In TCM, acupuncture works on the premise that humans have a natural flow of energy, Chi, throughout the body. Most elbow movements will be pain-free. Medial epicondylitis (golfer’s elbow) is a type of tendinitis that affects the inside of the elbow. The damage is typically related to excess or repeated stress — especially forceful wrist and finger motions. I approach treating your elbow pain to your presentation, which involves: Providing exercises to continue treatment success between acupuncture treatments. Whether the pain is localized, or radiates into the forearm and hand, elbow pain and injury can be extremely bothersome and acupuncture and massage can help reduce that pain naturally. Manual work was a combination of acupressure, tui na, and sotai. Despite the fact that 90% of patients can be initially cured with conservative treatment and rest, the complaint frequently recurs after resumption of work or sport . The onset of pain is usually gradual and aggravated by using the affected muscles - eg, grasping objects and shaking hands. Seven databases and the WHO International Clinical Trials Registry Platform Search Portal were searched to identify relevant studies. This study aimed at assessing the clinical effectiveness of acupuncture for lateral epicondylitis (LE). Tennis elbow is the exact opposite. When the pathways of the Chi, also known as meridians become blocked , pain is the most common result. Group 2 comprised patients whose occupation involved only little or no strain and did not have a repetitive pattern of motion. Large Intestine 10. The width of the thumb is 1 cun, width of two fingers is 1.5 cun, four fingers is 3 cun. LI 10 or Arms Three Miles is a popular point of acupuncture for tennis elbow. Scar tissue will not allow the flexor muscles to move correctly. Of the 54 patients selected by the screening process, 45 were enrolled in the study. At the 2‐week follow‐up these differences were significantly greater for all outcome parameters in the group treated with real acupuncture. Learn vocabulary, terms, and more with flashcards, games, and other study tools. More information can be found here on the differences between tennis elbow and golfer's elbow. The overall effect of real acupuncture was better because the improvement in the complaints was unrelated to occupational strain, whereas with sham acupuncture the patients with occupational strain exhibited significantly less improvement. It is more effective than acupuncture that is carried out without any particular training, comparable to the unaimed puncturing used in the control group of this study. Golfer’s elbow (medial epicondylitis) and tennis elbow (lateral epicondylitis) ... and use what acupuncture calls “mirror points.” Mirror points would include the unaffected elbow and the knees (the elbows of the legs, so to speak). With the elbow flexed, at the midpoint of the line connecting the medial end of the cubital crease and the medial epicondyle of the humerus. Results. There was a significant difference between treatment effects in subgroup 1 between real and sham acupuncture (P<0.05). Hay EM, Paterson SM, Lewis M, Hosie G, Croft P. Pragmatic randomised controlled trial of local corticosteroid injection and naproxen for treatment of lateral epicondylitis of elbow in primary care. Point your elbow in the direction of the ceiling and preserve the dumbbell. Repetitive activities resulting in localized stress in the medial elbow. The results are depicted in Fig. In the specific treatment, pricks at real acupuncture points might elicit a higher degree of stimulation than those at non‐acupuncture sites. A third needle is inserted the FCU motor point and a fourth needle, the control needle, is inserted into the medial epicondyle where pain is commonly found with epicondylitis. Other viable reasons of medial epicondylitis consist of: The most common symptom of medial epicondylitis is pain along the palm aspect of. Le‐Bars D, Dickenson AH, Besson JM. As a result of this, 54 patients who appeared to be suitable for enrolment were given an appointment so that we could assess their clinical history and run a clinical examination. The skin at the puncture sites was prepared with a conventional disinfecting agent. Lateral epicondylitis of the elbow or ‘tennis elbow’ is one of the commonest diseases of the arm, with an estimated incidence of 1–3% . The medial epicondylitis physical exam should look for increased carrying angle (greater than 10° in males, 15° in females); pain with point tenderness over the tip of the medial epicondyle extending distally 1 to 2 inches along the common flexor origin (usually PT and FCR); pain/weakness of wrist flexors and pronators with elbow extended and possible loss of full extension of elbow. Physical exam tips, orthopedic tests, and acupuncture for Medial Epicondylitis. Acupuncture is highly effective for various types of elbow pains: lateral epicondylitis (tennis elbow), medial epicondylitis (golfer’s elbow), and cubital tunnel syndrome. Elbow Pain Relief Treatment with Acupuncture Medically referred to as lateral epicondylitis or a repetitive