BEE VENOM TO TREAT LATERAL EPICONDYLITIS
What Is Lateral Epicondylitis?
Lateral epicondylitis is also known as tennis elbow, which is a painful state of the elbow that arises due to its overuse. It mostly results due to racquet sports like tennis, but that's not it, as some several other activities and sports can lead to this condition.
It takes place due to inflammation, in any of the tendons that are connected with the outer forearm muscles. And it also happens because of a particular motion, repeated again and again at the same angle, which ultimately causes the tendons and muscles of the forearm to become damaged. After some time the elbow becomes tender and painful.
To treat tennis elbow there are several treatment options available. Mostly, physical therapists and primary doctors are involved in the process of rehabilitation. Surgeons are only required in acute cases of lateral epicondylitis.
General Anatomy of the Elbow
Elbow joint consists of three bones: humerus – the upper arm bone and radius and ulna – the two bones of the forearm. At the bottom of humerus, there are a few bony bumps called epicondyles while; the bony bump present on the lateral side of the elbow is known as the lateral epicondyle.
Various muscles, tendons, and ligaments are responsible for holding this elbow joint in one place. Lateral epicondylitis involves various tendons and muscles of the forearm. Our forearm muscles help in extending the wrist and fingers. Forearm tendons are called extensors that attach muscles to the bone and they are attached with lateral epicondyle. ECRB (Extensor Carpi Radialis Brevis) is the main tendon, which is directly involved in lateral epicondylitis.
What are the Causes of Tennis Elbow?
According to the recent studies, it has been revealed that tennis elbow mostly results due to damage lent to a specific muscle of the forearm. Extensor Carpi Radialis Brevis helps in stabilizing the wrist once the elbow is straightened. This happens when a tennis groundstroke is played. With time, ECRB becomes weak and that causes microscopic tears in the tendon and the long run results in pain and inflammation.
ECRB is also at an increased risk of getting damaged, due to its delicate position and role. When the elbow is bent and straightened too much, it causes the muscles to become weak due to constant rubbing against the bony bumps. So we can say that the tendon and muscles both become weak due to the ongoing wear and tear. Let us have a look at different factors that can cause lateral epicondylitis.
Different Activities
You will be surprised to know that there are other people also, apart from active athletes, who can suffer from this condition. Any activity in which forearm muscles are used vigorously and repetitively can lead to tennis elbow.
Carpenters, plumbers, and painters are mostly prone to this condition. Various studies have revealed that butchers, cooks and auto workers also develop symptoms of tennis elbow with time.
Age Factor
According to an observation, it has been found that most of the subjects of tennis elbow are between the age bracket of 30 to 50 years. But anyone can have these symptoms; who are exposed to the risk factors – repeated motion and overuse of the forearm muscles and tendons. Most of the tennis players, which have improper equipment and a poor stroke technique, belonging to any age group can develop this condition.
What are the Symptoms of Lateral Epicondylitis?
Symptoms of this condition do not surface at once, as it develops gradually. Pain begins mildly and slowly gets worse with time. So any sort of pain, observed in this region, must not be neglected. Most common symptoms and signs of tennis elbow are:
A Case Study of 20 Patients with Lateral Epicondylitis of the Elbow by Using Hwachim (Burning Acupuncture Therapy) and Sweet Bee Venom Pharmacopuncture
Abstract
This clinical study was directed to examine the efficiency of Hwachim (burning acupuncture therapy) and S-BV pharmacopuncture (sweet bee venom pharmacopuncture) for treating lateral epicondylitis.
In the beginning, 33 patients, having symptoms of tennis elbow, were selected, but later 13 patients were removed due to unfitting medical records. So a total of 20 patients were treated from January 2012 to December 2013. All of the selected subjects went through Hwachim to treat lateral epicondylitis. And 19 out of the 20 patients were treated with S-BV pharmacopuncture obtained from Korea Pharmacopuncture Institute and TENS (transcutaneous electrical nerve stimulation) – an ancillary treatment. All of the 20 patients were examined through the VAS score (visual analog scale), on their first and last visit, to determine the level of pain experienced by them. Kruskal Wallis test and Wilcoxon rank test were carried out to compare VAS scores through proper statistics.
