Дорно дахины уламжлалт анагаах ухаан, 2012, 2(3)
SHOULDER PAIN DIAGNOSTIC APPROACH: VIEW OF EAST-WESTERN MEDICINES
( Тойм өгүүлэл )
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Introduction: Shoulder pain is quite common complaint worldwide, studied and
described in many trials evaluating the effects of different treatment methods.
Generally, shoulder complains managed by general practitioners and as a result of these
studies many countries developed guidelines for management of shoulder complaints
for general practitioners. In Oriental Traditional Medicine shoulder pain syndromes is a
part of "Bi" syndromes and explained as quite common syndrome and one of the oldest
afflictions. It is classified, as well as other joint complaints, as Complicated diseases,
and many textbooks give the explanations on diagnostics and treatments of joint pain.
In our days, when Traditional Oriental treatment methods becoming popular for the
treatment of the shoulder complains, there is need to compare diagnostic approaches of
two Medicines and try to develop integrated methods, which could be used by oriental
medical doctors (OMD) as well as medical doctors. Taking into account the popularity
of acupuncture for pain management in Mongolia we made a literature review and
wanted to develop integrative understanding of the patho-mechanism of shoulder
complaints and diagnostic guidelines for OMD. Diagnosis of the shoulder complaints
should be done in combination of modern medicine view and theory of Channels and
collaterals.
Objectives: To develop the chronic shoulder pain diagnostic principles for OMD,
basing on 10th international disease classification, diagnostic methods used in GP
practice, and theory of Pathogens, Channels and Collaterals, TCM.
Methods: We did a literature review on diagnostic methods of chronic shoulder pain in
modern medicine and Oriental medicine. By the shoulder pain we mean pain located in
the region of deltoid muscle, the acromioclavicular joint, the superior part of the
trapezoid muscle and the scapula. We excluded rheumatic disorders, severe traumas,
tumors, shoulder complains due to internal and neurological diseases because it needs
different treatment principles.
In TCM, the joint problems are caused by invasion of Wind, Cold and Dampness into
the body, which leads to obstruction or "Bi" syndrome. No doubt, that there are many
other factors, such as weakness of defensive energy or insufficient energy of certain
organs, but patho-mechanism describes that, pathogenic factors invade the body and
obstructs Channels and Collaterals and lead to insufficient flow of Qi and Blood. There
are five painful joint "Bi" syndromes such as Wind, Cold, Damp, Heat, and Bony
Painful Obstruction Syndrome. Three of them (Cold, Damp, Bony syndromes) could be
classified as chronic conditions, so we emphasized out attention on them.
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