Other Soft Tissue Pain Conditions

This is a case report of a 30-year-old healthy righthanded man who complained of pain in the lateral aspect of the right elbow with limited motion for two months. It began after he played badminton with a back-hand posture. The pain was aggravated by grasping, lifting or twisting the racket or any sudden movements of extension or supination of the elbow joint. Anti-inflammatory medication and conventional rehabilitation was of little help. The authors decided to treat with fire needle therapy, which is an acupuncture technique. They did triple needling on the Ah-shi point associated with Shousanli (LI10) and Quchi (LI11) over the muscular origin of the lateral extensor group of the forearm. In addition, triple needling was done at the Zhouliao (LI12) superolateral to LI11 and Chize (LU5) in the cubital region. These needles were single use, disposable sterile 40 millimeter 30-gauge needles and manipulated manually. They remained in situ for 15 minutes after manipulation and concomitant electroacupuncture was managed on LI10 and LI11. Moxibustion was used above the three Ah-shi points. After four sessions of acupuncture within two weeks, Visual analogue pain scores (VAS) improved compared to pre-treatment values. Furthermore, the pre-treated shoulder and hands (DASH) score of 43.33 decreased to 17.5. The average grip strength of the affected hand increased from 50 pounds to 65 pounds. Unfortunately, after resumption of work and sporting activity, the patient relapsed. The authors changed their technique a bit and used fire needle therapy which consisted of an acupuncture needle made of tungsten heated red hot over a lamp and then inserted into the three Ah-shi points. The patient received two sessions of the fire needle therapy. Afterwards, the elbow pain significantly improved and his strength was also increased. VAS and DASH scores were also significantly improved and the average grip strength of the affected hand increased from 65 pounds to 100 pounds. At four-month follow-up, the patient continued to be significantly improved.