RU2697326C2 - Method of surface controlled acupuncture - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to reflexotherapy, and can be used in treating pain syndrome in patients with cervical and/or lumbar spines dorsopathy or radial nerve neuropathy, or lateral epicondylitis. That is ensured by acupuncture. First, using a metal probe, painful seals of the superficial tissues are detected, in which acupuncture needles are placed at depth of 1–5 mm for 10–15 minutes. Metal probe is used to re-examine the superficial tissues, and if pain is detected, a needle and a scarifier of the centre of painful compaction are pricked out with a can of the rubber pear to create a vacuum to be obtained in the blood bank. Repeated examination of the superficial tissues with a metal feeler is performed, and if local tenderness is detected, the jars with the rubber pear are repeated on newly detected painful points. Jars with the rubber pear setting procedure is repeated 2–3 times. Microneedles are placed on the exposure site for 2–3 days and covered with a medical plaster. Sessions are performed 1–3 times week for 10–30 days.

EFFECT: method provides pain and affect syndrome relief and reduced rehabilitation time due to the most accurate exposure on the pathological focus throughout the procedure.

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Description

An urgent problem of modern medicine is the treatment of numerous diseases of the musculoskeletal system (OA), both in Russia and around the world (Parfenov V.A., Yakhno N.N., Damulin I.V., 2014). Among the pain syndromes, the leading position is occupied by back pain and at least 90% of people experience episodic pain in the spine during their lifetime. And in 50-85% of cases, the pain is caused precisely by dorsopathies (osteochondrosis) of the cervical and lumbosacral spine (Parfenov V.A., Gerasimova O. N., 2017). Differential diagnosis and treatment of such two diseases of ODE as carpal syndrome and lateral epicondylitis (Gods A.A., Hannanova I.G., Zhuravlev M.R., Mullin R.I., Shadrina A.F., 2016; Pustarnakov M.Yu., Pustarnakova E.S., Novikov Yu.O., 2016). It has been proven that in at least 10-20% of patients, acute pain syndrome of these nosologies transforms into a chronic form and causes additional psychosomatic disorders, as well as affective disorders (Kukshina A.A., Kotelnikova A.V., Vereshchagina D A., Tkachenko G.A., 2017).

The medical and social problem of the neurological manifestations of dorsopathies, epicondylitis and neuropathies is determined by several factors (Isaikin A.I., Ivanova M.A., Kavelina A.V., Sergeeva D.S., Yakhno N.N., 2016):

- economic losses associated with temporary disability of this group of patients, since 65% of patients are people aged 30 to 49 years and 15% are under the age of 30;

- a high percentage (28.7%) of disability from vertebral and extravertebral complications;

- low quality of life for these patients;

- A trend towards an increasing spread of vertebral pathology among adolescents and children.

In addition, these neurological diseases are often comorbid with various emotional (depressive) disorders, occupying an increasing place in the incidence of the population of Russia in recent decades, making, according to some researchers, from 0.4-0.7% to 25% (Krasnov VN ., 2015). At the same time, the effectiveness of the usually used symptomatic treatment of these diseases is often quite insufficient, which leads to the complication and chronicity of pain and affective syndromes in patients. The methods of non-drug therapy of pain and mild depression accompanying dorsopathies of the cervical and lumbar spine, neuropathy and epicondylitis have been studied very actively in recent years in our country and around the world (Malakhovsky VV., 2015; Stallard P., 2012).

The basis of the pain syndrome in diseases of OA is the formation of trigger points in the muscles, the irritation of which causes both local and reflected pain (in a zone remote from this point). The cause of the formation of trigger points can be injuries (including chronic microtraumatization of muscles), muscle overload (for example, when staying in an uncomfortable position for a long time, skeleton asymmetry, scoliosis), metabolic disorders, malnutrition, therefore their differential diagnosis requires separate and new researchers' works (Egorova S.A., Egorov N.A., Smirnova, O.N., 2016).

