Upper Extremity Condition/Treatment Wrist & Hand Flashcards
De Quervain’s Disease
Tenosynovitis
Tenosynovitis definition
Chronic inflammation of the tendon sheaths of EPB (extensor policies brevis) and APL (abductor policies longs)
De Quervain’s is what type of injury?
RSI
With Tenosynovitis, where is the pain?
Radial styloid process of wrist - LI5
When does Tenosynovitis hurt?
- moving thumb & wrist PROM
- thumb ABDuction, EXTension RROM
- forming a fist
- grasping/gripping things
- turning the wrist as in the Finkelstein’s test
What is the quality of pain w/Tenosynovitis? When does it occur?
electric, stabbing
with or without movement
What is Tenosynovitis difficult to distinguish with ?
Osteoarthritis of the Carpal-Metacarpal Joint
= CMC-Joint
Test for Tenosynovitis
Finkelstein
What are TCM possibilities for Tenosynovitis Dx?
- Wind-Cold invasion
- Blood Stag. = sharp Pain
- Painful Bi Syndrome
For Tenosynovitis Tx needle Ah Shi along
ABD pollicis longus tendon (APL)
EXT pollicis brevis tendon (EPB)
***don’t needle into the tendons!
Local LU pts. to needle Tenosynovitis
LU7, LU8, LU9, LU10
Local LI pt.s to needle Tenosynovitis
LI4, LI5, LI6
Pt to needle for Tenosynovitis to get rid of upper extremity obstruction
SI11
If it is not Tenosynovitis but Osteoarthritis of CMC, Tx
periosteal needling of 1st CMC
Tenosynovitis APL & EPB IZ
?????
CTS
Carpal Tunnel Syndrome
Most common form of chronic wrist injury
Carpal Tunnel Syndrome
Symptoms of Carpal Tunnel are related to
compression of Median Nerve, which travels through Carpal Tunnel
What harm to the synovial membranes around the tendons in the Carpal Tunnel causes compression?
swelling, thickening, irritation
Where is numbness felt w/Carpal Tunnel?
1st 3-1/2 fingers, thumb, index, middle & 1/2 ring finger
Shaking hands w/Carpal Tunnel Syndrome can
remove the sensation of numbness?
Pain w/Carpal Tunnel Syndrome can extend to
forearm, palm, but also up to shoulder
What muscle is possible to waste w/Carpal Tunnel Syndrome?
Thenar muscle
Odd reason for Carpal Tunnel Syndrome
dampness in pregnancy
Carpal Tunnel Syndrome Tests (3)
1-Phalen
2-Carpal Compression Test
3-Pronator Teres Syndrome (R/O)
TCM Dx for Carpal Tunnel Syndrome
Q/B Stag. in PC, LU meridian, dampness in pregnancy obstructing wrist
General Tx for Carpal Tunnel Syndrome
Remove Stagnation from Meridians
Where to look for Ah Shi pts for Carpal Tunnel Syndrome
near end of tunnel, palmaris longs, forearm
pt needled at wrist for Carpal Tunnel
Syndrome
PC7 toward hand
What distal pt is really important to needle for Carpal Tunnel Syndrome?
SI 11 better treatment than treating wrist alone
What IZ is used for Carpal Tunnel Syndrome?
Palmaris longus IZ
ST36, LI11, SP9 is needled in Carpal Tunnel Syndrome for what reason?
To remove water in pregnancy
What Huatuojiaji for Carpal Tunnel Syndrome?
C6 to T1
Forearm pts. for Carpal Tunnel Syndrome?
PC6 & TW5
