Foot Pain

General

Clinical Manifestations	Postural imbalance: 1. Metatarsalgia: Local Yang Deficiency Collapsed anterior arch of the foot Frontal flat foot or Frontal rounded foot Painful plantar calluses Plantar bursitis 2. Flat Foot (Pes Planus): Kidney Channel Yin Deficiency or Kidney Yang Deficiency Insensitivity Acute medial tarsalgia Limping Reluctance to rest on the deformed foot A painful spot on the talonavicular line in the area of KI-6 3. Pes Cavus (accentuation of the concavity of the medial anteroposterior arch): Generally asymptomatic Maybe mediolateral and metatarsalphalangeal joint pain Maybe hypertonicity under the metatarsal heads Maybe claw-foot 4. Tarsal Tunnel Syndrome: Related to pain in the posterior tibial nerve trunk or i9ts emerging branches in the tarsal tunnel 5. Nodular Plantar Fibromatosis (Ledderhose's Disease): Thickening and retraction of the medial plantar fascia Irreducible flexion of one or more toes 6. Plantar neuralgia (Morton's Neuroma): Results from local irritation of a mechanical nature Occurs on the intermetatarsal plantar nerve and associated arteries Acute stabbing pain Electrical sensation Stabbing type pain in the Heart 7. Plantalgia due to venous insufficiency: Usually found among obese menopausal women Heavy, burning plantar pain Cramps Nocturnal paresthesia Edema of the entire foot up to the ankle Varicose veins Stasis dermatitis Scars from ulcerated varicocities Thinning of the skin above the ankles 8. Osteodystrophy: Developmental problems involving the navicular and second metatarsal head Occurs in children between 3 and 15 Moderate, spontaneous pain which is aggravated by walking Inconstant and partial limitation of movement in range of motion Trigger Points: 1. Soleus Muscle: Pain in the heel climbing up the Achilles tendon 2. Gastrocnemius Muscle: Pain in the hollow of the arch radiating to the posteromedial aspect of the leg 3. Tibialis Anterior Muscle: Pain in the big toe and the anterolateral aspect of the leg 4. Extensor Digitorum Longus Muscle: Pain in the toes, instep, and anterolateral aspect of the leg 5. Extensor Digitorum Brevis Muscle: Pain in the lateral border of the foot and in the front of the lateral malleolus, following the Leg Shaoyang Channel 6. Peroneus Longus Muscle: Pain in the lateral aspect of the leg and in the lateral malleolus following the Shaoyang Channel| 7. Abductor Hallucis Longus Muscle: pain in the big toe and in the anterior and medial aspect of the sole of the foot
Treatment Principle
Herb Formulas
Points	Metatarsalgia: ST-37, ST-39, choose a few of the following: KI-1, KI-3, SP-4, ST-30, ST-41, ST-42 Flat Foot (Pes Planus): GB-37, KI-2, UB-63 Pes Cavus: GB-37, KI-2, UB-63 Tarsal Tunnel Syndrome: KI-5, ST-37 Nodular Plantar Fibromatosis (Ledderhose's Disease): Jing Well points, GB-37, ST-37, moxa the plantar nodules, SP-3, SP-5 Plantar neuralgia (Morton's Neuroma): UB-63 Plantalgia due to venous insufficiency: GB-37, GB-39, LIV-3, UB-56 Osteodystrophy: UB-61 Degenerative joint disease: Bafeng Trigger Points: 1. Soleus Muscle: In the area Jiuwaifan 2. Gastrocnemius Muscle: In the area of UB-56 3. Tibialis Anterior Muscle: In the area of ST-36 4. Extensor Digitorum Longus Muscle: In the area of Liwai 5. Extensor Digitorum Brevis Muscle: In the area of GB-40 6. Peroneus Longus Muscle: In the area of GB-34 7. Abductor Hallucis Longus Muscle: In the area of KI-2

Wind-Cold-Damp

Clinical Manifestations	Acute pain of the sole of the foot Pain is worse in Wind, Cold and Damp weather Heavy sensations in the legs and feet Difficulty walking Generalized body pain Aversion to Wind and Cold Heartache T: Normal C: Slightly greasy and white P: Floating and tight
Treatment Principle	Dispel Win and Cold Dry Damp Regulate Qi Invigorate the Blood Sedate the pain
Herb Formulas	Qiang Huo Sheng Shi Tang  modified Chinese Patent Medicines: Feng Shi Pian Tian Ma Qu Feng Bu Pian
Points	LI-4, LIV-3, SI-3, SI-4, SP-6 For a sharp pain with cold sensations: + ST-44, UB-60 With a heavy sensation in the feet: + SP-9 With an obvious aversion to exposing the feet to Cold: + ST-36 With generalized body pain and a headache: + GB-20 With a poor appetite: + REN-12

