Joint and Muscle Pain

Bu Tong Ze Tong: Lack of circulation causes pain. Full type. More acute and intense pains. Qi and/or Xue stagnation.
Bu Rong Ze Tong: Lack of nutrition causes pain. Empty type. More dull, mild and chronic pains. Qi and/or Xue deficiency.

Pain from Qi stagnation

Initial phase, blood still circulates well.

Pain of distension, painful swelling, more distension than pain.
Sensation of rigidity, lack of elasticity.
Pain mobile, changes location between nearby sites. Energy is more ethereal, not limited by structure.
Pain variable in intensity, varies during the day.
Rejects pressure and palpation because they increase the pain. Improves with friction because it helps move the Qi.
Worsens with rest. Improves with movement.
Often worsens-fluctuates with emotions. Emotion affects Qi Ji (H) directly.
Often accompanied by numbness, tingling (Ma Mu): it is due to blockage that does not nourish. Eg, distension, pain with gas.
Tongue may be normal, pulse possibly somewhat tense. Acute, intense.

We think of pain stagnated in Jing Luo or even in Zang Fu. See: Qi stagnation

Second phase. Stagnant Qi does not propel blood well and it stagnates.

Stabbing pain, sharp, fixed, acute and intense.
More rigidity and joint blockage. Mobility limitation.
Aged skin in affected area, with spots, darkened, dehydrated, purplish veins.
Clots and masses appear if it affects ZangFu, hemorrhages because blood flow is obstructed and bursts somewhere, extravasates, spontaneous bruising appears (this can also be Qi deficiency, which does not control blood).
Tongue with ecchymosis, purplish. Dark. Cyanotic lips. Darker face.
Choppy pulse.
There may be clots in menstruation.

Initial. When Qi is lacking, there is no thrust for blood. It can evolve to pain from Xue deficiency.

Chronic and dull pain, the patient describes being "sore".
Worsens with effort, improves with rest and with massage.
Relieved by pressure.
Accompanied by general symptoms of Qi deficiency (lack of strength, sweating at minimal effort, dizziness, fainting, etc).
If worse after sports it is deficiency, if better it is Qi stagnation.
Pale tongue with normal coating
Weak pulse, without force.

Insufficient blood in quantity or quality causes pain from lack of nutrition. See Xue deficiency.

Chronic, dull and mild pain, especially accompanied by Ma Mu: paresthesia, hypoesthesia, numbness.
Joint stiffness, ankylosis.
There may be in muscles pain like wind, joint rigidity, contracture with retracted tendons because blood does not hydrate, cramps, Wei Syndrome (muscular atrophy, loss of muscle volume).
Pale and peeled tongue.
Fine and weak pulse.