Pain In The Plantar Part Of Patients Diagnosed With Jokjeogeunmakyeom

Maeseon Precipitation Case Report

[Abstract]
Effects of Catgut-embedding Acupuncture Therapy on Plantar Fasciitis:
Case Report
Objectives : The purpose of this study was to report the clinical effects of catgutembedding acupuncture therapy on plantar fasciitis.
Methods : Two patients were treated mainly with catgut-embedding acupuncture
therapy and partly with other Korean medicine modalities. Catgut-embedding
acupuncture therapy was applied once a week for three weeks, and follow-up
observation was conducted by telephone survey two months after the first treatment.
Results : In these two cases, the pain numerical rating scale(NRS) gradually decreased
from 8 to 1, and the pain relief as well as the improvement in ambulatory function was
maintained at two-month follow-up.
Conclusions : Catgut-embedding acupuncture therapy could be effective for painreduction and functional improvement in plantar fasciitis.

I.

Introduction

Jokjeogeunmakyeom diseases commonly seen in clinical, calcaneus

The plantar medial and that caused pain and tenderness along the plantar internal
combustion And characterized by: 1), Calcaneal plantar surface of the pattern emitted
from lead They also expanded the pain along the plantar fascia in 2). The exact source
But it has not yet been identified by the jokjeogeunmakyeom alone, or It seems to occur
as a part of systemic inflammatory disease, obesity Or a long period of time barefoot or
wear indoor slippers, high strength aero And the like are thought to induce big factor 3)
. Most of the time Improve symptoms but is known to be improved and progress

6 ~ 12 months about the time required before and 4).Nonsurgical

Ever charged with long-term symptoms often persist despite treatment
Defeated therapy or surgical therapy situation is also being considered, such as fascia
incision 5). The aim of this herbal basically deep or seals
Maeseon precipitation method designed to treat the diseases of old
In view of the principle of maximum stimulation with the long and yuchim
To heal every disease by inducing a female biological treatment mechanism
Impregnation line 1) Determined to be applicable to the jokjeogeunmakyeom
The.
Maeseon precipitation is hyeolwi sheets formed the basis of the principle of and

Chapter one of the remedies to purchase a specific foreign substance ongoing hyeolwi
By providing incentives for a method for treating a disease. Metal tools
Yangjiang line, etc. are used in domestic and overseas that came with chromic
And the room was used mainly for surgery 1)
, Now tissue reaction
After a period of time less hydrated melting, suture proven safety
The Polydioxanone (PDO) seal is widely used 6)
.
Maeseon precipitation is ever enough to be used in almost all areas of Oriental
Medicine
Eungjeung but it is very broad. 7)
, As reported in national studies
Mainly facial lifting, facial paralysis, wrinkles, obesity, such as cosmetic surgery
Areas 8-10)
It was done by the center, musculoskeletal diseases and pain
The report relating to ankle ligament damage 11)
, Spinal cord injury 12)
, Disc herniation
13)
And the shoulder through 14)

A rare situation, etc., apply to jokjeogeunmakyeom

Yonghan example appears to have been reported.
The aim is to spit Pusan National University Oriental Hospital sub-plantar pain Address
When the maeseon precipitation in patients jokjeogeunmakyeom two people who visited
the former Department
Got a significant result is performed, so that reports the imsangrye
Bayida.
. Way
1. practitioners
All hanuihakjeok treatment, including treatment of this case is every scribe
Professor, Department of Clinical Acupuncture career more than 25 years in the
outpatient environment
We performed a clinical career more than three years of major medical and bedding
It was secondary (Fig. 1).

2. Every scribe treatment

Practitioners and assistants to wear sterile gloves and masks
Was to prevent the infection, the lesion before and after the needle Poby
Money was disinfected. Every scribe lines and characters are completely skin
Do not expose was out. Half of the patients after surgery every scribe
Response to treatment at 5 to 10 minutes after the other to take a stable
It was in progress. Specific treatment methods are lead individually depending on the
case
As it was described.
3. Evaluation
Numeric rating scale for the assessment of pain in the plantar part, to function measure

We used the assessment tools such as the open for safety assessment
It confirmed the presence of adverse events in question.
1) Number Assessment Scale (numerical rat ing scale,
Under NRS)
0 to 10 (most severe pain) in the (no pain) to the number
Number of patients using the degree of the pain felt by using
The words to say or to write glow. Overall pain intensity
And used to evaluate, it is very simple, convenient and fast
It has the advantage 15)
.
2) to measure function (foot function index, below
FFI)
A function to pain (pain), disability (disabi l ity), activity limitation (activity
In the three areas of restriction) as a tool to evaluate, 23
It consists of entry, and relatively high reproducibility and reliability
All. Displays the highest pain score 10 points for each item
And so, to obtain a percentage score. The higher the gross score
Means the pain and functionality 16)
. Case 1, used in the evaluation
No nails were, and was used only in case 2.
3) adverse reactions
Immediately after every treatment and after-treatment before and after every scribe any
fire treatment
Pyeongam even felt it was an open question whether or not
It confirmed through. In addition, every scribe telephone two months after the first
treatment
The elapsed call was confirmed.
. Case report
1. Case 1
1) Patients

