Sinews and Ligaments

Bursitis, Tendonitis
The Sinews and Ligaments are the soft tissues associated with the Joints. It includes the Tendons and Ligaments, and in traditional medicine, can sometimes encompass the cartilage. Bursitis and Tendonitis are two of the most common conditions that fall under diseases of the Sinews and Ligaments.
  • Bursitis in an inflammation of the bursa, the small fluid sacs in a joint.
  • Tendonitis is an inflammation of the tendons. It is responsible for such complaints as “tennis elbow,” “achilles tendonitis,” or “jumper’s knee.”

These conditions can be acute following an injury or strain, or chronic due to natural wearing of the joint. In acute cases following Trauma, other conditions such as tearing of the tendon or ligament or rupture of a meniscus may also be involved. In many chronic cases, an initial trauma or sprain is responsible for what becomes a chronic condition.

Both conditions present with swelling, discomfort or pain in an affected joint and disability of the joint. If there is bruising, pain and significant swelling after Trauma, a tear in a tendon can be expected. If a person is treated for 10 days or 2 weeks without improvement, a tear can also be expected.

In modern medicine scans such as an Ultrasound can be used to give a definite diagnosis. In Traditional medicine, to a large extent, it doesn’t matter, as the general treatment would be the same. The primary reason a Traditional Practitioner may refer someone for a scan is if they believe a fracture, tear or rupture has occurred which may need surgical intervention. However, Traditional Medicine treatment can generally be very effective in these cases.

In the Treatment of acute cases, an emphasis on medicines to clear Blood Stasis and resolve Inflammation and Swelling are used, both topically and internally. A number of medicines listed under Trauma and Bruising can be applied in such cases.

When Treating chronic cases, medicines that move the Blood and clear Inflammation may need to be used with medicines that strengthen the Bones and Joints, and nourish the Liver and Kidney. This can include medicines such as Comfrey root, Soloman’s Seal, Asparagus root and Dipscaus Xu Duan. Shilajit is also very good in such cases.

Special Medicines for the Joints and Sinews:
  • Turmeric–Turmeric has a proven effect against various types of inflammation and can be very good for Bursitis and Tendonitis. As it moves the Blood, it also helps resolve Inflammation associated with Blood Stasis and Trauma. If the person has a hot nature or there is redness and swelling of the joint, it should be combined with medicines that clear Heat.
  • Frankincense & Myrrh–Frankincense is a blood mover that clears Bruising and Blood Stasis while having a proven Anti-inflammatory effect. Myrrh and its cousin Bdellium (Guggulu) likewise move the Blood, resolve Stasis and have anti-inflammatory activity. The 2 are often combined in formula.
  • Comfrey–a superior Wound herb which includes Trauma to the Bones and Joints. While it is very good used internally, its internal use is restricted in some countries. However, it can still be used Topically in Oils, Ointments and Plasters.
  • Centaury–is a famous medicine for the Sinews and Ligaments, being regarded as a specific for Pain and Inflammation of the Joints. As it is Cool and Bitter, it clears heat while resolving Swelling.
  • St. John;s wort–a special Wound herb, clears Heat and Inflammation, moves the Blood and can also treat pain and anxiety associated with the Trauma and Inflammation. It can be taken internally or the Infused Oil can be applied topically.
  • Rhubarb–often used in formulas for Trauma and Blood Stasis, it clears Heat and Inflammation, helps resolve Blood Stasis, and gently purges off excess. It is most applicable in cases with Heat and Excess, but can be used briefly in other Trauma cases.
  • Shilajit–is a well known Eastern tonic medicine, especially useful to strengthen the Bones and Joints, and tonify the Kidneys. But it is also an important medicine for Bruising and Trauma. This makes it especially useful in chronic conditions.
  • Earthworm–is a very useful medicine for opening obstructions of the channels, clearing inflammation, and relieving pain. It has been used for this purpose in both TCM and the Western tradition. In the West, the Oil of Earthworms was also used topically in such cases. Being cooling, it is most appropriated to cases with Heat.

Other important medicines from TCM that strengthen and Heal the Sinews, especially in chronic conditions include Achyranthes Niu Xi, Eucommia Du Zhong, Drynaria Gu Sui Bu, Dipsacus Xu Duan. In chronic and severe cases with marked deficiency, Velvet Deer Horn (Lu Rong) is also very useful..

Acute cases from Trauma require Blood-moving medicines such as Myrrh, Frankincense, Dragon’s Blood, and Safflower, and these can be used topically and internally.


Other Therapies
  • Bloodletting–topical bloodletting can resolve Blood congestion and remove inflammatory waste from the area. “Wet Cupping”, that is Cupping with small cuts to draw Blood is often most effective.
  • Cupping–where possible, applying cups, such as over and affected shoulder or hip, can relieve inflammation.
  • Acupuncture–using acupuncture locally on painful points can be very effective to relieve pain and increase movement.
  • Oils, Plasters, Poultices–these can all be used very effectively to relieve swelling, inflammation and pain, and promote healing.

See also
Sprains and Strains
Trauma and Bruising

Western Tradition

TCM Classification

Simples
Centaury
Sage
Camomile
Cumin
Tumeric
Myrrh
Self Heal
Comfrey
Marshmallow
Rue
Elecampane

Mugwort
Rosemary
St. John’s wort
Aniseed
Blessed Thistle
Frankincense
Cowslip
Soloman’s Seal
Asparagus root
Rhubarb
Earthworm


Formulas

Diseases of the Sinews in General
Confected Calamus
Rosemary Wine
Powder of Cumin Greater (Diacyminum) (Nicholas)
Electuary of Cumin (Diacyminum) (Mesue)
Confection of Alfesera (Diabryonias) (Democrites)
Oil of Costus
Oil of Earthworms
Ointment of Marshmallow (Nicolas)
Ointment for Congealed Blood

Kaisor Guggulu
Punarnavadi Guggulu (Boerhaavia and Bdellium Pills)
White Channel Ointment (Tibetan) 


To purge Damp from the Sinews
Hiera Hermetis
Confection of Alfesera (Diabryonias) (Democrites)
Pil. Alhandal
Pill of Opopanax
Kaisor Guggulu
Mother of Pearl 13 (Tibetan) 


Cold diseases of the Sinews
Honey Water
Syrup of Stoechas


Ache of the Sinews
Cerate of Hyssop
Oil of Bitter Almonds
Oil of Hazelnut
Oil of Walnut
Oil of Bay
Oil of Elder
Oil of Meliot
Oil of Mastic
Oil of Euphorbium


Spasms and Contracture of the Sinews
Cerate of Alexander
Mother of Pearl 13 (Tibetan) 
White Channel Ointment (Tibetan) 


Hardness of the Sinews
Oil of Bitter Almonds
Oil of Linseed
Oil of Walnuts
Oil of Saffron
Oil of Bay
Diachilon Plaster


Loose Sinews
Oil of Quince


Simples
Eucommia, Du Zhong
Morinda, Ba Ji Tian
Polygonum, He Shou Wu
Achyranthes, Niu Xi

Gentiana, Qin Jiao
Dispacus, Xu Duan
Drynaria, Gu Sui Bu
Polygontaum, Yu Zhu

Spatholobus, Ji Xue Teng
Acanthopanax, Wu Jia Pi

Formulas

Blood Stasis from Acute Trauma
Die Da Wan
Qi Li San


Chronic cases with Blood Stasis
Shen Tong Zhu Yu Tang


Chronic Cases with Liver and Kidney Deficiency
Du Huo Ji Sheng Tang