Musculoskeletal injuries of the extremities are highly prevalent and place a significant burden on the society as well as the healthcare system. In particular, upper extremity musculoskeletal injuries are the leading cause of disabling work-related injuries in USA and Canada. In 2013, upper extremity "sprain" and "strain" type injuries accounted for 22.3% of all lost time to the Ontario Workplace Safety and Insurance Board. Acupuncture is commonly utilised to treat musculoskeletal injuries of the extremities. Its scientific credibility is still scrutinised in orthodox medicine, consequently, translation of acupuncture into clinical practice is limited. However, physiotherapists in particular continue to utilise acupuncture as an adjunct treatment and have been for the past 40 years.
Acupuncture Points of the Upper Limb
Location & Use
Pericardium Meridian
The pericardium channel consists of nine acupuncture points. The channel originates from the chest lateral to the nipple and travels upwards to the axillary fossa. It then descends down the anterio-medial aspect of the arm to the cubital fossa and continues between Palmaris Longus and Flexor Carpi Radialis. The channel terminates at the tip of the third digit.
Used as an antiemetic point especially during pregnancy and post-operative pain.
Heart Meridian
The Heart Meridian consists of nine acupuncture points. The channel originates from the centre of the axilla and descends through the anterio-medial aspect of the arm to the pisaform region, terminating at the tip of the little finger.
Used for forearm/hand paresthesia and pain, tremors, elbow injuries and neck stiffness.
Lung Meridian
The Lung Meridian consists of eleven acupuncture points. The channel originates on the lateral chest and descends through the anterio-medial region of the upper arm. It crosses over to the lateral aspect of the arm at the cubital fossa and continues to the radial side of the wrist, terminating at the tip of the thumb.
Used for facial paralysis, jaw pain, elbow, shoulder and thoracic injuries and local soft tissue injuries of the wrist.
Triple Energiser/Burner
The triple energiser/triple burner consists of 23 acupuncture points. The channel originates from tip of the ring finger and ascends through the posterior aspect of the arm until it reaches the shoulder. It terminates at the outer end of the eyebrow.
Used for facial pain, cervical spine and shoulder restricted range of motion, shoulder arthritis and arm/elbow pain.
Small Intestine
This channel consists of 19 acupuncture points. It originates at the tip of the 5th digit and ascends along the ulnar border to the scapula. Here it zig zags across the scapula and terminates at the anterior aspect of the ear.
Used for motor function impairment of the arm, lumbar/cervical spine pain or stiffness, arm pain or weakness
Large Intestine
This Meridian consists of 20 acupuncture points. It originates at the tip of the 2nd digit and ascends along the lateral aspect of the arm to the tip of the shoulder. It continues travelling upwards to terminate at the opposite side of the face.
Used during difficult labour, arm pain, headaches and facial paralysis, motor function impairment of the upper limb.
Common conditions treated
Frozen Shoulder
Although there is limited evidence on traditional acupuncture and frozen shoulder, The evidence available suggests that acupuncture or electro-acupuncture in combination with physiotherapy or alone may be effective in improving function and joint range of motion and reducing pain in patients with frozen shoulder/adhesive capsulitis when compared to physiotherapy alone.
The average number of treatments consisted of 4-10 sessions over 4-7 weeks. Duration of treatments varied between 15-30 minutes.
Lateral Epicondylalgia
Low to moderate quality of evidence suggests traditional acupuncture provides short term reductions in pain and improvements in function and strength, compared to sham/placebo and ultrasound.[3]
The average number of treatments consisted of 10 sessions over 2-6 weeks. Duration of treatments varied between 20-30 minutes.
Carpal Tunnel Syndrome
In patients with mild to moderate Carpal Tunnel Syndrome, short term acupuncture treatment over four weeks was reported as effective as short-term low dose steroid. Therefore, it was concluded as an safe alternate choice of treatment for patients who are unable to tolerate oral steroid medications.
Post-operative nausea and vomiting
Stimulation of wrist acupuncture, pericardium 6 (PC6) is likely to be beneficial for patients with a high base-line risk of post surgical nausea and vomiting.
Shoulder Impingement Syndrome (SIS)
Exercise combined with exercise based therapies such as acupuncture is recommended as a safe treatment method in patients with early SIS.
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