EFFECTS OF ACUPUNCTURE TREATMENT IN REDUCING PAIN IN PATIENTS WITH TENNIS ELBOW
Tennis elbow is also called epicondylitis of the humerus and is manifested as pain in the lateral epicondyle of he humerus. It is a form of overuse syndrome.
Etiology, Pathology and Clinical Manifestation:
According to Traditional Chinese Medicine (TCM), Tennis elbow ensues when there is local Qi stagnation and blood stasis causing pain and reduced flexibility of the elbow. In most cases, Qi stagnation and blood stasis is due to chronic strain in occupations that require frequently repeated rotation of the forearm. Improper exertion contributes significantly.
The most frequent area of pain is on the lateral side of the elbow, i.e. along the Large Intestine channel, but pain can sometimes occur immediately above the tip of the olecranon (i.e. along the Triple burner channel) or between the olecranon and the medial condyle of the humerus (i.e. along the Small Intestine channel). Occasionally, pain occurs on the medial surface of the arm along the Lung channel. The pain often radiates upwards or downwards along the Large Intestine channel. In some cases, pain can radiate from about L.I.11, downwards along the Large Intestine channel. Numbness and tingling can also be experienced down the arm and fingertips.
The characteristic symptoms are aching pain in the lateral elbow and weakness of the flexed elbow. There may be pain in the forearm as well. The degree of severity fluctuates; when severe, pain may radiate to the shoulder and back. The lateral epicondyle is tender to pressure, and pain may be precipitated or aggravated by rotation of the forearm or flexion of the wrist against resistance. The first requirement is to avoid further injury by stopping the precipitating activity and any activity that requires routine extension and flexion of the elbow. If necessary, restrain the elbow joint.
If an elbow joint is affected, the acupuncture treatment is applied mostly to that joint and can eliminate pathogenic factors directly (Wind-Cold-Damp).
The treatment is practically the same for acute or chronic cases apart of course for the intensity of needle manipulation which, following general principles, would be more vigorous in acute cases.
The main distal points are chosen from the Large Intestine channel and they are either L.I.1 or L.I.4 . If the area of pain extends slightly over to the tip of the olecranon, T.B.5 can be used in addition to one of the former. If the area of pain seems to cover both the Large Intestine and Triple Burner channels, T.B.8 is selected.
The most important local points is L.I.11. This point functions both as a local and a systemic point since it also benefits sinews in general. L.I.12, T.B.10, LU5, S.I.8 are helping to relieve Painful Obstruction Syndrome.
Quyangwei is an extra point located immediately adjacent to the epicondyle when the elbow is bent. This point is extremely effective especially when used with warming needle.
Results are usually very good with a few treatments. Occasionally, in long-standing cases, results are slow to come, especially if cortisone injections were administered to the elbow as these tend to slow down the effects of acupuncture. In these cases, it might be useful to try and needle the healthy side as well as the affected one. A particularly effective way of doing this is by needling the Connecting point of the affected channel on the opposite side. For example, if the pain occurs along the Large Intestine channel on the left side, L.I.6 on the right side would be needled. Other points can simply be used bilaterally. A more specific way of doing this is by reducing the points on the healthy side and reinforcing (especially with warming needle) those on the affected side. The rationale of this treatment lies in the fact that in chronic channel problems, the affected side becomes empty and the healthy side relatively full.
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