty bending and extending joints; restricted movement, sometimes with stiffness and deformity. Muscle tightness or spasms, stiff sinews and vessels, and difficulty bending the spine; a dark tongue with purple spots, a white or slightly yellow coating, and a wiry, choppy pulse
In plain language:
- The lower back and sacral area may be painful and stiff, with discomfort during movement.
- Joints may be difficult to bend or extend, making either movement feel strenuous.
- Range of motion may be limited, making movements such as turning or walking feel awkward.
- In severe cases, stiffness and deformity may develop, making the affected area look abnormal.
- Muscles may spasm or tighten and feel tense to the touch.
- Sinews and channels may feel tight, stiff, and inflexible, with a sense of stiffness when walking or stretching.
- Bending the spine may be difficult, including bending forward, backward, or sideways.
- The tongue may appear dark, with small purple spots visible on its surface.
- The tongue coating may be white or slightly yellow.
- On pulse examination, the pulse may feel taut like a tightened string and somewhat rough or uneven.
|Treatment Approach
Clinical description:
Tonify the kidneys, promote blood circulation, dispel Bi obstruction, and free the channels and collaterals; tonify the kidneys, promote blood circulation, dispel Bi obstruction, and free the channels and collaterals.
In plain language:
- Tonify the kidneys → In TCM terms, nourish kidney qi and kidney essence; address cold intolerance, fatigue, soreness and weakness in the lower back and knees, and frequent nighttime urination, and support the sinews, bones, and recovery.
- Promote blood circulation → Promote the flow of blood and address stasis, with the aim of easing pain, stiffness, and numbness.
- Dispel Bi obstruction → “Dispel” means to remove; “Bi” refers to painful obstruction. In TCM, this means removing factors such as wind, cold, and dampness that are thought to cause obstruction, and easing joint soreness and restricted movement.
- Free the channels and collaterals → In TCM terms, promote the flow through the channels and microcirculation, ease numbness and pulling pain, and support joint flexibility.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the outer packaging and product leaflet, and use under the guidance of a physician or pharmacist.
References
- Chinese Society of Rheumatology, Chinese Medical Association. Guidelines for the diagnosis and treatment of ankylosing spondylitis[J]. Chinese Journal of Rheumatology, 2010, 14(8): 557-559.
- Wu Shanshan, Duan Zhenhua, Pan Faming. Advances in epidemiological research on ankylosing spondylitis[J]. Acta Universitatis Medicinalis Anhui, 2013, 48(8): 988-992.
- You Hao, Cheng Cuinian, Zhang Hui, et al. Advances in research on the etiology and pathogenesis of ankylosing spondylitis[J]. Chinese Journal of Traditional Medical Traumatology & Orthopedics, 2012(9): 77-79.
- Tam L S, Gu J, Yu D. Pathogenesis of ankylosing spondylitis[J]. Nature Reviews Rheumatology, 2010, 6(7): 399.
- Wang Chengde. Practical Chinese Medicine Rheumatology[M]. Beijing: People’s Medical Publishing House, 2009.