Arthritis

ARTHRITIS

Case #930001. 

Gout – multiple joint involvement (1993, Taiwan)

Lin, a 65 years old male suffered hyperuricemia for long time. He noted to have swelling and painful joints for about three year before he came to see me. The involvement of joint was rather chronic in nature with first involving the right big toe joint. As time went by, swelling and painful involvement of the small joints of both hands followed. The uric acid in the blood maintained in a high normal level by taking anti-uric acid medicines. About three months prior to the first visit, swelling of the right knee joint developed with liquid accumulation. This caused him not only pain but difficulty in walking. Repeated aspiration of the joint fluid was performed but the liquid persistently recurred.

   Physically, he is a rather robust healthy looking short status male. Blood pressure was normal in range. Pulmonary, circulatory and neurological system revealed nothing abnormal. The first phalangeal joint of the right toe was enlarged and deformed, yet no tenderness was detected. First phalangeal joint of the fingers of both hands showed various degrees of enlargement and deformity. Some tenderness can be provoked. Marked reddish swelling of the right knee joint with hot sensation and tenderness by touch was found. A fluctuation feeling also can be detected which indicated liquid accumulation in the joint.

    Acupuncture treatment was performed with needle insertion around the right knee. Two needles also inserted into the right knee joint connecting with electric stimulation. A thirty minutes acupuncture treatment was performed in the first visit.

    A second visit was two days later. Surprisingly, the liquid in the right knee joint was almost dried up and the swelling showed much less than before. He can walk with the help of a stick. Of course, you can see the joyfulness from his face. A second treatment was given with the same method.

    A third visit was two days after the second. No swelling, redness or tenderness can be seen now. Treatment with needle insertions around the joint only was given.

    He came to see me and received acupuncture treatment intermittently later on only when he felt discomfort over the knee.  Follow up to one year, the liquid never returned to his knee joint.

Footnotes:

l    He is the father of the nurse of my OPD clinic in St. Mary’s Hospital, Lotung, Taiwan

l     I didn’t give any herbs to him to help his high serum uric acid since he still taking medicine for that purpose.

l    Electro-acupuncture is not only good for gout arthritis but can see remarkable effects on other type of arthritis.

l     Electro-acupuncture can clear up reactive liquid accumulation in the joint caused by trauma, post operation reaction, inflammation or idiopathic (unknown reason) as well.   

IRRITABLE COLON

Case #020212

Robert is a 30 years old film editor, suffering from chronic diarrhea since he was 12. Severe anxiety, abdominal pain, nervousness, muscle rigidity and tremor of hands are also frequently experienced. About six months ago, he started to have run to toilet 6-10 times a day with loose small amount of stool. Had been tried various method of therapy but in vain. He smokes 2 packages of cigarette a day.

On the first visit, he looked tire, weakness and nervousness. He was so afraid of needle that we only gave him 3 insertions on the body. He felt so good after ten minutes of treatment. Without further frighten by acupuncture, he ask for more needling on his body as a treatment.

With acupuncture and internal warming up therapy, the form of his stool turned to solid after the third session of treatment. The frequency of defecation became less, it was between 4 to 6 and even down to once a day. His emotional status getting more stable. But may be due to his work or life style stress seems always around him. He got better after each treatment but it was worse when he get back to his stressful work.

Comments: Irritable colon is caused by imbalance of autonomic nerve system. Mental stress can aggravated this situation. According to our experience, the accelerated function of the autonomic nerve system can be corrected by acupuncture treatment. And it does the same to stress as well. But acupuncture cannot eliminate the source of stress or to change the living environment. In order to get a better result, either one has to strengthen oneself or avoid the sources of stress.

Case 020109

Helen M. is a 60 years old woman suffered from frequent defecation (IBS) with loose stools for 12 years. She also experiences poor sleep and anxiety. Using antidepressant for long time which does good for her anxiety but not the bowel movements. Hysterectomy performed 16 years ago. She is a helper in the child day care center. Her job doesn’t give her much stress, but she got a lot of stress in the weekends. She has a simple quiet family. She cares and worries very much on her single daughter who was studying in Northern California. She usually was nervous to missing calls from her daughter. That is the reason why she has a lot of tenses during weekend times.

