Acupuncture Today – February, 2001, Vol. 02, Issue 02 >> Pain Management

Treatment of Post-Laminectomy Surgical Pain

By Alejandro Katz, MD, OMD, LAc, QME

More than 20 patients were referred to us after undergoing back surgery without improvement (after surgery, in some cases there was a worsening of the pain and stiffness). The patients' ages ranged from 20 to 50, with a 50/50 ratio of male and female patients.

The majority of them were taking 600-800 milligrams of ibuprofen (Motrin) or 375-500 milligrams of Naproxen (two times a day). Some cases used 100-200 milligrams of Celebrex a day or 12.5-25 milligrams of Viox two times a day. Physical therapy on these patients had already been discontinued due to lack of results.

Examination of the sacrospinalis muscle (UB, second line) with moderate digital palpation revealed numerous trigger points. The line that runs from the ribs to the iliac spine is divided into three identical segments. The upper segment (proximal) referred pain toward the abdominal-genital area; the middle segment radiated pain-tingling toward the lateral side of the thigh (GB channel); and the lower segment (distal) referred pain-tingling toward the buttocks and legs (UB channel).

Technique used: Chinese acupuncture needles (#36 or #38 gauge).

Microcurrent device used: Acutron Mentor: biphasic, interferential, 75-100 micro-amps, for 20-25 minutes. Pads were placed on top of the needles. The needles were inserted in a slant angle (from proximal to distal). The pads on the UB channel were combined with UB 40 (pads and needles). Treatment: The treatment protocol consisted of 12-24 treatments delivered three times a week. If pain was severe, the treatments were performed with pads only (microcurrent stimulation). When the pain subsided, the treatment proceeded with the combination of needles and pads.

Usually, 6-8 treatments were needed for the patient to begin feeling better (pain and medication reduction and increased range of motion). When the patient's results plateaued, the microcurrent stimulation was changed to milliamp stimulation (milliamp stimulation was maintained as a noticeable, mild tingling sensation).

A course of daily stretching exercises was also recommended (as part of the protocol) to assist in recovery of the muscles and tendons. Stretching exercises consisted of single and double knee stretches to the chest. Stretches were performed three times a day at five stretches per set, with the patient maintaining the stretch between 5-10 seconds.

Click here for previous articles by Alejandro Katz, MD, OMD, LAc, QME.


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