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Acupuncture in Toowoomba – for Peroneal Nerve Paralysis and Foot Drop

Foot drop is a gait abnormality in which the dropping of the forefoot happens due to weakness, damage to the peroneal nerve or paralysis of the muscles in the anterior portion of the lower leg. It is usually a symptom of a greater problem, not a disease in itself. It is characterized by the inability or difficulty in moving the ankle and toes upward (dorsiflexion). The severity in foot drop can range from a temporary to permanent condition, depending on the extent of muscle weakness or paralysis. It can occur unilaterally or bilaterally. In walking, while stepping forward, the knees are slightly bent so the front of the foot can be lifted higher than usual to prevent the foot from dragging along the ground. Foot drop can be caused by nerve damage alone. However, it is also caused by muscle or spinal nerve trauma, abnormal anatomy, toxins or disease. Diseases that can cause foot drop include stroke, Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease), muscular dystrophy, Charcot Marie Tooth disease, multiple sclerosis, and Friedreich’s ataxia. It may also occur as a result of hip replacement surgery.

Foot drop is characterized by steppage gait. While walking, people suffering the condition drag their toes along the ground or bend their knees to lift their foot higher than usual to avoid the dragging. This serves to raise the foot high enough to prevent the toe from dragging and prevents the slapping. To accommodate the toe drop, the patient may use a characteristic tiptoe walk on the opposite leg, raising the thigh excessively, as if walking upstairs, while letting the toe drop. Other gaits such as a wide outward leg swing (to avoid lifting the thigh excessively or to turn corners in the opposite direction of the affected limb) may also indicate foot drop.

REFERENCE: http://en.wikipedia.org/wiki/Foot_drop

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Toowoomba Acupuncturist Discusses Acupuncture Prescription for the Paralysis of Common Peroneal Nerve

Composition: Huantiao (GB 30), Yanglingquan (GB34), Yangfu (GB 38), Taixi (KI 3), Zhiyin (BL 67). Fuliu (KI 7) is added if there is inability of feet dorsiflexion. Chongyang (ST 42), Taichong (LR 3) and Qiuxu (GB 40) are added if there is foot drop.

Source: Compendium of Acumox written by Yang Jizhou.

Action: Promoting the flow of qi to activate blood circulation and dredging meridian.

Elucidation: The occurrence of the paralysis of common peroneal nerve results from injury, infection etc. in most cases. The pathogenesis is mainly the failure of nourishing tendons, bones and muscles, and unsmooth joint movement caused by meridional obstruction by pathogenic factors, unsmooth circulation of qi and blood. The disease mainly fails into the category of flaccidity-syndrome according to its manifestations. The disease involves principally the gallbladder meridian, so the acupoints in this prescription are mainly located on it.

Huantiao (GB 30), which is distally selected according to “acupoint in a meridian can be needled to treat the diseases to which the meridian flow”, can be needled to dredge the gallbladder meridian, to promote the flow of qi to activate blood circulation.

Yanglingquan (GB 34), a major acupoint of the gallbladder meridian and the confluent point of tendons, is a commonly used effective acupoint in treating lower limbs flaccidity in clinic practice. Yanglingquan (GB 34) is needled to toughen musculature, to smooth joint movement to recover patients’ lower extremities movement.

Yangfu (GB 38), located on the lower part of the shank, can be needled to expel wind and to dredge collaterals to regulate the regional qi and blood. Dysfunction of ankle joint is one of the main symptoms of the disease.

Taixi (KI 3), the Yuan-Source point of the kidney meridian located between ankle postior tendons, is the place of qi and blood pouring into. Hence Taixi (KI 3) can be needled to regulate and supplement qi and blood to nourish masculature,  to smooth ankle  jount  movement.

Dysfunction  of  toe movement is a common symptom of the disease.

