Two Case Reports-Acupuncture for Hand and Wrist Pain

Abstract

Arthralgia is a medical term which
means pain in joint. Wrist joint is very complex,
therefore it is very often exposed to injuries. Many
conditions which affect the wrist joint cause
problems like pain, stiffness and swelling in the
joint and it can reflects in the fingers, hands and
forearm. Hand pain can impedes important daily
tasks if hand pain is accompanied by tingling,
numbness, or weakness. Wrist pain can be caused
by injuries, rheumatoid arthritis, carpal tunnel
syndrome, gout and etc. According to the
Traditional Chinese Medicine (TCM), the
etiological factors for muscle/sinew pain are: Bi,
Qi and blood vacuity due to spleen QI vacuity,
Blood stasis, Liver depression, Qi stagnation,
combined factors and etc. Acupuncture as part of
the Traditional Chinese Medicine, is effective
treatment for wrist pain. Our patients are 51 and
65 years old females with wrist pain, treated with
acupuncture on Ashi i.e. trigger points. One
patients had only one treatment and the other three
treatments. The treatments were made in a clinic
for TCM and acupuncture in Skopje, Macedonia by
a doctor specialist in acupuncture, on a room
temperature, with fire and normal needles.

Full text

Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-6, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Imperial Journal of Interdisciplinary Research (IJIR) Page 944
Two Case Reports - Acupuncture for
Hand and Wrist Pain
Jihe Zhu1, Blagica Arsovska2, Kristina Kozovska3
1, 3 Faculty of Medical Sciences, University Goce Delcev – Shtip, Macedonia;
2 Institute of Biology, Faculty of Natural Sciences and Mathematics – Skopje;
Abstract : Arthralgia is a medical term which
means pain in joint. Wrist joint is very complex,
therefore it is very often exposed to injuries. Many
conditions which affect the wrist joint cause
problems like pain, stiffness and swelling in the
joint and it can reflects in the fingers, hands and
forearm. Hand pain can impedes important daily
tasks if hand pain is accompanied by tingling,
numbness, or weakness. Wrist pain can be caused
by injuries, rheumatoid arthritis, carpal tunnel
syndrome, gout and etc. According to the
Traditional Chinese Medicine (TCM), the
etiological factors for muscle/sinew pain are: Bi,
Qi and blood vacuity due to spleen QI vacuity,
Blood stasis, Liver depression, Qi stagnation,
combined factors and etc. Acupuncture as part of
the Traditional Chinese Medicine, is effective
treatment for wrist pain. Our patients are 51 and
65 years old females with wrist pain, treated with
acupuncture on Ashi i.e. trigger points. One
patients had only one treatment and the other three
treatments. The treatments were made in a clinic
for TCM and acupuncture in Skopje, Macedonia by
a doctor specialist in acupuncture, on a room
temperature, with fire and normal needles.
Key words: Arthralgia, wrist, injury, traditional
Chinese medicine, acupuncture, treatment
Introduction
The hand and forearm are connected with wrist
joint. It is a complex joint which include the distal
ends of the radius and ulna, carpal bones (eight
small bones arranged in two rows) and the bases of
the 5 metacarpals. There are 3 degrees of freedom
in the wrist joint: (1) flexing and extending, (2)
pronating and supinating, and (3) deviating ulnarly
or radially. Our wrist bones and our forearm bones
are surrounded by a fibrous capsule and connected
with bands of ligaments. [1][2] Wrist pain is often
caused by fractures from sudden injuries, but it can
also result from long-term problems, such as
repetitive stress, arthritis, flexor tenosynovitis, gout,
carpal tunnel syndrome and etc. Many daily
activities can also lead us to develop painful hand
problems. The repetitive stress can cause tendinitis
in the hand and wrist. It can pass into a chronic
inflammation, if tendons and muscles are
aggravated over and over again. Then the muscles
do not receive enough oxygen and other nutrients
from the blood and are unable to flush lactic acid
and other metabolic wastes. One of the features of
the joint inflammation is pain. [3-6] According to
the Traditional Chinese Medicine (TCM), the
etiological factors for muscle/sinew pain are: Bi, Qi
and blood vacuity due to spleen QI vacuity, Blood
stasis, Liver depression, Qi stagnation, combined
factors and etc. Bi or blockage pattern is used to
indicate obstruction of Qi and blood in the channels
and collaterals. The spleen is the organ of
transformation of Qi and blood and due to spleen
Qi vacuity can be caused Qi and blood vacuity too.
If the spleen is weak it may not be able to
transform enough Qi and blood. Because the spleen
rules the muscles and flesh and the four limbs,
when its function is weak it will results with pain in
wrist, hand, and/or arm. Blood stasis may cause
muscle or sinew pain anywhere in the body
including wrist, hand and arm pain. Liver
depression Qi stagnation usually is caused by
emotional stress. Because the liver governs the
sinews and movement, its dysfunction results with
hand/wrist/arm pain and dysfunction. Pain in the
wrist can also be caused by a combination of some
of these factors. [7]
Material and methods
Our patients are 51 and 65 years old females with
wrist pain. Both patients are treated in our clinic in
the period of April-May 2017. The treatments were
done in the clinic for Traditional Chinese Medicine
and Acupuncture in Skopje by a doctor specialist in
acupuncture. Acupuncture was done indoor on a
room temperature. In the treatment was used fire
needle acupuncture on Ashi i.e. trigger points,
located on the most painful places on the hand and
wrist area.
Case 1
Female, age 51, translator
The patient had numbness and pain on the right
wrist for two months, much worse on certain

Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-6, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Imperial Journal of Interdisciplinary Research (IJIR) Page 945
movements and worse with work. She is also
diabetic and use tablets for heart issues. One year
ago she had a broken arm and 30 years ago she had
car accident. Her digestion, elimination, blood
pressure, and sleep were normal. The patient works
as translator and she works for extended hours on a
computer. This is the probable reason for her
condition. The Western medicine doctors assumed
the condition as gout or osteoarthritis. The patient
has done one treatment on trigger i.e. Ashi point -
the most painful places on the right wrist. The
treatment was made on 04.04.2017 with fire needle
acupuncture. She had control on 11.04.2017 and
she said she was having small pain on certain
movements but that the main problem – the
unbearable pain is gone for now. Her condition is
good for now, but however in this case we will
make future follow ups to ensure the condition was
treated on a long-term. With the only one treatment
we succeeded to release the pain, relax the tensed
tendons and the strained muscles. If the remained
small pain doesn’t go away for a while, with few
more treatments we will be also able to release it
and improve the condition of the hand completely.
Case 2
Female, age 65, unemployed
This patient was diagnosed with carpal tunnel
syndrome, 2 months ago. She experienced pain in
the wrist, loss of strength and numbness especially
in the right hand. She could not bend the index
finger and middle finger. The patient is with high
blood pressire. Her digestion, elimination, blood
sugar, and sleep were normal. The patient has done
three treatments, first and second treatments were
made on trigger i.e. Ashi point on the wrist with hot
needle, third treatment was made with normal (cold)
needles. The treatments were made on 12.05, 16.05
and 20.05.2017. After second treatment the patient
experienced great improvement. She had no pain
and numbness in the fingers was reduced. In the
third treatment we used normal sterile needles to
relax the muscles of the hand.
Discussion
Wrist pain typically occur after injuries, repetitive
strain disorder, trauma. The most common cause of
pain in the wrist is repetitive stress that leads to
inflammation of the surrounding tendons. Without
rest and treatment, the tendons and muscles
succumb to inflammation. Pain may be localized in
any part of the wrist region and can be reflected in
the hand, even in the forearm. Pain can be
increased by certain movements. Other symptoms
that may occur are burning, tiredness, soreness,
stiffness, numbness, tingling, hot or cold feelings.
[1][2] Wrist pain can be successfully treated with
acupuncture. Acupuncture reduces inflammation
and eases movement restrictions. It can release
blocked Qi in the body and stimulate function,
improves circulation and relaxes spasms, brings
fresh blood and oxygen to the affected area.
According to TCM, pain results when there is
blockage for the flow of Qi. Acupuncture promotes
and restores the balance of energy. [8] First, the
acupuncturist should identify the cause of the pain.
Then with palpation the most painful points are
found and treated with acupuncture. These points
can be treated with normal or with fire needles.
Usually in our clinic, for wrist pain we use fire
needle acupuncture. For this technique we use
special needle which is heated on fire and after we
insert it in affected area very quickly. Fire needle
acupuncture enhances the blood circulation,
improves the Qi energy in the meridians, regulates
the function of the Zang Fu organs and etc. From
pathological view, fire needle removes the exudate
which is harmful for body very quckly, thus
reduces the inflammation, edema and improves the
physical movements. [9]
Conclusion
Acupuncture as part of the Traditional Chinese
Medicine can effectively relieve the wrist pain and
give excellent and very satisfying results for a very
short time.
References
1. Kerkar P; Wrist Joint Anatomy: Bones,
Movements, Ligaments, Tendons- Abduction,
Flexion; 2015 [www.epainassist.com]
2. Phillips ZB; Wrist Joint Anatomy; 2013
[www.emedicine.medscape.com]
3. Parker ML; Diagnosing Cervical Radiculopathy
vs. Other Causes of Hand Pain; 2016
[www.spine-health.com]
4. Stöppler CM; Wrist pain; 2017
[www.medicinenet.com]
5. Healthwise Staff; Finger, Hand, and Wrist
Problems, Non-Injury; 2016
6. Shipley M; ABC of Rheumatology: Pain in the
hand and wrist; BMJ 1995;310:239
7. Wolfe LH; One Approach to Acumoxa Therapy
for Pain due to Tendonitis of the Hand, Wrist,
and Forearm; 2017 [www.acupuncture.com]
8. Boyd D; Wrist pain & Acupuncture; 2017
[www.wholehealthcenters.com]
9. Zhu J, Arsovska B, Kozovska K, Jovevska S;
Treatment of Knee Osteoarthritis with Fire
Needle Acupuncture and Fire Cupping;
Imperial Journal of Interdisciplinary Research
(IJIR) Vol-2, Issue-11, 2016 ISSN: 2454-13