and connective tissue injuries lead to over 10 million clinic visits per year
in the United States.
Causes of these injuries may be external (sports injuries, car accidents,
trauma), internal (chronic wear and tear of muscles, ligaments and tendons;
bones weakened by osteoporosis), or both. Acute injuries are characterized by
severe pain, swelling and inflammation, and in some cases, internal bleeding.
Treatment of acute injuries should focus on relieving pain, reducing swelling
and inflammation, and stopping bleeding. Chronic injuries are characterized by
dull pain, stiffness and numbness, and decreased muscle mass and strength. Treatments
of chronic injuries include relief of pain and restoration of physical and
Flex (MLT) is designed specifically to treat chronic or mid-to-late stages
of musculoskeletal injuries, with atrophy of the soft tissues (muscles, tendons,
ligaments, and cartilage), decreased mobility of the joints, cartilage
degeneration, and generalized weakness and pain. This formula contains herbs to
tonify blood, activate blood circulation, nourish yin, and dispel wind-damp.
In this formula, many herbs are used to
tonify the underlying deficiencies. Dang Shen
(Radix Codonopsis) tonifies qi. Dang Gui (Radix Angelicae Sinensis),
Di Huang (Radix Rehmanniae), and Bai Shao (Radix Paeoniae Alba)
nourish blood and yin. Healthy joints depend on healthy surrounding cartilage
and soft tissue. Because there is no blood supply to the cartilage, it gets
nutrition and oxygen from the surrounding joint fluids. Therefore, adequate
blood supply to the surrounding areas of the cartilage will ensure a healthy
joint. Dang Gui
(Radix Angelicae Sinensis) tonifies blood and promotes blood circulation
to generate new tissues. Chuan
Niu Xi (Radix
Cyathulae) tonifies the Liver
and Kidney, strengthens tendons and bones, and helps Dang Gui (Radix
Angelicae Sinensis) move blood.
Together, they stimulate soft tissue (tendons, ligaments and cartilage) growth
and restoration. Furthermore, Wu Jia Pi
(Cortex Acanthopanacis), Qian
Nian Jian (Rhizoma
Homalomenae), and Xu
Dipsaci) dispel wind-damp, strengthen bones and tendons, and relieve
pain. Chu Shi Zi (Fructus Broussonetiae) and Zhi
He Shou Wu (Radix Polygoni Multiflori Praeparata) tonify
Liver and Kidney to strengthen muscles, tendons, cartilage, and ligaments. The
yin tonics of this formula, Bai
Paeoniae Alba), Zhi He Shou Wu
(Radix Polygoni Multiflori Praeparata), and Chuan Niu Xi
(Radix Cyathulae), prevent the narrowing of the space between joints,
especially in the vertebrae or the knee joint due to degeneration.
In summary, Flex (MLT)
works to support connective tissues around the joints. It contains herbs that
tonify the underlying deficiencies and facilitate healing and recovery. It
treats chronic or mid-to-late stages of musculoskeletal injuries with soft
tissue degeneration as it encourages repair and restoration.
formula should not be taken during the acute phases of injuries
with bleeding and bruises, as there are many tonic or
warm herbs that may worsen the condition.
herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis).
Therefore, patients who are on anticoagulant or antiplatelet therapies, such as
should use this formula with caution, or not at all, as there may be a higher
risk of bleeding and bruising.,,
* According to most textbooks and contemporary
references, the classic entry of "He Shou Wu" is now separated
into two entries: the unprepared Sheng Shou Wu (Radix
Polygoni Multiflori) and the prepared Zhi He Shou Wu (Radix
Polygoni Multiflori Praeparata), as they have significantly different
therapeutic effects and side effects. Sheng Shou Wu (Radix
Polygoni Multiflori) is a stimulant laxative that treats constipation, but may
cause nausea, vomiting, abdominal pain, diarrhea, and in rare cases, liver
disorder (dose- and time-dependent, and reversible upon discontinuation). On the other hand, Zhi He Shou Wu (Radix
Polygoni Multiflori Praeparata) is a tonic herb that is safe and
well-tolerated. The dramatic changes in the therapeutic effect and safety
profile are attributed to the long and complicated processing of the root
with Hei Dou (Semen Sojae) through repeated
blending, cooking, and drying procedures. When properly processed, the chemical
composition of the root changes significantly. Many new compounds
are generated from the Maillard reaction (four furanones, two furans,
two nitrogen compounds, one pyran, one alcohol and one sulfur compound).