It has long been widely known that irritation of various reflexogenic zones of the skin surface can relieve pain and cramps, increase or decrease metabolic processes, accelerate or slow down the rhythm of cardiac activity, etc. Namely skin zones of various physiological activity are used to diagnose and treat many diseases with methods acupuncture. The surface of the human skin contains so many reflexogenic zones that reflect information about all the processes in the internal organs and their condition. Such reflexogenic zones are called “biologically active zone” or “biologically active point” (BAP). The variability of signs at the entrance and exit of the BAT is the rationale for creating new methods of reflexology, which include methods of diagnosis, treatment and prevention, moreover, with their justification not only by the methods of traditional Chinese medicine (Agasarov L.G., 2014).

The present invention relates to reconstructive methods of treating pain and affective symptoms in three diseases of OA (dorsopathy (cervical and lumbar spine), radial nerve neuropathy and lateral epicondylitis). In recent years, methods of reflexotherapy of these complex nosologies through exposure to biologically active points and zones have become more widespread.

The prototype of our invention is the method of reflexology RU 2004103896 C2 "METHOD FOR TREATING PAIN SYNDROME" (Patent holder "Fedoruts Anatoly Valentinovich"), which includes the study of the pathological area of the patient’s body and the choice of BAP by pressing, focusing also on the pain and subjective sensations of the patient (and not recipes ancient Chinese medicine), followed by exposure to BAP with the application of metal plates, at the same time, the impact points are directly selected in the damage zone, focusing on b painful sensations, then they exert an impact on each of the selected BAP by pressing for at least 30 s, while a decrease in the intensity of pain confirms the correctness of the choice of the point of exposure, then an applicator is applied to the selected BAT, which is left at the point until itching and burning sensations appear, Sessions are carried out until the functions of the injured organ or part of the body are fully restored.

The disadvantage of this method is the lack of effectiveness precisely with dorsopathies, neuropathy of the radial nerve and lateral epicondylitis and the lack of influence on the emotional disorders that are present with each pain syndrome.

There is a patent RU 2015151228 C1 “METHOD FOR TREATING A PUSH-MOUSE SYNDROME” (Patent owners: Shilenkov Georgy Leonardovich, Popova Alla Sergeevna), in which a reflexotherapy needle is placed ~ at a point that is determined by constructing a triangle and the needle is inserted vertically until shooting pains appear; then a vacuum gradient therapy apparatus with a jar diameter of at least 10 cm is installed over this point with the needle inserted into it and the exposure is performed in an alternating mode for 20 to 30 minutes, the course of treatment is 5 to 10 procedures, every other day.

The disadvantages of this method are the lack of proven effectiveness also with dorsopathies, neuropathy of the radial nerve and lateral epicondylitis and the lack of influence on the depressive disorders present in patients with each pain syndrome.

Also known is the “METHOD OF TREATING POST-COMPRESSION DISORDERS OF FUNCTIONS OF PERIPHERAL NERVES AT RADICULOPATHIES”, RU 2527336 C2 (Patent holder of “DV-Med LLC Dr. Vojt Clinic" Ltd.), in which the following procedures are performed during one donation vacuum lazer: , acupuncture and, additionally, starting from the second day, they chise the compression zone with antispasmodics and chondroprotectors, and, starting from the third day, conduct therapeutic exercises.

The disadvantage of this method is the use of a significant number of additional methods of rehabilitation and pharmacotherapy and an undifferentiated selection of exposure points, which significantly increases the time and cost of the treatment and regeneration process and reduces the period of remission. Also, the effectiveness of this method has not been proven with neuropathy of the radial nerve and lateral epicondylitis and emotional disorders, which are always with any pain syndrome.

Existing patent analogue RU 2014122702 C1 “METHOD FOR TREATING HYPERTENSIVE DISEASE BY METHODER DRILLING HEMOEXFUSION OF CAPILLARY BLOOD” (Patent holder of LLC “North Caucasian multidisciplinary treatment and diagnostic center from the center of V”, from the center 14 of the Essen Zhui, V41 fu-fen, V43 Gao-huan on both sides. Punctures of the skin area in the area of the corporal point are carried out with an autolance with adjustable depth of puncture. Then a vacuum jar is applied to the skin area with punctures. output to 5 ml of blood from skin punctures with the vacuum portion removed jar.

