Acupuncture Continuing Education

Acupuncture Promotes Wrist Injury Recovery Confirmed

acupuncture ceu TFCC

Acupuncture is effective for the treatment of wrist, hand, and forearm pain and mobility impairment due to moderate triangular fibrocartilage complex (TFCC) injury. The TFCC is comprised of tendons, ligaments, and cartilage that connect the bones of the forearm and wrist. Tears and other forms of damage to the TFCC result in localized pain and decreased mobility of the wrist, hand, and forearm. Key components of the TFCC susceptible to injury are the triangular fibrocartilage disc, radioulnar ligaments, extensor carpi ulnaris sheath, ulnomeniscal homologue, and ulnar collateral ligament.

Researchers from the affiliated hospital to Chengde Medical University conducted a clinical trial comparing the efficacy of treating TFCC with regular physical therapy and regular physical therapy combined with electroacupuncture. The integrated protocol yielded superior patient outcomes in terms of relieving pain, restoring mobility, and promoting quality of life. [1] Learn more about the treatment of wrist pain at acupuncture continuing education online.

Measurement parameters were recorded at T0 (prior to treatment), T1 (one week after treatment), T2 (after three sessions of treatment), and T3 (last treatment). The parameters used were as follows:

  • Visual Analogue Scale (VAS)
  • Modified Mayo Wrist Score (MMWS)
  • Disability of the Arm, Shoulder, Hand (DASH)
  • Patient Reported Wrist Evaluation (PRWE)

At T1, the MMWS score in the integrated treatment group (66.28 ±10.63) was considerably higher than that of the physical therapy group (59.11 ±11.23). This disparity remained evident throughout the treatment process. At T0, the DASH score was 39.22 ±8.12 for the integrated treatment group and 37.35 ±9.67 for the physical therapy group; at T3, the figures dropped to 9.14 ±3.17 and 16.18 ±4.65 respectively, with the integrated group demonstrating a more significant decrease. The PRWE score was also markedly lower in the integrated treatment group at T1 (24.35 ±6.39 ), T2 (16.32 ±5.73), and T3 (14.90 ±5.86) compared to the regular therapy group with scores of 29.17 ±6.26, 22.69 ±5.11, and 19.89 ±5.61.

A total of 168 patients with moderate TFCC injury were admitted into the research study. They were randomized into either a regular physical therapy or a regular physical therapy combined with electroacupuncture group based on their time of admission. There were no statistical distinctions that might have interfered with the experiment results prior to treatment. Inclusion criteria were as follows:

  • History of significant wrist trauma
  • Prolonged and progressive wrist pain
  • Instability and pain observed in distal ulnar radial joints
  • Restricted wrist movement
  • Observed Popping sounds
  • Restricted movement of the forearm and reduced grip strength
  • TFCC injury indicated by MRI imaging

Patients who had undergone surgical procedures to fix wrist injury or who had a history of carpal dislocation, carpal tunnel syndrome, or distal ulnar radius fracture were excluded from the study.

For the regular physical therapy group, the left hand of the patient was fixed while the right arm was straightened and the wrist gently pulled and pushed by a therapist. The same therapist administered the same procedure three times a day for a total of 45 minutes.

For the integrated group, patients received electroacupuncture in addition to the above therapy. Patients took a seated position and acupuncture needles (0.25 mm × 40 mm) were perpendicularly inserted up to a maximum depth of two to three centimeters. The points used were as follows:

  • HT5 (Tongli)
  • HT3 (Shaohai)
  • HT7 (Shenmen)
  • SI5 (Yanggu)
  • TB4 (Yangchi)
  • SI6 (Yanglao)
  • LI5 (Yangxi)
  • BL62 (Shenmai)
  • BL63 (Jinmen)

A point-pressing manipulation was applied to achieve deqi. Upon achieving deqi, a mild reinforcing-attenuating manipulation was employed on all acupoints for at least 30 seconds. Then, an electroacupuncture device was linked to the needle handles. A disperse-dense wave of 2–100 Hz was used, with the intensity set to patients’ individual comfort tolerance levels. The treatment was given daily for 20 minutes, with seven days completing a session. Three sessions were conducted with an interval of three to four days between each session.

The researchers conclude that the addition of electroacupuncture therapy to physical therapy for the treatment of TFCC injuries increases positive patient outcome rates. The combination alleviates pain and promotes mobility.

[1] Zhang Ningning, Zhang Hongyi, He Man, Lu Zenan, Guo Changli, Chen Chao, Wanghuajun, Effects of Electro-acupuncture in Wrist Triangular Fibrocartilage Complex Repair, China Journal Acupuncture and Moxibusion, November 2021,Vol. 10, No. 4.


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