Flex (SPR)™

TCM herbal formula for bone spurs, plantar fasciitis, joint calcification, joint stiffness, and spine pain — analgesic; anti-inflammatory; invigorates blood circulation; breaks up blood stagnation; dispels phlegm; relieves pain

⚠️ Contraindicated during pregnancy and nursing. Not recommended for infants or young children — long-term impact on growth of teeth and skeleton is unclear. Contains Dang Gui (Radix Angelicae Sinensis) — patients on anticoagulant or antiplatelet therapies such as Coumadin (warfarin) should use with caution or not at all. Clinical note: patients generally have an all-or-none response — most experience varying degrees of pain and inflammation relief; up to 20–30% experience long-term resolution of pain; some patients may not notice any change. Evaluate every 1–2 months to determine progress and efficacy. Some patients experience immediate relief; others may require up to 6 months. Adequate rest of affected joints is essential to complete recovery.

CLINICAL APPLICATIONS

* Bone spurs with pain and inflammation

* Joint stiffness

* Calcification of joints

* Plantar fasciitis

* Spine pain

Background: Bone spurs form in response to pressure, rubbing, or stress on the same joint over a long period of time. As the body tries to protect and repair itself, it builds extra bone on top of normal bone. Most bone spurs are smooth and do not cause pain. However, some bone spurs press or rub on other bones or soft tissues, causing pain, inflammation, and burning sensations. Bone spurs are caused by repetitive use of, or recurrent injuries to, the affected joint(s). There are very few treatments available for bone spurs — Flex (SPR) offers a much-needed treatment option. Herbs should definitely be tried before considering surgery.

TCM differentiation: Bone spurs are diagnosed as stagnation of blood and phlegm arising from repetitive use. Treatment focuses on activating blood circulation, resolving phlegm, and relieving pain. Flex (SPR) is formulated by Dr. Jimmy Wei-Yen Chang with herbs that treat bone spurs, relieve pain, and reduce swelling — with both immediate and long-term therapeutic benefits.

Topical adjunct protocol: In addition to oral use, apply herbs topically to enhance overall treatment. Cook herbs in water, filter out residue, soak a towel in the hot decoction, and apply the warm towel to the affected area. Re-soak as needed to keep warm for a total of 30 minutes. Perform twice daily. Recommended topical formula: Dang Gui (Radix Angelicae Sinensis) 15g, Chi Shao (Radix Paeoniae Rubra) 15g, Chuan Xiong (Rhizoma Chuanxiong) 12g, Hong Hua (Flos Carthami) 12g, Dan Nan Xing (Arisaema cum Bile) 12g, Bai Jie Zi (Semen Sinapis) 15g, Ji Xue Teng (Caulis Spatholobi) 20g, Wei Ling Xian (Radix et Rhizoma Clematidis) 15g, Ru Xiang (Gummi Olibanum) 15g, Mo Yao (Myrrha) 15g, Gui Zhi (Ramulus Cinnamomi) 15g, Du Huo (Radix Angelicae Pubescentis) 15g.

Key herb-level clinical data:

— Po Bu Zi Ye (Folium Cordia Dichotoma / Cordia Leaf): indigenous herb from Taiwan; historically used for "sharp pain of the heel"; now recognized by many experts as the chief and most effective herb for treating bone spurs affecting various parts of the body; regulates qi circulation; relieves pain

— Zao Jiao Ci (Spina Gleditsiae / Gleditsia Spine / Chinese Honeylocust Spine): treats "hardness and nodules"; marked anti-inflammatory effect (NF-κB suppression, NO inhibition); clinical study 1: sciatica in 117 patients — 73 complete recovery, 20 significant improvement, 18 moderate improvement, 6 no improvement; clinical study 2: hyperosteogeny in 41 patients — 26 significant improvement, 12 improvement, 3 no effect (formula with Dang Gui, Hong Hua, Shan Zhu Yu, Chuan Xiong, Ji Xue Teng)

— Zao Jiao (Fructus Gleditsiae / Gleditsia Fruit / Chinese Honeylocust Fruit): treats "hardness and nodules"; marked anti-inflammatory effect; breaks up phlegm obstructing channels and joints