  • So Zhi-yin (BL 67), the Jing-Well point of the bladder meridian, is selected to smooth joint movement.
  • Fuliu (KI 7), an acupoint of the kidney meridian, is added to produce coordinated effect of smoothing joint movement if there is inability of doxiflexion.

Acupuncture Treatment of Foot Drop

Foot drop is another commonly encountered main manifestation caused by tendon weakness resulting from severe failure of nourishing musculature. The liver, closely related to the tendons, controls the tendons. Taichong (LR 3), the Source-Yuan point of the liver meridian, is added to toughen tendons, to smooth joint movement, if there is foot drop. Chongyang (ST 42) located on the anterior surface of the ankle, and Qiuxu (GB 40) located on the lateral side of the ankle are selected to coordinate with Taichong (LR 3).

Indication: Paralysis of the common peroneal nerve. The main manifestations are feet drops, inability of the foot and toe doxiflexion, inability of foot eversion. The foot assumes talipes equinovarus., raise leg too high with toes touching down first, and the sole patting the road surface when walking which appears the state of taking by strides. There is muscular atrophy (myophagism) on the lateral side of the shank, and hypoesthesia on the anterior, lateral side of the shank, dorsum of the foot as well as No. 1 – 4 toes.

Performance:

Huantiao (GB 30) is needled perpendicularly 2 – 3 cun. The needle is swirled-rotated and lifted-inserted for strong stimulation to make the acu-esthesia transmit to the lower limb as far as possible.

Yanglingquan (GB 34) is needled perpendicularly 1 -1.5 cun. The needle is manipulated with the reinforcing method achieved by swirling-rotating and lifting-inserting for 1 minute to make the obvious acu-esthesia be felt in the local region.

Yangfu (GB 38) is needled obliquely 0. 5 – 1 cun downward. The needle is manipulated with the mild reinforcing-reducing method for 1 minute to make the acu-esthesia be felt in the local region.

Taixi (KI 3) is needled perpendicularly O. 5 – 1 cun. The nnedle is manipulated with the reinforcing-reducing method achieved by swirling-rotating and lifting-inserting for 1 minute to make the obvious acu-esthesia be felt in the local region.

Zhiyin (BL 67) is needled obliquely about 0.2 cun upward. The needle is slightly swirled-rotated.

Fuliu (KI 7) is needled obliquely 0.5 – 1 cun downward. The needle is manipulated with the mild reinforcing-reducing method for 1 minute.

Taichong (LR 3) is needled obliquely 0.5  1 cun upward. The needle is manipulated with the reinforcing method achieved by swirling-rotating for 30 seconds to make the obvious acu-esthesia be felt.

Chongyang (ST 42) is needled perpendicularly about 0.5 cun avoiding the artery. The needle is manipulated with the mild reinforcing-reducing method for 30 seconds to make the obvious acu-esthesia be felt.

Qiuxu (GB 40) is needled perpendicularly about 0.5 cun. The needle is manipulated with the mild reinforcing reducing method for 30 seconds to make the obvious acuesthesia be felt.

All the needles are retained for 30 minutes during which the needles are manipulated 3 – 5 times. Or put through the electrical needle instrument with the principal points such as Huantiao (GB 30) and Yangfu (GB38), or Yanglingquan (GB 34) and Yangfu (GB 38) to strengthen the stimulation.  Or coordinate suspending moxibustion with moxa roll, warm needling, or cupping at the corresponding place of the affected part after puncturing.

Clinical material: Ren Yalan reported the treatment of 30 cases of the paralysis of common peroneal nerve with electric acupuncture therapy.

Therapeutic method:

The acupoints selected were divided into two groups.

  • 1. Huantiao (GB 30), Yanglingquan (GB 34), Juegu (GB 39), Zu-linqi (GB 41);
  • 2. Zusanli (ST 36), Fuxi (BL 38), Xia-juxu (ST 39), Jiexi (ST 41).

