Managing repetitive strain injuries with channel-based acumoxa therapy

Townsend Letter for Doctors and Patients,  Feb-March, 2005  by Honora Lee Wolfe

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5. Go over self-care techniques with the patient if you have not already done so. Find out if their work habits have changed or if work-related stress levels have worsened. Suggest dietary changes to support your root treatment.

Self-care

There are a variety of things that patients can do to help themselves. Here are a few that I suggest:

1. Wearing a splint at night (many patients will already have one of these) or during work can help maintain proper blood circulation to the area. Rest the affected part as much as possible.

2. Patients may want to take extra doses of B5, B6, and Vitamin C. For inflammatory stage of pain, high doses of bioflavonoids may be helpful.

3. Using indirect moxibustion with liniments at home is a good way to extend the therapy they receive during an acupuncture treatment.

4. A variety of herbal liniments are on the market that can be used to help these patients; it is recommended to use these two-three times per day.

Notes and suggestions

If the patient is also seeing a physical therapist or an orthopedic surgeon, they will often be using regular ice therapy on affected areas and will ask my opinion of this practice. If there is obvious heat, swelling, and redness, or if the patient is in the first 24 hours after a soft tissue injury, ice can be useful therapy. Chinese medicine does not, however, recommend it for everyday, long-term use. Such strong cold therapy can aggravate stagnation and stasis by "freezing" the tissue when what is needed is more circulation through the channels and connecting vessels. My feeling is that long-term use of ice makes things worse rather than better. I give them my opinion and suggest that they try a liniment or a soak instead for one week and see if that works better than ice. If they are obviously very Western medically aligned in their thinking, however, it may be better to approach this issue with caution. One does not want to contradict direct orders from any patient's MD. My way of approaching it is to use the phrase, "If it were my wrist, I would try using this soak or liniment; however, if your doctor has suggested ice and that seems to help you, then fine. You might consider trying the liniment for one week. If it is not as helpful as the ice, then go back to using ice. I want you to do what gives you the most relief." This seems to be non-threatening and gives them the option to choose, while clearly stating your opinion.

As with any health problem, no treatment will work for 100% of patients. Pain due to damp and/or cold with mild vacuity is often easy to treat. Cases with the complication of blood stasis respond well with the addition of mild blood letting therapy. That which is due to damp heat and severe vacuity (of blood, qi, spleen, kidneys, a combination) is the hardest (as in cases of fibromyalgia). Also, it is my experience so far that if a person has already had surgery on their wrists, you may or may not fight battles successfully, but you cannot totally win the war. They will probably require treatment, at least from time to time, for the rest of their life because the tissues have been damaged and the scar tissue aggravates the tendency to stagnation and stasis. Such cases do better with lots of liniment and indirect moxa at home, but even then they can be difficult to treat. It is important to remember that you will never see those people whose surgery has been successful. Therefore, it is impossible to say definitively that the surgery does not work. However, it has been my experience with people who have had surgery and did end up in my office that they are no better off after the surgery than before. If you can help prevent a person with this type of problem from having surgery, you may have done them a great favor.