after cast (right ankle stiffness)

gb 43 UB 66 + LI 1 GB44 - is routinely done for stiffness and pain after cast is taken off. however we as an acupuncturist should be awake all times meaning we should not forget to differentiate based on clinical findings.

40 yr old female patient came due to severe pain in right foot knee and calf along with stiffness in right ankle (she had cast around right ankle for 1 month) she states all pain came along with her ankle injury except her foot pain is chronic.

her right ankle is stiff without pain. at night time she feels heat sensations around the ankle and it travels from the ankle to right knee along st/gb channels.

s.s/ no palpitation no sleeping problems no urination no other heat signs other than the heat sensation around right ankle at night

tx: gb 43 + 30 % better then gb 38 - no more stiffness

foot pain knee pain stay the same

calf pain is better by 80 % (dahm point mater tong added) then calf pain was gone.

right knee pain (st --- ub)

70 yr old female patient came to due right knee pain with swelling for 1 week. she had this knee pain before on and off but pain is so severe this time she cant walk.

s/s: slightly heavy body type prefers summer over winter dry eyes and dry skin, no palpitation, no insomnia, ringing in both ears poor digestion stomach distention patient states her stomach size doubles after meal at times moderate appetite, acid reflux, chronic constipation frequent urination day and night, itchy ears dry skin in occiput area, knee is swollen and warm to touch pain is located in
GB and UB area in right knee.
dx ub deficient st excess

tx: shin guan --> no change

2nd needle LI 1 - pain 30% reduced

3rd needle ST 45 - almost no pain after this point.

question if this problem is st invading ub will st 36 - work better than the points above?

pain in left toes for 6 months

she had right knee surgery last aug 09 and she has been having pain in left toes (#234) since then she developed left groin pain. she is 50 yr old.

s/s: heavy body type. cold feet at times bleeding gum dry skin, trouble staying asleep for the last few months normally her sleep is shallow st acid (reflux) abdomen distention at times lower jiao gas (frequent) ankles--edema when humid thumb pain all fingers have arthritic pain borborygmus, post meno hot flashes night sweats excessive appetite

dx. st excess and gb deficiency

1st tx gb 43 + LI 1 -

upon second visit she states toes/fingers are 30% better. her sleep quality was good as well. however groin pain stayed the same.

2nd visit

GB 41 + ST 43 + pain in toes is gone. finger pain improves. groin pain stays the same.

Shen Men -- master tong right side groin pain improves.