Acupuncture for Elbow Pain
Tennis elbow refers to pain on or around the outside of the elbow joint, usually due to damage of the tendon which connects the extensor muscles of the forearm to the humerus (upper arm bone). This can be caused by a single traumatic event, but is more usually due to repetitive over-use of the muscles. Playing tennis a lot if you are not used to it can lead to tennis elbow, but it may also arise from other causes such as using a computer mouse a lot. Conventional treatment for tennis elbow may involve anti-inflammatory medications, physiotherapy, and steroid injections. Resting the arm from the activity which has given rise to the problem is an important part of the recovery process.
Golfer’s elbow is a similar condition, except that the pain is on the inside of the elbow and the muscles/tendons involved are the flexors.
Elbow Pain and TCM
Pain arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of elbow pain, the obstruction is in one or more of the meridians which flow down the arm from the shoulder through the elbow joint to the hand. Different meridians are involved for tennis elbow and golfer’s elbow. Treatment involves freeing up that flow, usually involving acupuncture treatment on the elbow and further down the meridians on the forearm or hand. However, it is also important to understand why the Qi is getting stuck at the elbow, and from the perspective of TCM there are several possible causes of this.
i) A single traumatic injury to the area will have temporarily damaged the meridians and blocked the flow of Qi. This is the most straightforward case and unless the injury is particularly severe a few treatments will usually be enough to substantially reduce the pain if not eradicate it completely.
ii) Sometimes the Qi is blocked at the elbow due to what in TCM is called a pathogenic factor obstructing the flow. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels at the elbow and as it were ‘frozen’ the Qi there. In this case as well as moving the Qi with acupuncture, we will want to warm the meridians, perhaps using moxibustion and warming topical applications such as Tiger Balm.
iii) If the problem is due to repetitive strain, this may have weakened the Qi locally. Treatment here will involve a balance between strengthening the Qi and getting it to move.
iv) The problem at the elbow may arise partly because of problems further up the meridians in the neck and shoulder. When you first come to treatment, we will check these areas as well as the elbow, and if necessary treat any problems in the meridians in these areas as well as the elbow.
v) We will also check for any underlying or systemic weakness which may have made you more susceptible to injury or slower to heal. This is especially relevant for repeated or chronic injury. For example, recurring elbow problems may suggest that the muscles and tendons are not getting the nourishment they need to sustain the level of activity required, and this in turn might reflect (to take one possibility among many) an impairment of the digestive system. TCM practitioners are quick to recognise such a weakness and will use acupuncture, herbal medicine, or other modalities to help to restore the affected system to optimum functionality.
Is Acupuncture Helpful in the treatment of Elbow Pain?
A survey of Randomised Control Trials for acupuncture treatment of tennis elbow 1 concluded that there is strong evidence for acupuncture’s effectiveness, and the World Health Organisation 2 considers that the efficacy of acupuncture for this condition is proven.
1 Trinh el al (2004) Acupuncture for the Alleviation of Lateral Epicondyle Pain: a Systematic Review Rheumatology 43 (9)
2 WHO (2002): Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials