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CASE
REPORT
Acupuncture
For Post-Surgical Pain
Denise McKee, MD
Holly Rooney, MD
ABSTRACT
Context Medical acupuncture has many potential uses in a family practice
setting, especially if integrated with conventional medicine.
Objective To describe the treatment of a patient with post-surgical
pain.
Design, Setting, and Patient A man presented to a Family Medicine practice
with inguinal pain following herniorrhaphy.
Intervention A principal meridian medical acupuncture circuit plus local
needling for 5 acupuncture treatments.
Main Outcome Measure Patient report of pain alleviation.
Results The patient reported being nearly pain-free and was able to
completely discontinue naproxen.
Conclusion This case illustrates the utility of medical acupuncture
in the management of post-surgical pain.
KEY
WORDS
Alternative Medicine, Acupuncture, Hernia, Post-Surgical Pain
INTRODUCTION
Acupuncture, considered alternative medicine in the United States, is
defined as medical therapies not taught in conventional Western medical
training.1,2 In the United States, medical acupuncture has emerged as
a hybrid mainstream discipline; it has been successfully incorporated
into traditional medical practice.
CASE
REPORT
A 42-year-old man presented with left inguinal pain. His medical history
was notable for bipolar disorder and mild obesity; surgical history
included a left inguinal herniorrhaphy. The surgery required the placement
of mesh. Follow-up visits for 4 consecutive months revealed no residual
inguinal pain. Five months following the surgery, however, the patient
began experiencing burning pain lasting 5 to 10 seconds, occurring intermittently
throughout the day and night. The discomfort occurred in the inguinal
crease, approximately 5 cm below the surgical incision, as well as at
the site of the incision. Diagnosis was post-surgical incision pain.
He was prescribed naproxen, 500 mg/d orally over 1 month, without relief.
The naproxen dosage was then increased to 500 mg orally twice daily,
with noticeable improvement. The patient was able to start exercising
without impedance from pain.
During the next 3 months, unsuccessful attempts were made to reduce
the naproxen dosage. The patient was referred back to the surgeon, who
injected the area with cortisone and novocaine. This provided relief
for 2 or 3 days. Corticosteroid injection failed to provide pain relief.
The patient continued to experience increasing severity and frequency
of pain. Both superficial and deep scar tissue blocks were administered
with Traumeel and novocaine without pain alleviation.
Acupuncture Method
A principal meridian medical acupuncture circuit was used for 20 minutes
involving SP 6, ST 36, and LI 4, as well as local needles surrounding
the herniorrhaphy scar.
RESULTS
The patient received 5 acupuncture treatments for 4 consecutive months
with positive results. On his last visit, he reported being pain-free
with rare exceptions when the pain would be aggravated. Naproxen was
completely discontinued.
CONCLUSION
Patients often present in a physician's office for acupuncture when
traditional approaches to pain management have failed. While there is
a paucity of controlled studies, medical acupuncture has proven useful
in the management of both acute and chronic pain.
ACKNOWLEDGEMENT
We thank Gary Johnson, MD, for his helpful contributions to this article.
REFERENCES
1. Belgrade M. Two decades after ping-pong diplomacy: is there
a role for acupuncture in American pain medicine? APS J. 1994;3:73-83.
2. Gordon JS. Alternative medicine and the family physician.
Am Fam Physician. 1996;54:2205-2220.
AUTHORS' INFORMATION
Dr Denise McKee is an Associate Professor in the Department of Family
and Community Medicine at the University of Nevada School of Medicine.
Denise
McKee, MD
Associate Professor, Dept of Family & Community Medicine
University of Nevada School of Medicine
Brigham Building/MS 316
Reno, NV 89557
Phone: 775-784-6180
Fax: 775-784-4473
Dr
Holly Rooney is a Resident in the Family Practice Clinic, Department
of Family and Community Medicine at the University of Nevada School
of Medicine.
Holly
Rooney, MD
Resident, Family Practice
Dept of Family & Community Medicine
University of Nevada School of Medicine
Brigham Building/MS 316
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