World Journal ofAcupuncture-Moxibustion (WJAM)

·48· Vol. 22, No.4, 30th Dec. 2012 ELSEVIER

Clinical Report

Seventy-two cases of external humeral epicondylitis treated

by wrist-ankle acupuncture
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Luohe Medical College, Luohe 462002, Henan Province, China (~rPJ~~~~~f-I.~;&, rPJl¥i~rPJ
462002, 9=' ~ )

ARTICLE INFO ABSTRACT

Author: SUN Zhao-hui (1968-), male,
associate chief doctor, associate professor.
Research field: prevention and treatment
on motor system injury.
E-mail: Ihyzsch@163.com.
Accepted on July 12,2012
Objective To observe the clinical effects of wrist-ankle acupuncture on
external humeral epicondylitis. Methods Seventy-two cases diagnosed as
external humeral epicondylitis were brought into the study. Horizontal needling
was used at upper area 3, upper area 4 and upper area 5 near wrists with
long filiform needles. The frequency was once a day, and a course included
10 times. Results 27 cases got cured, 36 cases were marked effective, 5 cases
were effective and 4 cases were failed after 1 course to 5 courses oftreatment.
The total effective rate was 94.5%. Conclusion Wrist-ankle acupuncture is a
simple and effective therapy on external humeral epicondylitis.
KEY WORDS: external humeral epicondylitis; wrist-ankle Acupuncture;
acupuncture therapy

External humeral epicondylitis, also termed
as "tennis elbow", is a common chronic injured
tendoperiostitis in elbow. The author treated 72 cases
of this disease with wrist-ankle acupuncture, and the
report is as follows.
CLINICAL DATA
All the seventy-two cases were outpatients in the
Third Affiliated Hospital of Luohe Medical College
from 2002 to 2010. Of them shlow 32 cases were
men, and 40 were women. The age was from 16 to
78 years old, and the course of disease was from 3
months to 3 years. Most patients were manifested as
show onset, gradually showing pain on the lateral side
of elbow. There was obvious pain during heavy lifting
and griping, and the wring towel and bathe. There
were also symptoms in upper arm and forearm in
some cases. Most cases had the habits of excessively
using arm, especially elbow in one side repeatedly.
There was a local tender point on lateral epicondyle
of humerus, and the pain could reach to extensor
common tendon. The local skin and the activities of
elbow were normal. Mills sign was positive. X-ray
examination was usually negative, except that there
were calcification and sedimentary on humeral
periosteum in cases with long course of disease. Some
forearm-nerve compression syndromes caused by
tension of pronator teres tender or flexor digitorum
superficialis, the radial tunnel syndrome and so on
should be excluded by clinical differential diagnosis.
METHODS
Upper area 3 (2 cun above wrist crease, between
radial artery and the edge of radial bone), upper area
4 (2 cun above wrist crease, between the internal and
external edges of radial bone in the side near thumb)
and upper area 5 [between radial and ulna bone, in
the site of Waiguan (1r~ TE 5)] in the affected side
were used Pl. The upper area 5 was main point, and
2 to 3 points were used every time. After routine
disinfection on local skin, skin in distal end was fixed
using left hand, and the needle in diameter of 0.30
mm and length of 40 to 50 mm was kept using right
hand. The needle was inserted quickly into skin to the
direction of affected part in angle of 30° with a depth
of 35 to 50 mm along subcutaneous shallow layer. The
 WorldJournal ofAcupuncture-Moxibustion (WJAM)
ELSEVIER Vol. 22, No.4, 30th Dec. 2012
needling sensation should be soft without block. If the
patient felt soreness, numbness, distension, sinking
and tight feeling or pain, it meant the needle position
was too deep and into deep fascia, so it was necessary
to adjust the needle to subcutaneous shallow layer.
After getting proper needling insertion, needle was
retained for 20 to 30 min without lifting and thrusting
or twirling manipulation. The frequency was once a
day, and 10 times were a course, there was 1 to 2 days
of rest between courses.
RESULTS
The therapeutic effect criteria were established
according to Diagnostics and Therapeutics of
Pain [2]. Clinical cured: clinical symptoms and signs
disappeared totally (27 cases, 37.5%). Markedly
effective: most clinical symptoms and signs
disappeared, there was no influence on normal
life, there was still discomfort after tiredness but
disappeared quickly after rest (36 cases, 50.0%).
Effective: local pain relieveed obviously with positive
Mills sign (5 cases, 7.0%). Failed: symptoms or signs
were not improved after acupuncture (4 cases, 5.5%).
The total effective rate was 94.5%. The treatment
course in the group was from 1 course to 5 courses.
TYPICAL CASE
Patient, female, 72 years old, visited on February
6th, 2002. Main complaint: pain and discomfort in the
right arm for more than 3 years. The pain got worse
after tiredness and catching cold. The patient had
severe obstacles on wring key to open the door, wring
valve to open liquefied gas, bathe and so on. Effects
of massage, local blocking and acesodyne plaster
were not so good. The skin and tissue of arms were
normal. The tenderness on right lateral epicondyle
of humerus was obvious. Mills sign was positive,
and X-ray examination showed thickening on local
periosteum. The diagnosis was tennis elbow. The
symptoms relieved obviously after 4 times treatment,
and the obstacles on wring key and valve were
also improved. All the symptoms disappeared after
1 month of treatment combined with local hot
compress, and the Mills sign was negative. Symptoms
appeared occasionally during 10 years of follow-up,
but they disappeared after 3 to 5 times of acupuncture.
EXPERIENCE
External humeral epicondylitis is a clinically
common disease, its pathological manifestations
include local congestion and edema, exudation,
inflammatory cell infiltration, fibroustissue hyperplasia
and adhesion and other aseptic inflammation. This
049 0
disease is commonly seen among table tennis, tennis,
and badminton players, construction workers and
housewives. It belongs to muscular rheumatism and
vessel impediment in TCM. It is recorded in Lingshu:
Zhoubi (~:tI2<: 0 mlm.
Miraculous Pivot-Arthralgiai
that the pain developing from upper part to lower part
should be treated in the lower part first to stop the
development and then the upper part to remove the
disease in acupuncture. It means that the doctor should
determine the asthenia or sthenia around the pain
first, and then guide the movement of qi by therapies
such as acupuncture with the aim of circulating
qi and blood and making them harmonious in the
treatment of bi syndrome. Three yang meridians of
hand run from hands to head, and puncture along their
running direction is reinforcing method. The effect of
regulating yin and yang of wrist-ankle acupuncture
was combined with the effect of dredging meridians
of long needles. Get the harmony and stability
through changing the disharmony of yin and yang and
balancing interior and exterior, causes and symptoms.
That is to say, the way to cure should be in accordance
with the reason of diseases [3].
Wrist-ankle acupuncture is a simple and
convenient therapy which treas diseases by stimulating
corresponding points around wrist and ankle with
intradermal needles. It is a developed application
of body acupuncture. There are lots of clinical
applications and reports on this therapy nowadays
because of its little suffer, safety and good clinical
effects. Its mechanism may be related to the change
of ion channel in local lesion caused by sympathetic
nervous sensitive lines, stress change of subcutaneous
vessels, formation and transmission of interstitial
fluid pressure wave in the running way of cutaneous
regions of the twelve channels. To control external
humeral epicondylitis, inducements should be reduced
and a proper balance between work and rest should be
stressed beside paying attention to the treatment of this
method [4].
REFERENCES
[1] Xi YJ, Situ L. Techniques of acupuncture and moxibustion
(Chin). Shanghai: Shanghai Scientific and Technical
Publishers; 1985:87-88.
[2] Zhao J, Li SR, Song WG. Diagnostics and therapeutics
of pain (Chin). Zhengzhou: Henan Medical University
Publishing House; 1999: 662--(j63.
[3] Lu GX. The way to traditional Chinese medicine (Chin).
Beijing: People's Medical Publishing House; 2001:111-
112.
(Turn to page 52)
 World Journal ofAcupuncture-Moxibustion (WJAM)
·52· Vol. 22, No.4, 30th Dec. 2012 ELSEVIER

