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Writer's cramp


#1

Patient History

  1. Patient is suffering from Writer's Cramp since 2007 in right hand.
  2. Patient used to have severe headace and stiff neck from 2006 but it was cured in 2012
  3. Patient faces problem while typing, using spoon, eating food and writing.
  4. patient is going acupuncture treatment since sept 2013 but the progress is very slow.
  5. patient had a very stress oriented life

Current condition

  1. during the course of the treatment typing has become easy
  2. still while using spoon and eating food, stiffness and twisting kicks in
  3. writing is still 'none' but during the course , it has been seen that sometimes the writing is restored but it again deteriorates within days
  4. for the last 2 days started working on PC8

Need suggestions !!


#2

First what is your overall diagnosis, with supporting signs (tongue, pulse, etc.)? Second, when you say "patient is going acupuncture treatment since sept 2013 but the progress is very slow." - what exactly are you doing? What points used (exactly)? treatment frequency? Any other therapies, cupping? tuina?

In general, what I can tell you is that hand problems come from the neck - maybe not 100% from there but the entire line from the neck, through the shoulder and into the hand has to be worked on. Needling locally will do very little in my opinion - very little that will last anyhow.


#3

<ol>
<li>from Sep to Nov 13, the patient was undergoing a daily session (1 session = 20 minutes of electro stimulation)</li>
<li>from Dec 13 onwards, he is undergoing two sessions a day (morning and evening)</li>
<li>primary diagnosis has shown following : hyperactivity; stress oriented life; sleep pattern very irregular; fire and heat excess; lack of apetite; pimples; weak eye-sight; dermatographia (started after some time of writers cramp); few skin cysts (in arms and thighs; these also atarted appearing after writers cramp); when the patient tries to write with the left hand, reflexes (jerks) come in right hand, these start from the right hand thumb and if he continues to write they progress involving writst and then elbow</li>
<li>as i earlier told that, writers cramp problemdeveloped after 1 and a half yrs of stiff neck, pain and headache, although neck problem is now cured</li>
</ol>

Point that have been used

<ol>
<li>Ear: shenmen and heart (regularly using sticker needle); fingers (occasionally)</li>
<li>Neck: UB channel (UB 11 most frequently)</li>
<li>Hand: Lu, Li, PC, Triple Warmer channels (different points on these channels)</li>
<li>GB34</li>
<li>Scalp: DU 20 (very occasionally)</li>
</ol>


#4

Here are some ideas that may help (Only in addtion to what you feel is important for your patient is done)

1) trace the arm meridians of the affected side - look for skin changes, nodules, tenstion, etc. Then apply acupuncture or TuiNa techniques that you feel comfortable with to bring balance in the affected area. I would not underestimate the Ashi points.

2) As Chad has mentioned, neck is often a major player. Huatuo points, meridian pathways need be checked and cleared. You said the patieint&#39s neck problem has been cured. But in many cases the patient may be pain free, not problem free. Gentle Tui Na near ST 11/12 area may reveal some information - affected side vs normal.

3) From the description of your patient, anywhere from T1-7 area may have sizeable knots. Small but significant number of patients may get arm/hand issues from those areas. Check the Huatuo points and points nearby such as GB21, SI13, BL41-45.

4) This type of issue may involve brain plasticity. Refer to this book and you may find useful information how to approach this case: See Chapter 22. http://books.google.com/books?... scalp acupuncture may prove useful.

5) This is just my personal opinion. Perhaps giving some more time between the treatments may help - given you feel you found a sound treatment stragety. Often patient needs to bring major changes in their lifestyle in combination with our treatments - otherwise the progress in this particular case may be too slow or you may be giving only temporary relief. Meditations, walking in the woods, tai chi or yoga... probably essential thing for a very stressed patient.

Good luck!


#5

hey everybody. it has been long time, since i posted first. thanks for your replies.

here i am posting a good news.

the patient has recovered significantly. his problems with eating, holding spoon, typing have disappeared. he has started writing. writing 300-400 words in one go. then he has to take break due to muscle fatigue. feels very tired. but we are working on that.

the recovery is stable.

since the last post. i tried some innovations. with ususal electro stimulation and needles. i used "sticker needles which are used for auricular acupuncture" at regular points. i put a sticker needle at this and volla !!!!!

for this patient, Li5 is was the most problematic point (which we figured out during the treatment). except this, Si4, Si3, Pc7, Pc8 and Lu10 are regularly used for electro.

hope the guy recovers fully.

may the god bless him.


#6

the guy has cyst type structure in the hand affected with writers cramp which appear like swollen lymphnodes. they are at tw7 + tw9 + si8. could they be hindering in recovering?

whats the way to dissolve them?

although he has these structures of varying sizes at many places in body.


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