stress injury, tennis elbow occurs because of the overuse of certain muscles in the region. We therefore preferred to use this special device, which permits selective examination of the lower arm extensors, the muscles that are primarily affected in epicondylitis. ). Common in non-athletes – painters, construction workers, gardeners. We have been healing clients for over 10 years & specialize in pain management. Medial epicondylitis (golfer’s elbow) is a type of tendinitis that affects the inside of the elbow. A P value of <0.05 was considered significant. No significant differences between groups were found at the second follow‐up with respect to pain reduction and peak force. To treat Christina’s lateral epicondylitis, I used the following acupuncture points: LI 10 Shou San Li, LI 11 Qu Chi, LI 12 Zhou Liao, and Arshi points. Fink M, Kuensebeck HW, Wippermann B, Gehrke A. Haker E, Lundeberg T. Acupuncture treatment in epicondylalgia: a comparative study of two acupuncture techniques. In: Zhang X, ed. LI 10 or Arms Three Miles is a popular point of acupuncture for tennis elbow. This point is located on the forearm, approximately 1 inch below . A further limitation in the evaluation of our results could be connected with our exclusive recruitment of patients through press advertisement, which might have caused a bias in selection. Lateral epicondylitis is a form of tendonitis at the lateral side of the elbow (thumb side when palm is facing forward/upward). Pan C. Morphological study of sensations produced by needling different points. Medial epicondylitis is provoked by frequent eccentric loads on the muscles that are responsible for forearm pronation and wrist flexion . To compare the effect size, the number needed to treat (NNT; Table 5) was calculated  on the basis of a minimal improvement of 50% in the complaint. This is difficult to assess, however, as it was not possible in this study to have a second control group receiving no treatment at all for 3 months. Before treatment, there were no significant differences between the two treatment groups with respect to peak force, pain and disability. In spite of the increased demand for complementary medicine, there is little evidence that needle acupuncture has a specific action in the treatment of epicondylitis . This systematic review aimed to assess the effectiveness and safety of acupuncture for lateral epicondylitis (LE). In TCM, acupuncture works on the premise that humans have a natural flow of energy, Chi, throughout the body. Lower end of sternum to umbilicus 8 cun. Two weeks and 2 months after the end of treatment, there were significant reductions in pain intensity and improvements in the function of the arm and in maximal strength in both treatment groups. working at a computer or on a production line). The self‐assessment scale for the subjective rating of pain could take values between 0 and 30. Tsun or cun is the measurement of one “body inch” used locate acupuncture points. Pain can occur with twisting motions – shaking hands, turning a door knob or screw driver. We used the Mann–Whitney U‐test for group comparisons and the Wilcoxon test for paired longitudinal comparisons. The assessor had no knowledge of acupuncture techniques and was blinded with respect to the treatment modality (acupuncture or sham acupuncture). See Pic 7-1 below: Acupuncture, which is very effective if started early, and at the correct acupuncture points. Ashi points. However, at the 2‐month follow‐up the treatment effects were less evident. Regulates the lower jiao, Builds the Yin in the whole body In most cases, your wrist should be in a neutral position (not bent in either direction) on impact, and repeated bad form only aggravates the tendons and ramps up the pain. The actual sample size was achieved in both treatment groups. Lung point 6 which is located 5 inches away from lung point 5 towards the wrist when the palm is facing up. Lateral epicondylitis and medial epicondylitis both produce dull and sharp pain around the elbow that can radiate toward the hand when using the elbow muscles. Golfer's elbow is characterized by pain and tenderness on the medial side of the elbow that may radiate down the arm on that side. No side‐effects occurred, apart from pain resulting from needling, which led one patient to drop out. Lateral epicondylitis and medial epicondylitis both produce dull and sharp pain around the elbow that can radiate toward the hand when using the elbow muscles. The needles were inserted down to the musculature; by twisting the needles at the start of treatment a De Qi sensation was induced. Medial epicondylitis is commonly referred to as “golf elbow” (or golfer’s elbow). II. Even though the condition is labelled as “tennis elbow”, tennis players only make up about 10% of the patient population for the condition, and the annual incidence of tennis elbow in the United States is one to three percent. When classical conservative treatment and the topical application of non‐steroidal anti‐inflammatory drugs (NSAIDs) and the injection of steroids and/or local anaesthetics have been unsuccessful