— Ru Xiang (Gummi Olibanum / Frankincense / Boswellia): moves blood; disperses blood stagnation; relieves pain; anti-inflammatory — inhibits nitric oxide production in macrophages; antiarthritic — reduces edema and arthritic scores in adjuvant-induced arthritis; suppresses pro-inflammatory cytokines TNF-α and IL-1β; facilitates wound healing by stimulating maturation and differentiation of white blood cells; clinically treats pain from trauma and external injuries

— Mo Yao (Myrrha / Myrrh): moves blood; disperses blood stagnation; relieves pain; anti-inflammatory; antiarthritic — reduces edema and arthritic scores; suppresses TNF-α and IL-1β; facilitates wound healing; clinically treats pain from trauma and external injuries

— Dang Gui (Radix Angelicae Sinensis / Angelica Sinensis / Dong Quai): moves blood; disperses blood stagnation; relieves pain; caution with anticoagulants

— Jin Yin Hua (Flos Lonicerae Japonicae / Honeysuckle Flower / Lonicera): significant analgesic and anti-inflammatory effects — inhibits COX-2, inducible nitric oxide synthase, and 5-lipoxygenase activities

— Fang Feng (Radix Saposhnikoviae / Saposhnikovia / Ledebouriella Root): analgesic; anti-inflammatory — marked suppression of inflammation via inhibition of nitrite production by inducible nitric oxide synthase; disperses wind; releases pain lodged in peripheral levels of the body

— Gan Cao (Radix et Rhizoma Glycyrrhizae / Licorice Root): relieves pain; anti-inflammatory — enhances glucocorticoid effect through increased production and secretion and decreased hepatic metabolism; comparison of cortisone to glycyrrhizin and glycyrrhetinic acid (two compounds from Gan Cao) is approximately 10:1; clinical applications: pain, inflammation, edema, arthritis, spasms, cramps; harmonizes the entire formula

— Zhe Bei Mu (Bulbus Fritillariae Thunbergii / Thunberg Fritillary Bulb / Zhejiang Fritillaria): breaks up phlegm obstructing channels and joints

— Bai Zhi (Radix Angelicae Dahuricae / Dahurian Angelica Root): breaks up phlegm; relieves pain

— Mo Gu Xiao (Caulis Hyptis Capitatae): indigenous herb from Taiwan; anti-inflammatory; analgesic; treats musculoskeletal conditions with pain and inflammation

— Liu Zhi Huang (Herba Solidaginis / Goldenrod): indigenous herb from Taiwan; anti-inflammatory; analgesic; treats musculoskeletal conditions with pain and inflammation

— Huang Jin Gui (Caulis Vanieriae): indigenous herb from Taiwan; anti-inflammatory; analgesic; treats musculoskeletal conditions with pain and inflammation

— Da Ding Huang (Caulis Euonymi): indigenous herb from Taiwan; reduces inflammation; relieves pain

— Chen Pi (Pericarpium Citri Reticulatae / Tangerine Peel / Aged Citrus Peel): regulates qi

— Tong Cao (Medulla Tetrapanacis / Rice Paper Pith / Tetrapanax): drains accumulation of damp and phlegm out of the body via urination

WESTERN THERAPEUTIC ACTIONS

* Analgesic — Po Bu Zi Ye (chief herb for bone spurs); Ru Xiang + Mo Yao (trauma, external injuries); Jin Yin Hua (COX-2↓, iNOS↓, 5-LOX↓); Fang Feng (iNOS inhibition); Gan Cao (pain, edema, arthritis)

* Anti-inflammatory — Zao Jiao Ci + Zao Jiao (NF-κB↓, NO↓); Ru Xiang + Mo Yao (TNF-α↓, IL-1β↓, adjuvant arthritis↓); Jin Yin Hua (COX-2↓, iNOS↓, 5-LOX↓); Fang Feng (nitrite production↓, iNOS↓); Gan Cao (glucocorticoid enhancement, cortisone:glycyrrhizin ≈ 10:1)

* Wound healing / tissue regeneration — Ru Xiang + Mo Yao (white blood cell maturation and differentiation↑)

CHINESE THERAPEUTIC ACTIONS

* Invigorates blood circulation; breaks up blood stagnation; relieves pain (Ru Xiang, Mo Yao, Dang Gui)

