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Anesth Analg 2007;104:452
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000247767.10131.35

LETTER TO THE EDITOR

Section Editor:
Lawrence Saidman

Collateral Meridian Therapy Dramatically Attenuates Pain and Improves Functional Activity of a Patient with Complex Regional Pain Syndrome

Chih-Shung Wong, MD, PhD, Chang-Po Kuo, MD, Yu-Ming Fan, MD, and Shan-Chi Ko, MD

Department of Anesthesiology; w82556{at}ndmctsgh.edu.tw (Wong, Kuo) Department of Nuclear Medicine; Tri-Service General Hospital, National Defense Medical Center; Taipei, Taiwan (Fan) Pain Clinic; Painless Ginza Hospital; Ginza, Japan (Ko)

To the Editor:

Complex regional pain syndrome (CRPS) remains a difficult and frustrating disorder to treat. Sympathetic blockade with local anesthetics is the "gold standard" treatment, but its efficacy is variable (1). We describe successful treatment of a young male having CRPS with a new acupressure method, collateral meridian therapy.

The patient had previously received various treatments: repeated lumbar sympathetic blockade and large quantities of oral medications (total 91 analgesic pills per week, consisting of Ultracet, tramadol, imipramine, and dextromethorphan). These interventions only modestly controlled his pain (pain scores between 6/10 and 4/10). During the subsequent 7 mo of collateral meridian therapy, his pain and medications were substantially reduced (Fig. 1). Bone scans also revealed dramatic improvement (Fig. 2).


Figure 140
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  		Figure 1. The open boxes show the patient’s VAS scores over time for the 7 mo before therapy. The closed box shows the rapid and sustained improvement in the months following BMT treatment. The patient’s pill usage decreased as the pain resolved with BMT treatment.

 

Figure 240
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  		Figure 2. Three-phase bone scan. Before (A) and after (B) acupressure, BMT treatment.

 

According to traditional Chinese medicine, pain originates from the obstruction of Qi (2). Traditional acupressure uses only a single acupoint on the involved meridian (3), which relieves the obstruction and smoothes the flow of Qi in the body. In this case, we found that manipulating two acupoints on a collateral meridian, one for connecting with the involved meridian and the other, corresponding, point for the treatment of the involved location, is more effective than the traditional acupressure, which is limited to treating the involved meridian. Our case demonstrates successful treatment of a CRPS patient with collateral meridian therapy, which merits further study, and may prove useful in combination with standard treatments for intractable pain.

REFERENCES

  1. Cepeda M, Carr D, Lau J. Local anesthetic sympathetic blockade for complex regional pain syndrome. Cochrane Database Syst Rev 2005;4:CD004598.
  2. Lee YH, Lee MS, Shin BC, et al. Effects of acupuncture on potential along meridians of healthy subjects and patients with gastric disease. Am J Chin Med 2005;33: 879–85.[Web of Science][Medline]
  3. Lee MK, Chang SB, Kang DH. Effects of SP6 acupressure on labor pain and length of delivery time in women during labor. J Altern Complement Med 2004;10: 959–65.[Web of Science][Medline]



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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press