Aug 2, 2013 ... Volume 2 • Issue 7 • 1000132. Altern Integ Med. ISSN:2327-5162 AIM, an open
access journal. Open Access. Case Report. Alternative and ...
Alternative and Integrative Medicine
Jung et al., Altern Integ Med 2013, 2:7 http://dx.doi.org/10.4172/2327-5162.1000132
Case Report
Open Access
A Case Report of Bee Venom Acupuncture on Hip Joint Pain in Rehabilitation Stage of Stroke Woo Sang Jung1, Seung Won Kwon1*, Seong Uk Park2, Sang Kwan Moon1, Jung Mi Park2, Chang Nam Ko2 and Ki Ho Cho1 1 2
Department of Cardiovascular and Neurologic Diseases, Kyung Hee University Oriental Medicine Hospital, Seoul, Korea Deptartment of Cardiovascular and Neurologic Diseases, Kyung Hee University Hospital at Gangdong, Seoul, Korea
Abstract Osteoarthritis in patients with an intracerebral hemorrhage can cause difficulties for stroke rehabilitation and can delay neurologic recovery. In an attempt to overcome these problems, we used bee venom acupuncture injections for hip joint pain in a patient with hip joint osteoarthritis who had suffered an intracerebral hemorrhage. A female patient of 72 years old complained of hip joint pain due to osteoarthritis during stroke rehabilitation. The pain was initially assessed as 7 in Numeric Rating Scale. Prior to bee venom therapy, this symptom was treated with medication, intra articular injection, transcutaneous electrical nerve stimulation, and acupuncture. However, her pain did not improve. She subsequently received bee venom injections at hip joint acupuncture points and her Numeric Rating Scale score changed from 7 to 2 after this treatment, indicating improvements in hip joint pain. Her scores on the McGill Pain Questionnaire for pain intensity and frequency were also improved. Herein, was port the observed effects of bee venom therapy for hip joint pain with osteoarthritis in this patient, but caution that further controlled studies are needed?
Keywords: Bee venom; Bee venom acupuncture injection; Osteoarthritis; Intracerebral hemorrhage; Visual analogue scale; McGill Pain Questionnaire; Rehabilitation Introduction Neurologic deficits induced by stroke such as hemiplegia, dysphagia, and aphasia can affect the patient’s everyday life. Several studies [1,2] have suggested that early and intensive introduction of a rehabilitation program is essential for treating neurologic symptoms. The majority of the elder lies are ill with the degenerative arthritis. To treat osteoarthritis, we have used conservative treatments such as medication therapy, exercise, and physical therapy and surgical treatments. However, the pain induced by osteoarthritis which is uncontrolled by conventional therapies can cause a handicap on the rehabilitation treatment. Bee venom acupuncture is coming up into the new alternative plan of the osteoarthritis. Many studies [3-11] suggested that bee venom acupuncture can treat pain induced by osteoarthritis. Therefore, we think that bee venom can be an adjunctive therapy for patients whose pain is severe enough to stop them from completing the exercise therapy. We experienced a case of hip joint pain due to osteoarthritis in a patient who had suffered an intracerebral hemorrhage. This patient experienced severe left hip joint pain assessed as NRS score 7 and stopped the exercise therapy. Her hip joint pain was successfully treated with bee venom acupuncture point injections combined with conventional therapeutic options such as non-steroidal antiinflammatory drugs (NSAIDs), muscle relaxants, and manual physical therapy, facilitating subsequent stroke rehabilitation.
Case History Patient characteristics and diagnosis A 72-years-old female patient with left side weakness, dysphagia, and dysarthria after stroke was admitted to the Department of Cardiovascular and Neurologic Diseases at Kyung Hee University Oriental Medicine Hospital after 7 months of ictus. The motor power of her upper and lower extremities was assessed as grade 1, and she used a nasogastric tube for nutrition at admission. Although she Altern Integ Med ISSN:2327-5162 AIM, an open access journal
had been diagnosed with osteoarthritis of the left hip joint 2 years before admission, she had only used non-steroidal anti-inflammatory drugs (NSAIDs) intermittently. A brain computed tomography (CT) image taken at onset revealed a right basal ganglia hemorrhage. None of her laboratory data were abnormal. After undergoing a 2-weeks rehabilitation program, the patient stopped all conventional rehabilitation due to increasing pain in her left hip joint. The pain was characterized as follows: (1) there was no difference in pain during the day and at night, (2) pain was worse after exercise and after completing rehabilitation exercises, (3) the appearance of pain was not different from 2 years previously. Hip joint X-ray revealed osteoporosis and soft tissue atrophy at the left lower extremity and calcific deposits near the left greater trochanter (Figure 1). None of the laboratory data were abnormal (including Rheumatoid factor [RF]) (Table 1). A bone scan revealed increased uptake in the left acetabulum. The patient was therefore diagnosed with osteoarthritis. She subsequently began an therapeutic regimen comprising acetaminophen 650 mg and aceclofenac 200 mg daily, 2 intraarticular injections (triamcinolone 40 mg each), transcutaneous electrical nerve stimulation (TENS), and acupuncture (dry needling) at GB29, GB30, GB34,GB43, GB44, BL66, LI1 (selection of acu-points is based on classical meridian system theory) for 5 weeks. However, there was no improvement, and she was still not able to complete the rehabilitation program (she was only treated with manual physiotherapy).
*Corresponding author: Seung Won Kwon, Department of Cardiovascular and Neurologic Diseases, Kyung Hee University Oriental Medicine Hospital, 1 Hoegidong, Dongdaemun-gu, Seoul 130-702, Korea, Tel: (+82)02-958-9128; Fax: (+82)02-958-9132; E-mail:
[email protected] Received July 19, 2013; Accepted July 31, 2013; Published August 02, 2013 Citation: Jung WS, Kwon SW, Park SU, Moon SK, Park JM, et al. (2013) A Case Report of Bee Venom Acupuncture on Hip Joint Pain in Rehabilitation Stage of Stroke. Altern Integ Med 2: 132. doi:10.4172/2327-5162.1000132 Copyright: © 2013 Jung WS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Volume 2 • Issue 7 • 1000132
Citation: Jung WS, Kwon SW, Park SU, Moon SK, Park JM, et al. (2013) A Case Report of Bee Venom Acupuncture on Hip Joint Pain in Rehabilitation Stage of Stroke. Altern Integ Med 2: 132. doi:10.4172/2327-5162.1000132
Page 2 of 4 frequency of hip joint pain; and rehabilitation program performance to evaluate the influence of pain on her rehabilitation.
Acc:3532573 Srs:1 Img:1
Course of symptoms
17cm Zoom : 38.28% WL : 1600 WW : 2801
Sens:200. 000000
Figure 1: Hip Joint X-ray and Brain computed tomography (CT) image.
The patient’s hip joint pain was treated with bee venom acupuncture injections for 17 days, and the progress and results are presented in Figures 2-4 and Tables 2-3. The initial NRS score of 7 was improved slightly during the procedure: the first improvement in this score (5 points) was observed after the 2nd day and the second improvement to 3 points was confirmed after the 7th day; a further improvement to 2 points was noted by the 16th day treatment. The NRS score remained at 2 points at the final session (Figure 2).
Value (Normal value) BUN/Cr, mg/dL
20/0.7
ESR/CRP
