Du Huo Ji Sheng Tang: A Chinese Medicine Perspective on Joint Support

By Dr. Eric Karchmer, PhD, MD (China), LAc /

Du Huo Ji Sheng Tang: A Chinese Medicine Perspective on Joint Support

The need for joint and lower back support is probably the condition that most often has us reaching for the medicine cabinet or heading to the doctor’s office. When joint support needs become chronic and debilitating, lives are altered, sometimes ruined. Taken a step further, the tragic opioid crisis that has been spiraling out of control in recent years reminds us that the biomedical answers for chronic pain are deeply flawed. Even our milder medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen, should not be taken long term. They not only damage the stomach lining but are now known to also harm the kidneys in high doses or with sustained use, leading to loss of kidney function. Fortunately, Chinese medicine offers a unique approach to the treatment for such needs, particularly for joint support. It has the potential to bring support and strength to countless individuals with little or no side effects.

DAO Labs Joint Vitality is inspired by the 7th century formula called Du Huo Ji Sheng Tang ("Pubescent Angelica and Taxillus Decoction"). It is a unique and versatile Chinese formula for addressing chronic joint support needs that I have found indispensable to my own clinical practice. In order to understand how this special blend of herbs can provide support, we need to first explore the Chinese medicine understanding behind the need for joint discomfort. At the most fundamental level, there are two causes in Chinese medicine - either the flow of Qi and Blood is obstructed or it is insufficient. Joint Vitality is unique in Chinese formulary in that it addresses both causes.

Du Huo Ji Sheng Tang joint pain

Treating Obstruction

Let’s first tackle the problem of obstruction. According to The Inner Canon, one of the foundational texts of Chinese medicine, the need for chronic joint support is often related to climatic factors. Put simply, “the three Qi of Wind, Cold, and Dampness combine to create a blockage.” Most commentators have interpreted this passage to mean that the external pathogens of "Wind", "Cold", and "Dampness" become lodged in the body and obstruct the flow of Qi, "Blood", and Fluids in the body. This creates the condition of “Blockage” (also known as “Obstruction” or "Bi syndrome"), a Chinese medicine theory term which describes many chronic pain conditions and can encompass a range of modern rheumatological diseases, from fibromyalgia to rheumatoid arthritis.

In the West, we are not used thinking about climatic factors as forces injurious to our bodies. Yet, have you ever had the feeling that it was going to rain just by the feeling in your joints that day?  The quality of pain will differ depending on which pathogen is primary in any particular instance of "Blockage", but more experts agree that it is important to address all three factors in most treatments.

What’s important about this passage from the Inner Canon is that it not only gives us new ways of thinking about the need for chronic joint support (which may also present with numbness), it also guides us on how to use herbal formulas to address these three causes of discomfort.

Not surprisingly, roughly half the herbs found in Joint Vitality directly address these climatic factors. Siler (Fang Feng), angelica pubescent (Du Huo), and  Gentiana microphylla root (Qin Jiao) work together to drive out "Wind and Dampness"; poria (Fu Ling) drains "Dampness", and cinnamon bark ("Rou Gui") powerfully warms the interior (one very important note: we do not include asarum (Xi Xin), a very warming, wind-dispersing medicinal, in our preparation, even though it is found in the original formula. It contains aristolochic acid, which is known to be a carcinogen.)

These herbs are assisted by a second set of medicinals to help move the "Blood". When blockage persists for a long time, it can in turn lead to "Blood stagnation". So this formula also contains ligusticum (Chuan Xiong), cyathula (Chuan Niu Xi), and angelica sinensis (Dang Gui) to mitigate this additional need for joint support.

Du Huo Ji Sheng Tang joint pain

Treating Deficiency

Now let’s turn to the second main reason for joint support. In addition to the pathogens above, chronic joint pain is also a manifestation of deeper forms of “deficiency.” When our bodies become weaker, the flow of Qi and "Blood" is less robust. On its own, this insufficiency can cause pain, but it is even more nefarious in this case, because deficiency makes us more vulnerable to the external pathogens of "Wind, Cold, and Dampness".

"Deficiency" is a concept that can be difficult for Westerners to grasp. In the case of chronic pain, it can be caused by a number of factors. First, the aging process itself will make us a vulnerable. Even with careful diet and exercise, everyone’s body slows down eventually and deficiencies inevitably arise. Second, our everyday activities, whether its an overly vigorous exercise routine, or just our mundane efforts to get through the day, can easily cause injuries. We may be only dimly cognizant of the problems when they occur. Over years and decades, however, these injuries can add up and lead to serious deficiencies.

Fortunately, Chinese medicine has numerous medicinals to address the problem of "deficiency". In Joint Vitality, ginseng (Ren Shen), white peony (Bai Shao), and angelica sinensis (Dang Gui), all help treat deficiencies of Qi and "Blood". Other herbs, such as loranthus (Sang Ji Sheng), eucommia (Du Zhong), cyathula (China Niu Xi), and cooked rehmannia (Shou Di Huang), help to treat deficiencies of the Liver and Kidney. This last set of herbs are intriguing. In Chinese medicine, the organs are all associated with various body parts. For example, the Liver is related to the tendons and the Kidneys to the bones. Because of this last set of herbs, it is often said that this formula can “strengthen the tendons and bones.”

Du Huo Ji Sheng Tang joint pain

A Versatile Formula to Support the Joints

The unique composition of Joint Vitality makes it a versatile formula, particularly anyone with a recognizable deficiency manifesting in the need for chronic joint support. Who might these individuals be? Classically, the formula is said to be more appropriate for individuals who require low back and knee support. But I have found it useful for most individuals who are dealing with long term needs, especially in the joints. These individuals may also have stiffness and numbness as well.

Sometimes, the need for support can be traced to past traumas, such as a car accident, a fall, a sports injury, etc. Other times, the cause may simply be the aging process. Because the supplementing medicinals in this formula also balance out the (relatively mild) harshness of the draining and dispersing herbs, it is a well balanced formula that can generally be taken for a long term. That’s perfect for many chronic joint needs. These conditions often develop over years and therefore take a long time to address. The good news is that this formula, when used properly, should not cause any major side effects and can lead to a gradual but meaningful improvements in the joints.


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Disclaimer: These statements have not been evaluated by the FDA and are not intended to treat, mitigate or cure any disease or symptom.  The above statements are based upon Traditional Chinese Medicine theory, a 2,500 year old practice.  The above commentary is not intended to diagnose, treat, cure or prevent any disease.  For more information visit mydaolabs.com.

Dr. Eric Karchmer is a practicing Chinese medical doctor, medical anthropologist, and co-founder and Chief Doctor of Chinese Medicine for DAO Labs. From 1995-2000, Eric studied at the Beijing University of Chinese Medicine and today is both a licensed acupuncturist and professor at Appalachian State University. Eric can be reached at drkarchmer@mydaolabs.com.

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  • I am on several prescriptom medications including blood pressure and blood thinner. Are there any interactions I need to worry about? My doctor would likely not be familar with these herbs.

    Suzanne Davis on

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