I am concerned about a patient I treat for back pain using tui na.
He presents with:
Tongue= indents along LV area on both sides with a purple patch on right side, small cracks all over tongue, Heart crack at tip
Pulse=changing each week, first few month of weekly treatments it was intermittent (skipping every 2-4 beats) when he was very stressed and not sleeping well, at other times skipping every 8-25 beats. I recommended he see an MD for the irregular pulse and he reports that he has and that there is no problem.
2 weeks ago, pulse was slow and skipping, and now this week it's fast (not from exercise) and regular.
The background is an MVA. He has on-going back pain in the low back, neck and shoulders (Gall Bladder channel) that goes right up into his face and eyes and around GB 14. He also has pain along the Gb channel of the legs on the left side. On palpation, the LR and GB Back Shu points are very tight, as is GB 21. His skin turns quite red after massage.
He is very stressed and doesn't sleep well. I've recommended stretches and dietary advice such as avoiding alcohol, fried foods and eating more green vegetables.
I use a lot of deep pressure and kneading techniques with my elbows to break up the stagnation. I have recommended acupuncture but he doesn't want needles. I have also used gua sha which helped but he prefers massage. He gets a couple of days of relief and then the pain returns.
I would appreciate any thoughts as to why his pulse picture keeps changing, and any other recommendations for how to treat him.
Thanks for your help.