Introduction

Sprain and contusion here refer to the injury of soft tissues, such as skin, muscles and tendons of the trunk or limbs without fracture, dislocation orwound.

Main manifestations are pain and swelling of the injured areas, and motorimpairment of the joints.

Etiology and Pathogenesis

Local stagnation of qi and blood in the meridians of diseased areas is due toinjury of tendinous tissues and joints by violent movement, awkward posture ofthe body, bruise, falling, traction or over twisting.

Differentiation

Main manifestations: Local swelling and pain, redness or ecchymosis. A new injury is slightly swollen with tenderness. Large area of swelling together with motor impairment of the joints is found in serious cases. Old injury is characterized by absence of marked swelling but repeated recurrence due to invasion of exogenous pathogenic wind, cold and damp. The injury mostly happens in the shoulder, elbow, wrist, back, hip, knee, and ankle.

Analysis: Sprain or contusion at any place of the body is due to tendinous injury with local qi stagnation and blood stasis, manifested by swelling and pain with tenderness. In a protracted case, qi and blood are consumed, and their circulation in the meridians tends to be further obstructed by exposure to wind, cold and damp. That is why pain is exacerbated in bad weather.

Treatment

Ashi points are used as the principal points. Local and distal points of involved meridians may be combined to ease tendons and activate blood circulation, relieving swelling and pain. Apply needling plus moxibustion to the local points and needling alone to the distal points.

Prescription:

• Ashi points.

Supplementary points:

• Neck: [BL10 - SI3].
• Shoulder joint: [GB21 - LI15].
• Elbow joint: [LI11) - LI4].
• Wrist joint: [TH4 - TH5].
• Hip joint: [GB30 - GB34].
• Knee joint: [ST35 - ST44].
• Ankle joint: [ST41 - GB40 - BL60].

Explanation: Local and distal points from the affected meridians are selected to promote the circulation of qi and blood in the meridians. Moxibustion to the local points promotes the circulation of qi and blood by warmth so as to relieve swelling and pain, and to speed up the recovery of the injuried tissues.

Remarks

Needling can be applied to the healthy side at the area corresponding to the affected area. When manipulating the needle, ask the patient to move the sprained joint. Alleviation or subsidence of pain may be expected.