The disadvantage of this method is the lack of clinical testing of the effectiveness of bloodletting in the treatment of pain syndromes with dorsopathies, neuropathy of the radial nerve and lateral epicondylitis and the lack of influence on the affective disorders that are present with these pain syndromes, because the pathogenesis of diseases is very different.

Also known is the technique of complex reflexology for pain in osteochondrosis (dorsopathies) of the lumbar spine (Verkhozina T.K., Ippolitova E.G., Tsyslyak E.S. Reflexotherapy of pain syndromes in osteochondrosis of the lumbar spine // Siberian Medical Journal (Irkutsk). - 2013. - T. 119. - No. 4. - pp. 32-36), which includes drug therapy in combination with reflex treatment methods: physiotherapy, reflexology, therapeutic gymnastics and massage, while some patients use small bloodletting by banks of the painful pressure sensitive points lumbosacral area. The method also has an analgesic, pronounced angiotropic, vegetotropic and restorative effect, normalizes sleep and stops neurotic reactions.

The disadvantage of this method is the very great complexity and high cost of complex reflexology and the lack of proven effectiveness in dorsopathies of the cervical spine, radial nerve neuropathy and lateral epicondylitis and comorbid depressive disorders.

The claimed invention is as follows.

In the claimed method, it is the complex use of acupuncture with vacuum point bloodletting that sharply enhances the effect of the therapeutic effect of needles on both pain and affective syndromes. At the same time, it is important to consider the compatibility of existing factors. Acupuncture and vacuum-bloodletting, but with other nosologies, have long been one of the most proven effective combinations of at-times.

The inventive method of acupuncture, using the painless and superficial introduction of acupuncture needles to treatment points that are inconsistent with the classical points of traditional Chinese acupuncture and localized to a precision of 1 mm by examination of the surface tissue with a metal probe, is based on the property of the nervous system to respond quickly by calming the irritated nerve receptors to the precise effect them with an acupuncture needle, which, in turn, just as quickly causes the elimination of violations emodinamiki in a place of pain and start healing reflexes.

In diseases of OAD, accompanied by pain, and its analogues in the form of painful subjective discomfort (paresthesia, bursting, pressure, burning, irradiation, hypersensitivity), in the place of complaints indicated by the patient, as well as in segmental areas on the spine and distal extremities , reflexively connected with the place of pain, by palpation examination of the surface tissues with a metal probe, in our method a zone of edema is detected, as a result of peripheral circulatory disorders with blood stasis venous system, and within the boundaries of the established edema, a further examination of the probe determines surface tissue seals 1-2 mm in diameter, which have the most pronounced therapeutic effect.

In addition to suppressing the flow of nociceptive impulses at the spinal level, analgesia through acupuncture in combination with vacuum bloodletting activates the anti-receptive structures of the brain stem and optic tubercle, modulating presynaptic inhibition along the descending paths. Another effect of reflex effects is to increase the production of endorphins and enkephalins and increase their content in the cerebrospinal fluid. Reflex methods of suppression reactive aseptic inflammatory process, under the influence of acupuncture normalization of vascular permeability occurs, which helps to reduce swelling and infiltration, activation of phagocytic activity, production of corticosteroids in the blood, which modulates the endogenous anti-inflammatory response. This reflexology also allows you to achieve a pronounced muscle relaxant effect, which ensures the correction of reflex muscular-tonic disorders in patients.

The painlessness of the surface tissues, the restoration of their elastic homogeneity and the absence of tissue seals and local increased sensitivity after treatment, indicates the normalization of the state of nerve receptors, which automatically favorably affects blood circulation.

