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Post Herpetic Neuralgia treatment?


#1

Wondering if anyone has experience with Post Herpetic Neuralgia? Upon a cursory internet search, it seems that hua tuo points and bleeding ah shi points can be utilized.

Patient is 82 yrs old.
Pulse:
Wiry Liver position.
Slippery and Tight Spleen and Lung.
Remarkably strong Kidney pulses for his age.

Tongue: Red HT/LU areas, constrained sides. Dry, thick yellowish coating.

Pain is worse at night when laying down. Can’t sleep because of it. Sometimes experiences pins and needles or pain during the day. Experiences itching as well, but the pain is more prominent. Pain is localized to a dime shaped area on inferior angle of scapula (most intense pain is here) and usually surrounds it a few inches on every side. Sometimes pain spreads to ribs under the axilla and the front of chest.

I am a student practicing at a student clinic, so any insight would be greatly appreciated.


#2

With active shingles, I find huatuo points and cupping with bloodletting the most effective in the vast majority of cases. With the lingering affects huatuo points and tuina (in the huatuo area and out a bit towards the area - but no on the area) is the most ideal. Bloodletting could be applied as well, but, again, I usually only see that helpful in active shingles - but if I didn’t start seeing results in 3-5 treatments I might add it in. This should respond very well. I’ve done lots of cases of shingles and some folks with the lingering neuralgia (some having up over 10 years) and they all come along really well.

So a treatment from our approach with your patient might be LV 8, LU7, KD 6, UB 40, GV 19, GB 20, and then the huatuo of T1 (bone marrow), T2 (thymus), T3 (lung/lymph) (t1,2 and 3 aid the immune system), T4 (breast/sweat gland and local), T5 (heart and local) and T7 (blood and local) and T9 (liver).


#3

I appreciate the response Chad. I will utilize the Hua tuo points next time.

Would you be willing to explain the rationale for use of the other points (LR8, LU7 etc.)? Are these more to balance/treat the patient’s underlying condition (qi constraint, damp-heat, yin xu) or are they connecting with the areas of pain in some way?

thanks!


#4

Both really, but LU 7 and KD 6 also an extraordinary vessel pairing (yin qiao mai) good for balancing the yin overall but also clearing heat and congestion from the chest area generally. I have a preference for ev pairings with huatuo points in our system. Then LV 8 is a good point for the yin of the body as well, but also draws heat from the lower part of the body and clears it (so the fire that may be rising to the chest and the itching).


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