July 2009 Archives

Carpal tunnel syndrome (CTS) is one of the most common job-related injuries and is responsible for the highest number of days lost among all work related injuries. It is the reason for over two million visits to physicians' offices and approximately 465,000 carpal tunnel release operations each year, making it the most frequent surgery of the hand and wrist.

Acupuncture is extremely effective at treating carpal tunnel syndrome; eliminating the need for surgery or the use of anti-inflammatory drugs or corticosteroids. In fact, one of the most common reasons that people get acupuncture is for repetitive stress injuries, including carpal tunnel syndrome. Recent studies even suggest that acupuncture may be more effective than corticosteroids when it comes to treating CTS.

What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway in the wrist made up of ligaments and bones. The median nerve and the tendons that connect the fingers to the muscles of the forearm pass through this tightly spaced tunnel.

Carpal tunnel syndrome, also known as median nerve entrapment, occurs when swelling or irritation of the nerve or tendons in the carpal tunnel results in pressure on the median nerve. The median nerve controls sensations to the palm side of the thumb and fingers, as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.

Symptoms usually start gradually, with frequent burning, tingling, or numbness in the palm of the hand and the fingers, especially the thumb, index and middle fingers. The symptoms often first appear during the night. As symptoms worsen, people might feel pain, weakness, or numbness in the hand and wrist, radiating up the arm during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. If not properly treated, CTS can cause irreversible nerve damage and permanent deterioration of muscle tissue.

Diagnosis and Treatment of Carpal Tunnel Syndrome with Acupuncture

From an Oriental medicine perspective, CTS is seen as a disruption of the flow of Qi and Blood within the area and associated with Cold, Dampness or Wind penetrating the muscles and sinews of the wrist. Acupuncture points, stretching exercises, herbal remedies and nutritional supplements are chosen to treat accordingly.

As well as reducing the swelling, inflammation and pain in the wrist, acupuncture addresses any headaches, neck pain, shoulder stiffness and sleeping problems that often accompany this condition.

Your treatment may also take into account any underlying conditions that contribute to the development of CTS including obesity, rheumatoid arthritis, thyroid problems, diabetes, hormonal changes of pregnancy and menopause.

Tennis elbow can also be helped with acupuncture. 

If you or someone you love suffers carpal tunnel syndrome, please call NYCTCM Teaching Clinic in Mineola or Manhattan to find out more about how acupuncture and Oriental medicine can help you.

NYCTCM Teaching Clinic in Manhattan: 212-685-0888
NYCTCM Teaching Clinic in Mineola: 516-739-1545

Sources:
Acupuncture: A Comprehensive Text. By Shanghai College of Traditional Chinese Medicine, 1981
Plastic and Reconstructive Surgery: Volume 105(5) April 2000 pp 1662-1665

Visit Acufinder for acupuncture articles, a list of acupuncture schools, and to find an acupuncture practitioner.

In part 3 of AnnaMarie's paper on Lateral Epicondylitis she discusses the Traditional Chinese Medicine Understanding of 'tennis elbow' and shows the acupuncture points that are used to treat it.She cites clinical studies on acupuncture treatment of lateral epicondylitis.

AnnaMarie is an acupuncture student at New York College of Traditional Chinese Medicine in Mineola, NY.

"Lateral Epicondylitis is named 'Elbow Strain' in TCM. It is also called zhuo lao, elbow taxation, zhuo tong, elbow pain and shang jin, damaged sinews.

• Overstrain exhausts the Qi and blood, and tendon and muscle are malnourished that causes the lateral epicondylitis
• Overwork taxation causes detriment and damage to the sinews and vessels of the elbow. On the one hand, there is insufficient blood to nourish the sinews, while, on the other hand, there is blood stasis obstructing the free flow of vessels. This may then be complicated by external contraction of wind cold evils due to defensive qi vacuity.

—

Major Pattern Differentiation

• Characterized by marked soreness, numbness and heaviness. It is cause chiefly by pathogenic damp. Soreness and fixed pain in the joints, numbness or heavy sensation with possible swelling of the limbs.
• Recurrent or enduring pain which is worse on exertion, worse on exposure to cold, and better on obtaining heat

Treatment Principle

• Sooth the tendon and activate meridian circulation
• Boost Qi and nourish the blood, warm the channels and free the flow of impediment"

To read part 3 of Lateral Epicondylitis or Tennis Elbow click on the link below. 


TCM understanding of tennis elbow.swf

Informative paper on lateral epicondylitis, or tennis elbow, by New York College of Traditional Chinese Medicine student Anna Maria DiLisio.

This is part 1, presenting basic bioscience knowledge about lateral epicondylitis.

Symptoms Of Tennis Elbow

• Recurring pain on the outside of the upper forearm just below the bend of the elbow; occasionally, pain radiates down the arm toward the wrist.
• Pain caused by lifting or bending the arm or grasping even light objects such as a coffee cup.
• Difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments).
• Pain that typically lasts for 6 to 12 weeks; the discomfort can continue for as little as 3 weeks or as long as several year

The damage that tennis elbow incurs consists of tiny tears in a part of the tendon and in muscle coverings. After the initial injury heals, these areas often tear again, which leads to hemorrhaging and the formation of rough, granulated tissue and calcium deposits within the surrounding tissues. Collagen, a protein, leaks out from around the injured areas, causing inflammation. The resulting pressure can cut off the blood flow and pinch the radial nerve, one of the major nerves controlling muscles in the arm and hand.

To see the slide show click on the link below.

tennis_elbow_1.swf

Part 2 explains standard treatments and exercises for tennis elbow.

Exercises & treatments for tennis elbow.swf

Interesting discussion on Ling Shu's famous quote in Richard Goodman's Blog.

"While working on selecting texts for Volume Two of Classical Chinese Medical Texts, I found some interesting information on what constitutes a superior physician. There is also some information on what constitutes an inferior physician. I have picked three texts to look at. These three texts do not necessarily represent all that has been written on the subject, but as they are three of the older texts in Chinese medicine, namely the Ling Shu, the Nan Jing, and the Jin Gui Yao Lue, I consider them great models for one who strives toward becoming a superior physician.

Ling Shu Chapter 55

The superior physician treats that which is not yet ill. The inferior physician treats that which is already ill.

This is a fairly famous statement, which is often interpreted to be a call to preventative medicine. Modern physicians often complain that patients come in with specific complaints and it is impossible to treat what is not yet ill. I find this stance strange, as if we are to believe if someone has a disease which has already become manifest, the practitioner is prevented from treating what is not yet ill.

At any rate, the following quote from Nanjing has a completely different interpretation of the above passage:

Treating what is not yet ill means that when one sees illness in the liver (for example), this (can be) transmitted to the spleen. First fill (shi2) the spleen qi so that there is no way for it to accept the liver's evil qi. This is what is called treating what is not yet ill.

As you can read, the writer of the Nan Jing felt that the meaning of treating what was not yet ill did not mean some psychic rendering of signs and symptoms, but a way of treating a person who comes with a specific complaint. One might go so far as to suggest that when the superior physician sees that one zang-organ has been afflicted by evil qi, the zang-organ in the control/destruction (ke) cycle of the five phases needs to be supported."

read the complete article  "Superior & Inferior Physicians" on Richard Goodman's blog

Kelsey Dixon, a NYCTCM graduating acupuncture student, wrote on how she will contribute to the future of Chinese medicine in an American culture which is so different from the Taoist principles of Traditional Chinese Medicine.

" The TCM that exists in the United States of America is, in some ways, childlike, having progressed past the novelty of its infantile stages and the tremendous growth of early childhood, and now entering its adolescence, and the struggle to blossom to its fullest potential while maintaining its roots. It is an old and sacred medicine reborn within a young and eager culture- a culture still, sometimes awkwardly, undecided as to how to approach and integrate this strange new paradigm. At times, the impending pressure upon becoming a practitioner of this healing art can seem intense..."
"Reviewing the words of wisdom from the 'sages' of both ancient Chinese culture and contemporary American culture, the irony of TCM in America is obvious. In TCM, we have a paradigm of health based on a worldview that holds passivity and acceptance, and harmony within a greater whole, in highest esteem. The American Dream, on the other hand, is fundamentally about individuals distinguishing themselves, about challenging the status quo and seeing the way things ought to be rather than the way things are. "

read the complete article at NYCTCM blog page..