It was found that the VAS score came down from 10.00 to 4.00 (P=0.000) at the end of this clinical study. There were no prominent changes observed found based on several treatments (P=0.246), location of the lesion (P=0.076), duration of illness (P=0.705) and age of patients (P=0.810). It can be said that S-BV pharmacopuncture and Hwachim treatments are extremely effective for dealing with tennis elbow or lateral epicondylitis.
Introduction
Lateral epicondylitis is one of the most common ailments of the elbow, which has different cardinal symptoms; pain and tenderness while using extensor muscles of the wrist repetitively. It can occur in any person having a minimum age of 12 years and a maximum of 80 years, but most people falling in the age bracket of 30 to 50 years suffer from tennis elbow. As stated above, overuse of the forearm muscles and the elbow joint is the major reason behind lateral epicondylitis.
But in a few cases, like trauma can also lead to any sort of injury to the epicondylar area. It results due to unusual contraction that produces powerful stress on the ECRB. Diagnosis can be done through Cozen's Test, which involves extending the wrist with some sort of resistance and judging the tenderness present in lateral epicondyle.
Local medical clinics make use of focal steroid injections, forearm strengthening exercises, physical therapy, a gypsum cast, anti-inflammatory drugs, restricted movement techniques and even surgery in severe cases of lateral epicondylitis. The procedure differs from one patient to another and there is a lot of debate present, related to the after-effects of surgery and restricted movement. Thus, it is important to choose an appropriate treatment.
In the field of Korean medicine, Hwachim and S-BV Pharmacopuncture are being used to relieve pain by strengthening the ligaments and tendons. Various clinical examinations have revealed impressive results when it comes to using Hwachim and S-BV Pharmacopuncture for tennis elbow. For this study, the medical record of 20 subjects of lateral epicondylitis was thoroughly scrutinized, who received Hwachim and S-BV Pharmacopuncture, to determine the practicality of Hwachim and S-BV Pharmacopuncture.
Method
A list of 33 cases of lateral epicondylitis was acquired from Semyung University Oriental Medicine Hospital, who was treated there for tennis elbow by Hwachim and S-BV Pharmacopuncture from January 2012 to December 2013 at the Department of Acupuncture and Moxibustion Medicine. Only 20 cases were inducted in this research and the remaining 13 cases were omitted due to poor medical records. The selected 20 patients had a very severe pain according to Cozen's Test.
To conduct Hwachim, tender points were sterilized properly with an alcohol swab and after that, an acupuncture needle having a length of 40mm and a diameter of 0.30mm, manufactured by the Dong-Bang Acupuncture, Korea, was inserted in periosteum located near to ECRB point. Besides, acupuncture was applied to LI11 (Gokji) and LI10 (Susamli) according to the symptoms observed. To prevent any sort of burn injuries to the skin, wet gauze was applied to the lateral epicondyle. The needle was then heated with the help of a gas torch placed nearly 1.5cm away from the skin. After this treatment, the acupuncture point was again sterilized with a swab.
To conduct S-BV Pharmacopuncture, a 0.1cc to 0.2cc injection was given at the tenderness point through a 1cc insulin syringe. Only 19 patients, out of 20, were given this treatment as one patient did not want to go through pharmacopuncture treatment. BV supports the immune system, as it delivers anti-fungal, anti-bacterial, neurotoxin effect, and immune cytolysis and anti-inflammation properties. Several clinical studies are present that uphold bee venoms pharmacopuncture benefits for treating epicondylitis.
Physical therapy was given to 19 patients through TENS (transcutaneous electrical nerve stimulator), only one patient did not go through this treatment. TENS is widely used for treating different diseases that lead to pain and is equally effective for chronic neurologic and musculoskeletal pain-causing diseases. Only 4 patients took some herbal medicine also. There was no other type of treatment record found in the patient’s history.
The pain level was examined with the help of VAS (visual analog scale), which is normally adopted to evaluate general pain intensity. With the help of that scale, a patient selects any number from 0 to 10, for indicating the severity of pain experienced. It is one of the simplest and most convenient scales because it is easily understandable by a patient.
SPSS version 12.0K was used to examine data gathered, while the Wilcoxon rank test was made use of for comparing VAS scores – registered before starting the treatment and once the treatment was completed. Kruskal Wallis test helped in determining a fair comparison between VAS scores of patients having different illness durations and different age groups. Significance, for all cases, was documented at P<0.05.