or side‐effects have occurred, an increasing number of patients consider the possibility of complementary medicine, particularly of needle acupuncture [3, 4]. In the past 10 years, acupuncture is becoming increasingly recognized as an alternative treatment for pain, including epicondyle pain. The needles were inserted in exactly the same way as in the real group. lifting and carrying) or with a repetitive pattern of motion (e.g. Molsberger and Hille  found a significant immediate effect of treatment in alleviating pain after one treatment session, using distant points in the lower extremities in the treatment group. Patients were randomized to the different treatment groups according to a list of random numbers prepared by the Department of Biostatistics of Hannover Medical School. Heart point 3 also known as Lesser Sea, which is located between the cubital crease end and the medial humerus epicondyle. Fitness injury aids – An adjustable support, worn below the elbow joint to help with medial (inside of the elbow joint) or lateral (outside) epicondylitis – known as golfer’s. The possible reasons for the better effectiveness of real acupuncture are unclear. The diagnostic criteria for epicondylitis were as follows: (i) a typical history of lateral elbow pain, characteristically aggravated by (overhand) gripping or by exertion of the arm, especially by active extension of the wrist, and often alleviated by rest; (ii) pressure pain on the radial epicondyle of the humerus; (iii) aggravation of pain during extension of the wrist against resistance and a positive middle‐finger test. Methods . Lateral Epicondylitis. The Metal should be the temperature of the Earth. In our study are included 12 patients, 9. male and 3 female, all with symptoms of lateral epicondylitis and all treated with fire needle acupuncture. The data were analysed with the StatView package (Abacus Concepts, Berkeley, CA, USA) on an Apple Macintosh computer. Trends in alternative medicine use in the United States, 1990–1997: results of a follow‐up national survey. When stimulate it relieves pain in the forearms, wrist, and elbow. NEEDLING: Oblique distal or proximal insertion 0.5 to 1 cun. Lateral epicondylitis is a form of tendonitis at the lateral side of the elbow (thumb side when palm is facing forward/upward). The main symptoms are: The following databases were systematically searched: China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wan Fang database, Chinese Biomedicine Literature, PubMed, EMBASE, and Cochrane Library from inception to May 2019. For the acupuncture in this study, we selected points which have frequently been recommended for the treatment of epicondylitis (e.g. Measurement is always taken from the patient’s hand. Binder AI, Hazelman BL. Although appearing to show an advantage for acupuncture, this may also be regarded as a potential disadvantage of acupuncture compared with local steroid injection with respect to treatment costs. During your initial appointment we do a full assessment to find out where the pain is coming from through orthopaedic assessment. On the basis of the calculated experimental and control event rates, this seems to be predominantly due to differences in the efficacy of the control treatments in these studies (present study >Molsberger and Hille>Haker and Lundeberg), which results in an increased NNT. The results of Haker and Lundeberg and of the present study indicate that acupuncture with correct location and stimulation according to the recommendations of traditional Chinese acupuncture seems to alleviate pain and improve function in epicondylitis. This point is located on the forearm, approximately 1 inch below the elbow fold. Traditional Chinese acupuncture regards treatment as consisting of local, regional and specific distant points. Acupuncture points, Shaohai, treats ... this point can be found in the depression between the end of the transverse crease on the ulnar side of the elbow and the medial condyle of the humerus. Please check for further notifications by email. Methods: Studies using non‐acupoints close to real acupoints more frequently failed to show any difference between real and control acupuncture treatment than studies using non‐acupoints which lay well clear of real acupoints. Caution: the ulnar nerve lies deep to this point. Efficacy of the two types of acupuncture in patients with different degrees of occupational strain. On the medial side of the stifle joint, caudal to the medial epicondyle of the femur. We invited to the clinical examination only those patients who had stated that there were no marked changes in their complaints after previous treatments and who reported no significant variation in their complaints in the previous 4 weeks; they were therefore rated as non‐responders in relation to earlier treatment. Golfers elbow can involve problems with grip, lifting and grasping. Hold a dumbbell. Some of the most common causes of elbow pain we see are lateral epicondylitis (tennis elbow) and medial epicondylitis (golfer’s elbow). The primary cause of the condition comes from repetitive movements placing improper stress on the flexor muscles. Stimulating this point with fingers can relieve arm pain and immobility of the arm. Acupuncture treatment options for medial epicondylitis or golfer's elbow using Master Tung acupuncture points. The other patients had received different treatments, mostly involving local anaesthesia, exercise, immobilization or NSAIDs. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Acupuncture for the treatment of lateral epicondylitis, commonly known as tennis elbow, is gaining in popularity. 4 cun above the medial epicondyle of the femur, between vastus medialis and sartorius muscles. Lower end of sternum to umbilicus 8 cun. The cost-effectiveness of different approaches to exercise and corticosteroid injection for subacromial pain (impingement) syndrome, Prevalence of gastrointestinal, cardiovascular, autonomic, and allergic manifestations in hospitalized patients with Ehlers-Danlos syndrome: a case-control study, Dual-energy computed tomography versus ultrasound, alone or combined, for the diagnosis of gout: a prospective study of accuracy, HAPLOIDENTICAL α/β T-CELL AND B-CELL STEM CELL TRANSPLANTATION IN SEVERE MEVALONATE KINASE DEFICIENCY, About the British Society for Rheumatology, https://doi.org/10.1093/rheumatology/41.2.205, Receive exclusive offers and updates from Oxford Academic, Chronic lateral epicondylitis of the elbow (duration >3 months), Pain treatment with analgesics or NSAID in the last 2 weeks, Diseases of the central or peripheral nervous system, Radio‐ulnar or radiohumeral osteoarthritis, Earlier episodes of lateral epicondylitis of the elbow treated, Copyright © 2021 British Society for Rheumatology. The objective of the present study was to investigate the specific effect of correct point location and stimulation in the treatment with needle acupuncture of patients with chronic epicondylitis, by comparing this with sham acupuncture, in which there was no selection of specific acupuncture points. On the basis of this comparison, it may be concluded that the results of real acupuncture treatment in the present study are lower than in the other acupuncture studies. Research has already confirmed that acupuncture is beneficial for tennis elbow and in New Zealand the Accident Compensation Corporation (ACC) covers the cost of treatment for lateral and medial epicondylitis. Medial epicondylitis is commonly known as golfer's elbow. This review will evaluate the effectiveness of acupuncture as a treatment for lateral epicondylitis using the appropriate analysis. Pain and dysfunction in osteoarthritis of the hip: A randomised controlled trial. Discussing potential lifestyle dynamics impacting the effected elbow. The following databases were systematically searched: China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wan Fang database, Chinese Biomedicine Literature, PubMed, EMBASE, and Cochrane Library from inception to May 2019. This combination … Symptoms of golfers elbow can start soon after a sudden force to the elbow or wrist or it can gradually develop. LV11 Yinlian 2 cun below ST30, 2 cun from the midline at the proximal end of the thigh and on the lateral border of adductor longus muscle. Sports Medicine Acupuncture® is a synergistic blend of the ancient wisdom and methods of Traditional Chinese Medicine (TCM), modern sports medicine science and assessment, and specialized treatment techniques. There are unconfirmed hints in the literature that classic acupuncture points are in regions of relatively high density of A‐δ‐fibres . Start studying Acupuncture Meridian Points. Melzack R, Wall PD. It was assumed for this study that the patients in the treatment group would have a mean of 10 at the end of treatment and the patients in the control group a mean of 15. If untreated, the continuation of the activity can result in micro tears in the extensor muscle. Willer JC, Roby A, Le Bars D. Psychophysical and electrophysiological approaches to the pain‐relieving effects of heterotopic nociceptive stimuli. Correspondence to: M. Fink, Department of Physical Medicine and Rehabilitation, Hannover Medical School, 30625 Hannover, Germany. The duration of illness (median 9.0 months), age and gender of the patient were distributed equally in the two groups and had no influence on treatment results; R2 was 0.01 for the duration of illness/treatment success and 0.115 for age of patient/ treatment success. The effect of treatment (real vs sham) was particularly marked at the first follow‐up and was clinically relevant at that time. Prior to the study, the test–retest reliability of the device was assessed, giving an intraclass correlation of between 0.92 and 0.96. Acupuncture has been used in China for over 3,000 years, but there also are a developing range of scientific studies indicating that acupuncture has a number of validity. In accordance with the criteria for inclusion and exclusion, 45 patients were selected and enrolled after they had given informed consent (Table 1). If you have symptoms of tennis elbow, consult with your health-care provider to determine the best treatment plan