Acupuncture and Herbs for Osteoarthritis

Chief Complaint: pain and stiffness in both thumbs
Western Diagnosis: osteoarthritis
Medical History: P is 54yr female currently menopausal, @40lbs overweight, has a hx of auto-immune disease in form of psoriatic arthrosis is the lumbar spine. overuse of yoga triggered the disease. Also has minor patches of psoriasis on legs and arms. Diet is rich in dairy, wheat, sugar, salt and wine.
Questioning exam: pain in the first and second joints of both thumbs, constant, stiffness, lack of manual dexterity, weakness, no heat signs, some swelling, pain on palpation. Additional signs include: onset of night sweats and hot flashes recent, low back pain worse in am. pain in thumbs is fixed and ranges from dull ache to sharper more intense pain. Stressful work environment, some insomnia, digestion is good. Patient historically prefers warm, feels cold but due to onset of menopause is beginning to warm up.
Pulse exam: Pulse is generally weak, small and has a slippery aspect. Kidney position is weak and deep.
Tongue exam: tongue is pale dusky and small. less to no coat.
OM Diagnosis: damp bi pattern
Kidney yin w some def heat
Kid yang def
Damp spleen
Treatment Principle: expel wind, move blood stop pain
tonify Yin and Yang
Drain damp, tonify spleen
Point Prescription: Lung10 sedate
Baxie 1st and 2nd fingers
Low back Du and UB points
UB 40, 62, SI3
Kid 3, 6
Spleen 9
Herbal Formula: Patient is not open to taking herbs at this time.
I would prescribe a remove wind and damp formula as well as a modified du huo ji sheng wan type formula with herbs to address the yin def.
Lifestyle Prescription: far infrared and moxa are very effective for both the hands and low back. this helps me rule out heat as a pathogenic factor in the hands. I also use a topical yuk jiao formula for the hands.
Results: Patient is basically maintaining a pain free existence with weekly acupuncture tx. The addition of herbs would probably reduce the frequency needed.