Furthermore, the preparation process causes changes in the composition of
sugars and 16 kinds of amino acids; it also reduces the pH of the herb from
6.28 to 5.61., In summary, these changes give rise to the tonic
effects of the prepared roots, and eliminate the adverse
reactions associated with the unprepared roots. Note: Due to medical risks and legal
liabilities, it is prudent to exercise caution and not use
this herb in either prepared or unprepared forms
in patients with pre-existing or risk factors of liver diseases.
packs should be used during the first 24 to 48 hours of acute injuries to
reduce swelling and inflammation. On the other hand, hot packs should be used
for chronic injuries to promote blood circulation and enhance healing in the
formula should be taken during the recovery and rehabilitation phases after an
injury, but not during the acute phases with acute pain and severe inflammation.
* There are three
excellent formulas for post-surgical recovery. Flex (TMX) should be taken after the surgery for 5 to 10
days to facilitate the immediate healing of wounds. Continue herbal
treatment with Flex (MLT) and Osteo 8 for one to three month
to facilitate healing and recovery of soft tissues and bones, respectively.
recovery from chronic neck and shoulder injuries, combine with Neck & Shoulder (CR).
recovery from chronic low back pain, combine with Back Support (CR).
recovery from chronic arm (shoulder, elbow, and wrist) injuries, combine with Arm Support.
recovery from chronic knee and ankle injuries, combine with Knee & Ankle (CR).
osteoarthritis, add Osteo 8.
bone spur, add Flex (SPR).
individuals with severe weakness and deficiencies, combine with Imperial Tonic.
Tung’s Points by Dr. Chuan-Min Wang:
* Tendon, ligament disorders: Cesanli (T 77.22), Cexiasanli (T
77.23), Zhengjin (T 77.01), Zhengzong (T 77.02)
Method by Dr. Richard Tan:
side: Ququan (LR 8), Rangu
(KI 2), Dazhong (KI 4), Fuliu (KI 7), Neiguan (PC 6), Tongli (HT 5)
side: Waiguan (TH 5), Yangxi
(LI 5), Zusanli (ST 36), Yanglingquan (GB 34)
Medicine by Dr. Li-Chun Huang:
* Low back pain, lumbar ligaments disease:
Lumbar Vertebral Area near the antihelix middle line positive point, Lumbar
Vertebral Area of the Groove of Spinal Posterior (select the positive point).
cucumber is very beneficial because it has a rich amount of lubricating
compounds that are needed in all connective tissues, especially joints and
joint fluids. Gelatin is also recommended.
is important to consume an adequate amount of multiple vitamins and minerals,
as they are essential to prevent bone loss and promote bone growth.
sulfate and chondroitin sulfate are great nutritional supports. They are important
for the formation of bones, tendons, ligaments, and cartilages.
it is important to relax and rest during the recovery process of injuries, it
is also important not to stay completely bedridden. Gentle exercises will not
only facilitate recovery, but will also prevent muscle atrophy and muscle
a 42-year-old male, presented with right hip and leg pain and numbness. He was
using crutches with decreased impaired mobility for the previous three months.
Symptoms of stiff neck, frozen ankle, and pain affecting his sleep were
present. The patient had a tendency to get injuries due to his poor balance.
The practitioner diagnosed the condition as bi zheng (painful
obstruction syndrome) with blood deficiency and blood stasis with qi
constraint. His Western diagnosis was muscle atrophy. The patient was given Flex (MLT) and directed to take it for eight weeks with the addition of Knee & Ankle (CR) for four weeks. With both formulas and receiving acupuncture
treatment for the eight weeks, the patient regained 100% use of his leg, moving
from crutches to a cane. The patient resumed sleeping flat after three weeks
and riding a bicycle after eight weeks. Pain reduced from 10 to 0 on a 1-10
scale. The patient was very pleased with the herbs, started practicing yoga,
and has become more enthusiastic towards life. Submitted by K.F., Honolulu,
* M.K., a
39-year-old female, presented with a previously treated ankle sprain; however,
the pain was still present due to increase of pressure and activity. Objective
findings include swelling and pain upon palpation on the lateral side of the
right ankle. The practitioner diagnosed this condition as qi and damp bi
zheng (painful obstruction syndrome). Upon diagnosis the practitioner
prescribed Flex (MLT) for the recovery stage of the patient’s ankle
sprain. With the addition of Flex (MLT), the swelling and pain
reduced and the patient was able to tolerate standing for long periods of time
without pain or fatigue. Submitted by L.H., Chicago, Illinois.
