Kunitachi Ozawa Acupuncture Clinic.

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Case Reports

症例報告
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gluteolumbar pain that has not improved for more than 6 months and symptoms of inability to extend knees

gluteolumbar pain that has not improved for more than 6 months and symptoms of inability to extend knees

【male,40s triathlete】

【male,40s triathlete】

main symptoms

since last year, his lower back pain and hip pain have worsened. his knee pain has been increasing and he has been unable to extend his knee. he has tried various treatments such as stretching and osteopathy, but no improvement.

he went to a pain clinic in tokyo and received trigger point block injections. There were no abnormalities in the MRI or other tests.

since it is an injection, it works at the time, but he does not feel that he is improving. he visits the clinic once a week. he wants to participate in triathlon as soon as possible, so he wants to get better, not just maintain the same symptoms. he came to see us for trigger point therapy.

visual observation and palpation

visual observation showed swelling and pigmentation in the lower back, hips, and hamstrings.

on palpation, there was strong tension in the gluteus medius (especially near the iliac crest), gluteus minimus, and hamstrings (especially medial).

treatment

at first, we focused on acupuncture to treat the main complaint of lower back pain and hip pain, using a trigger point approach.

from the 1st treatment, the symptoms were effective, and by the 5th treatment, the symptoms of lower back pain and hip pain were almost gone. however, since the points remained, we treated the hamstrings for the symptom of inability to extend the knee while still approaching the lower back and hips.

by the 8th treatment, the symptoms were noticeably relieved and he started exercising little by little, and was able to run about 10 km lightly.

by the 12th treatment, he was able to participate in triathlon training sessions. however, the symptom of not being able to fully extend his legs did not improve, so we started approaching the gastrocnemius muscle (medial and lateral) as well as the hamstrings.

currently, treatment is ongoing.

Summary

the difference between trigger point injections at a pain clinic and acupuncture trigger point therapy

recently, the word "trigger point" has been heard a lot, but when i started trigger point therapy, it was still a minor treatment method.

nowadays, the term "trigger point" has been picked up by the media and is gaining recognition.

however, in general, trigger point injections are injected in places where the pain is felt. the actual trigger point treatment is to use acupuncture needles with the question, "isn't the cause of the pain in a place other than where the patient said it was?" then, we need to look for the recognition sensation of "there!" (acupuncture needles hitting the target trigger point).

it is a difficult treatment, a treatment that goes beyond the placebo effect, where the patient's symptoms are being relieved while gaining recognition, and at the same time, a difficult treatment. therefore, i am fascinated by it.

there are two types of trigger points: active trigger points, which have subjective symptoms, and latent trigger points, which have not yet caused painful symptoms (but may cause pain in the future) (inhibiting movement).

in addition to treating active trigger points, muscles are also "interlocked". when there are interlocking muscles, it is natural to ask, "why did it become the cause of the pain?" therefore, it is not enough to treat only one point.

in addition, as you can see from the microscopic images, acupuncture needles are made for the specific purpose of stabbing, so there is little tissue damage.

however, the purpose of injection is different. injections are designed to cut and penetrate the tissue, so injecting the same area repeatedly will cause the skin, muscle and other soft tissues to harden, and in some cases, become scarred. if the hardened or scarred area is the boss of the root cause of the pain, it will lead to a worse healing process.

the same is true for pain relief, but if you want to continue to play sports. if you want to improve your performance. if you want to create a pain-free state in a natural way. in such cases, acupuncture trigger point therapy is recommended.
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