Chief Complaint: Achilles Tendinitis
Western Diagnosis: Achilles Tendinitis
Medical History: Patient, 62, with primary complaint of achilles heel tendinitis. She has been a ice skater for over twenty years and has only recently began feeling a fixed pain and swelling at KD3 to KD7 area.
She is slightly overweight with poor eating habits, yet has a good exercise regimine, exercising at least 4 times a week for at least 45 minutes.
Questioning exam: what type of treatments where tries? Cast isolation, Physical therapy, podiatric inserts, rest.
What makes it better? nothing
What do you do to keep the inflammation down? Ice.
Pulse exam: Pulse: deep and slow
Marked edema below the waist.
Tongue exam: tongue: Thick white coat, scalloped
OM Diagnosis: wind-Cold-Damp BI due to overexposure to cold.
Treatment Principle: expel Wind Cold damp
Point Prescription: local; KD3, KD7, ST36,
Distal; BL17, BL20, BL23, BL57
Moxa on related points
Herbal Formula: Du Huo Ji Sheng Tang (no modifications)
Hua Tuo Plaster
Lifestyle Prescription: Continue to walk.
Results: marked improvement within 3 weeks. patient began walking much better and did not experience any inflammation during workouts.
Began herbs after 4 weeks and is currently on the second week of herbs.
Synopsis: prognosis: since case is chronic (over 1 1/2 years) treatment will be slower, but prognosis is a complete recovery within 3 months.
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