Treatment of Musculoskeletal Disorder - Research Paper Example

 Traumatology: Treatment of Musculoskeletal Disorder with Chinese Medicine Table of Contents II. Literature Review 3 III. Discussion/Argument 7 IV. Conclusion 8 Reference List 9 I. Introduction This paper discusses musculoskeletal disorder treatment making use of Chinese medicine. Such a paper is easily justified by the need for more avenues and modes of treating the condition, to complement existing therapies, and to potentially widen the horizon with regard to the literature, and future research on the subject matter, with an aim towards improving patient outcomes. As the name implies, musculoskeletal disorders are disorders that impact the tendons, muscles, nerves and the support structures around those, such as vertebral discs. They are the result of such structures, or parts of those, having to exert greater effort and work as a result of imbalances, in comparison to other parts. Such overexertion and overwork can result in injuries, pain, and damage, leading to chronic conditions (IOSH, 2012). Back pain is a common form of the disorder, alongside others, and musculoskeletal disorder, or MSD, can manifest along the upper and lower limbs, by classification. Upper limb disorders, or ULDs, has in its fold the so-called RSI, or repetitive strain injury, even as some forms of RSI are not located in the upper limb. Lower Limb Disorders, or LLD, cover the lower torso, including the legs, knees, and hips (Health and Safety Executive n.d.; European Agency for Safety and Health at Work 2012). The symptoms of disorder are well-documented, and include the following: heavy lifting done in repetitive fashion; twists and bends; inappropriate positions when working; too forceful exertions; long hours of work (IOSH 2012). Chinese medicine in general is recognized, meanwhile, to be a treatment modality for various forms of trauma, and in this are included the host of musculoskeletal disorders that have been well-documented and treated in western medicine. Trauma in general, has been documented in western medical literature as benefiting from some forms of Chinese medicine, such as acupuncture (Highfield et al. 2012). A sampling of the available Chinese medicine treatment modalities, in turn, reveal that Chinese medicine has specific, complementing, and varied treatment options for a host of identified MSDs, including lumbar strain, lumbar contusion and sprain, stiff neck, patella strain, piriformis syndrome, lumbar intervertebral disc prolapsed, cervical syndrome, sprain and contusion of the neck, knee joint meniscus injury, tennis elbow, scapulohumeral periarthritis, and trigger finger or flexor digitorum tenosynovitis. A description and a discussion of treatment modalities for lumbar strain in Chinese medicine reveals a very deep understanding of the disorder, by way of example, and open us to the world of possibilities with regard to how Chinese medicine can aid treatment of MSDs in the west. Aside from describing manual manipulation protocols, the treatment outlined also includes herbal treatment to address specific pains, as well as exercise, and treatment modalities to address collateral damage to the main lumbar strain. This paper takes off from this promising initial pass at Chinese medicine to explore how else Chinese medicine addresses MSDs in the particulars and specifics (Guilin Sino-Western Joint Hospital, 2003; Guilin Sino-Western Joint Hospital, 2003b). II. Literature Review This part of the literature details scientific literature on progress made with regard to the western medical establishment’s use of Chinese medicine to treat various forms of musculoskeletal disorders. The thinking here is that a review of groundbreaking work on MSDs and Chinese medicine will give us an indication of where the treatment modalities associated with Chinese medicine is headed, and how far it can help in treatment. Also, a corollary goal is to determine how complementary Chinese medicine is with western treatment protocols for MSDs. The counter-flow is also interesting, and by counter-flow is meant the cross-pollination of ideas and findings from western medicine into Chinese medicine literature and practice. An example of this latter point, for instance, is with regard to practitioners of traditional Chinese medicine looking to advances in western medical understanding of synovial lesions to advance Chinese medicine understanding and treatment of osteoarthritis (Song et al. 2012). Another cross-pollination makes use of advances in polypeptide chemistry knowledge, to advance understanding on the use of Pilose Antler polypeptides in Chinese medicine to advance knee osteoarthritis treatment. The study methodologies adhere strictly to western medical and scientific standards, and so does the publishing of the results, in order that Chinese medicine may likewise benefit from the same rigorous and scientific language that the rest of the western medical world demands, for inclusion in the discussion. The findings for this particular study, set up in the western fashion, show that pilose antlers do in fact aid in the treatment of knee osteoarthritis and limits damage from the knee cartilage as a result of the crippling MSD (Xiu and Sun 2012). Knee osteoarthritis is a key focus for different modalities of treatment in Chinese medicine, again making use of the language and protocols of western medicine to gain legitimacy and also to benefit the study of Chinese medicine treatment protocols for managing the disease (Zhan 2012). Chinese medicine also benefits with new and existing medications proving their value in treating various forms of MSD, including adjuvants arthritis or AA as is the case in the study making use of nux vomica total alkali gel for its treatment. The finding of efficacy advances Chinese medical protocols as being enhanced by the use of the substance to treat AA (Zheng et al. 2012). Going back to literature on the efficacy of Chinese medicine in the treatment of MSD’s itself, there are very promising new advances in the literature, taking existing Chinese medical protocols and expanding them via mixing existing treatments in order to improve treatment outcomes for a number of MSDs. One such study impacts Chinese medicine treatment of knee synovitis, and in this particular study, Nanxing pain paste was mixed with Chinese herbal medicines that act as diuretics and blood enhancers. The result was the substantial easing of synovitis symptoms, including pain management, swelling management and easing, and joint function improvement. The combination is unique and new, and offers a new treatment mode for knee synovitis, where Nanxing pain paste alone was only effective to a more limited extent than the combined treatment. Taking a step back, the research underscores how Chinese medicine has proven itself to be effective in treating and managing MSDs, with the proof being offered in the medical and scientific terms that western medicine can validate, accept and incorporate into its own canon of effective treatments for the disorder (Chen et al 2012). There are also studies further detailing the action of certain forms of Chinese medicine, such as fire needle, in the treatment and management of synovial lesions associated with rheumatoid arthritis. In particular, the study associates the use of fire needle as treatment of rheumatoid arthritis with improving the profile of certain markers in serum, in this case IL-1 and TNF-alpha. By demonstrating that fire-needle treatments affect these serum markers exactly, and affect them positively to improve the condition, Chinese medicine ups the ante on research that demonstrates its effectiveness in ways that complement and that makes western medicine sit up and notice (Han et al. 2012): The pathological states (synovial cells' arrangement, inflammatory infiltration, synovial membrane thickening, etc.) of synovium tissue of the right knee-joint in both medication and fire-needle groups were relatively lighter than those of the model group…Fire-needle therapy can down-regulate serum IL-1 and TNF-alpha contents in rheumatoid arthritis rats, and reduce the degree of arthroncus of the affected joint, which may contribute to its effect in improving synovial lesions (Han et al. 2012). Literature likewise exists for the efficacy of Chinese medicine treatment modalities in the management of pain and the rehabilitation of patients with replaced knees, post surgery. In this study, the Chinese treatment modality is electronic acupuncture, or acupuncture with the addition of electricity to the body part being rehabilitated or treated. The study proves that electronic acupuncture conveys many positive benefits and greatly aids in the rehabilitation of patients after the total replacement of their knees (Chen et al. 2012b): HSS scores in acupuncture-rehabilitation group were markedly higher than those in rehabilitation group in 2, 6 and 12 weeks after surgery (P < 0.05, P < 0.01); VAS scores in acupuncture-rehabilitation group were markedly lower than those in rehabilitation group (P < 0.05, P < 0.01);…Rehabilitation therapy combined with electroacupuncture can obviously restrain the pain during rehabilitation process for total knee replacement patients, improve the endurance capacity of rehabilitation training and motivation, and obviously promote the recovery of total knee joint function (Chen et al. 2012b). Recent literature also explains, in western medical terms, the use of Chinese herbal pastes in the treatment of MSDs in chronic form. The range of MSDs that benefit from the use of herbal pastes in Chinese medicine attests to its wide applicability, and the extensive knowledge of MSD conditions in the canon of Chinese medical literature. The excerpt below abstracts the treatment of MSDs making use of the herbal creams concocted by Professor Shi Qi, a respected Chinese medicine practitioner in Shanghai (Li et al. 2012): When it is time for using tonics in winter, he advocates applying herbal paste for treating chronic musculoskeletal diseases. This paper introduces Professor Shi Qi's commonly used prescription for treating chronic musculoskeletal conditions and puts forward demands and understandings in concocting herbal paste, experience in herbal paste for treating chronic musculoskeletal diseases such as cervical spondylosis, lumbar disc herniation, lumbar spinal stenosis, lumbar muscle strain, ankylosing spondylitis, osteoporosis, knee osteoarthritis and avascular necrosis of femoral head, and the advantages of herbal paste for treating chronic musculoskeletal conditions as opposed to alternative treatments (Li et al. 2012). Literature also exists confirming, via scientific methods, the efficacy of other traditional treatments in Chinese medicine for a host of conditions, including celastrus for ailments that are rheumatic in nature. Here the arena is not a Chinese traditional medicine facility or Chinese medical facility, but a western medical team, investigating the use of celastrus, and finding that it has indeed effective properties that aid in the treatment of arthritis, and does so via mechanisms that are understood to be of importance in western medicine (Yu et al. 2012): Thus, Celastrus treatment (Tc) significantly downregulated a large proportion of genes compared to controls (Tw). The DEG were mainly associated with the processes of immune response, cell proliferation and apoptosis, and cell signaling. These results provide novel insights into the mechanism of Celastrus anti-arthritic activity, and unravel potential therapeutic targets for arthritis (Yu et al. 2012). III. Discussion/Argument The academic and scientific literature on the impact of Chinese medicine on musculoskeletal disorder is vast and promising. The context of the literature review is the on-going porting, so to speak, of