For Pain Provoked By Palpation

Any part of the body, if painful at palpation, can be challenged with NCT.

The locomotor apparatus is the favorite for this kind of test, and inflammation of the joints, bursitis and tenosynovitis are often successfully treated. For example, in Figure 8.4 the 45-year-old male patient had been suffering with tennis elbow for 3 months. In the previous 2 weeks the pain had increased and he was limited in his daily activities. He felt acute pain on palpation and pressure on his right lateral epicondyle. Also movements of pronation of the arm and dorsiflexion of the wrist were very painful.

The patient asked for treatment with steroids but I convinced him to try ear acupuncture first. Performing PPT, I found a sensitive point on the scapha corresponding to the representation of the elbow. NCT on this point lowered pain at palpation of the lateral epicondyle (Fig. 8.4A) and a temporary sterile single-use steel implant (ASP) was placed there. Two more ASPs immediately beneath improved pain at pronation of the arm and dorsiflexion of the wrist (Fig. 8.4B). This treatment with three grouped implants in all was efficacious enough to make steroid treatment unnecessary. The patient received similar therapy 15 days later with lasting results.

As regards the issue of the different representation of the lower limb in the French and Chinese maps, see the section on the musculoskeletal system in Chapter 5 (p. 115). The hypothesis that different parts of the knee and the ankle may have a different representation on the ear was forwarded by Dr Caterina Fresi. She examined 34 patients with knee pain caused by current injury of the lateral

Fig. 8.4 NCT on a tender area identified in a 45-year-old male suffering with tennis elbow (A); three single-use steel implants (ASP-Sedatelec) for reducing pain at palpation and pain at movements of arm and wrist (B).

capsule-ligament complex (14 patients) or of the medial complex (20 patients). In the first group the pain syndrome evoked a sensitization of an extended oval area covering the Chinese hip and knee area (area 1 in Fig. 8.5), whereas in the second group the sensitized area was rather rounded and corresponded to the French thigh and knee area (area 2 in Fig. 8.5). Dr Fresi also examined 15 patients with ankle pain caused by current injury of the capsule-ligament complex of the malleolus lateralis (8 patients) or of the complex of the malleolus medialis (7 patients). In the first group the sensitized area corresponded to the Chinese ankle and toe/heel area (area 3 in Fig. 8.5) whereas in the second group the sensitized area corresponded to the French foot area (area 4 in Fig. 8.5).

The following procedure was applied by Dr Fresi in all these patients: pain was rated at palpation by means of the VNS. The most tender point was identified and marked with ink on the knee

Fig. 8.5 Representation of knee and ankle pain according to Dr Caterina Fresi (unpublished data, with permission). 1 and 2 = lateral and medial capsule-ligament complex of the knee; 3 and 4 = capsule-ligament complex respectively of lateral and medial malleolus.

or the ankle as well as on the auricle of the same side, with PPT identifying the most sensitive point. A second pain score was obtained after 15 seconds of NCT followed by a further interval of 45 seconds. The average pain dropped from 7.4 to 3.8 in the whole group of patients with knee pain, and from 7.6 to 3.5 in those with ankle pain. Four patients with chronic and widespread musculoskeletal pain were excluded from this evaluation, as these symptoms were a possible sign of fibromyalgia. The advice of Dr Fresi is therefore to exclude fibromyalgic patients from this kind of experimentation.

Traditional Chinese Medicine

Traditional Chinese Medicine

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