Understanding Painful Obstruction Syndromes

Bi, or Painful Obstruction Syndromes, are commonly encountered clinical syndromes. They result from the obstruction of meridians by the combination of the “three demons” (Wind-Cold-Dampness) according to TCM. These correspond to multiple pathologies in Western medicine such as osteoarthritis, arthritis, fibromyalgia… among many others.
Let’s explore these Bi through Koffi’s story.

The morning everything went wrong

Koffi is not a hero, nor a sage, nor a serious sick person. He is just a normal man…
A self-employed graphic designer, aged 36, he lives in a small apartment, surrounded by his plants and his cat Noodle. Two to three times a week, he runs a few kilometers. He has adapted to the pains he regularly feels upon waking up: “I must have slept wrong”.
But one morning, as he puts his foot on the ground, a searing pain shoots through his hip. Not violent enough to scream, but too precise to be ignored. He stretches, shakes his leg but to no avail. And Koffi thinks to himself: “It’s official. I’m getting old.”
But this pain bothers him, he doesn’t understand the cause. He spends the day limping, searching the internet: “right hip pain upon waking up for no reason”, exploring forums but with no result.
Come evening, a friend tells him about a “Chinese doctor” located nearby, in a discreet little courtyard. Pushed to the limit by fatigue, pain, and probably a touch of curiosity, Koffi makes an appointment.

At Doctor Shen’s

The Chinese doctor is a small, slender man, with a disconcerting acuity in his gaze. His name is Shen. He gestures for Koffi to sit down, then without a word, takes his wrist, and delicately places three fingers on the radial at the wrist. The contact is light, almost imperceptible. Yet Koffi feels something – a form of intense attention. Doctor Shen closes his eyes.
After a moment, in a calm voice, Shen tells him: “The Qi is not circulating. There is an invasion of Wind – Dampness.” Koffi, feeling a little embarrassed, coughs: “An invasion… by what exactly? Bacteria? A virus?”
Shen opens his eyes and tilts his head: “No. Perverse energies. External breaths. Wind, Cold, Humidity. They have entered. Your body has opened the door.”
Koffi is a little taken aback by this speech, but he feels that he can trust this strange doctor. Shen continues: “Do you have pain upon waking, but less when moving?”
Koffi nods. “A sensation of heaviness in the leg? The pain that moves a little?” Koffi nods again.

Bi syndrome

“Bi Syndrome,” Shen concludes. “Qi and Blood blockage in the meridians.” He pauses, then says, “We’re going to get things moving. You’ll see.”
He takes out his acupuncture needles and begins his treatment. Shen handles them like a calligrapher, with a calm, almost affectionate concentration. He inserts one into Koffi’s leg, just below the knee. Another into the ankle. Then another near the hip. “You’ll feel like a taut thread,” he says calmly. “That’s the Qi. It responds… It returns.”
Koffi does indeed feel something, a deep tingling sensation. He wants to know more about this Bi and asks Shen about it.
Shen sits up straight: “Bi means ‘obstruction.’ It’s when something blocks the circulation of Qi and Blood. When the body becomes like a city with traffic jams: the streets are there, but nothing is moving.” He explains that there are different types of Bi, each with its own personality (see sidebar).
Then he continues: “These ignored pains, these little ailments that ‘will pass,’ sometimes they are Bi. And if we let them take hold, they become chronic. They infiltrate. They gnaw. And one day, you can’t lift your arm. Or walk. Or sleep.”

Pain: A Signal to Take Seriously

Pain: a signal to take seriously
Staring into Koffi’s eyes, he said to him: “It’s not urgent because it’s serious. It’s urgent because it’s light.” Koffi blinks: “You mean… the more discreet it is, the more attention it needs?”
Shen smiles for the first time. “Exactly. The body speaks softly at first. Then it screams. And sometimes, it falls silent… but it deteriorates.”
Koffi begins to realize that Shen’s medicine is not “alternative” medicine. That it is an ancient, precise, demanding, but deeply human reading of life.
After the treatment, Dr. Shen removes the needles and says again: “Pain is not the enemy. It’s an alarm bell. It’s the body warning you that there is an imbalance, that something is not flowing properly, or not enough. And that you have exceeded your limits without listening.” He explains that where the Qi flows, there is no pain. On the contrary, where the Qi stagnates, pain appears. Pain is the Qi knocking at the door because it can no longer pass through.
If we ignore this signal, the pain settles in, or even changes shape. And in the long run, if the imbalance persists, the disease sets in. “Pain – concludes Shen – is the body asking for a return to harmony. Don’t silence it. Learn its language. And it will thank you.”
Leaving the office, Koffi is not “cured”. Not yet.
But he walks differently. Slower. Straighter. Like someone who no longer avoids his pain, but listens to it. He begins to perceive its hidden meaning.

Key points

According to TCM, the term Bi means “obstruction”. This is a disturbance in the harmonious circulation of Qi (vital energy) and Blood. This imbalance is often caused by the invasion of external pathogenic influences, called Xie Qi: Wind, Cold, Dampness, and sometimes Heat.

Each type of Bi has specific characteristics:
– Wind Bi: migratory, variable pain.
– Cold Bi: fixed, deep pain, worsened by cold.
– Damp Bi: sensation of heaviness, swelling, numbness.
– Heat Bi: intense pain, redness, inflammation.
Here are some situations that can generate Bi:
• Irregular waking and sleeping hours, or overwork, injure Qi and Blood, weaken the meridians, and weaken the body’s defenses. This allows external Pathogens to enter.
• A cold or damp living environment, a professional activity exposing to Cold, Wind, and Dampness favor the penetration of external Pathogens into the body.
• Excessive alcohol consumption, a diet that is too rich or insufficient injure the Qi of the Spleen, leading to the internal production of Phlegm and Dampness that then circulate in the meridians.
• Excessive eating injures the Essence and Blood. The Deficiency of Yin leads to excess Fire, and the Blood can no longer nourish the Tendons.
• Stagnation of the Seven Emotions (Anger, Joy, Emotional Shock, Worry, Sadness, Excessive Thinking, Fear), and stagnation of Blood in the meridians.
• Bruising or stagnation of Blood after external trauma.