(1) Present history

About 4 months ago, 58-year-old woman with byeolmu motive inde left ankle
Part pain occurred by visiting a nearby orthopedic plantar fascia
Salt diagnosed with symptoms such as physical therapy and acupuncture Byzantines
It was continued. 20 days before the present admission of steroid injections
Hit once, improvement of symptoms was 3 days taking NSAIDs
This was not admitted on June 19, 2013.
(2) address authentication
The main symptoms are most severe in the morning weather during naedinneun pain
plantar part of the first walking, walking or standing upon this aspect to increase
sustainable
It was. Parts of the calcaneal tuberosity part confined to the typical jokjeogeunmakyeom
It showed the pain aspect.
(3) history
There were no unusual medical history and medications you are taking.
2) treatment
(1) stable and tender evaluation
The patient takes the supine position in a quiet and stable while clinics
So then, practitioners are left calcaneal tubercle part in the vicinity through the
promotion
2 where the highest tender was confirmed appears.
(2) Every scribe treatment
Every markers (cue Mira, 31 G 2.5 cm, the highest tender Eastern bedding
Works, Korea), one by one, were a total of 2 characters.
(3) every other scribe treatment
After every scribe surgery, disposable hochim (0.40 40 mm, making the Eastern
bedding
Cattle, the affected South Korea) (ST36) and (SP9) and (GB39)
and
(LR3) and a needle depth of about 2.0~2.5 cm and
Connect the clip to the EA was yuchim 20 minutes. EA is

2 to 100 Hz, and the alternating frequency of the magnetic pole in 150 ms, the patient is
indeed
It was adjusted to be in the strength immediately before a pain thresholds.
(4) Period
A method of needle selection and combination of the EA in every week intervals
The total procedure was three times, the fourth admission, the treatment was performed
only EA
All. Markers and other every other EA treatment was not performed.
3) treatment progress
(1) Before treatment
Week average of subjective pain as measured by the initial examination of patients
NRS
Was the NRS 8, walking is possible without pain for about 5 hours buneu
It was limited to.
(2) After each treatment
The primary characters immediately after the patient every scribe remarkable sense of
family root pain
It did not appeal represented a small discomfort in walking. After Exchange
The temporary pain in the treated area about 1-2 days after each treatment Scriber
There has been increasing gradually since the pain is reduced, 3rd
The similar pattern was repeated courses of treatment. Fourth complained pain
The lighter it is refreshing to express hardly occurs, EA
The treatment was completed with treatment
(3) after 2 months after the initial examination
Two months after the first medical examination was confirmed progress through the
phone, the ring
The average pain NRS 1 is the last week or so, limited to walking

No improvement was that the state is maintained (Fig. 2).

(4) adverse events

Every scribe than the pain I had temporarily increased after characters
Discomfort or adverse events were not observed.
2. Case 2
1) Patients
(1) Present history
About five years ago, 54-year-old woman with bilateral plantar part byeolmu motive inde

The pain was diagnosed as jokjeogeunmakyeom appear. Initially ankle

A heart full of pain in the plantar part nateu appear to me, long morbidity
While there was a slight variation in the period was pain site. self
He continued stretching exercises and physical therapy, but did not improve
And, four months before admission anti-inflammatory steroid injections for pain hit
Taking the first but the symptoms persisted visited July 31, 2013
It was.
(2) address authentication
Top tenderness upon palpation pain in the plantar part iteudoe whole metatarsal
PIP was up 2-5 in the metatarsal portion. Particularly severe on the left
He complained of pain.
(3) history
There were no unusual medical history and medications you are taking.
2) treatment
(1) stable and tender evaluation
After the patient is in the supine position to stabilize in a quiet office,
Put on the plantar surface tenderness three fingers left metatarsal 2-4 is a vision check
It was lowered.
(2) Every scribe treatment
1 car: highest tender destination from which side of the left plantar metatarsal 2-4
magazine
place every three markers (cue Mira, 29 G 4 cm, Eastern bedding
Works, Korea) and one by one, were a total of three characters.
2 cars: one week after the second visit, the scope and degree of pain sense
1-3 cows with left foot span two appeared only where tenderness wife
And were characters every scribe in the area.
3 car: after the third week also left second toe at the time of visit
who appear only where the pain is, only where that area, and
Characters every scribe was to end the treatment.
(3) every other scribe treatment

