From Dr. Natalie Meiri’s Clinical Pearl Stories:
Chiropractor West Palm Beach: Acupuncture for Elbow Pain
This was a 55 year old patient. To be HIPAA compliant, I will call him Miguel instead of his real name. Miguel was doing a project at home to build a “barn door” for his spare room. He stated after presenting to my office, “I have been building my barn door and using my right arm. Yesterday, my right elbow started to really hurt!” To make matters worse, the project wasn’t finished and he was planning on having guests over for the holidays.
Miguel hadn’t gone to urgent care or his primary care, just took some NSAIDS (Non-steroidal anti-inflammatory drugs) without much relief. On the intake form he indicated pain in his right elbow.
Migeul’s Examination and Diagnosis
Firstly, upon examination, there were positive tests for his right elbow.
Secondly, I explained his diagnosis: right elbow sprain/strain. I explained that a strain is an overstretching and tearing of musculotendinous tissue. Tendons are connective tissue that attach a muscle to other body parts, usually bones.
Thirdly, a sprain involves a ligament. It is a short band of tough, flexible fibrous connective tissue. Furthermore, it connects two bones together in proper articulation at the joints. A Joint injury in which some of the fibers of a supporting ligament are torn or ruptured is a sprain. However, the continuity of the ligament remains intact in a sprain. Grade 1 (mild) sprains cause slight stretching and tiny tears in the ligament. Miguel had a grade 1 sprain of his right elbow. Grade 2 (moderate) sprains refer to partially torn ligaments with pain and swelling.
Thirdly, I explained his prognosis and treatment plan.
Miguel’s Acupuncture Treatment
Miguel’s Acupuncture treatments consisted of the insertion of very thin metal needles. These were inserted into the skin and underlying tissues in the indicated areas. At first, Miguel came in 3 times a week for 2 weeks. Next, his right elbow felt well enough to finish his barn door project. And Miguel enjoyed his holidays with his guests and returned to continue his care afterwards. Finally, Miguel’s outcome from the acupuncture was a complete resolution
Elbow Conditions Helped by Acupuncture
As the link between the shoulder and the wrist/hand, your elbows are challenged with repetitive activities. These overuse mechanisms account for the majority of elbow pain. In particular for instance in throwing sports and in activities requiring the use of an arm extension device such as a bat, racquet, or club. So the pivot is at the elbow and your forearm acts as the lever arm. These devices increase the medial (toward the center) stress across the elbow by increasing the length of the lever arm.
Additionally, you may also have a fall. And as with the rest of the upper extremity (arm), the elbow becomes weight bearing during the fall. An axial (racquet) force (load is applied to the structure along the length) is applied acutely during this fall to your elbow. Furthermore, this can happen chronically with gymnastic maneuvers.
- Lateral Epicondylitis (Tennis Elbow)
Lateral epicondylitis causes lateral (outer or same side as thumb) elbow pain associated with a repetitive sport or occupational activity. Repetitive movements requiring forceful wrist extension (movement of raising the back of the hand), radial deviation (bending the wrist to the thumb), and supination (rotation of the forearm) are the most common causes. Although it is associated with tennis, other sports and occupational activities are also possible causes. Butchers, plumbers, and weavers are examples of those who may be affected. With tennis, novice players with poor backhand technique account for many cases. With professional players, the forehand or serving may be the cause. Obviously, the more frequently an individual plays, the higher the risk of developing tennis elbow. Although, lateral epicondylitis is called tennis elbow, it also occurs in computer keyboardists, carpenters, and golfers.
Cause:
The currently accepted theory is that initially there is tearing of the extensor carpi radialis brevis (ECRB) muscle origin (attachment). This process may extend to the extensor digitorum communis (EDC) or the extensor carpi radialis longus (ECRL) muscles. These muscles in conjunction with the other muscles and tendons in your forearm help move your wrist and hand. The histologic (seen by microscope) description of the change in tissue is called angiofibroblastic hyperplasia. Angiofibroblastic hyperplasia or angiofibroblastic tendinosis describes the pathologic (disease cause) alterations seen in the tissue of tendonitis (inflammation of tendon).