62-year-old female, presented with multiple symptoms including a stiff lower
back, low grade pain bilaterally on both legs, as well as pain on the heel of
the left foot. The patient had been previously diagnosed with plantar
fasciitis. Objective findings included areas of the legs having knots within
the muscles. The practitioner diagnosed this condition as qi and blood stasis,
with underlying Liver and Kidney yin deficiencies. For treatment, the patient
had received acupuncture, which had relieved the pain for only a few days. With
the addition of Flex (MLT), it had accelerated the progress and reduction of
the pain. The patient had commented that her legs had never felt as loose
before. Submitted by L.H.,
a 58-year-old male, presented with pain located on the right knee. He had
mentioned that he had had ten previous operations on it, one being a knee
replacement in 2009. The TCM diagnosis was qi and blood stagnation; Western
diagnosis was arthritis of the knee. Flex (MLT) was prescribed, followed
with taking Knee & Ankle (CR). Overall the herbs reduced the pain,
especially when walking, and it continued to improve. Submitted by M.P.,
a 50-year-old female, presented with a swollen right ankle. She mentioned she
had broken it about a month ago and it had become stiff as well, making it hard
to drive and run. Objective findings were swelling and pain upon palpation. The
practitioner diagnosed the condition as qi and blood stagnation, as well as
Liver and Kidney yin deficiencies. Flex (MLT) was prescribed at 3
capsules twice daily. After one week of taking the herbs as directed, the pain
had resolved and the swelling had improved. The patient stopped taking the
herbs after two weeks. Submitted by M.P., Muskego, Wisconsin.
AND CLINICAL RESEARCH
Flex (MLT) is an excellent formula for rehabilitation of patients who suffer
from chronic musculoskeletal injuries. After acute injuries (such as broken
bones, bone fracture, and tear of muscles, tendons or ligaments), patients are
often asked to rest for an extended amount of time. As a result, lack of
movement on a long-term basis often contributes to atrophy of the soft tissues
(muscles, tendons, ligaments, and cartilage), decreased mobility of the joints,
and generalized weakness and pain. Flex (MLT) is designed
specifically to treat this condition, and it contains herbs with
chondroprotective effects to benefit cartilages, osteogenic activity to promote
generation of bones, neuroregenerative benefit for healing of nerves, and
adaptogenic functions to facilitate rehabilitation.
Flex (MLT) incorporates many
herbs to facilitate the healing and recovery from chronic musculoskeletal
injuries. Chu Shi Zi (Fructus Broussonetiae) and
Nian Jian (Rhizoma Homalomenae) have been used traditionally
to strengthen the soft tissues, such as muscles, ligaments and tendons. Chuan Niu Xi (Radix Cyathulae) is an
excellent herb to protect the cartilage from repetitive and stress-induced injuries.
According to one study, the extract of Chuan Niu Xi
(Radix Cyathulae) has a potent effect to inhibit the induction of MMP-13,
an important enzyme for the degradation of the cartilage collagen matrix,
especially under arthritic conditions. By down-regulating the MMP-13 activity, Chuan Niu Xi (Radix Cyathulae) shows great chondroprotection
against cartilage degrading disorders. Dang Gui (Radix Angelicae Sinensis)
is an effective herb to promote the generation of bones. According to one study,
the water extract of Dang
Angelicae Sinensis) has been found to contribute to the formation of
bones and treatment of bone injuries. It directly stimulates the proliferation,
alkaline phosphatase activity, protein secretion and particularly type I collagen
synthesis of human osteoprecursor cells in a dose-dependent manner.
