We know from clinical experience that acute severe pain is a common patient presentation. In these unfortunate presentations, patients and clinicians alike are hoping for quick resolutions. In this installment, let’s discuss an interesting acupuncture case that features the always-welcome and somewhat miraculous rapid resolution of acute pain.
The Case
The patient was a 35-year-old female presenting with severe pain in the right arm radiating from the neck down to the hand / fingers, and also into the right scapula area. There was no acute trauma on the arm precipitating the pain. The patient said she woke up with pain in the neck, which eventually spread throughout the entire shoulder, arm, hand, and scapular area.
There was no visible swelling or discoloration; and interestingly, there was no pain on any area of palpation throughout the entire neck / arm / scapula. There were no other presenting symptoms aside from stress from the intense pain, which she described as “10 out 10.”
The patient’s tongue was a healthy red color with a normal coat and slightly purple sublingual veins; the pulse was rapid and wiry. After examining the right arm, I palpated down the exact same areas of the left arm and interestingly, she experienced significant pain on many areas throughout the left arm.
“Why is my left arm more sensitive to touch than my right arm, which is the one hurting me?” she asked.
This was a very interesting question! It was a perfect opportunity to discuss meridian theory with the patient and explain some unique facets of classical Chinese acupuncture theory. The overall pattern diagnosis was qi stagnation / blood stasis in the meridians.
Treatment Protocol
I treated the left arm, which was tender to palpation, first and chose the following points: LI 3 + LI 4 + LI 10 + SI 6. LI 3 is the shu-stream and wood point of the large intestine channel, and has the actions of expelling wind and heat, dispelling heaviness, and stopping acute pain. The ever-popular LI 4 is the yuan-source point of the large intestine meridian and has the actions of expelling wind and releasing the exterior, activating the channels, and strongly alleviating pain.
LI 10 is a unique point of the large intestine channel, often referred to the as “upper ST 36” due to its unique ability to tonify as well as regulate. LI 10 has the actions of strongly regulating the qi and blood, activating the channel, alleviating pain, and harmonizing the intestines and stomach.
SI 6 is the xi-cleft point of the small intestine channel and has the actions of activating the channeling, alleviating pain, uniquely benefiting the shoulder and arm, moderating acute conditions, and benefiting the eyes.
The needles were inserted at the above points and gently manipulated until the patient experienced the arrival of qi. I then instructed the patient to gently begin to move the right arm around in various ways and gently move the neck around as much as possible.
After two to three minutes of moving the right arm, the patient stated, “This is crazy, the pain and heavy sensation in my right arm are fading a bit.” I continued to have her gently move the right arm around for a total of five minutes.
After this, I removed the needles in the left arm, and then inserted needles at the same points in the right arm. Gentle needle stimulation was administered until the patient experienced the arrival of qi and I then had the patient move the left arm around in the exact manner as we had previously done in the right.
After one to two minutes of movement in the left arm, the patient stated, “This is so weird! The more I move my left arm around, the less pain I feel in my right arm, and it feels like the needles are still in my left arm, too!”After five minutes of slowly moving the left arm around with the needles gently stimulated for a second time in the right arm, the patient stated that her pain was reduced by more than half and the sensation of heaviness in the right arm was completely resolved.
I instructed the patient to check in with me the following morning and that we could potentially administer a follow-up acupuncture treatment. The patient called the next morning and stated that her pain was “95% gone.” She was extremely happy, to say the least. Interestingly, the patient’s neck and arm pain never returned after one acupuncture treatment.
Clinical Takeaway
I find these unique cases extremely interesting to present and discuss, and I hope this short installment helps inspires you to continue to help eliminate the unfortunate suffering of patients in pain. Perhaps it’s one treatment, perhaps it’s five treatments. But regardless of the number of treatments, we should always strive to see each patient’s pain as a unique expression of suffering and provide acupuncture prescriptions uniquely crafted to help resolve the patient’s pain.
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The Oregon College of Oriental Medicine (OCOM) has announced it is closing after 41 years. Pending accreditor approval, OCOM will cease offering classes after September (fourth-year OCOM students graduate Aug. 26). All current / incoming OCOM students have the option of continuing their education at the National University of Natural Medicine or Five Branches University, or transferring to another school altogether.
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