At this stage most clients take prescription medication usually involving pain medications and sertonin reuptake inhibitors. Frequently, female clients report an early onset of menopause and are advised by their physicians to take hormone replacement therapy. From the viewpoint of Chinese medicine the liver is further stressed by the use of drugs making a recovery less likely. The herbal therapy needs to be changed to Dang gui si ni san preferably 2 to 3 ji a week. The addition of evodia can be helpful.
Clients benefit from moxabustion especially if they self administer it on a daily basis.
While a client in the first stage will benefit substantially from regular exercise it is no longer of importance here because the deficiency now outweighs the stagnation. Exhaustion of kidney yang and jing As the disease progresses further, all vital substances become depleted especially the kidney yang leading to severe stasis of blood with significantly more severe pain. At this point the client is usually unable to continue with the ordinary demand of life and they are vastly incapacitated. The tongue is usually pale and purple, the pulse faint and choppy. Progress in treatment can be frustratingly slow for both clients and the practitioner.