Each needle selection and treatment in the same manner as the method of EA
treatment Case 1
But it was conducted on both sides, and further , and vapor of
Ssoeneun fumigation therapy to the affected area to either side was applied for 20
minutes.
(4) Period
The scribe sheets, how to circle the combination of EA and fumigation treatments
But the procedure three times a day intervals, every scribe treatment and the number of
characters
Position was adjusted according to the symptoms.
3) treatment progress
(1) Before treatment
The initial examination of the patient's subjective pain NRS 8 Average been a week
Was, FFI was 51 points. Possible time walking without pain
10 minutes, so there is limited.
(2) After each treatment
Temporarily in case 2, the patient is also treated area in the course of treatment
It showed an increase in pain after a lapse of 4 to 5 existing procedures
The pain has been significantly reduced (Fig. 3).
(3) after 2 months of treatment
Pain initial examination confirmed by telephone two months after the lapse of so as
NRS 1
Was good, the patient is "conceivably If you do not mind a bunch," said
It was.

(4) adverse events

Pain or discomfort, temporary increase in other adverse show
I was born.
. DISCUSSION
Jokjeogeunmakyeom origin of the plantar fascia of the medial calcaneal rough to
It means a micro-tear and chronic inflammation that occurs, and 17)
, Pain
Characterized by a predominantly occurs in the plantar medial calcaneal, in part
calcaneus
Since it also expanded along the plantar fascia 2)
. Fall or twist
Damage is independent, is the main histological findings in the fascia fibers
Is a chronic degenerative changes are present 4)
. The prevalence of the disease,

Risk factors, prognosis, etc., but itjineun is clearly presented, adults

It is one of the major causes of foot pain, plantar associated with running
It appears to account for one-quarter of the injury, being overweight, standing for a long
time
Because, ankle movement restrictions and the like are estimated to be a risk factor 2)
. Godfather
Here are the symptoms minute Hansung improvement over time (selfabout 6-12 has been known to be improved by l imiting) disease
The time required for about a month, will have an effect on daily walking
Caused considerable discomfort, and this, no case has yet to be prolonged symptoms
Knees, hip, waist and can also result in a longer week
The disease righteousness required 4)
. In general, a history and clinical findings minutes
When people X-ray, MRI, etc. are not required view of one about 6-8 weeks
If you do not improve with treatment and underwent further tests jonjeok 4)
.
Also it is known to occur in approximately one-third of bilateral
I 18)
When it appears to be a bilateral joint pain Blood Sword
Four suspected spinal arthrosis and the voice is the differential diagnosis for this field
Yohada 4)
.
Jokjeogeunmakyeom of treatment with generally conservative treatment is applied
And, a good result with only conservative treatment in patients with a large number of
yet
And it has been known to exhibit 5)
These various conservation
Based on the effectiveness of treatment methods it can be quite limited
The 2)
. Custom orthoses (insoles) is hayeoteu sikindago improve functionality
The effect on pain and was not confirmed, taping Pain

It seems to be helpful in reducing short-term (one week) of effects

There are limited grounds. Steroid injections are commonly used
However, effective in reducing pain compared with placebo or other therapies
Clear evidence is not yet sure and the risk of long-term complications
Is related to the transient 2)
.
Hanuihakjeok geuntong to family therapy and the and , toe
Extensor origin, mainly ahsihyeol rod acupuncture, anti-inflammatory, Goku, yunje
It was presented, including the use of acupuncture 1)
, EA 19)
, Antler 20 acupuncture)
, EA
Acupuncture and Chinese medicine and antler 21)
, Relaxation therapy and acupuncture plantar fascia 22)
And so on
There is a case report applies. In this case coming jokjeogeunmakyeom
Was applied every scribe in the barrel due to plantar, plantar far
Apply every scribe in fasciitis report that unfulfilled
It appears.
Every scribe of 'skin, meridians, long lines and oil to purchase gyeonggeun
Changes in the structure and function of the human body through the maximization of
irritation caused by the needle
With the main objective of precipitation Tuesday as "8)
, with the principle of
It was formed on the basis of 1)
. and and in "
, , , , "was called
He said, and and The "
, , , , "referred to more
Deep and long yuchim said that the disease is necessary. 8)
. Also maeseon