The improvement in microcirculation, registered through a decongestant therapeutic effect and the appearance of hyperemia and the perceived subjectively “pleasant” relaxing heat, indicates the restoration of blood circulation and the creation of optimal conditions for the regeneration of affected structures.

The main pathogenetic factors of ODA diseases are various compression mechanisms, trophic and reflex effects, accompanied by an inflammatory process, microcirculatory disorders and their combination. The correlation between radiculopathy, neuropathy, even epicondylitis and peripheral hemodynamics is very high. So, with radicular syndrome, a pronounced spasm of arterial vessels of the limb is usually determined, more pronounced from the side of a pronounced radicular syndrome. Violation of venous outflow and a corresponding increase in venous pressure in the lower extremities in patients with neurological disorders leads to regional disturbance of transcapillary metabolism, manifested by the appearance of edema in the distal extremities |

At the beginning of the procedure, the area of complaints in the superficial tissues covers the diffuse surface. Diagnosis is carried out initially only on superficial tissues at the site of pain, as well as reflexively associated segmental zones on the spine and on the extremities and revealing in the case of pathology signs of microcirculation disturbance and inflammation, manifested by trophic edema, painful tissue seals and increased sensitivity, and then within the region local edema with an accuracy of millimeter localized points of maximum pain sensitivity,

Then, the identified points are first treated with a painless surface injection of an acupuncture needle to a depth of 1-5 mm, which has a inhibitory effect on irritated nerve receptors and within a few seconds improves local blood circulation, which manifests itself as a quick anti-edematous effect, confirmed by repeated examination with a probe and an analgesic effect.

To further enhance anti-inflammatory, analgesic and antispasmodic therapeutic reactions, to enhance the therapeutic result, especially in the case of pronounced resistance to the indicated gentle reflex effect, canned bloodletting is added, consisting of one injection with a needle or a center scarifier of trigger points 1-5, found by the probe and the subsequent setting 15 ml cans with a rubber bulb to create a vacuum for 1-2 minutes and get a small amount of blood (about 1 ml), which is about 95% Luciano has once pronounced analgesic effect. This injection is applied to the place of maximum pain sensitivity to a depth of about 2 mm, and since a standard can is installed on top to create a vacuum in it, then as a result of its suction effect, bloodletting begins. Its value depends on the degree of local blood stagnation and the level of complaints. Direct proportion - the greater the severity of the signs of pathology, the more temoexfusion. Usually from 1 to 2 ml. After removing the cans and sanitizing the site of exposure, a repeated examination of the surface tissues with a probe is carried out.

Cupping is carried out necessarily depending on the number and size of the found bioactive points. If there is only one point, then single cupping is used and then after the session the place of exposure is covered with a medical plaster, together with a microneedle left in the tissue to maintain therapeutic effects. If the examination reveals a residual local tenderness, shifting somewhat to the side from the place of the primary exposure, then in this case, can bloodletting should be repeated at a new, second pain point. Usually this happens no more than 2-3 times.

In the vast majority of cases, at the next treatment session, when removing microneedles and examining these places with a probe, a stable therapeutic effect is established. Only traces of an injection on the skin indicate the place of exposure with a needle or scarifier. Complaints are greatly reduced. The presence of residual complaints indicates the presence of minor focal zones at the site of pain, which should be detected by palpation examination of the probe and treated according to the already indicated scheme.

Therefore, great importance in the method is given to questioning the patient and the exact location of the residual pain, about the movements or body position that reinforce these residual complaints and look for irritation zones there. If the localization of minor pain is indicated by the patient exactly in the place where the treatment was carried out, then by palpation examination, the pressure on the tissues should be increased and, thus, penetrate into the deeper layers.

The initial introduction of acupuncture needles to a depth of 1-5 mm contributes to a significant reduction in trophic puffiness and local pain. As a result of this effect, the residual irritation zone is focused, which is the epicenter of the manifestation of inflammatory reactions from deeply affected structures on the surface.