According to another study, Dang
Angelicae Sinensis) shows a marked stimulatory effect in osteoblast
proliferation and differentiation systems, as well as in a fibroblast-secreted
hyaluronic acid assay. This herb enhanced the deposition of hyaluronic acid and
proliferation of osteoblasts in vitro,
as well as bone regeneration. Xu Duan (Radix Dipsaci) has significant osteogenic and
antiosteoporotic properties to promote generation of new bones and prevent
osteoporosis. According to a bone cells culture experiment, administration of Xu Duan (Radix
Dipsaci) shows a potential effect to increase the proliferation
and differentiation of osteoblasts without affecting osteoclast activity. The
researchers conclude that these herbs can effectively increase the rate of
tissue regeneration of damaged bones.
Lastly, Dang Shen (Radix Codonopsis) has been
shown in one study to promote
neuron regeneration in a dose-dependent manner.
The rehabilitation of chronic
musculoskeletal and connective tissue disorders is often accompanied by mental
and physical stress. Dang Shen (Radix Codonopsis) has a regulatory effect on the central
nervous system to help with adaptation to various stressful environments. Wu Jia Pi (Cortex Acanthopanacis)
enhances physical adaptation by increasing endurance and performance.
Together, these two herbs exert adaptogenic
effects to help patients cope with mental and physical stress during the
transition of rehabilitation.
In addition, many herbs in this formula
have marked analgesic effects to relieve pain, and anti-inflammatory effects to
reduce swelling and inflammation. Dang
Angelicae Sinensis) has marked analgesic and anti-inflammatory effects,
with potency similar to or stronger than that of acetylsalicylic acid.,
Wu Jia Pi (Cortex Acanthopanacis)
also has excellent analgesic and anti-inflammatory effects, with duration of
action lasting up to five hours., Bai Shao (Radix Paeoniae Alba) and Di Huang (Radix Rehmanniae) have
anti-inflammatory and antipyretic effects to reduce inflammation and swelling
and relieve burning sensations in the affected areas., Clinically,
these herbs have been used with great success to treat a wide variety of musculoskeletal
conditions, including but not limited to muscle wasting, muscle atrophy,
chronic soft tissue injuries, and various types of pain.,
Lastly, Bai Shao (Radix Paeoniae Alba) has
an excellent muscle-relaxant effect to relieve spasms, cramps, and muscle
stiffness. This efficacy has been
demonstrated in both smooth and skeletal muscles.
Flex (MLT) is an excellent formula for chronic or mid-to-late
stages of musculoskeletal injuries. With chronic injuries, degeneration of the
soft tissues (muscles, tendons, ligaments, and cartilage) leads to decreased
range of motion and mobility of the joints. With mid-to-late stages of
musculoskeletal injuries, muscle wasting and muscle atrophy due to lack of
exercise and physical movement are the main concern. Flex (MLT)
is developed specifically to address all of these conditions by using herbs
that compliment the rehabilitation process and complete the recovery from these
basic bodily sensation induced by a noxious stimulus that causes physical
discomfort (such as pricking, throbbing or aching). Pain may be of acute or chronic state,
and may be of nociceptive, neuropathic, or psychogenic origin.
Western medicine excels in treatment of
acute pain. There are many drugs with potent and reliable analgesic effects.
Furthermore, many drugs are available as injection for immediate pain relief.
However, these drugs treat the symptom of pain but do not alter the underlying
disease. Furthermore, long-term use of these drugs for
chronic pain are likely to cause more side effects, and complicate the
condition further. In short, while drugs are effective for treating acute pain,
they should be used sparingly to manage chronic pain.
of pain is a sophisticated balance of art and science. Proper treatment of pain
requires a careful evaluation of the type of disharmony (excess or deficiency,
cold or heat, exterior or interior), characteristics (qi and/or blood
stagnations), and location (upper body, lower body, extremities, or internal
organs). Furthermore, optimal treatment requires integrative use of herbs,
acupuncture, and tui-na therapies. All these therapies work together to
tonify the underlying deficiencies, strengthen the body, and facilitate
recovery from chronic pain. TCM pain management targets both the symptom and
the cause of pain, and as such, often achieves immediate and long-term success.
Furthermore, TCM pain management is often associated with few or no side
treatment of mild to severe pain due to various causes, TCM pain management
offers similar treatment effects with significantly fewer side effects.