Treatments with acupuncture were provided to her with very good result on the frequent bowel movements right after the first three treatments. Follow up with 6 more treatments the movement of bowel returned to regular and no relapsing was observed.

Regarding to the anxiety, acupuncture gave her a clam mind and let her use less antidepressant. After treatment started she only take medication in the weekends few or non in the weekdays.

Comments: Acupuncture provides a very good effect on relieving anxiety or stress reaction. Acupuncture can strengthen one’s mind and adjust the nervous imbalance of body secondary to stress. But if the source of stress can not be eliminated, the patient has to face a continuous attack, the effect of acupuncture treatment would be fluctuated. 

MUSCLE WEAKNESS

Case 020104

Name: Michael XXX

Sex: Male

Date of birth: 6/7/1999 (2.5 years old)

MEDICAL HISTORY

Michael was a full-term, 8 lb. 3 oz. Born via c-section due to large size and abnormal fetal position at Northridge Hospital. The pregnancy was unremarkable for illness, vaginal bleeding, diabetes, smoking, alcohol, recreational drugs, or prescription medications. Fetal movement seemed normal throughout the pregnancy. Prenatal studies included ultrasound examinations, which were normal by report. There were no complications at the delivery and no abnormalities were noted at birth.

After discharged from the hospital, Michael was growing and developing well with no feeding problems. He was receiving Enfamil with iron. By 12 months of age, he began eating table foods.

The parent were first concerned about Michael at 6 months of age when he was chronically lethargic, did not have head control and seemed to be floppy. A brain MRI study was performed in Mexico at 18 months of age, which reportedly found that “ part of the brain is smaller than the other part”.

A nerve conduction velocity study was performed on 9/28/00. The result was suggestive of mild axonal neuropathy with a partial conduction block in the right peroneal nerve. The conduction velocities in the right median motor and right peroneal nerves were measured at the lower limits of age. An EMG study was also performed and was within normal limits.

Michael was noted to have a Werdnig-Hoffman pattern of neuromuscular weakness and 4-hydroxybutyric aciduria. He was found to be making slow developmental progress although the fine motor skills continue to be impaired.

DEVELOPMENT HISTORY

According to the parents, Michael smiled at 3 months, rolled over, reached for objects and sat without support at 12 months, crawled and pulled to a stand at 28 months of age. He can cue and cruise. He spoke his first word at 18 months of age and currently says one word “ma”.

PROGRESSIVE NOTE

As the parents can understand, the attending physician did not pay much hope on Michael’s future and the MRI taken in Mexico was interpreted as normal to his age. Physical therapy is prescribed as the only treatment.

Michael’s muscular strength seemed improved by occupational therapy/physical therapy but he still can not stand or hold his head for longer time. He can not walk even with other’s help.

Due to the dissatisfaction on Michael’s progress, his parents started to search for an alternative treatment with Acupuncture.

ACUPUNCTURE TREATMENT

1^st. Visit (1/4/02): Patient was rather lethargic, not well response to sound or pain stimulation. He cannot sit without support. Weakness of both lower extremities with moderated rigidity on the right thigh. He seemed receive hearing well but not speaking. Neurological examination revealed both right knee jerk and ankle jerk diminished. No pathologic reflex was detected. Muscle tone preserved without obvious atrophic change.

   Electro-acupuncture was applied.        

4^th. Visit (1/8/02): Patient was more alert and reactive to needle insertion.

5^th. Visit (1/9/02): Michael can stand up and walk a little bit by the help of his Mom. 

   He cried for the first time during treatment.

8^th. Visit (1/12/02): His mother reported that Michael can walk by himself along the 

   sofa and the cradle.

9^th. Visit (1/14/02): Started treatment with skull needles to provoke the speech ability.