The criterion for the correctness of the localization of pain points and the therapeutic effect on them is the elimination of their increased pain sensitivity and, against this background, an increasingly strengthening and stable positive therapeutic result. After a painless introduction of an acupuncture needle into the center of such a tissue densification to a depth of 1 to 5 mm with a second speed, controlled anti-inflammatory, analgesic and antispasmodic therapeutic reactions occur, reaching their maximum development after 10-15 minutes of needle stay in the tissues.

As a rule, as a result of an accurate and painless acupuncture needle, two thirds of the identified treatment points, in the form of tissue seals, are significantly reduced during one procedure. This is accompanied by a pronounced decongestant, and, consequently, anti-inflammatory effect, controlled by the probe. Also, a significant, not less than 50% reduction in pain and improved limited mobility is an analgesic effect. The place of complaints and the place of treatment becomes warm to the touch and hyperemia is observed, an antispasmodic effect.

To continue the therapeutic reactions activated as a result of the procedure, the remaining third of the detected tissue seals receives a therapeutic effect in the form of standard microneedles for acupuncture, penetrating the skin to a depth of 1 mm and a fixed medical patch. Microneedle patients do not feel, are not limited by their movement, during sleep, shower, pool and even sauna. Microneedles are in the body for 2-3 days, improving the processes of self-regulation, local blood circulation and immunity in the remaining tissue industries and contribute to a significant acceleration of the onset of stable therapeutic results. Later, they can be successfully used for active prevention of possible exacerbations of diseases in conditions of elevated distressors.

After 3-5 sessions, the overall improvement is at the level of 30-50% of the initial conditionally accepted as 100% .. After 10 procedures, the overall stable result averages 95%. To minimize the remaining complaints, it is recommended to go through five more procedures in 2 weeks.

The main physiological therapeutic mechanisms of the proposed method for pain and depressive syndrome are as follows: there is a stimulation of the production of endogenous opiates, which have analgesic and timoleptic activity. Acupuncture promotes the synthesis of serotonin, thereby enhancing the antinoceptive and antidepressant mechanism. The anti-inflammatory effect is due to the secretion of cortisol, which is proven to increase during an acupuncture session. Exposure to BAP through acupuncture with neuropathies, epicondylitis and dorsopathies also improves microcirculation and local blood flow. The above mechanisms contribute to the reduction of puffiness and the regeneration process in the affected areas of the spine or limbs. When using hemoexfusion, normalization of muscle tone also occurs, and local blood circulation in the affected sections of the musculoskeletal system increases reflexively.

The technical result of the claimed invention is to increase the accuracy and information content of diagnostics, reduce treatment time, reduce the cost and simplify therapy technology and the time of registration of changes in the BAP, the ability to use a probe to identify nervous pathology at the preclinical stage of the disease.

For a clinical study of the method, its therapeutic dynamics was studied in 120 patients with chronic pain syndrome with dorsopathies of the cervical and lumbar spine (55 patients, 45.9%), radial nerve neuropathy (32 patients, 26.7%) and lateral epicondylitis (33 patients, 27.5%), which were accompanied by depression of a nonpsychotic (subclinical, lung) level.

The average age of the patients was 46.6 ± 9.2 years, men - 58 (48.3%), women - 62 (51.7%). According to MRI, degenerative-dystrophic changes of the type of "osteochondrosis" were detected in 54 (45%) patients. All patients were diagnosed with dorosopathy of the cervical or lumbar spine.

Assessment of pain by visual analogue scale (VAS): mild pain 25 (20.8%) people, moderate - 69 (57.5%) people, severe - 26 (21.7%) people.

Assessment of the psychoemotional (affective) state was carried out using a jackal of Hamilton Depression Assessment (HDRS) and subclinically expressed depression was revealed - in 120 people (100.0%), the average score was 10.7 ± 2.9.

