Postpartum general aching is a disorder occurring during puerperium characterized by soreness, numbness and heaviness of the extremities.

Etiology and Pathogenesis

Deficiency of blood or kidneys or an attack of exogenous wind-cold after childbirth leading to malnutrition of the Bao meridian cause the disorder.

Diagnosis and Differential Diagnosis

A. Diagnostic evidence

General arthrodynia occurring during puerperium.

B. Differential diagnosis

Puerperal flaccidity is a condition required to be differentiated. It is caused by profuse postpartum hemorrhage and is characterized by flaccidity (not pain), numbness, and even paralysis of limbs. It may persist for years far beyond puerperium.

Syndrome Differentiation and Treatment

Although deficiency of qi and blood are the basic pathogenic factors of this disorder, it is always accompanied by an attack of exogenous evil, and the cases appear as a combination of asthenia and sthenia syndromes. Therefore, the therapies of supporting healthy qi and eliminating evils while nourishing blood should be the chief measures used. Potent wind-clearing agents are contraindicated so as to avoid impairment of yin.

Syndrome Differentiation

A. Blood-deficiency syndrome

Manifestations: General arthrodynia, soreness and numbness of limbs, dizziness, palpitations, reddish tongue with little coating and thready and weak pulse.

Therapeutic principles: Nourish blood, benefit qi, and warm and dredge meridians.

Prescription: The Modified Decoction of Five Drugs with Astragali and Ramulus Cinnamomi

Radix Astragali 15 g
Ramulus Cinnamomi 10 g
Radix Paeoniae Alba 15 g
Radix Gentianae Macrophyllae 10 g
Radix Angelicae Sinensis 10 g
Caulis Spatholobi 15 g
Ramulus Taxilli 15 g
Rhizoma Chuanxiong 10 g
Rhizoma Zingiberis Recens 6 g
Fructus Jujubae 5 pcs

Remarks: For cases with puerperal heel pain, dizziness and tinnitus due to deficiency of kidney-yin, the Modified Decoction of Six Drugs Containing Rehmanniae Praeparata should be employed.

Radix Rehmanniae Praeparata 15 g
Rhizoma Dioscoreae 15 g
Fructus Corni 10 g
Cortex Eucommiae 15 g
Radix Achyranthis Bidentatae 10 g
Radix Dipsaci 15 g
Radix Polygoni Multiflori Praeparata 20 g
Poria 15 g
Radix Paeoniae Alba 15 g
Radix Glycyrrhizae Praeparata 6 g

B. Wind-cold syndrome

Manifestations: General arthrodynia with limited movement or wandering or stabbing pain, swelling, numbness and heaviness of the limbs which can be relieved by warmth, pale tongue with thin, white coating and thready and slow pulse.

Therapeutic principles: Nourish blood, dispel wind, and eliminate cold and dampness.

Prescription: The Modification Decoction of Angelicae Pubescentis and Taxilli.

Radix Angelicae Pubescentis 10 g
Ramulus Taxilli 15 g
Radix Gentianae Macrophyllae 10 g
Radix Ledebouriellae 10 g
Radix Angelicae Sinensis 10 g
Radix Paeoniae Alba (fried) 15 g
Rhizoma Chuanxiong 10 g
Cortex Eucommiae 15 g
Radix Achyranthis Bidentatae 10 g
Radix Astragali 15 g
Ramulus Cinnamomi 10 g
Poria 15 g
Herba Asari 3 g

Remarks: For cases with wind as the predominant pathogenic agent manifested as wandering pain, add Rhizoma seu Radix Notopterygii (10 g) and Radix Clematidis (10 g). For cases with cold as the predominant pathogenic agent manifested as severe pain, add Radix Aconiti Praeparata (6 g). For cases with dampness as the predominant pathogenic agent manifested as swelling and numbness, add Semen Coicis (15 g), Rhizoma Atractylodis (15 g) and Fructus Chaenomelis.

C. Kidney-deficiency syndrome

Manifestations: Postpartum lumbago, weakness of legs, heel pain, reddish tongue with thin coating and deep and thready pulse.

Therapeutic principles: Tonify kidneys, and strengthen the bones, loins and tendons.

Prescription: The Modified Decoction for Strengthening the Kidneys and Nourishing Blood

Radix Angelicae Sinensis 10 g
Rhizoma Chuanxiong 10 g
Radix Angelicae Pubescentis 10 g
Cortex Cinnamomi 6 g
Radix Ledebouriellae 10 g
Cortex Eucommiae 15 g
Radix Dipsaci 12 g
Ramulus Taxilli 15 g
Radix Morindae Officinalis 10 g
Rhizoma Cibotii 15 g
Radix Rehmanniae Praeparata 15 g
Rhizoma Zingiberis Recens 6 g
Folium Photiniae 10 g

Remarks: For cases with obstruction of meridians by blood stasis manifested as limited movement of limbs, abdominal pain, lochiostasis, dark purplish tongue with petechiae and deep and unsmooth pulse, the Modified Decoction for Removing Blood Stasis and Relieving General Pain is recommended. The therapies of activating blood circulation, eliminating wind-evil, dredging meridians and stopping pain should also be employed.

Radix Gentianae Macrophyllae 12 g
Rhizoma Chuanxiong 10 g
Flos Carthami 10 g
Rhizoma seu Radix Notopterygii 10 g
Myrrha 10 g
Radix Angelicae Sinensis 10 g
Faeces Trogopterori 10 g
Rhizoma Cyperi Praeparata 10 g
Radix Achyranthis Bidentatae 10 g
Lumbricus 10 g
Radix Glycyrrhizae Praeparata 10 g
Herba Speranskiae Tuberculatae 12 g
Herba Erodii seu Geranii 15 g

Copyright 1995 Hopkins Technology