11^th. Visit (1/16/02): Michael can climb up to the sofa and sit straight by himself.

12^th. Visit (1/18/02): His mother reported that Michael can stand up very easily now.

15^th. Visit (1/24/02): He speaks out of his mouth the first word “more” in his life.

16^th. Visit (1/28/02): He added “Dad” to his vocabulary list yesterday.

 

 After three months of treatment his mother stated: “ Michael now can stand where he can holding himself up. Usually he can stand for more than 30 minutes all by himself. He tries to talk more and learns to follow what his sister says. He doesn’t shake much when reaching for something as he usually to be. He can walk to everywhere by holding something around.”  He plays with his parents and sister all the time. Laugh loud and smile a lot. He stopped to go to the physical therapy and prepares to go to school with special training.           

QUIT SMOKING CASES

GROUP CASE

Case  #File 971200

Name: Quit smoking class 1

42 attendants

Date: December 1997

Average age: 45

Sex: All Male

Length of smoking: From 18 Months to 45 years

Number of cigarette smoked: From 10 to 40 per day

Quitting method: Acupuncture and Herb tea

Treatments: From 1 to 14 treatments

Estimated success rate: 90 %

Remarks: This was a quit smoking grouping class supported by the Taiwanese government to the local community of Ilan County in the Northern-Eastern area of Taiwan. Follow up for a period of six months only 5 % retake their habit of smoking. To a group therapy, since it does not individualized, a detailed study of the lifestyle, the mental condition or health problem of each individual attending the class is not possible. That is why the recurrent rate is so high and more treatments needs to give than one would expected.     

FIFTY YEARS MODERATED SMOKER

Case  #010110

Name: James K.

Age: 28

Sex: Male

Length of smoking: 15 years.

Number of cigarette smoked: 1 package per day

Motivation for quitting: Family request (asked by his young daughter)

Quitting method: Acupuncture

Treatments: One

Result: Quitted

Follow up: Follow up his condition on the 17^th day after the treatment showing that he did not smoke even one cigarette after the acupuncture treatment.

Remarks: He urged his wife to quit smoking after his success by Acupuncture.

MOERATED SMOKER IN A SMOKING FAMILY

Case # 010510

Name: Dennis K.

Age: 33

Sex: Female

Length of smoking: 5 years

Number of cigarette smoked: 10-12 per day

Motivation for quitting: Family request

Quitting method: Acupuncture and Herb tea

Treatments: One treatment

Follow up: She smoked no cigarette thereafter. Follow up visit showed up on 10/17/01, 12 days later, she was still free from smoking.

Remarks: She is the wife of one of our patient and was urged by her husband to come forward for cessation of smoking with acupuncture. She was quite amazing that her husband can stop smoking by acupuncture. It costs only one treatment to eliminate a habit of 15 years.

ACUPUNCTURE CAN STOP SMOKING HABIT AND CONTROL WEIGHT ON THE SAME TIME

Case #020522

Name: Marcia J.

Age: 38

Sex: Female

Length of smoking: 5 years.

Number of cigarette smoked: 5-10 per day

Motivation for quitting: Health reason

Quitting method: Acupuncture and Herb tea

Treatments: Ten treatments

Follow-up: No relapsing of smoking in the following three weeks was noted.

Remarks: She actually has had her habit of smoking stopped by the first

         acupuncture treatment. She came to finish a course of ten treatments in

         order to not getting too much weight after cessation of smoking. In fact, the

         subsequent treatments were given for weight control only.

A NON-COMPLIANT CASE—NOT COMPLETETED STOPED BUT CUT LESS

Case  # 020611

Name: Roger W.

Age: 40

Sex: Male

Length of smoking: 25 years

Number of cigarette smoked: Average 10 per day

Motivation for quitting: Health reason—cardiac problem

Quitting method: Acupuncture

Treatments: one treatment

Follow-up: He received one treatment of cessation of smoking with acupuncture, in the

         next day the consumption of cigarette was cut to 6 a day.