for you. Molsberger A, Hille E. The analgesic effect of acupuncture in chronic tennis elbow pain. M. Fink, E. Wolkenstein, M. Karst, A. Gehrke, Acupuncture in chronic epicondylitis: a randomized controlled trial, Rheumatology, Volume 41, Issue 2, February 2002, Pages 205–209, https://doi.org/10.1093/rheumatology/41.2.205. Golfer's elbow, also known as medial epicondylitis, is caused by damage to the muscles and tendons that control your wrist and fingers. Roughly the point on the inside of your elbow that’s about level with the lowest rib you can feel. The mean standard deviation was assumed to be 5 points. This could be due to the different forms of control treatment used in the studies. Acupuncture orthopedics for upper extremity injuries (Rotator cuff injuries, Impingement syndrome of shoulder, Bursitis, Adhesive capsulitis (frozen shoulder), Medial epicondylitis (Golfer’s Elbow), Lateral epicondylitis (Tennis Elbow), Carpal tunnel syndrome, Ulnar/ Radial nerve entrapment, DeQuervain’s Tenosynovitis, Tendonitis, Myositis) 4. LV10 Zuwuli 3 cun below ST30 at the proximal end of the thigh on the lateral border of adductor longus muscle. Tenderness on the medial side of the elbow Acupuncture can be a very effective treatment for Golfer’s elbow. Playing the backhand during a tennis session can cause irreparable damage and stress to the forearm muscles. If the analgesic effect were only the result of segmental counter‐irritation, we would expect no difference between the two groups in our study, as the acupuncture points and the non‐acupuncture points were in the same dermatomes (C5–C8). There was no significant difference between the groups at baseline for any outcome parameter. Haker and Lundeberg  found that needling to a normal depth with mechanical stimulation was superior to superficial needling, both carried out at acupuncture points. The peak strength of three consecutive maximal extension efforts was recorded and the average was used for further evaluation. The distribution of these subgroups was equal in both treatment groups (Table 3). Improper lifting, throwing or hitting, as well as too little warmup or poor conditioning, also can contribute to golfer's elbow. When classical conservative treatment and the topical application of non‐steroidal anti‐inflammatory drugs (NSAIDs) and the injection of steroids and/or local anaesthetics have been unsuccessful or side‐e… Proportional measurements: Mid-line of spine to medial border of scapula 3 cun. Perpendicular insertion 0.3 to 0.5 cun. Aranjo MS. A sprain is a stretching or tearing of ligaments, the fibrous bands that bind bones together at a joint. If micro tears go untreated, the tendon of the flexor muscles will degenerate. Real acupuncture treatment led to similar improvement in the two subgroups. In particular, it is unclear what is the specific effect of the selection and stimulation of specific acupuncture points, as the insertion of a needle at any site can alleviate pain [6, 7]. Basic Points — For elbow pain, you can also needle according local and ashi points using some basic points. RMP, repetitive motion pattern; n.s., not significant. Several muscles of the forearm act at the wrist, extending the hand straight back or back and to either side. In the treatment of chronic epicondylopathia lateralis humeri, acupuncture in which real acupuncture points were selected and stimulated was superior to non‐specific acupuncture with respect to reduction in pain and improvement in the functioning of the arm. Pain was assessed five‐dimensionally with a self‐assessment scale (pain at rest, in motion, during exertion, duration and frequency of pain) consisting of six items with a six‐point verbal rating scale (0–5). Diffuse noxious inhibitory controls (DNIC). During treatment we utilize traditional acupuncture points, motor points as well as trigger points of the muscle tissue. Golfers Elbow is a condition of pain on the inside (aka: medial) of the elbow. Medial Epicondylitis or Golfers Elbow admin 2020-02-12T09:39:33-05:00 Golfers Elbow is a condition of pain on the inside (aka: medial) of the elbow. Pain can also be present when the muscles are stretched. Screening was carried out by means of a semistructured telephone interview. Methods . Referred Pain: Epicondyle pain, pain in the posterior aspect of the shoulder, and possibly at the base of the neck: Area around SJ-13 e. Triceps Brachii Muscle, Medial Head: Referred Pain: Pain on the radial aspect of the forearm: SJ-11 f. Triceps Brachii Muscle, Lateral Head: Referred Pain: Epicondyle pain: Area around Yingxia g. Liver 9 | Yin Bao | 陰包: This acupuncture point, used in traditional Chinese medicine, is located 4 cun above the medial epicondyle of the femur, between m. vastus medialis and m. sartorius.. Objective . The treatment of epicondylitis with acupuncture might be a useful alternative to classical conservative methods in chronic epicondylitis, and where other treatment modalities have failed. As regional points we selected LI 4 and SJ 5 for the treatment of pain in the upper limb. 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