pain in TMJ neck knee ankle for 3 yrs

60 yr old female patient came to my office complaining of pain in left jaw/face (TMJ), neck, left knee and left ankle for 3 yrs.

history: about 3 yrs ago some one punched her face (left side) causing her to fall on the floor. since then she has suffered from all the pain stated above.

first sp3 + LI 11- sj 5 - 10 min later patient tells me her knee feels much better but TMJ and neck are the same.

LI 4 (have patient open and close her mouth while stimulating the needle using even technique)

TMJ is much better she can open 100% and pain is almost gone.

asked patient to come back for more tx.

knee pain for 3 yrs

50 yr old male patient came due to chronic knee pain for three yrs. Doctors want to do a surgery and he wants to try acupuncture first. his knee pain is located near sp10 (right side) and LV 8 area (bilaterally) he is using a walker due to his pain. he fell and broke his right femur when he was 13 yr old and he was so stressed about 3 yrs ago.

rom restricted for both knee he can move (flex) only 20 degrees or so)

pain is worse with high humidity and cold weather. they swell up at times. he feels heavy and tired at times (usually when it rains) appetite and digestion is fine.

tx: Sp 3 + Li 11- (all left side) right side sp 10 pain is much better then

then left side LV 1 SP 1 - .... right side lv 8 pain is better ROM became full

blood stasis + cold damp bi

2nd tx: LV1 SP 1 - for right knee worked fine. wanted to try master tong point for his left knee. ShinGuan (1.5 cun below sp 9) did not work. then Giun Joong (posterior to LI 14) worked fine for his left knee.

stroke patient

60 yr old male patient came due to some stroke symptoms. his left arm (elbow) is locked at 90 degrees and he can't move his arm or shoulder or hands at all. his whole left side is affected including left leg so walking is difficult; however, he is not dragging his legs.
he had stroke 10 yrs ago and since then he has been getting physical therapy without any improvement.

he is tall and slightly heavy. he doesn't look stressed or anxious. he takes medication for HTN.
s/s: digestion is fine. spit out white sticky phlegm in the morning. borborygmus, palpitation which is not related to anxiety or stress, frequent urine (seems to be due to medication) dry eyes. energy is fine. appetite and bowel movement is fine. there is some shaking in his left hand if he tries to grab some object.

text book says left side is most due to blood deficiency and right side due to qi deficiency.

1st tried KD 10 + (nothing happened)
2nd tried LV 1 + (nothing)
then Sp 3 - he says his shoulder and left arm feel loose and he can move his shoulder and elbow about 30 degrees.
added HT 8 + left arm and shoulder feel looser but ROM is still about the same (30 degrees)

suggested herbs but he wanted to try next time.
(wanted to prescribe Dao Tan Tang- banxia tian nan xing ju hong ze ki chi fu ling gan cao)

TMJ for 10 yrs

30 yr old female came complaining of TMJ pain. She says it is a chronic problem. Left side is worse than right side and pain is worse when she is stressed and tired.

normally, LI 4 is good enough but since it has been there for 10 yrs I asked more questions.

s/s: slightly low blood pressure, thin body type. hands and feet are sweaty and cold. prefers summer. heavy feeling worse with fatigue, dry skin stuffiness in chest, lots of dizzy spells which is worse when she stands up from sitting position, blurry vision pain in her eyes, neck ears are itchy, dry eyes, low ab filled with gas with pain near left st 25 point area, sl acid relux, frequent bowel movement (loose) worse when she is stressed. frequent urination (scanty)

very irregular menses with PMS. right ovary removed due to cyst 7 yrs ago. tai yang HA, right calf spasms at night, cant stay asleep, history of depression and anxiety, fobia, OCD.

there are lots of s/s. some seem to be related to HT, LV, GB, SI...

TX: SI2 - SI 3+ GB 41 + UB 66- (seemed this would be good for her tmj out of all other channels)

TMJ left side is much better. then patient tells me she is always very anxious and recently she is going through lots of stressful and anxious issues.

upon the following visit she tells me she is very pleased with the result. she is not as anxious, palpitation is almost gone and TMJ pain is much better. there is still clicking sound but no pain.
her face did not look deviated anymore.

TX: same as above.
then tried LI4 but did not work. patient says pain is completely gone but again the clicking sound remains the same.

coldness heat deficient or excess?

long ago I thought reducing LV2 would treat millions problems and a number of patients benefited from this particular point. It took me awhile to realize it works only when patients have liver excess or heat s/s. and many patients in the city have such disorder.

if liver problem is suspected, we can treat it with

1. tonifying liver LV 8 KD 10 + LU 8 LV4 -
2. sedate LV 2 HT 8 - LU 8 + LV 4 +
3. cool it LV 2 HT8 - LU 5 LV 8 +
4. heat it LV 2 HT 8 + LU 5 LV 8 -

then what?

what about LV 1? you can Tonify or sedate LV 1 and it can be liver problem that is related to SP HT KD PC channels. for ex, LV invading SP or LV is mother of HT and so forth.

this is very complicated but as an acupuncturist it is so much fun to think about .