For a 10-day course of treatment by the method, 6 sessions (after 1 day) of this complex reflexology for 25 minutes were carried out and the following results were noted: a decrease in pain in 114 (95%) people, the absence of depressive disorders

- in 25 (20.8%) people, depression reduction - in 89 (74.2%) people, subclinically expressed depression remained in 6 (5.0%) people. According to YOUR dynamics, it was this: absence of pain - 52 (43.3%) people, weak - 5 (42.5%), moderate - 11 (9.2%), strong - 6 (5.0%) people.

According to YOUR data, there was a significant (p <0.05) decrease in pain intensity in patients 10 days after the start of treatment, there were no significant differences in pain intensity between nosologies, and the difference between the effectiveness of the method in patients depended on many factors - the duration of the disease, the age of the patients, the presence of harmful external factors, etc. In turn, according to HDRS, the level of anxiety and depression significantly decreased in all patients after 10 days from 10.7 ± 2.9 points to an average of 4.6 ± 3.1 points (p <0.05).

Thus, the advantages of the proposed method of reflexology include its reliable proven effectiveness with three nosologies at the same time, increased efficiency relative to analogues, reliably and stably appearing after 10 days of treatment, shortening the duration of procedures, safety, affordability, compliance and low cost. Using the method leads to an acceleration of the treatment process by about 2 times, also reducing the likelihood of relapse. Even after two or three treatment procedures, a significant decrease in pain and depressive syndrome and other symptoms accompanying the disease is noted.

In general, against the background of the treatment with these methods of reflexology, pronounced positive dynamics are noted, which allows recommending the use of this method of treatment both separately and in combination with standard therapy, rehabilitation and prevention of OA diseases.

We give clinical examples:

Example No. 1.

Patient M., born in 1988, complained of severe pain in the right neck, aggravated by movement of the body. The above complaints arose after hypothermia.

The patient underwent general clinical examination, electrocardiography, ultrasound examination of the kidneys, liver, pancreas, x-ray of the chest and spine, computed tomography of the spine, laboratory examination of the general analysis of blood and urine.

Examinations revealed a limitation of mobility of the spine in the cervical spine, and a deflection of neck muscles on the left. When applying the proposed method for the differential reflexology of pain points with a metal probe, the zone of increased pain sensitivity of the paravertebral points was determined at the level of C4-7, in the area of the cervical spine on the right and left. MRI of the cervical spine revealed signs of osteochondrosis and moderate protrusion of the intervertebral disc on the right at the level of C6-7. Also, before and after the course of treatment, the patient determined the magnitude of the pain syndrome on the VAS scale and depressive - on the HDRS scale.

The patient was diagnosed with: Exacerbation of Afonic dorsopathy of the cervical spine, cervicalgia.

After the course of treatment according to the proposed method for 10 days (5 sessions of 25 minutes of simultaneous use of acupuncture and reflexotemoexfusion, 1-4 needles), the pain completely stopped, mobility in the cervical spine was restored. After applying the proposed method of treatment, a significant difference was determined between the VAS values obtained before the start and the clinical (palpation) disappearance of pain sensitivity of the paravertebral points at the level of C4-7 on the right and left side, and even subclinical depression was not determined on the HDRS scale.

Example No. 2.

Patient R., born in 1978, complained of increased pain in the lower back, buttock on the left, radiating to the left leg, aggravated by sitting, standing, and body movements; numbness of the foot. The above complaints arose after lifting weights.

The patient underwent general clinical and neuroorthopedic examination, electrocardiography, ultrasound of the kidneys, liver, pancreas, X-ray of organs of the difficult cell and spine, computed tomography of the spine, laboratory examination of the general analysis of blood and urine. In addition, before and after the course of treatment, the patient determined the magnitude of the pain syndrome according to the YOUR scale and the depressive syndrome according to the HDRS scale.

Examinations revealed a limitation of spinal mobility in the lumbar region; the back muscles of the back on the right; moderate decrease in periosteal and tendon reflexes on the left lower limb; positive symptom of Lasseg. Computed tomography of the spine in the lumbar revealed signs of osteochondrosis and a left-sided lateral hernia of the intervertebral disc at the level of L4-5.