filiform needle stimulation and physiological effect of
electricity, which could arouse meridian qi, regulate
yin and yang, dredge meridian, smooth the blood and
stretch the muscle and tendon, as a result, benign
regulatory effect can be made at adductor muscle of
thigh to relieve the spam, swelling and ecchymosis,
and promote recovery of local tissues function.
REFERENCES
[1] State Administration of Traditional Chinese Medicine.
Criteria of Diagnosis and Therapeutic Effect of Diseases
and Syndromes in Traditional Chinese Medicine (Chin).
Nanjing: Nanjing University Press; 1994: 193-194.
[2] Ouyang BS, Che JL, Gao J, Zhang Y, Li J, Yang HZ, et al.
Effects of electroacupuncture and simple acupuncture on
changes ofIL-l, IL-4, IL-6 and IL-lO in peripheral blood
and joint fluid in patients with rheumatoid arthritis. Chin
Acup-Mox (Chin) 2010; 30(10): 840-843.
[3] Ye JR, Jiang JG. Effect of electroacupuncture analgesia
on rat's pain tolerance. Chin J Basic Med Tradit Chin
Med (Chin) 2004; 10(4): 71-78.
[4] Zhang J, Zhang N. Study on mechanisms of acupuncture
analgesia. Chin Acup-Mox (Chin) 2007; 27(1): 72-75.
(Editor: QI Shu-Ian Translator: LID Zhao)

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[4] Ru X, Ling CQ. Biomechanical mechanism of analgesic 2004; 24(5): 361-363.

effect of wrist-ankle acupuncture. Chin Acup-Mox (Chin) (Editor: WANG Xiao-hong Translator: HU Jing)

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