that vast knowledge from traditional Chinese medical contexts to more modern, rigorous, scientific contexts. Such porting does not affect its efficacy, but it does affect the way Chinese medicine and its components, especially herbal medicines and animal extracts, alongside acupuncture, electroacupuncture, and physical interventions such as acupressure and massage, are accepted and validated/incorporated into mainstream medical practice in the west. The literature above samples just a tiny fraction of that vast archive, that is continually being added on to and expanded as we speak. The minute details and the extensive branching of the various investigations into the efficacy of Chinese medicine in these contexts attribute to the vast understanding embodied in the Chinese medicine treatment modalities and protocols. It is noteworthy that even the lay literature on Chinese medicine already features an extensive array of diagnoses, treatments, and interventions for many common and not so common forms of MSDs, including lumbar sprain, as already discussed earlier, and many modern occupational musculoskeletal disorders, from simple back pains to work conditions associated with repetitive actions, such as those involving the fingers, the hands, and the arms. In fact, looking at the vast literature to be had from the scientific publications, and looking at the vast history of successful use of traditional Chinese medicine in the treatment of MSDs and a host of other chronic body conditions, one can imagine that the existing literature itself is just a fraction of what can be had from that storehouse of knowledge relating to the management and treatment of MSDs. In this regard, actual practice on the ground can further inform with regard to how Chinese medicine treats these conditions (Li et al 2012; Chen et al. 2012b; Yu et al. 2012; Guilin Sino-Western Joint Hospital, 2003; Guilin Sino-Western Joint Hospital, 2003b). IV. Conclusion Chinese medicine presents a vast and profound treatment option for musculoskeletal disorder, and the trend towards the increasing dialogue between west and east will only benefit practice on both sides. That dialogue is evident in the continued increase in the scientific and academic literature on Chinese medicine for MSD, and in the way Chinese practitioners have embraced scientific language and protocols to demonstrate the efficacy of Chinese medicine protocols conditions (Li et al 2012; Chen et al. 2012b; Yu et al. 2012; Guilin Sino-Western Joint Hospital, 2003; Guilin Sino-Western Joint Hospital, 2003b). Reference List Chen SQ et al. 2012, Combined use of compound nanxing pain paste with blood-promoting and diuretic chinese herbal medicines in treatment of chronic knee synovitis, Zhongguo Gu Shang 25(4). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22812089 [Accessed 6 October 2012]. Chen G et al. 2012b, The application of electroacupuncture to postoperative rehabilitation of total knee replacement, Zhongguo Zhen Jiu 32(4). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22734376 [Accessed 6 October 2012]. European Agency for Safety and Health at Work 2012, Musculoskeletal Disorders, OSHA.europa.eu [Online] Available at: http://osha.europa.eu/en/topics/msds/index_html [Accessed 6 October 2012] Guilin Sino-Western Joint Hospital, 2003, Injury of Muscles and Tendons, TCM Discovery [Online] Available at: http://tcmdiscovery.com/TCMDisease/Orthopedics/list7_1.html [Accessed 6 October 2012] Guilin Sino-Western Joint Hospital, 2003b, Lumbar Strain, TCM Discovery [Online] Available at: http://tcmdiscovery.com/TCMDisease/Orthopedics/info/D-Treatment/20081113_127.html [Accessed 6 October 2012] Han et al. 2012, [Effect of fire-needle intervention on serum IL-1 and TNF-alpha levels of rheumatoid arthritis rats, Zhen Ci Jan Jiu 37(2). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22764596 [Accessed 6 October 2012]. Health and Safety Executive n.d., Muscoloskeletal Disorders (MSDs), HSE [Online] Available at: http://www.hse.gov.uk/MSD/msds.htm [Accessed 6 October 2012] Highfield ES et al. 2012, Acupuncture and traditional Chinese medicine for survivors of torture and refugee trauma: a descriptive report, PubMed/Journal of Immigrant Minorities Health 14(3) [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22005843 [Accessed 6 October 2012] IOSH, 2012. Muscoloskeletal disorders, iosh, the heart of health and safety. [Online] Available at: http://www.iosh.co.uk/books_and_resources/our_oh_toolkit/musculoskeletal_disorders.aspx [Accessed 6 October 2012]. Li XF et al. 2012, Professor Shi Qi’s experience of applying herbal paste for treating chronic musculoskeletal conditions, Zhong Xi Yie Jie He Xue Bao 10(6). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22704421 [Accessed 6 October 2012]. Song PF 2012. Manifestation of synovial lesions in osteoarthritis, Zhongguo Gu Shang 25 (5). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22870698 [Accessed 6 October 2012]. Xiu, ZB and Sun L. 2012, Effects of Pilose antler polypeptide on apoptosis of chondrocyte and related cytokines in experimental knee osteoarthritis, Zhongguo Gu Shang 25 (5). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22870691 [Accessed 6 October 2012]. Yu H et al. 2012, Celastrus treatment modulates antigen-induced gene expression in lymphoid cells of arthritic rats. International Journal of Immunopathologic Pharmacology 25(2). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22697077 [Accessed 6 October 2012] Zhan HS 2012, Multidimensional assessment and treatment strategy of knee osteoarthritis, Zhongguo Gu Shang 25 (5). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22870675 [Accessed 6 October 2012]. Zheng Y et al 2012, Therapeutic effect of nux vomica total alkali gel on adjuvants arthritis rats, Zhongguo Gu Shang37(10). [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/22860457 [Accessed 6 October 2012]. Read More