Select one group each time. Connect the first two acupoints with the negative electrode, the later two with the positive electrode. Control the frequency at 20 – 30 times per minute. Enlarge the electrical current gradually till the patient’s foot dorsiflexion appeared or to the patient’s tolerance. Electrify 20 -30 minutes per time.

The treatment was given every other day. One course of the treatment was composed of 10 times. The interval between two courses was 5 days. Consequently, 19 cases were cured, 3 were significantly effective, 4 effective, 4 ineffective. The total effective rate was 86.7 %.

The patients whose disease was due to constriction and injection, whose course of disease was shorter than six months and who had good responses to the electric treatment had the ideal effect.

Reference: Shanghai Journal of Acumox, 1986, (4) : 18

Xie Linyuan reported the treatment of 40 cases of the paralysis of common peroneal nerve with Acumox therapy. The therapeutic method: The manipulative technique of reinforcement achieved by lifting-inserting and rotating-swirling was applied on Zusanli (ST 36) and Taixi (KI 3). The mild reinforcing-reducing method was applied on Jiexi (ST 41), Taichong (LR 3) and Shangqiu (SP 5). All the acupoints selected were located on the affected side. The needles were retained for 30 minutes during which the needles were manipulated twice. Moxibustion with moxa roll on Zusanli (ST 36) was applied for 5 minutes after withdrawing the needles. The treatment was given once a day. Consequently, all were cured. Seven cases were cured after 6 times of treatment. Twenty nine were cured after 7 – 12 times of treatment. Three were cured after 13 – 18 times of treatment. [Journal of TCM, 1982,(9): 43]

Typical case: Zhang, a male worker of 30. Fracture of the right femora shaft …reposition through operation. Four days after operation, the patient was aware of hypoesthetic sense, numbness of the part below the right shank, and dyskinesia of toes. Examination: Foot dropping, inversion, limited movement of the ankle joint and toes, hypoesthesia of the dominating skin of the common peroneal nerve. It was analyzed that the reason was plaster pressing. Loosen it at once. Give VB1, VB12, etc., the patient was not improved.

Shift him into Acumox-physiotherapy department. The prescription was composed of Zusanli (ST 36), Yanglingquan (GB 34), Sanyin-jiao (SP 6) (bilaterally), and Taichong (LR 3), Jiexi (ST41), Taixi (KI 3) (located on the affected lower limb). Performance: –Manipulate the mild reinforcing-reducing method. After the acu-esthesia was induced, put through the two No. 1 output electrodes with the needles handle on bilateral Zusanli (ST 36), the two No. 2 output electrodes with the needles handle on bilateral Yanglingquan (GB34), the two No. 3 output electrodes with the needles handle on Taixi (KI 3), Jiexi (ST 41) respectively. Control the electrical current at 2mA. Adopt Continuous wave. Select 4 – 6 acupoints each time. The treatment was given once a day. The needles were retained for 25 minutes. Ten days made up one course of treatment. The interval between two courses was l0 days. After 2 courses of treatment, the toes could stretch, the foot drop was almost corrected. After another continuous 2 courses of treatment, Shenshu (BL 23), Huantiao (GB 30), Xuehai (SP 10) etc. were added. The patient was guided to strengthen the functional training of the affected lower limb. Two months later, symptoms and physical signs eliminated, and the function recovered. [ China Journal of Acumox, 1997, (8) : 484]

From:tcmencyclopaedia.com Time:2008-12-05 14:35:14

REFERENCE: http://tcmencyclopaedia.com/Acupuncture-Moxibustion/info/20081205_666.html

Accupuncture, Acupunture or Accupunture common misspelling

Note that “Acupuncture” is often misspelt as accupuncture, acupunture or accupunture, that is with either too many c’s or not enough c’s. I would love to be able to clear up this very common spelling mistake, and set the record straight.

Ac·u·punc·ture – pronounced ak-yoo-puhngk-cher; Origin: 1675–85; < Latin acū with a needle (ablative of acus  needle) or acu- (as combining form of acus ) + puncture.

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