Wind-Cold-Damp Bi With Wind Predominant

Clinical Manifestations	Moving pain Pain aggravated by Wind Aversion to Wind Muscle numbness Shoulder pain Neck pain Elbow pain Hand pain Low back pain Hip pain Knee pain Foot pain Preference for warmth Limited movement Lack of thirst Cold extremities T: Pink C: Thin and white P: Wiry and tight
Treatment Principle	Dispel Wind Warm the channels Sedate pain Circulate Qi Harmonize the Blood
Herb Formulas	Qu Feng Tang
Points	Ahshi points, GB-20, GB-31, LI-4, LIV-3, SJ-5

Wind-Cold-Damp Bi With Cold Predominant

Clinical Manifestations	Aversion to Cold Cold extremities Coldness of the affected area Cold pain Pain better with warmth Pain aggravated by Cold Sharp, stabbing pain Shoulder pain Neck pain Elbow pain Low back pain Hand pain Hip pain Knee pain Foot pain Lack of thirst Limited joint movement T: Pale or Purple C: Thin, white or Greasy white P: Wiry and tight
Treatment Principle	Warm the Channels Dispel Cold Circulate the Blood Alleviate pain
Herb Formulas	Qu Han Bi Tang
Points	GB-31, GB-34, SJ-6, SP-9, ST-40 With Yang Deficiency: + REN-4, REN-6

Kidney Yin Deficiency

Clinical Manifestations	Low back, knees and legs painful and weak Foot pain Light-headedness Vertigo Tinnitus Diminished hearing Five Sole Heat Chronic dry, sore throat Toothache Wasting and thirsting disorder (Xiao Ke) Dizziness Muscular weakness Dry skin Deafness Steaming bones Tidal fevers Loose teeth Cough Cough with Blood Impotence Shortness of breath Frequent urination Weakness in the lower body Hemoptysis Dripping urine Thirst Dry tongue Numbness and weakness at the waist and knees Heel pain Dry mouth Blurred vision Asthma Hot flashes Nocturnal emissions Urinary incontinence Spontaneous and nocturnal emissions Spermatorrhea Night sweats Lusterless complexion Wan complexion Generalized weakness and fatigue Lack of appetite Phlegm Maybe decreased urination T: Red C: Little or None P: Thready and rapid
Treatment Principle	Enrich Yin Nourish the Essence of the Kidneys
Herb Formulas	Ba Xian Chang Shou Wan Liu Wei Di Huang Wan Mai Wei Di Huang Wan
Points

Kidney Jing Deficiency

Clinical Manifestations	Pain on the sole of the foot which is worse with fatigue and better with rest Difficulty walking Flaccidity of the feet Weakness of the low back and knees Dizziness Tinnitus Deafness Loose teeth Infertility T: Normal C: Thin P: Thready With Yin Deficiency: Hot flashes Night sweats Thirst Dry throat T: Red C: Little or None P: Thready and rapid With Kidney Yang Deficiency: Aversion to cold Cold limbs Edema Profuse clear urine T: Pale C: Thin and white P: Slow, deep and thready
Treatment Principle	Tonify the Kidneys Benefit Jing Strengthen the bones Relieve pain
Herb Formulas	Zuo Gui Wan  Chinese Patent Medicines: Du Huo Ji Sheng Wan Kang Gu Zheng Sheng Pian
Points	KI-3, KI-4, KI-5, KI-10, LIV-3, LIV-8, UB-64 With dizziness: + DU-20 With an aversion to Cold and/or cold limbs: + moxa or moxa needle REN-4 With shortness of breath: + LU-9 With weakness in the knees: + GB-34 With edema: + SP-9 With diarrhea: + SP-3 With profuse urination: + REN-6 With amenorrhea: + SP-4 With tidal fever and Five-Sole-Heat: + KI-2, KI-7 With profuse night sweats: + HT-6

Kidney And Liver Yin Deficiency Heat

Clinical Manifestations	Low back, knees and legs painful and weak Foot pain Light-headedness Vertigo Tinnitus Diminished hearing Five-Sole-Heat Chronic dry, sore throat Toothache Wasting and thirsting disorder (Xiao Ke) Dizziness Muscular weakness Dry skin Deafness Steaming bones Tidal fevers Loose teeth Dripping urine Scanty menstruation Delayed menstruation Thirst Dry constipation Dry tongue Numbness and weakness at the waist and knees Heel pain Dry mouth Blurred vision Hemoptysis Asthma Hot flashes Nocturnal emissions Urinary incontinence Spontaneous and nocturnal emissions Night sweats T: Red C: Little or None P: Thready and rapid
Treatment Principle	Enrich Yin Nourish the Blood Clear Heat
Herb Formulas	Dang Gui Yu Zhu San
Points

Kidney And Liver Yin Deficiency With Blood Deficiency

Clinical Manifestations	Low back, knees and legs painful and weak Foot pain Light-headedness Vertigo Tinnitus Diminished hearing Five sole Heat Chronic dry, sore throat Toothache Wasting and thirsting disorder (Xiao Ke) Dizziness Muscular weakness Dry skin Deafness Steaming bones Delayed closing or unclosed fontanel in infants Tidal fevers Loose teeth Dripping urine Thirst Dry tongue Numbness and weakness at the waist and knees Heel pain Dry mouth Dry throat Blurred vision Urinary incontinence Spontaneous and nocturnal emissions Night sweats T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish the Liver and Kidneys Tonify Yin and Blood Clear Deficiency Heat
Herb Formulas	Gui Shao Di Huang Tang
Points

