"The four limbs and their eight flexible joints are in use from early morning until late at night. When people lie down to rest the blood flows back to the liver. When the liver receives the blood it strengthens the vision. When the feet receive the blood it strengthens the footsteps. When the palm of the hand receives the blood the hand can be used to grasp. When the fingers receive the blood they can be used to carry.

The increase in cases of chronic pain and arthritis during the cold winter months is extremely common in clinical practice. In my last Planetary Herbalism column [February], I touched upon warming medicinals which can target cold-natured health challenges. In this On Point column, let's discuss important acupuncture points to stimulate the warming effect of blood circulation to assuage pain exacerbated by the winter chill.

One of the most effective and fundamental actions of acupuncture is to move the qi and circulate the blood. This action alone can stimulate dramatic healing actions within the mind / body of patients suffering from pain. During the winter months, acupuncture can become an important adjunct therapy along with exercise to prevent the stagnation of qi and blood, which can potentially worsen due to exposure to winter cold and wind. Fortunately, two important acupuncture points – alone or combined with other points – can help stimulate healthy blood circulation to assist in relieving and preventing cold-natured pain.

Sp 10: Alone or With SP 21

Sp 10 is named "sea of blood" and has the actions of invigorating the blood, dispelling stasis, cooling the blood, harmonizing menstruation, and healing the skin. During the winter months, warm-needle therapy or indirect moxa can be extremely effective for chronic poor circulation worsened by exposure to cold temperatures. Sp 10 is particularly effective in cases of pain in the lower limbs such as knee pain, leg pain and foot pain worsened by cold; however, its actions spread throughout the body.

A particularly effective two-point acupuncture combination for pain all over the body is: Sp 10 + Sp 21. The great luo-connecting point of the spleen (Sp 21) has the unique actions of regulating the qi, moving the blood, firming the sinews / joints, and unbinding the chest / lateral costal region. Both points can be needled, or indirect moxa can be used on both points to strongly circulate qi and blood throughout the body. This unique combination is particularly important for patients who work outside in cold and windy climates during the winter months.

BL 17: Alone or With BL 19, BL 43 and/or SP 21

BL 17 is the hui-meeting point of blood and has the actions of invigorating blood, dispelling stasis, cooling blood, stopping bleeding, nourishing / harmonizing the blood, harmonizing the diaphragm, and descending rebellious qi. BL 17 is one of the most important points to treat pain over the entire body when worsened by exposure to cold temperatures.

The TCM adage, "to treat wind, first treat the blood; once the blood moves wind will be dispelled," echoes the importance of using BL 17 in cases of wind-damp pain during the winter season. Using moxa on BL 17 and Sp 10 is a powerful combination for moving the blood to bring warmth throughout the body.

If the patient is suffering from pain due to cold and also shows signs of significant deficiency, the two-point combination termed "The Four Flowers" is particularly important. The Four Flowers consists of BL 17 + BL 19 and is highly effective for patients who are suffering from chronic pain worsened by cold, yet also have significant blood deficiency.

A related acupuncture point combination I use frequently during the winter season is BL 17 + BL 19 + BL 43. This three-point combination deeply nourishes qi, blood and yin, as well as calms the mind. BL 43 has a wide range of actions, including tonifying / nourishing the lungs, heart, kidneys, spleen and stomach; nourishing yin; clearing heat; calming the spirit; and resolving phlegm.

Using indirect moxa on these points can be deeply nourishing and calming for the patient. The point Sp 21 also can easily be added to this three-point combination, resulting in a four-point acupuncture prescription perfectly suited for the winter months.

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