The patient was diagnosed with Dorosopathy of the lumbar spine. Acute vertebrogenic radiculopathy L5 on the left, lumbago.

After the course of treatment (3 sessions per week, for 10 days, 2-4 needles) in this method, the pain and depressive syndrome decreased significantly, mobility in the lumbar spine was restored, and the tone of the back muscles returned to normal. The dynamics of pain on the VAS scale and depressive on the HDRS scale showed a significant decrease in these indicators below the clinical level.

Example No. 3.

Patient T., born in 1970 She complained about a dull, aching pain in the wrist on the right, which increases with prolonged physical exertion.

Prior to this exacerbation, bouts of pain in the wrist periodically appeared for 3 years. This exacerbation within two months. It was treated: drug therapy, physiotherapy, acupuncture in the clinic at the place of residence. As a result of the treatment, a slight improvement is noted.

Objectively: The condition is satisfactory. Palpation tenderness of soft tissues in the wrist joint area on the right. Tendon reflexes from the hands are torpid. There are no sensitive violations. Before and after the course of treatment, the patient determined the magnitude of the pain syndrome on the VAS scale and depressive - on the HDRS scale.

Diagnosis: Carpal tunnel syndrome, chronic form, exacerbation.

Conducted a course of acupuncture and hemoexfusion on the identified BAP probe. After the course, for 25 days (10 procedures, 25 minutes, 2-3 needles each), the treatment of pain and depressive syndrome (according to YOUR and HDRS) almost completely stopped. Palpation - mild soreness in the medial region of the wrist joint.

Example No. 4.

Patient V., born in 1955, was admitted for treatment with a diagnosis of Lateral medial left-sided epicondylitis.

Complaints of pain in the area of the medial epicondyle on the left appeared 3 months ago, after severe physical exertion associated with lifting and carrying weights, after which subsequent episodes of physical exertion were always accompanied by a pronounced exacerbation of the pain syndrome. In connection with the restriction of labor activity, multiple treatment was carried out, including physiotherapy, local blockade with anesthetic and non-steroidal anti-inflammatory drugs, the use of ointments with hydrocortisone and heparin, hirudotherapy with restoring the right hand with a scarf dressing, but no tangible result was obtained.

An examination was performed, including CT and MRI. Like all patients, before and after the course of treatment, the magnitude of the pain syndrome was determined according to the YOUR scale and depressive syndrome - according to the HDRS scale.

Then, treatment was carried out according to the proposed method of complex acupuncture (acupuncture and reflexohexoexfusion). After the diagnosis of BAP according to our method, 2-3 needles were placed laterally into the area of the medial epicondyle. Needles were placed 6 times (6 procedures) for 10 days. During the second and subsequent "procedures, vacuum hemoexfusion was also carried out. During the observation, exacerbation was first observed from the second to the seventh day after the 1st procedure, then the pain syndrome disappeared and perifocal soft tissue edema was stopped 6 days after the procedure. 10 days later the treatment of pain and depressive syndrome completely stopped, both according to complaints, and according to YOUR and HDRS.

Subsequently, the patient was recommended to begin physical activity gradually, and, taking into account the long experience of the disease, once a year, put microneedles and banks on their own as maintenance therapy and prevention. Thanks to this, the achieved result has been maintained for 3 years.

References:

1. Avershin V. A. et al. Myofascial meridian reflexology in the complex sanatorium treatment of shoulder-shoulder periarthrosis // Problems of balneology, physiotherapy and physiotherapy. - 2016. - T. 93. - No. 2-2. - S. 25-25.

2. Vyshlova I. A. The use of acupuncture and physiotherapy in the treatment of patients with chronic nonspecific pain syndromes in the lower back // Russian Journal of Pain. - 2016. - No. 2. - S. 141-142.

3. Golubev V.L., Wayne A.M. Neurological syndromes. A guide for doctors. - M .: MEDpress-inform, 2016.

4. Ippolitova E.G. and other Functional diagnostics and acupuncture in patients with osteochondrosis of the cervical spine // Bulletin of the East Siberian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences. - 2016. - T. 1. - No. 4. - S. 40-45.