Qi Deficiency

Clinical Manifestations	Sole pain that worsens with fatigue and is better with rest Lack of obvious tenderness of the sole Lassitude Shortness of breath A weak voice Spontaneous perspiration Poor appetite Lower back pain Nocturia T: Pale C: thin and white P: Weak
Treatment Principle	Tonify Qi Relieve pain
Herb Formulas	Si Jun Zi Tang  modified Chinese Patent Medicine: Bu Zhong Yi Qi Wan
Points	GB-34, KI-3, LIV-3, SI-3, SI-4, SI-6, ST-36, UB-60, UB-64 With aversion to exposing the foot to Cold: + moxa ST-42 With generalized fatigue: + REN-4 With spontaneous perspiration: + LU-9 With shortness of breath: + LU-1, UB-13 With a poor appetite: + SP-3 With diarrhea: + ST-25 With a sensation of fullness in the abdomen: + ST-40

Qi And Blood Stagnation

Clinical Manifestations	Long- lasting stabbing pain in the sole of the foot with a fixed location Pain worse at night Worse with rest Better with movement Usually a history of fracture, strain, surgery or trauma Purplish color of the feet T: Purplish C: Thin P: Wiry and choppy
Treatment Principle	Move Qi Invigorate the Blood Unblock the Channels Stop pain
Herb Formulas	Tao Hong Si Wu Tang  modified Chinese Patent Medicines: Xiao Huo Luo Dan Jin Gu Die Du Wan
Points	GB-34, LI-4, LIV-3, SI-3, SI-4, SP-4, UB-60 With swelling of the feet: + Bafeng With a purplish color to the feet: + GB-44, UB-67 With a bone fracture of the foot: + GB-39, KI-3 With red spots on the foot: + SP-10 With depression: + LIV-14, REN-17 With aversion to Cold: + moxa or moxa needle KI-3, ST-36 With restlessness and insomnia: + HT-3, PC-6

Blood Deficiency

Clinical Manifestations	Slight sole pain In women, the pain worsens during menstruation Numbness in the soles of the feet Weakness in the knees and feet Pale complexion Pale lips Brittle nails Fatigue Dizziness Blurred vision Palpitations Insomnia Numbness of the limbs Scanty or delayed menstruation or amenorrhea T: Pale C: Thin and white P: Weak
Treatment Principle	Nourish the Blood Tonify Jing Relieve pain
Herb Formulas	Ba Zhen Tang  modified Chinese Patent Medicines: Ba Zhen Pia Shi Quan Da Bu Wan
Points	GB-34, GB-39. KI-3, LIV-3, REN-6, SI-3, SI-4, SP-6, ST-36 With swollen feet: + SP-9, ST-40 With an aversion to Cold or Cold limbs: + moxa or moxa needle REN-4, REN-6 With dizziness: + DU-20 With insomnia: + HT-3

Damp-Heat

Clinical Manifestations	Pain in the sole of the foot Feverish, heavy sensations in the foot Redness and swelling, worse with Heat and better with Cold Bitter taste in the mouth Poor appetite Fever Heaviness in the legs Painful urination Loose stools Abdominal distention and pain Deep, yellow urine T: Red C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Eliminate Damp Clear Heat Harmonize the collaterals Stop pain
Herb Formulas	Er Miao San  modified
Points	GB-34, KI-2, SI-3, SI-4, SJ-6, SP-6, SP-9, UB-63, UB-64 With a sharp pain on the sole: + LI-4, LIV-3 With a heavy sensation on the foot: + KI-6 With redness of the feet: + SP-10 With ulcers on the foot: + ST-44 With itching of the sole: + Bafeng With a fever: + DU-14, LI-11 With a headache: + GB-20 With a poor appetite and nausea: + REN-12, SP-4 With vaginal discharge and itching in the genitals: + GB-41, LIV-5 With difficult, painful urination: + KI-4, KI-5 With diarrhea: + ST-37

Toxic Heat

Clinical Manifestations	Acute pain in the sole of the foot Redness, swelling and severe pain of the soles of the feet Inability of the sole to touch the ground High fever Restlessness Insomnia Thirst Constipation T: Red C: Yellow and dry P: Forceful and rapid
Treatment Principle	Clear Heat Remove Toxins Reduce swelling Relieve the pain
Herb Formulas	Pu Ji Xiao Du Yin   modified Chinese Patent Medicine: San Huang Jie Du Pian
Points	KI-2, LI-4, LI-11, SJ-6, SP-6, SP-10 With redness and swelling of the foot: + GB-43 With itching on the feet: + LIV-2 With a stabbing pain on the sole: + KI-1 With a wound on the sole: + Bafeng With a fever: + DU-14 With nervousness: + GB-20 With throat pain and swelling: + LU-10 For coughing with expectoration of yellow Phlegm: + LU-5 With restlessness and insomnia: + HT-8 With constipation: + ST-25