Acupuncture and Chinese Herbal Medicine for Healing Radial Nerve Palsy
December, 2014
In early 2013, a patient with radial nerve injury sought acupuncture in my clinic. His right wrist was "dropped", a typical sign of radial nerve palsy. Four months prior, he had a humerus fracture, which led to prolonged entrapment of the radial nerve. He had received reparatory surgery, followed by many sessions of physical therapy. However, four months later, the functional improvement was still minimal. He could not extend his right wrist or any fingers in the right hand. He was frustrated and depressed. He was on the verge of losing his job.
Evaluation and Treatment
After a comprehensive evaluation, I was optimistic in his full recovery, based on his young age (40 years old), physical fitness and strong willpower. He received weekly acupuncture for three months. The treatment included acupuncture on his arm, auricular acupuncture, scalp acupuncture, electro-stimulation and low level laser therapy. I also prescribed Chinese herbs to improve blood circulation and stimulate nerve regeneration. After four sessions, he began to notice some improvement. After six sessions, the wrist extension was comparable to the healthy hand. After eleven sessions, he regained nearly full range of motion and strength in his hand. He was happily discharged after twelve sessions. I asked him to continue strength and flexibility exercises. When I ran into him a year later, he proudly showed me his hand and gave me a strong handshake. It made me very happy.
Looking back now, 3 months of treatment for 12 sessions were not slow for recovery of traumatic nerve damage. However, during the process, the healing felt slow to the patient. It often felt like two steps forward, one step backward. A period of plateau followed each leap before the next leap took place. Patients can get frustrated and lose hope. Therefore, it is extremely important for the practitioner to help the patient understand that the healing process is never a linear ascent, and it requires faith, patience and persistence. The practitioner needs to hold the vision for the patients so that they will stay on the course in order to achieve complete recovery.
Acupuncture
The acupuncture points I used for this patient include Ashi points near the fracture site, points along the San Jiao and Large Intestine meridians, and motor points in the extensor muscles for the wrist and fingers. In each session, two rounds of electrical acupuncture were performed. In the first round, Hua Tuo Jia Ji points (华佗夹脊穴) on C5-C7 cervical spine were connected to LI 12-10. In the second round, points in the wounded area on the upper arm were connected to the motor points of the extensor muscles on the forearm. Electrical stimulation was carried out with alternating frequency of 2/80 Hz for 15-20 min.
Chinese Herbs
The herbal formula I used was a modified version of Bu Yang Huan Wu Tang (Promote Yang to Restore Five Decoction, 补阳还五汤), with the addition of Gui Sui Bu (Drynaria Rhizome), Xu Duan (Dipsacus Root) and Shui Zhi (Leech). Bu Yang Huan Wu Tang was initially formulated by the famous Chinese medicine doctor, Wang Qing Ren (1768-1831 C.E.). For 200 years, this formula has been used for treating cerebrovascular stroke and traumatic injury. Huang Qi (Astragalus Root) is the emperor herb in this formula. A large dosage (30-50 grams of raw herb, or 6-10 grams of 5:1 concentrated granules per day) is required to be effective. Recent scientific studies have shown that Huang Qi can stimulate nerve regeneration and increase muscle strength. Other herbs in this formula have a combined effect of improving blood circulation and promoting the healing of bones, tendons, ligaments, muscles and blood vessels, all of which are involved in nerve regeneration.
Discussion
Recovery time for radial nerve palsy varies greatly, depending on the severity of nerve damage. In mild cases, no treatment is needed and spontaneous recovery occurs within weeks to months. In some cases, full healing can take up to a year. In other cases, there can be a partial or complete loss of sensation or motor function.
For this patient, humerus fracture happened outside the U.S. He did not have easy access to medical intervention at that time. The radial nerve was trapped in enormous swelling for 2 days prior to the surgical repair. Therefore, the damage to the nerve was considerable. This can explain why he had almost no improvement for four months despite surgery and physical therapy.
I think the key to his recovery is the comprehensive treatments he received including surgery, physical therapy, braces, acupuncture and Chinese herbal medicine. His young age and physical fitness also played an important role. Chinese medicine always aims to stimulate the patient’s own healing power to overcome diseases. It has proven effective in this case.
