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Arm and Hand Edema


#1

Submitted By: espintl

  • The swelling is all around the arm and on the hand, most of the dorsum of the hand. Obviously this is a problem with the lymphatic system.The pressure leaves marks on the skin of the dorsum of the hand, i.e. a pitting Yin edema, while it does not on the arm, i.e. non-pitting Yang edema. This appears a local problem and not systemic.
    What do you think about the following treament?
  • Li-4/ 11/ 15 - distal direction
    P-6/ P-5 - proximal direction
    All on the affected side by strong dispersion.
    Sp-6/ Sp-9/ Ren-10 = dispersion, possibly warm needling on Ren-10.
  • Any other ideas?

#2


What is the patients diagnosis overall? The points more or less seem ok. Personally, I would first want to know why they are having edema. This is important because it can be an early sign of more complicated medical conditions. Chinese Medicine, properly used, is very good at finding these tendencies before they turn into something serious. In other words, edema for no reason whatsoever is somewhat rare, so I generally take the diagnostic aspect very seriously. Based on what I find, I would most likely treat more systemically in the sense that it is either inflammatory/immune based or circulatory. I would probably be doing more points in the neck and upper back where the nerves begin to innervate the arms/hands (and they happen to be the same points you use to regulate immune activity), but that is simply our style of treatment. What are you are proposing seems fine so long as you are not needling directly into the edemic areas.


#3


Put hand and arm above heart level high, to make the blood circle easily back to body when needling.


#5


Massage did not help, holidng the arm high likewise. This is obviously a case of too much respective too little energy, an imbalance in Yin and Yang in the arm channels possibly aggravated by weakness in kidney and spleen. Supplying points on the dorsum of the hand helped to diminish the swelling. The sedation of the points on pericardium and large intestine also made the arm less taut.



I wonder if anyone had a patient with similar problem and successfully treated it. Experience is the best master.


#6


I imagine most acupuncturists have treated all kinds of edema, it&#39s a common case and generally resolves well. If you can answer my initial questions to you, I&#39d be happy to offer some opinions but what you&#39ve offered already is not all that helpful. And what do you mean by massage "did not help" - like you tried it once and everything didn&#39t go away, you did it 3x/day for 5 days and there was absolutely no change.... If you want help us from you will have to be quite a bit more specific about what you are doing, for how long, and what it is exactly you are trying to treat (i.e. the cause). For me personally, I would like an idea of what the cause is in medical terms not in vague terms like the yin and yang are not balanced... Even as an acupuncturist that is not a clinically relevant statement.


#7


As I understand Yin and Yang are the beginning and end of all things and as far as I understand anything can be analysed in those terms. All the other terminology is simply an addition to the basics. After all, heat and cold, excess and vacuity, etc. are only manifestation of Yin and Yang. As the "Plain Questions” points out "The excess of Yin leads to disorders of Yang, and the excess of Yang leads disorders of Yin." Obviously, this is where I have started. When I said that massage or holding the arm up did not work it means that it has been done for a few months already, after all this is the most basic things you try with edema. Also exercising of the arm has been done including Tai chi with very little improvement.






#8


The other way of TCM is "heat steam", wear glove and use heat lamp 80-100 c help sweating on hand. and you need diagnosis the true reason cause the edema, from heart or from kidney, or just local edema. then you can find a new way to do the treatment.


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