Results
This clinical study comprised 10 women and 10 men, of whom 4 were 61 to 70 years old, 4 were 51 to 60 years old, 10 were 41 to 50 years old and 2 were 31 to 40 years old. According to Choe et al, the duration of illness was divided into 4 different stages, hyperacute (less than 1 week), acute (less than 1 month), sub-acute (less than 6 months) and chronic (greater than 6 months).
In this case, only two patients were found to be in a hyperacute stage, five were in the acute stage, eight were in the sub-acute stage and the remaining five were in the chronic stage. Coincidentally, all of the subjects were right-handed. And 5 of them had pain in their left elbow while the other 15 had pain in their right elbow.
11 patients were given the Hwachim and S-BV Pharmacopuncture 5 times, 5 patients were given Hwachim and S-BV Pharmacopuncture for 10 times and the remaining 4 were given Hwachim and S-BV Pharmacopuncture for more than 10 times, during their initial visit. VAS score was examined during their second visit. It was found that the average had gone down from 10.00 to 4.00 once the treatment was completed.
A comparison of VAS scores was carried out according to the number of treatments given: in the 11 patients the score had gone down from 10.00 to 4.27 after 5 treatments, in 5 patients the score had gone down from 10.00 to 5.00 after 10 treatments and in the remaining 4 patients the score went down from 10.00 to 2.00 after more than 10 treatments.
Conclusion
In the end, we can say that the combined effect of Hwachim and S-BV Pharmacopuncture therapy in the 20 subjects of lateral epicondylitis was quite noticeable as the VAS score on average decreased from 10.00 to 4.00 (P=0.000). However, there was no statistically noticeable difference recorded in the aftermath of the therapy based on the frequency of treatments given (P=0.246) duration of illness (P=0.705), location of pain (P=0.076) and age (P=0.810). Thus, this study proves that a cumulative treatment of Hwachim and S-BV Pharmacopuncture is quite effective for dealing with lateral epicondylitis.
Source: A Case Study of 20 Patients with Lateral Epicondylitis...Hwachim (Burning Acupuncture Therapy) and Sweet Bee Venom Pharmacopuncture
Lateral epicondylitis is also known as tennis elbow, which is a painful state of the elbow that arises due to its overuse. It mostly results due to racquet sports like tennis, but that's not it, as some several other activities and sports can lead to this condition.
It takes place due to inflammation, in any of the tendons that are connected with the outer forearm muscles. And it also happens because of a particular motion, repeated again and again at the same angle, which ultimately causes the tendons and muscles of the forearm to become damaged. After some time the elbow becomes tender and painful.
To treat tennis elbow there are several treatment options available. Mostly, physical therapists and primary doctors are involved in the process of rehabilitation. Surgeons are only required in acute cases of lateral epicondylitis.
General Anatomy of the Elbow
Elbow joint consists of three bones: humerus – the upper arm bone and radius and ulna – the two bones of the forearm. At the bottom of humerus, there are a few bony bumps called epicondyles while; the bony bump present on the lateral side of the elbow is known as the lateral epicondyle.
Various muscles, tendons, and ligaments are responsible for holding this elbow joint in one place. Lateral epicondylitis involves various tendons and muscles of the forearm. Our forearm muscles help in extending the wrist and fingers. Forearm tendons are called extensors that attach muscles to the bone and they are attached with lateral epicondyle. ECRB (Extensor Carpi Radialis Brevis) is the main tendon, which is directly involved in lateral epicondylitis.
What are the Causes of Tennis Elbow?
According to the recent studies, it has been revealed that tennis elbow mostly results due to damage lent to a specific muscle of the forearm. Extensor Carpi Radialis Brevis helps in stabilizing the wrist once the elbow is straightened. This happens when a tennis groundstroke is played. With time, ECRB becomes weak and that causes microscopic tears in the tendon and the long run results in pain and inflammation.
ECRB is also at an increased risk of getting damaged, due to its delicate position and role. When the elbow is bent and straightened too much, it causes the muscles to become weak due to constant rubbing against the bony bumps. So we can say that the tendon and muscles both become weak due to the ongoing wear and tear. Let us have a look at different factors that can cause lateral epicondylitis.
Different Activities
You will be surprised to know that there are other people also, apart from active athletes, who can suffer from this condition. Any activity in which forearm muscles are used vigorously and repetitively can lead to tennis elbow.
