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Abstract: The patient was a tennis enthusiast and recently suffered from pain at the left lateral epicondyle of the humerus due to force in sports, with limitation of movement and worsening of symptoms after corresponding partial activities. After informing the patient of his condition, the patient agreed to undergo minimally invasive surgery with a small needle. After the operation, the patient’s symptoms improved significantly, and there was no sign of recurrence during the subsequent follow-up.
Basic information】Male, 28 years old
Type of disease】Tennis elbow
Hospital】Guanganmen Hospital, Chinese Academy of Traditional Chinese Medicine
Date of Consultation】April 2021
Treatment Plan】Physiotherapy (Tuina treatment, Gua Sha treatment) + Minimally invasive surgery (small needle knife)
Treatment Period】2 weeks
Treatment effect] The patient’s condition improved significantly
I. Initial consultation
The patient experienced pain at the left lateral epicondyle of the humerus after playing tennis with great force, causing damage to tendons, fascia fibers and the synovial membrane of the lateral epicondyle of the humerus, accompanied by limited movement, and the symptoms were aggravated after rest and weight-bearing or activity of the corresponding area. The patient came to our hospital for further clarification of the cause. The examination showed that there was obvious pressure pain at the left humeral epicondyle, which could spread in the direction of the common tendon of the extensor muscle.
II. Treatment history
The treatment plan given to the patient included tui na treatment, gua sha treatment, and minimally invasive surgical treatment such as small needle knife. The patient was asked to take a supine position, and the operator used the 㨰 method and the one-finger Zen pushing method on the affected side along the dorsal side of the forearm, starting from the lateral epicondyle of the humerus to the distal end of the forearm, repeatedly for 3-5 minutes, focusing on the elbow, and pointing and pressing the Quchi, Elbow Shao, and Hand San Li points in a homeopathic manner. The last can be done in the patient’s elbow rubbing and to penetrate the heat is appropriate. Gua sha treatment specifically involves applying an appropriate amount of tea oil to the dorsal side of the affected forearm, then scraping, and with flushing as appropriate. Minimally invasive small needle knife surgery requires taking a 0.40x40mm small needle knife and doing a fan cut peeling and loosening at the patient’s external epicondyle of the humerus as well as the radial extensor generalis tendon where the pressure pain is obvious, with appropriate postoperative bleeding squeezing and gauze pressure. After treatment, the patient’s pain and other symptoms improved significantly, and the limitation of movement was not obvious. 1 week later, the patient’s left elbow pain was significantly relieved compared with that before the consultation, but because he still could not bear weight, he was considered to have inflammatory adhesions at the lateral humeral epicondyle, and continued treatment for 1 week for review.
III. Treatment effect
The patient was treated with symptomatic treatment, such as acupressure treatment to significantly improve the patient’s blood circulation and loosen the adhesions in the elbow, and scraping treatment to relax the tendons and promote tissue repair, relieve synovial and fascia tension, and restore the flexibility of the elbow joint. In addition, the patient’s synovial and fascial tissue adhesions can be peeled and loosened through the minimally invasive small needle knife surgery to reduce the pressure on the microvascular and nerve bundles, thereby reducing pain and improving the pain threshold. At present, the patient’s condition is basically cured, and no signs of recurrence were found during the follow-up consultation.
IV. Notes
I am glad to see the patient’s symptoms gradually reduced, but still need to remind the patient to pay attention to some matters in daily life: 1.
1. Pay more attention to rest and avoid activities that can aggravate the disease, such as tennis, badminton, volleyball, etc. Pay attention to heat preservation of the affected area to avoid aggravation of symptoms after getting cold.
2, increase the nutritional intake at the same time, pay attention to nutritional balance, it is recommended to consume more food rich in trace elements, including eggs, beans, beef, celery, etc., fruits including apples, dragon fruit, oranges, etc.
V. Personal insight
Epicondylitis of the humerus is a common clinical disease, and from the perspective of Chinese medicine, it is mostly caused by the invasion of cold and dampness. With the gradual increase of sports enthusiasts, the incidence of the disease is also rising significantly and has affected the daily life and work of patients, but there are many treatments for the disease because of the consequent development of its medical treatment. In this case, the patient developed epicondylitis due to excessive exertion during sports. After timely hospital consultation and symptomatic treatment, the symptoms have largely disappeared and no recurrence has been observed.