Radiographs (xrays) may demonstrate calcification in as many as 25% of patients with lateral epicondylitis.
- Medial Epicondylitis (Golfer’s Elbow)
Medial Epicondylitis causes medial (inner) elbow pain following a repetitive activity such as golfing, hammering or use of a screwdriver. In athletes, the inciting activity usually involves wrist flexion (moving wrist down so palm faces arm) and pronation (rotatory movement of elbow where palm faces down). Examples of these include in serving and overhead and forehand strokes in various sports. Obviously, golfing (“golfer’s elbow”) or throwing may also cause symptoms. You may also feel pain or weakness on gripping.
Cause:
Medial epicondylitis is a tendinopathy of the origin of the wrist flexors and pronator teres muscles in your forearm. In chronic cases, an elbow flexion contracture may occur, leading to restrictions of movement (eg. extension). An ulnar neuropathy (compression of ulnar nerve at elbow) may coexist with medial epicondylitis. Radiographs (xrays) may reveal calcifications in close proximity to the medial epicondyle in 20% to 30% of patients with epicondylitis.
- Triceps Tendinitis (Posterior Tennis Elbow)
The triceps is a large muscle on the back of your upper limb. Triceps tendinitis causes pain at the tip of the elbow after a repetitive extension activity or a single event involving forceful elbow extension.
Cause:
Strain of the triceps insertion on the olecranon (bony prominence of the elbow) is usually due to common athletic endeavors performed by boxers, weight lifters, pitchers, and occasionally tennis players.
- Posterior Impingement Syndrome
Posterior Impingement Syndrome usually occurs in an athlete and especially on quick extension of the elbow. You will have a sharp posterior (back of) elbow pain. Similarly, popping or clicking may occur with extension. Your elbow may occasionally lock.
Cause:
Firstly, repetitive extension leads to compression between the olecranon trochlea and olecranon fossa (1 of 3 joints of elbow). Secondly, this may simply cause a reactive synovitis. So the synovium is connective tissue that lines the inside of the joint capsule. Thirdly, synovitis (synovial inflammation) is when the synovium of a joint becomes inflamed (swollen). Lastly, it may progress to degeneration and the production of osteophytes (bone spurs) or loose bodies.
Chiropractor West Palm Beach: Acupuncture for Elbow Pain
A Study in China found: “Acupuncture treatment can significantly relieve athletes’ elbow joint pain and locking symptoms, improve joint range of motion, and is beneficial to recovery of special training and high-level competitive competitions. It is a sensitive, effective, and noninvasive method.”(1)
Neuroscientists at Harvard Medical School looked at the underlying neuroanatomy of acupuncture. Specifically, that acupuncture activates a nerve signaling pathway. The signaling affects the function of other parts of the body, including organs (and neuromusculoskeletal body parts).
Acupuncture has been used for over 4000 years to treat pain and other health problems safely and effectively. The acupuncture treatment stimulates the imbalanced pathways called meridians. This activates the body’s natural healing abilities. Ultimately, this brings balance back to your body. Indeed, Acupuncture has a beneficial effect when treating many diseases and painful conditions such as elbow pain.
Many people injure themselves every year around the holidays. This could be due to stress or “holiday projects” as in the case of Miguel. Meiri Chiropractic offers acupuncture for elbow pain and many other ailments. Dr. Natalie Meiri is a chiropractic physician, board certified in acupuncture with over 20 years of experience. Call today for your acupuncture treatment for elbow pain at 561-253-8984.
References: (1) The Effect of Acupuncture on Elbow Joint Sports Injuries Based on Magnetic Resonance Imaging Weihua Yang 1,✉, Fei Wang 2 PMCID: PMC9001099 PMID: 35419078 https://pmc.ncbi.nlm.nih.gov/articles/PMC9001099/