* Breaks up phlegm obstructing channels and joints (Zao Jiao Ci, Zao Jiao, Zhe Bei Mu, Bai Zhi)

* Treats "hardness and nodules" — bone spurs (Po Bu Zi Ye, Zao Jiao Ci, Zao Jiao)

* Reduces inflammation; relieves pain in musculoskeletal conditions (Mo Gu Xiao, Liu Zhi Huang, Huang Jin Gui, Da Ding Huang)

* Regulates qi circulation (Po Bu Zi Ye, Chen Pi)

* Disperses wind; releases peripheral pain (Fang Feng)

* Drains damp and phlegm via urination (Tong Cao)

* Relieves pain; harmonizes formula (Gan Cao)

DOSAGE

Standard: 3–4 capsules three times daily as needed to relieve pain. For maximum effectiveness, take on an empty stomach with two tall glasses of warm water. Evaluate every 1–2 months to determine progress.

Supplementary formulas: Bone spurs in neck and shoulder — add Neck & Shoulder (AC). Bone spurs in lower back — add Back Support (AC). Bone spurs in back with herniated disks — add Back Support (HD). Bone spurs in arm (shoulder, elbow, wrist) — add Arm Support. Bone spurs in knees — add Knee & Ankle (AC). Arthritis — add Flex (Heat) or Flex (CD). Bone spurs with nerve pain — add Flex (NP). Severe pain — add Herbal ANG. Degeneration of muscles, tendons, ligaments, and cartilage — add Flex (MLT). Severe blood stagnation — add Circulation (SJ). Excess heat — add Gardenia Complex. Severe inflammation — add Astringent Complex.

Nutrition: Increase vinegar intake. Avoid bamboo and acidic fruits (orange, grapefruit). Minimize seafood and red meat to avoid creating additional deposits of uric acid.

Lifestyle: Rest is essential — discontinue repetitive movement and overuse of the affected joint if possible. Slow stretching exercises of the affected area reduce or diminish pain. For knee bone spurs, mild to moderate movements such as tai chi chuan and walking are recommended (per Dr. Luo Jun-Qing, tui-na master). Ice packs for the first 24 hours to reduce swelling and inflammation — long-term ice pack use is not recommended as it may cause more stagnation.

CASE STUDIES

— E.L., 40-year-old female: Heel pain from bone spur + right hip flexor pain; pain level 7/10; calcaneum calcium deposit / qi and blood stasis with Kidney yin deficiency. Flex (SPR) 4 caps 3x daily for 2 weeks. Result: almost immediate cessation of pain; swelling decreased; returned to running after 5 days.

— M.A., 60-year-old female: Left foot pain from heel spur (X-ray confirmed calcaneal spur); phlegm and qi and blood stagnation. Flex (SPR) 4 caps 3x daily. Result at 2 months: decreased foot pain. Result at 3 months: pain resolved. Patient very pleased.

— E.F., 60-year-old male: Right knee pain above patella (2 days); X-ray confirmed bone spur; aggravated by weight bearing and position change; slight swelling and warmth; no preceding trauma; qi and blood stagnation. Knee & Ankle (AC) + Flex (SPR) 2 caps each 3x daily. Result at 6 weeks: condition resolved.

— 53-year-old female: Neck and shoulder pain for 12 years; X-ray confirmed bone spur at C6–7; no spinal curvature; yin and qi deficiencies with local qi and blood stagnation. Neck & Shoulder (CR) + Flex (SPR). Result: pain decreased from 7–8/10 to 3–4/10.

Related Reading

Also see: Flex (NP) – for bone spurs with nerve pain | Flex (MLT) – for degeneration of muscles, tendons, ligaments, and cartilage | Flex (Heat) – for arthritis with heat signs | Flex (CD) – for arthritis worsening in cold weather | Herbal ANG – for severe pain | Neck & Shoulder (AC) – for bone spurs in neck and shoulder | Back Support (AC) – for bone spurs in lower back | Back Support (HD) – for bone spurs with herniated disk | Knee & Ankle (AC) – for bone spurs in knees | Circulation (SJ) – for severe blood stagnation | Gardenia Complex – for excess heat | Pain & Musculoskeletal Support Collection.