Ask an expert - muscles and bones - arm

19 questions

Q  My son is 14 and dislocated his elbow last summer since then he has been unable to straighten his arm completely.  He recently had an operation to remove excess tissue from his elbow joint and came out of the op with a straight arm.   However,  since then his arm has shortened again.  He is doing the exercises that his physio has given him but i wondered if there was anything else we could do to help this.

A:  This is a rather difficult question to answer without slightly more information about the exact nature of the dislocation, and the physio's assessment of what may need to be done to restore greater mobility in the joint. Our understanding is that most people suffer a 5-15 degree loss of extension even when the dislocation heals well, so one has to be cautious about chasing rainbows.
 
If the loss of extension is a result if irreversible physical damage to the ligaments and tendons there may be little hope of using acupuncture treatment to good effect. The majority of problems seem to arise, however, when the joint is immobilised, and the consolidation and stiffening of tissue is something for which acupuncture treatment may be beneficial. Chinese medicine is based on an entirely different understanding of the body, mind and emotions based on the concept of 'qi', a form of energy whose flow and balance determine how healthy someone is and to which treatment is directed in order to restore balance when this has been lost. Although the majority of Chinese medicine and acupuncture treatments are systemic, the same logic applies to physical injuries and the process of recovery. The flow of Qi is blocked or derailed by an injury, and restoring the proper flow in an area should, in theory, help to restore the full range of movement. If this local treatment is supported by systemic treatment aimed at helping the whole body to repair better, then this may make the results more sustainable.
 
The best advice that we can give you is to visit a BAcC member local to you and ask them to offer a slightly more focused view based on a brief face to face assessment of the problem. We are confident that they will give you an honest appraisal of what may be possible and if they feel it is not within their scope of practice they may well have other useful suggestions about what may be of benefit. Many BAcC members use techniques such as moxibustion, a warming herb used to encourage recovery, and tui na, a form of massage, both of which can be helpful in promoting a flow of qi where this has been compromised.  
 

 

 

Q:  Does accupuncture relieve sharp pain in the upper left arm of an elderly woman? The pain moves from the upper left arm to the top area of the back.

 

A:  An acupuncture practitioner would need to ask a great many more questions before venturing a view. Amongst the more obvious ones would be how frequently the pain occurs, what kinds of movement trigger the pain, what has been found to help with the pain (heat, cold, pressure, etc etc), whether there are certain times a day when it is at its worst, whether it makes sleeping difficult, in short, all of the sorts of questions any competent medical professional would ask.
 
However, traditional chinese acupuncture is based on theories which sound slightly alien to the western ear, involving as they do concepts of energy, or 'qi' as it is called, and its correct balance and flow throughout the body, and an understanding of the Organs of the body in an entirely different way as a group of inter-related functions. Working within this 2500-year old system the practitioner will first want to establish whether this is a local problem, a simple musculo-skeletal problem which may respond directly to a fairly direct approach, or whether this is part of a wider pattern of imbalance. The practitioner will also be careful to assess in western medical terms whether there is something which might require an urgent or non-urgent referral to a conventional doctor. Most sharp pains are relatively benign and caused by msuculo-skeletal problems, but occasionally they can be a warning sign of something whihc requires further investigation.
 
We would advise you to visit a BAcC member and seek a brief face to face assessment of the problem in order to find out whether or not it is amenable to treatment. Most problems of this kind are usually benefited by acupuncture treatment, and they are the most frequent category treated, according to a recently pubished survey
 
http://bmjopen.bmj.com/content/2/1/e000456.full
 
but each person's case is unique and different, and an individual assessment would always be essential. 

Q. My Father has a bulging disc in his neck which is pushing against his nerve, which in turn causes him pain down his shoulder and arm when the weather is cold. It's caused his arm to be extremely weak.

 

 

Tests have proven nothing wrong with his nerves but its a few discs which are pushing against the nerve causing the problem. Doctors have suggested surgery to replace the discs.

 

I was wondering if Acupunture is a feasible alternative to surgery? Can you please advise?

 

A. This is a very difficult question to answer. Generally speaking, when there is a physical change in the structure of the body, it would be foolish to suggest without qualification that acupuncture can correct it. The neck, in particular, is an area where structural changes through wear and tear as someone gets older are very difficult to treat. That said, acupuncture may be able to reduce to an extent any inflammation which is associated with the bulging disc.

In the case of sciatica, for example, which is sometimes caused by a similar problem in the lower spine, there is some evidence that acupuncture may reduce inflammation, as we point out in our fact sheet here

 

However, it is quite likely, if the doctors are proposing surgery, that things have gone a bit further, and the structural changes may well continue to cause inflammation, even if acupuncture treatment provided some relief in the short term. It would probably not be wise, therefore, to consider acupuncture as an alternative to surgery.

Chinese medicine treats the person, not the disease, however, and regards each person's patterns of energy as unique and different. There may be some merit in seeking advice from one of our members tocal to you who can perhaps see your father and assess whether in his case there is greater reason to feel that acupuncture may provide positive help.

A great deal depends on how the problem is being generated. It usually manifests in a pinching of one of the nerve roots in the neck, and if the cause is physical and of this nature, then acupuncture will have little long term effect, although it may be of value in bringing some form of temporary relief. If the pain is not arising as a result of pressure at the nerve root, there may be more hope

 

 

One of the strengths of acupuncture and Chinese medicine is the different understanding of the physiology and pathology of the body. This often allows it to make sense of a symptom or a group of symptoms in ways which are different from western medicine, because whatever system of medicine one employs, the patient's account of what they feel and the visible signs are the same. Chinese medicine has developed over 2000 years with a system of its own for classifying pain and discomfort by location, strength, heat or cold nature, how it feels - sharp, dull, etc, and has a number of ways of making sense of symptoms like yours which may help to reduce the level fo discomfort you are feeling.

 

The best course of action is to see if one of our members local to you is happy to spare you a little time without charge to assess briefly whether your specific problem is one which they feel they may be able to help.

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