Sprain+(Niu+Shang)

See also "Sprains and Strains" "Sprain" describes an injury of the soft tissue surrounding the joints of the limbs & trunk. The soft tissues involved include fascia, tendons, ligaments, parts of muscles, subcutaneous tissues, joint capsules & articular cartilage Majopr clinical manifestations are local swelling & pain as well as restricted movement of the injured joint. Damage to the skin, dislocation of the joint, or fracture of bones are not involved in //Nui Shang//. In Traditional Chinese Medicine, sprains are collectively known as //Shang Jin//, "damage to the sinew"

Relevant Western Diseases
Sprain

Etiology & Pathogenesis
Can involve strenuous exercise, external blows or collisions, falls, forceful stretching, overburdening or twisting the joints. All of these factors can lead to local stagnation of Qi and Blood and symptoms of sprain. Conditions of local deficiency following sprains often allow the invasion of external wind, cold, and dampness. These evils gradually add to the severity of the injury, prolonging the illness. In extended cases, the viscera & bowels can be affected, blocking complete recovery

Static Qi & Blood Obstruction
In chronic cases, the symptoms are aggravated by overwork or exposure to cold or draughts In chronic cases w/ wind-cold-dampness: use Da Huo Luo Dan or Xiao Huo Luo Dan In aged patients to also supplement Liver & Kidney: use Bu Shen Zhuang Jin Tang in acute cases needle w/ draining; in chronic cases needle w/ supplementation, add moxa or warm needle Main points: Ashi Auxillary Points: For shoulder injury: + LI-15, TW-14, SI-9 For elbow injury: + LI-11, SI-8, TW-10, LI-4 For wrist injury: + TW-4, LI-5, SI-5, TW-5 For lower back injury: + BL-25, GV-3, BL-40 For hip injury: + GB-30, BL-54, BL-36, GB-34 For knee injury: + ST-35, ST-34, Nei Xi Yan For ankle injury: + ST-41, BL-60, GB-40 For neck injury: + GB-20, BL-10, Si-3, BL-11
 * Clinical Manifestations:** Local distention, swelling & pain, sometimes w/ redness or dark purple discoloration, and restriction of movement.
 * Treatment Methods:** Rectify Qi, quicken the blood, soothe soft tissues, clear the connections
 * Herbal Treatment:** Shu Jin Huo Xue Tang
 * Acupuncture Treatment:**

Alternate Therapeutic Methods

 * Ear Acupuncture:** Sensitive points corresponding to the site of injury, Subcortex, Shen Men, Adrenal - 10-30 minute once daily or every other day
 * Bloodletting Cupping therapy:** Use plum blossom needle to tap heavily over painful areas until droplets of blood appear. Follow with local cupping

Treatment Notes:
Needles should be repeatedly manipulated while having patient move the injured part. Tuina may also have high therapeutic value.

Source: Practical Therapeutics of Traditional Chinese Medicine, Yan Wu