Carpenters, plumbers, and painters are mostly prone to this condition. Various studies have revealed that butchers, cooks and auto workers also develop symptoms of tennis elbow with time.
Age Factor
According to an observation, it has been found that most of the subjects of tennis elbow are between the age bracket of 30 to 50 years. But anyone can have these symptoms; who are exposed to the risk factors – repeated motion and overuse of the forearm muscles and tendons. Most of the tennis players, which have improper equipment and a poor stroke technique, belonging to any age group can develop this condition.
What are the Symptoms of Lateral Epicondylitis?
Symptoms of this condition do not surface at once, as it develops gradually. Pain begins mildly and slowly gets worse with time. So any sort of pain, observed in this region, must not be neglected. Most common symptoms and signs of tennis elbow are:
- Burning or pain in the outer elbow
- Tenderness present on the outside of the elbow
- Persistent aching and morning stiffness
- A weak grip strength
- Soreness in the outer forearm muscles
- Pain in the outer elbow gets worse while holding an object.
A Case Study of 20 Patients with Lateral Epicondylitis of the Elbow by Using Hwachim (Burning Acupuncture Therapy) and Sweet Bee Venom Pharmacopuncture
Abstract
This clinical study was directed to examine the efficiency of Hwachim (burning acupuncture therapy) and S-BV pharmacopuncture (sweet bee venom pharmacopuncture) for treating lateral epicondylitis.
In the beginning, 33 patients, having symptoms of tennis elbow, were selected, but later 13 patients were removed due to unfitting medical records. So a total of 20 patients were treated from January 2012 to December 2013. All of the selected subjects went through Hwachim to treat lateral epicondylitis. And 19 out of the 20 patients were treated with S-BV pharmacopuncture obtained from Korea Pharmacopuncture Institute and TENS (transcutaneous electrical nerve stimulation) – an ancillary treatment. All of the 20 patients were examined through the VAS score (visual analog scale), on their first and last visit, to determine the level of pain experienced by them. Kruskal Wallis test and Wilcoxon rank test were carried out to compare VAS scores through proper statistics.
It was found that the VAS score came down from 10.00 to 4.00 (P=0.000) at the end of this clinical study. There were no prominent changes observed found based on several treatments (P=0.246), location of the lesion (P=0.076), duration of illness (P=0.705) and age of patients (P=0.810). It can be said that S-BV pharmacopuncture and Hwachim treatments are extremely effective for dealing with tennis elbow or lateral epicondylitis.
Introduction
Lateral epicondylitis is one of the most common ailments of the elbow, which has different cardinal symptoms; pain and tenderness while using extensor muscles of the wrist repetitively. It can occur in any person having a minimum age of 12 years and a maximum of 80 years, but most people falling in the age bracket of 30 to 50 years suffer from tennis elbow. As stated above, overuse of the forearm muscles and the elbow joint is the major reason behind lateral epicondylitis.
But in a few cases, like trauma can also lead to any sort of injury to the epicondylar area. It results due to unusual contraction that produces powerful stress on the ECRB. Diagnosis can be done through Cozen's Test, which involves extending the wrist with some sort of resistance and judging the tenderness present in lateral epicondyle.
Local medical clinics make use of focal steroid injections, forearm strengthening exercises, physical therapy, a gypsum cast, anti-inflammatory drugs, restricted movement techniques and even surgery in severe cases of lateral epicondylitis. The procedure differs from one patient to another and there is a lot of debate present, related to the after-effects of surgery and restricted movement. Thus, it is important to choose an appropriate treatment.
In the field of Korean medicine, Hwachim and S-BV Pharmacopuncture are being used to relieve pain by strengthening the ligaments and tendons. Various clinical examinations have revealed impressive results when it comes to using Hwachim and S-BV Pharmacopuncture for tennis elbow. For this study, the medical record of 20 subjects of lateral epicondylitis was thoroughly scrutinized, who received Hwachim and S-BV Pharmacopuncture, to determine the practicality of Hwachim and S-BV Pharmacopuncture.
Method
A list of 33 cases of lateral epicondylitis was acquired from Semyung University Oriental Medicine Hospital, who was treated there for tennis elbow by Hwachim and S-BV Pharmacopuncture from January 2012 to December 2013 at the Department of Acupuncture and Moxibustion Medicine. Only 20 cases were inducted in this research and the remaining 13 cases were omitted due to poor medical records. The selected 20 patients had a very severe pain according to Cozen's Test.