Remarks: He did not continue to receive acupuncture treatment because he was not

        comfortable with needling on his ears. This case demonstrated that people fail

        to compliant with acupuncture due to sensitive to needle insertion on a  

        particular area of body. Commitment to quit is another factor.

NON-COMPLETED TREATMENT OF A HEAVY LONG TIME SMOKER

Case # 020114

Name: Russell H.

Age: 55

Sex: Male

Length of smoking: 40 years.

Number of cigarette smoked: Average 35 per day

Motivation for quitting: Health reason.

Quitting method: Acupuncture and Herb tea

Treatments received : 6 treatments

Remarks: This man came to receive treatment in the period of out of job, a lot of stress, 

         smokes more cigarettes when he was rejected by employer. After the first

         treatment he can cut down his smoking to 10-12 cigarettes a day. After the

         fourth treatment he smoked only 9 cigarettes a day. Then, he smoked only 2 a 

         day right after the fifth treatment. He can not come for further treatment after 

         the sixth session of acupuncture mainly due to unemployment. The treatment

         actually was not completed and he might jump back to the habit of smoking

         with larger amount of cigarette later on.

CHEWING TOBACCO CAN BE RESULTED THE SAME GOOD

Case # 020920

Name: Stuant D

Age: 59

Sex: Male

Length of smoking: 48 years.

Number of cigarette smoked: Average 30 per day, by chewing.

Motivation for quitting: Health reason.

Quitting method: Acupuncture and Herb tea

Treatments received :

Remarks: He stopped to chew cigarette right after the first treatment with acupuncture. 

He usually have problem of insomnia and was better resulted by acupuncture.

        He also afraid to get weight once if stop to chew cigarette and it was never

        happened by our therapeutic method.

SHINGLES (HERPES ZOOSTER)

Case 020211. Early phase of Shingles (2002, Los Angeles)

Mr. Tucker, a 62 years old geologist, suffered from shingles with small vesicles over his left lower chest and back (over the T6 level) for about nine days. He was treated by a dermatologist with analgesic (Valtrex, aspirin and aleve). Since the vesicle did not showed any progressive signs of healing and because the sever pain (especially in the nights) disturbances his daily life very much, he decided to seek for an alternative way to treat his sickness.

2/11/02 First visit: Multiple small vesicles distributed on the left lover chest, upper abdomen and back. Pain persistently and increased by touch.

       Treatment: Acupuncture with needling on the ear points and local points around the vesicle area.

       Herbal lotion spray on the lesions three time a day (by himself).

2/13/02 Second visit: He reported to feel worse on the next day after the first treatment, but soon felt better on the third day. Physically, the vesicles were dried out. Pain was much less. Same treatment was performed.

2/15/02 Third visit: He stopped to take any pain killers. Cluster formation of the vesicles was shown. He still experienced mild pain and soreness around the chest and back.

2/25/02 6^th visit: The skin lesions were completed healed. Mild itching and numb sensation over the back still presented. No more pain.

Comment:

l   Herpes Zooster is a viral disease and usually self-limited (healed by itself even no treatment given). But the duration of disease to some people who have lower immunity would prolong for a longer period of time. The pain and the vesicle formation on the skin, chiefly due to the involvement of an individual spinal nerve trunk, commonly are the main sufferings to the patient and are the reason to look for help.

l  Acupuncture and herbs can alleviate the degree of pain and to help the course of illness become shorter.

l   For the residual pain (pain remained for a long time) of Herpes Zooster, acupuncture might be the only treatment can provide help.         

SHOULDER PAIN

Case # 020509

Cecilia, 60 years old woman, came to our clinic with a complaint of pain over her shoulder, neck and arm off an on for about four years. She had to use pain-killer, celebrex, to combat her pain for years. The pain usually aggravated by activity and mildly relieved by hot compression or pressure. The pain interfered very much to her sleeping. She also suffers headache, sinus problem, stress and high blood pressure.

