Release adhesion method

Small needle knife therapy is the best way to relieve adhesion;

I. [Overview]

Small needle knife is an acupuncture instrument made of metal material, which looks like a needle and a knife. It is developed on the basis of the needle and the front needle in the ancient nine needles, combined with the scalpel used in modern medical surgery, and is the product of organic combination with soft tissue release surgery. It has a history of more than ten years, and has a trend of further development in recent years, which has been valued by the world.

Small needle knife therapy is a closed release between surgical and non-surgical methods. It is formed on the basis of open surgery combined with acupuncture. The operation characteristic of small needle knife therapy is to easily cut, peel and other different starting stimuli in the deep part of the treatment site to achieve the purpose of relieving pain and getting rid of the disease. The indications are mainly soft tissue injury and osteoarthrosis.

The advantage of small needle knife therapy is that the treatment process is simple and is not limited by any environment and conditions. In the treatment process, the incision is small, no suture is needed, the damage to human tissues is small, infection is not easy to cause, no adverse reaction is caused, the patient has no obvious pain and fear, there is no need to rest after operation, the treatment time is short, the course of treatment is short, and the patient is easy to accept.

Two. [Basic content]

1, needle

Small needle knives are mostly made by themselves, with slightly different shapes and lengths, generally about 10- 15 cm, with diameters ranging from 0.4- 1.2 mm, and are divided into three parts: handle, needle body and needle knife. The width of the needle knife is generally equal to the diameter of the needle body, and the cutting edge is sharp. Some are modified with small surgical blades, and some are modified with dental probes.

Small needle knife must be autoclaved or soaked in alcohol before use.

2, the operation method

(1), the choice of body position is based on the principle that doctors are convenient to operate and patients feel comfortable when receiving treatment. If the neck is treated, sitting position is often used; The head can be raised or lowered according to the position of the disease;

(2), choose a good location, choose a good treatment point, local aseptic disinfection, namely, first with alcohol disinfection, then with iodine disinfection, then with alcohol to smell.

The doctor puts on the sterile gloves, and finally confirms the injection site and marks it. Sterile hole towel can be applied to the body joints or complicated parts to prevent pollution during operation.

In order to alleviate the pain caused by local surgery, local anesthesia can be used to block nerve pain conduction. Commonly used injection drugs are:

A, 1% novocaine 2-5ml/ each injection point.

B, about 5 ml of 2% lidocaine per injection point.

C, 5ml of 2% lidocaine and 0 ml of triamcinolone acetonide A 1, mixed and injected into 2-3 treatment points respectively.

(3), commonly used demoulding methods are:

A, along the distribution direction of muscle fibers or tendons, that is, the tip of the needle knife clings to the tissue to be peeled and moves forward and backward (it is not allowed to pull up and down for insertion), so that the laterally adhered tissue fibers are broken and loosened.

B swing the tip of the horizontal or fan-shaped needle knife to break and loosen the vertically adhered tissue fibers.

C, do oblique or non-directional needle knife tip stroke swing action, make irregular adhesion tissue fiber fracture, loose.

Stripping measures should be taken according to whether there is adhesion or not. Pay attention to all kinds of peeling actions, and the amplitude must not be too large to avoid scratching important tissues such as blood vessels and nerves.

(4) Each acupoint can be removed by cutting and peeling for 2-5 times each time, and it can be cured after general treatment of 1-5 times, and the interval between two times can vary from 5-7 days as the case may be.

(5), small needle knife application indications:

First, the patient consciously has pain symptoms somewhere.

B, the doctor can touch the sensitive tenderness in the lesion.

C, palpation can touch the subcutaneous cord-like or flaky or spherical hard objects and nodules.

D, there is a noise when dialing the lesion with your finger.

Three. [Clinical application]

1, cervical spondylosis

Acupoint selection: pain points are the main ones. Yangming meridian headache combined with valley and Neiting points; Headache in shaoyang meridian with foot near weeping and Fengchi point; Taiyang meridian headache with Kunlun and Houxi points.

Methods: Straight needling method was used. Gently peel 1-2 times, which can be combined with local massage to enhance the curative effect.