When using a needle transverse to stimulate simultaneously two or more hyeolwi

It may, ' ' related to significant transient
There. precipitation is as much a practical application value, less surgery
There are benefits of a strong stimulus, the stimulus also maebeop pole of
Equals in the sense that the purpose of the conversation because every scribe and
ilmaek
When utilized with the fairly efficient way to stimulate hyeolwi
It is expected to be.
Each needle selection by this principle is the chronic and intractable disorders
Feed the effect was to be expected, a longer yuchim
It was motivated by the need to maximize patient jokjeogeunmakyeom
Each needle selection to apply, and it was confirmed that the elapsed.
Looking at the motivation of this case presented the patient, case 1 is affected
This period of four months, this case is a duration of 2 to 5 years, whilst the non-stereo
Lloyd St. multiple beams, including NSAIDs and steroid injections
Jonjeok treatment does not improve the Byzantines was admitted. Patients
With regard to the address of increased pain in the plantar region is eoteuna there is
limited portion week average of initial examination NRS pain intensity in all 8
Were higher, the pain is caused when walking or outdoor activity I work
Ball subjective discomfort that appeals greatly limits the ability of simultaneously
Tongjeom had. Every scribe in the plantar part of the procedure up to tender
Every other week for three times subjected to pain and observed changes. Hawk
Scriber after treatment, in addition to applying the foot and EA
Part of the sotoe hyeolwi not for the purpose of wealth improve circulation and pain
relief
Was a core, of this that
(ST36), subjectivity that plantar part (SP9)
And the to (LR3), the (GB39)
I was selected. Case 2 is also oriented to the medicine
It was added to the fumigation therapy for the purpose of improving circulation and pain
of the affected area

All. In the present case to rule out the effects of EA and fumigation treatment
But the number, the old R 19)
EA treatment with therapeutic ends at
Up to twice a week, on the 10th or 15th degree of treatment with 3 to 4 intervals
Compared to what was needed, one EA treatment of this case is
AA, that number is considerably less by only four times in a week interval,
In addition, it reduced back pain temporarily increased after each treatment Scriber
After treatment with aspects that will be shown to specific short-term reactions
The main change as pain reduction was seen to be due every scribe
The feed. Looking at the course, both cases two months after the first visit
Pain reduction was observed lapse also state was maintained, gait function
Also it has been shown to maintain a good condition.
Looking at the existing research on the course and outcome of treatment,
23, etc.)
In the study to 37 patients in both conservation treatment
Standing symptoms were consuming an average period of three months disappeared
six months
Patients were spent on the road as 8%. The antler-oriented acupuncture
If you have visited one months after onset of treatment also apply to the
10 were reported to be 20 times more therapeutic needs)
. However, this
Case 1 and 2, so the patient does not need additional treatment
Pain is the time it took about 3 weeks to reduction treatment
Count circuit 3, it was able to significantly shorten the healing process
Also it found that significantly reduced pain level decreased to 1 in NRS 8
It was.
Pain reduction was seen in this case, every scribe ,
With the physical effects through the and , non-corrupt organization
, Causing the phagocytic inflammatory response promoting the recovery of the tissue
site
Or the treatment of the living tissue that is induced by a chemical effect

So look to other woke l)

. The plantaris muscle in characters that every needle selection hwancheo
Chronic inflammation is thought that the film would facilitate the recovery of the tissue.
In general, the reaction and after every scribe regard to treatment, treatment
After local redness, swelling, pain within 1-5 days, such as hot flashes appear
Can be 1)
Domestic research in every scribe bruising and pain after the procedure
Appeared in all patients, discomfort in the area characters 2-78%
There were reports of 24)
. In this case also 2-3 days
Pain in the treated area was temporarily increased, the patient reported a
Pain intensity according to the most simhaetgo, after repeated once during the first
treatment
The more alcohol increases the degree of pain decreased. Therefore every scribe
For four of the pain and discomfort that can occur during surgery
It is needed before this explanation. Scriber bruises after every treatment, whole
Syndrome, symptoms such as discomfort is usually lost within 1-2 weeks
Look, every scribe after treatment side effects such as foreign body granuloma Case
It also reported 25)
Precautions such as aseptic handling procedures
Punctuality will need to have, and short- and long-term pain after acupuncture part
Be careful observations about the action, reporting and analysis is done
Will. Maeseon is the time to be absorbed normally takes about 28 days
Considering that L)
After one last procedure in this study every scribe
March and confirmed by the lapse of an open question at this point in time lapse
Was, all of a patient's case there was no sense of discomfort due to maeseon
And he replied.
This study is the case, and only 2 cases, pressure from various fields and to stand pain
After using objective tools, such as rub evaluation will be done
But the point is not whether you can limit that, so far jokjeogeunmakyeom

Apply every scribe who reported no example of the effect on, every scribe
Lack of research applied to many diseases and musculoskeletal pain, plantar
Meaning that was presented during the course of the procedure in every scribe fasciitis
And that in future more advanced study and consider a variety of clinical fields
It is considered cost.
. conclusion
Pain in the plantar part markers every two people diagnosed with jokjeogeunmakyeom
It applied the law, through significant after treatment three times a week apart
Increase was observed reduction and improved gait function is displayed, after two
months
It was kept in good condition even when observed