During physical examination, it found to have very tight shoulder muscles, more on the right side. Pain over the neck and shoulder induced by moving the upper arms. No limitation of movement or abnormal reflex was detected. X-ray of the spine revealed rather normal to her age.

Acupuncture treatment and heat treatment started to use for her condition.

Since she had to go out of the States for work, the treatment was not regularly applied in the first three sessions. Regular daily to every other day treatment received since then. Two weeks (7 treatments) later, she can sleep well without disturbance by pain in the night. And she is free of pain medication now.

Note: By the time of writing this statement she was still on her regular treatment (12th. treatment) with two times a week. We will follow up this case for a while and see the prolong effect of acupuncture.

Case # 020504

Sherryl is a 30 years old female secretary of a finance firm, suffering from pain in the neck, shoulder and arms since December 2000 (1 1/2 year ago). This pain was a consequence of car accident (so called whiplash injury). She had been gone through treatment by chiropractor and even with epidural infiltration. X-Ray and MRI examinations revealed nothing particular. She suffered headache, depression, fatigue, anxiety, insomnia and stress because of the persistent pain.

She started her first 6 acupuncture treatments every other day with better improvement. Two treatments a week were given after the 7^th. session and she got definite improvement since then.

Note: Whiplash injury was showed to be very effective by acupuncture treatment. Acupuncture can relieve pain by adjusting the nervous conduction and increase the secretion of endophines. On the other hand, acupuncture improves the micro-circulation over the injured areas to lessen the edema and congestion which resulted with an enhancement of the healing process of soft tissues. Application of immobilization to a non bony fracture situation actually diminish circulation. Over use of manipulation would increase tissue damage.

Case 020416

Nancy is a 70 years old woman, suffered from pain over her shoulder, left arm and left leg for about two weeks. Had been treated with analgesics without good result. The pain was moderated and persistent in nature. No other positive finding was detected by physical examination except tenderness over the shoulders with a very tight muscle tone.

Acupuncture with heat application was given to treat. The pain condition was completely resolved at the end of 13 treatments.

Note: Although Nancy had had pain over multiple areas of her body but she is not a typical case of fibromyalgia. The stiffness and pain of shoulders could be the early phase of frozen shoulder. Pain over the back or shoulder frequently due to muscle strain, but most of them are caused by unknown reason. Examination with modern medical technique such as CT scan or MRI, usually did not discover any organic damage. It is believe that changes of cell function or metabolism can be the cause of pain. In a way to look at this, it is an unbalance or disharmony condition of tissue and system which acupuncture provides a good solution.        

TENDENITIS

Case 010822

Chris is a 14 years old student, suffered an injury over his right elbow during baseball playing on May 1, 2002. He experienced persistent pain of moderated degree with light degree of movement limitation since then. X-ray of the right elbow revealed no bony destruction and tendenitis was diagnosed. Treated with medication without defined effect.

8/22/01 First visit: Tenderness over the posterior portion of the right elbow. Pain induced by turning the forearm and elbow flexion. Neurological examination revealed nothing abnormal. Electro-acupuncture treatment performed with local needling plus heat applied.

8/29/01 Forth visit: He started to feel better relief. The degree of pain lesser and the movement range increased. Same type of treatment continuous to apply.

       He came for treatment every three to four day since then till 9/14/01 (9^th. treatment) with progressive improvement.

 

10/3/01 Tenth visit: New injury over the right elbow occurred by throwing baseball. Repeat acupuncture and heat treatment performed.

The pain of his right elbow was found to be completely resolved on 11/7/01, the 9^th. treatment after the newly injury, with unlimited motion.

 

Comment:

Acupuncture stimulates the secretion of neural hormone such as endophines. Endophine is a morphine-like substance with more potent then morphine yet there is no any side effect or addiction effect as morphine does. Endophines also have effect of helping the cell’s regenerative process. Acupuncture is proven to be very helpful for the neuro-muscular injury. Many athletes after suffering of injury look for acupuncture treatment as the only effective method of healing.