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Remark: the tennis-elbow condition seems completely lost in this abundance of causes, but still is the most frequent and the most typical.
Most of the time the patient has already undergone several treatments:
1. Anti-inflammatories: - pills, tablets, creams, sprays.
Résultats: negative, or don’t last for long.
2. Infiltrations of local anesthetics + cortisone:
Résultats: - Complete cure
- The pain comes back after a while → several infiltrations (with the danger of its secondary effects, not frequent but must not be neglected!)
- Negative: The infiltration was not correctly done?
Physiotherapy:
Résultats: - slight improvement.
- negative or worse!
4. Plaster cast during six weeks: as a last resort before the next choice.
5. Surgery: can sometimes be very successful; The surgeon displaces the insertion of the tendon to an area which is not irritated by a former mini-trauma.
6. Elbow bandage
7. Technique of the “hook”, done by physios. Sometimes efficient, although it can be quite painful…
8. BUT it happens that you get a “virgin” patient?, and by “virgin” I don’t mean what you are thinking, just a patient who is “virgin” of any kind of treatment. Let me have some fun from time to time, and I often tell the story to the patient,…who smiles.
9. BUT then you have to make a diagnose of epicondylitis. It is easy.
Bend his elbow at an angle of 45° (more or less, you are not going to use a compass!). Hold the elbow joint in your left hand, and use your right index to hit (not too strong because he is not going to like you, and not too light because you might miss the result). Normally the patient will jump and sometimes yelp (discreetly), and he will be impressed by your knowledge of the exact spot where he has pain. After a few dozen experiences, it would be sad if you didn’t know it yet.
Hold his wrist with your left hand, slip it towards the back of the hand, ask him to bent it and grip it strongly, then ask him to try to straighten his wrist. The result will be another yelp, and some more admiration for your such precise knowledge. Of course he doesn’t understand the obvious muscle and movement stuff. Don’t try to explain. He is more interested in the fact that you have created the pain so quickly and so easily, and he will usually not really understand the movement mechanics. So why bother.
I forgot to use the simple expression: resisted extension of the wrist; Sorry, but it is every now and then interesting (for you as well as for you patient) to dissect (not an anatomical dissection! Phewww, the dangers of English writing), I mean to dissect the movements in details.
10. What to do in acupuncture? The rule, the rule, the rule!!!
1. Spot the Channel’s) involveds :
2. Insert needles in local and/or regional and/or distant points:
3. Search for painful point other than Channel points.
Pain:
- Spontaneous.
- By pressure or percussion (A Shi Points?)
- These points (or little zones) can be found:
- In the mass of the muscle.
- Between two muscles.
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