5. Kotelnikov G.P., Mironov S.P., Miroshnichenko V.F. Traumatology and orthopedics. Textbook. - M: GEOTAR-Media, 2006.

6. Kuchaeva A.V., Semenikhin D.G., Mikhailova E.B. Depression and chronic pain, rational pharmacotherapy and psychosocial rehabilitation // Bulletin of neurology, psychiatry and neurosurgery. 2017. -№.1. - S. 9-13.

7. Mironov S.A., Denisyonok P.A. Reflexotherapy as a method of choice for outpatient treatment of reflex manifestations of osteochondrosis of the lumbar spine // Bulletin of medical Internet conferences. - Limited liability company Science and Innovation, 2016. - T. 6. - No. 10. - S. 1547-1547.

8. Parfenov V. A. Yakhno N.N. Damulin I.V. Nervous diseases. General neurology. Textbook - Moscow: MIA, 2014.

9. Sherstyuk M.A., Sherstyuk S.A. A specific clinical and diagnostic “platform” for the treatment of pain with extrusion of the intervertebral disc // International Research Journal. - 2017. - No. 4-3. - S. 201-204.

10. Borah B.J. et al. Cost-effectiveness of acupuncture in an employee population: A retrospective analysis // Complementary Therapies in Medicine. - 2017. -T. 31.-pp. 14-19.

11. Cifu D.X., Lew H.L. Braddom's Rehabilitation Care: A Clinical Handbook E-Book. -Elsevier Health Sciences, 2017.

12. Eshkevari L. Acupuncture and Chronic Pain Management // Annual review of nursing research. - 2017. -T. 35. -№. 1. - pp. 117-134.

13. Gardiner P. et al. Design of the integrative medical group visits randomized control trial for underserved patients with chronic pain and depression // Contemporary clinical trials. - 2017. -T. 54.-pp. 25-35.

14. Liu L. et al. Acupuncture for chronic low back pain: a randomized controlled feasibility trial comparing treatment session session // Clinical Rehabilitation. - 2017 .-- C. 0269215517705690.

15. MacPherson H. et al. Acupuncture for chronic pain and depression in primary care: a program of research // Program Grants for Applied Research. - 2017 .-- pp. 1-342.

16. MacPherson H. et al. The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain // Pain. - 2017. - T. 158. - No. 5. -pp. 784-793.

17. Oh J. E. et al. Acupuncture for chronic pain and depression in primary care // Australian Journal of Acupuncture and Chinese Medicine. - 2017. - T. 11. - No. 1. -p. 36.

18. Taylor P. et al. Cost-effectiveness of Acupuncture for Chronic Nonspecific Low Back Pain // Pain Practice. - 2014. - T. 14. - No. 7. - pp. 599-606.

19. Yang Z. et al. The effectiveness of acupuncture for chronic pain with depression: A systematic review protocol // Medicine. - 2017. - T. 96. - No. 47. - e8800.

Claims (1)

A method of treating pain in patients with dorsopathy of the cervical and / or lumbar spine or radial nerve neuropathy, or lateral epicondylitis by means of acupuncture, characterized in that with the help of a metal probe, painful consolidations of the surface tissues are detected, into which 1-5 mm are installed acupuncture needles for 10-15 minutes, then surface tissues are re-examined with a metal probe and, if soreness is detected, they are pricked with a needle and a center scarifier leznennogo seal with the production of cans with a rubber bulb to create a vacuum to obtain a blood bank; a repeated examination of the surface tissues with a metal probe is carried out and when local pain is detected, the cans with a rubber bulb are repeated at the newly identified pain points, the procedure for setting cans with a rubber bulb is repeated 2-3 times; then microneedles are placed on the place of exposure for 2-3 days and covered with a medical plaster, sessions are carried out 1-3 times a week for 10-30 days.