Treatment of Pain of Upper Extremities, RSI with Acupuncture
Chief Complaint: pain of upper extremities
Western Diagnosis: RSI
Medical History: A very common referral to our practice by Neurologists and Orthopedics is patients with the diagnosis of CT (Carpal Tunnel). The majority of the times the patients will have a median nerve conduction that is normal. Main complaints: pain and burning of the elbow-hand-fingers, not responding to any of the usual NSAIDs (Not Steroids Anti-Inflammatory Drugs), physical therapy or surgery. The medication usually prescribed will be Ibuprofen 600-800 mgs. 2/3 times a day, Naproxen 500 mgs. 2 times/day or newer drugs like Viox or Celebrex. The secondary effects of these drugs are related to the upper GI: nausea, vomiting, heartburn etc. In many cases the secondary effects are so severe that the patient needs to discontinue the medication.
Questioning exam: The examination of the patient showed many times a misdiagnosis, the label of Carpal Tunnel (in some cases treated with a failed surgery) was in fact an Overuse of Upper Extremities, for which acupuncture can have excellent results. The overuse of upper extremities comprehends: carpal tunnel Syndrome, Ulnar Entrapment, Pectoralis Syndrome, Rotator Cuff Syndrome, and Epycondilits to name some.
OM Diagnosis: In this article, I will deal with Rotator Cuff and the Pectoralis Syndrome (Myofascial Pain). The examination of both areas will determine the points to be used: in general the SI9 and SI10 (plus a few trigger points in between) will be very useful for the myofascitis of the rotator cuff and Lung 1 and 2 will be the primary points for the Pectoralis inflammation.
Points combination: SI9, SI10 (Plus active trigger points between the previous points) and Lung 1-2 for the anterior area: Pectoralis muscle. Under moderate digital palpation, the mentioned points will reproduce the symptoms that the patient is complaining of.
The treatment frequency is 1-3 times a week, for 4 weeks. The acupuncture needles are inserted with a slant direction with the micro-current stimulation pads on top of the needles.
The Acutron Mentor pads (biphasic, with an output of 75 to 100 micro-amps, for 15-20 minutes) are applied directly on top of the needles. The use of micro-current is in the majority of the cases, sub-sensational (the patient does not feel the electric stimulation).
Results: Within 6-8 treatments, the patient should be able to have pain and burning improved, as well as reduced the pain medication.
The indication of stretching exercises for the muscles involved, assist in speedy recovery.
The use of a micro-current device (Acutron Mentor) combined with acupuncture is in our experience an excellent tool for the treatment of overuse of upper extremities.
David Katz OMD, L.Ac.
Aspen Pain Control Clincs
12840 Riverside Dr., #412
Sherman Oaks, CA 91607