2. Inflammation of lateral humerus and upper ankle (tennis elbow)

Acupoint selection: Find the most obvious tenderness.

Methods: the knife edge line of the small needle knife was parallel to the extensor carpi and penetrated into the subcutaneous layer of the lateral epicondyle of humerus. First, use the longitudinal dredging and peeling method, then use the incision and peeling method to go backwards, and feel that the sharp edge has been scraped flat. Then use the transverse scraping method to dredge the extensor carpi extensor carpi communis and supinator tendon, and then take out the needle knife for dressing. Elbow flexion and extension 2-4 times, generally 1, 2 times can be cured, with an interval of 5 days each time.

3. Stenosing tenosynovitis of flexor tendon (snapping fingers)

Acupoint selection: local pain points.

Methods: longitudinal shovel stripping method was used

4, heel pain (heel spur)

Acupoint selection: the tip of bone spur (tenderness is the most obvious).

Methods: The patient lay on his back on the treatment bed, put his feet firmly, and found out the most obvious tenderness point. After routine disinfection, the needle edge line is perpendicular to the longitudinal axis, and the needle body forms a 60-degree angle with the heel, and the depth reaches the tip of the bone spur. After 3-4 times, the needle knife can be taken out. If 1 time does not heal, you can do it again after 5-7 days.

5, the third lumbar transverse process syndrome

Acupoint selection: where tenderness is obvious.

Methods: the knife edge line of small needle knife was parallel to the longitudinal axis of human body. When the knife edge touches the bone surface and there is a sense of looseness between the muscle and the bone surface, the needle can be taken out by horizontal stripping method. Generally 1 time, you will be cured, and you will be cured again after 5 days.

6. Chronic lumbar muscle strain

Acupoint selection: waist tenderness point (Shenshu point).

Methods: Same as before. Can be combined with cupping to enhance stimulation.

7. Lumbar disc herniation

Acupoints: the tender point of intervertebral space (at the intervertebral joint), the midpoint of numbness area of calf or Chengshan point.

Methods: Insert the needle knife into the waist at the center of the pain point. When the needle tip reaches the tissue around the intervertebral facet ligament, dredge and peel it for 3-4 times, and then take out the needle knife. The calf part can be peeled off vertically by a straight needle.

Four. [Notes]

1, because the small needle knife therapy is operated under non-direct vision, it is easy to cause injury if you are unfamiliar with human anatomy, especially local anatomy, and the technique is improper. Therefore, doctors must be familiar with the anatomical knowledge of deep acupoint stimulation, so as to improve the accuracy of the operation and improve the curative effect.

2. Acupoint selection must be accurate, that is, when Ashi point is selected as the treatment point, the needle must be inserted in the center of the pain point and kept vertical when inserting the needle (the needle insertion method can be flexibly selected for non-pain point selection). For example, if the needle is deviated, it will easily dislocate from the deep lesion and damage the non-pathological tissue.

3. Pay attention to aseptic operation, especially for deep treatment, especially for deep cutting of important joints such as knee, hip, elbow and neck. If necessary, it can be covered locally with sterile hole towel or carried out in sterile operating room. Other parts of the body, pay attention to aseptic operation.

4. The needle insertion method of small needle knife should be quick and agile, which can reduce the pain caused by needle insertion. Deep stripping, such as shovel stripping, horizontal stripping and vertical stripping, should be done lightly, otherwise it will aggravate the pain and even damage the surrounding tissues. When cutting joints longitudinally, be careful not to damage or cut ligaments, tendons, etc.

5. After operation, local massage can be given to some treatment points with less trauma to promote blood circulation and prevent postoperative bleeding and adhesion.

6. For some cases, the short-term curative effect is very good. 1-2 months or more later, the pain recurred and the original disease state was restored, especially in the heavily loaded parts such as knee joint, shoulder elbow joint and waist. Attention should be paid to the following factors: the patient's habitual life, walking posture, working posture and so on lead to recurrence; The local adhesion was relieved by surgery, but the local activity was insufficient after operation and the wound was adhered. It is also caused by cold and dampness. Therefore, special attention should be paid to daily life.