To conduct Hwachim, tender points were sterilized properly with an alcohol swab and after that, an acupuncture needle having a length of 40mm and a diameter of 0.30mm, manufactured by the Dong-Bang Acupuncture, Korea, was inserted in periosteum located near to ECRB point. Besides, acupuncture was applied to LI11 (Gokji) and LI10 (Susamli) according to the symptoms observed. To prevent any sort of burn injuries to the skin, wet gauze was applied to the lateral epicondyle. The needle was then heated with the help of a gas torch placed nearly 1.5cm away from the skin. After this treatment, the acupuncture point was again sterilized with a swab.
To conduct S-BV Pharmacopuncture, a 0.1cc to 0.2cc injection was given at the tenderness point through a 1cc insulin syringe. Only 19 patients, out of 20, were given this treatment as one patient did not want to go through pharmacopuncture treatment. BV supports the immune system, as it delivers anti-fungal, anti-bacterial, neurotoxin effect, and immune cytolysis and anti-inflammation properties. Several clinical studies are present that uphold bee venoms pharmacopuncture benefits for treating epicondylitis.
Physical therapy was given to 19 patients through TENS (transcutaneous electrical nerve stimulator), only one patient did not go through this treatment. TENS is widely used for treating different diseases that lead to pain and is equally effective for chronic neurologic and musculoskeletal pain-causing diseases. Only 4 patients took some herbal medicine also. There was no other type of treatment record found in the patient’s history.
The pain level was examined with the help of VAS (visual analog scale), which is normally adopted to evaluate general pain intensity. With the help of that scale, a patient selects any number from 0 to 10, for indicating the severity of pain experienced. It is one of the simplest and most convenient scales because it is easily understandable by a patient.
SPSS version 12.0K was used to examine data gathered, while the Wilcoxon rank test was made use of for comparing VAS scores – registered before starting the treatment and once the treatment was completed. Kruskal Wallis test helped in determining a fair comparison between VAS scores of patients having different illness durations and different age groups. Significance, for all cases, was documented at P<0.05.
Results
This clinical study comprised 10 women and 10 men, of whom 4 were 61 to 70 years old, 4 were 51 to 60 years old, 10 were 41 to 50 years old and 2 were 31 to 40 years old. According to Choe et al, the duration of illness was divided into 4 different stages, hyperacute (less than 1 week), acute (less than 1 month), sub-acute (less than 6 months) and chronic (greater than 6 months).
In this case, only two patients were found to be in a hyperacute stage, five were in the acute stage, eight were in the sub-acute stage and the remaining five were in the chronic stage. Coincidentally, all of the subjects were right-handed. And 5 of them had pain in their left elbow while the other 15 had pain in their right elbow.
11 patients were given the Hwachim and S-BV Pharmacopuncture 5 times, 5 patients were given Hwachim and S-BV Pharmacopuncture for 10 times and the remaining 4 were given Hwachim and S-BV Pharmacopuncture for more than 10 times, during their initial visit. VAS score was examined during their second visit. It was found that the average had gone down from 10.00 to 4.00 once the treatment was completed.
A comparison of VAS scores was carried out according to the number of treatments given: in the 11 patients the score had gone down from 10.00 to 4.27 after 5 treatments, in 5 patients the score had gone down from 10.00 to 5.00 after 10 treatments and in the remaining 4 patients the score went down from 10.00 to 2.00 after more than 10 treatments.
Conclusion
In the end, we can say that the combined effect of Hwachim and S-BV Pharmacopuncture therapy in the 20 subjects of lateral epicondylitis was quite noticeable as the VAS score on average decreased from 10.00 to 4.00 (P=0.000). However, there was no statistically noticeable difference recorded in the aftermath of the therapy based on the frequency of treatments given (P=0.246) duration of illness (P=0.705), location of pain (P=0.076) and age (P=0.810). Thus, this study proves that a cumulative treatment of Hwachim and S-BV Pharmacopuncture is quite effective for dealing with lateral epicondylitis.
Source: A Case Study of 20 Patients with Lateral Epicondylitis...Hwachim (Burning Acupuncture Therapy) and Sweet Bee Venom Pharmacopuncture