TA pharmacopuncture as a primary and independent treatment for frequent sprains occurring over 9 months in a patient with needle sickness: Case report

RATIONALE: Sprains, stretching or tearing of ligaments are common injuries. Clinicians should try to prevent acupuncture-associated vasovagal responses (AAVR) when treating patients with such injuries. In this study, we report the treatment of frequent sprains of various body parts in a patient with a history of AAVR using only TA (a 7-herb extract consisting of Scutellaria baicalensis, Phellodendron amurense, Pulsatilla koreana, Sophora tonkinensis, Aucklandia lappa, Aquilaria agallocha, and Carthamus tinctorius L.) pharmacopuncture. PATIENT CONCERNS: The patient was a 47-year-old woman who was injured 23 times in 9 months. The injuries occurred in the knees, thumb, wrist, ankle, and low back region due to overextension during physical activity or frequent exercise. This patient had great fear of acupuncture after fainting due to her experience with a previous fire needling on an ankle sprain 18 years ago. Therefore, she did not want to undergo conventional acupuncture, including needle retention. DIAGNOSES: With the exception of the bruising and sprain of a knee occurring over 1 week after onset at the initial visit, the injuries were diagnosed as acute sprains of grade 1 with pain without range of movement limitation in various parts of the knee, ankle, thumb, and lower back. Time to onset of these injuries was within 3 days. INTERVENTIONS: The patients received only TA pharmacopuncture at 4 to 6 ouch points (ashi points). The patient returned to work immediately after the conclusion of treatment without any posttreatment such as infrared and hot pack which can help absorbing the extract and calming the injection site. OUTCOME: The treatment was usually completed within 4 sessions, and led to a reduction in pain (visual analog scale [VAS] score of 1). In the absence of mild swelling and warmth or when there was mild pain (VAS score <3) in the affected area, the patient reported reduced pain and smoother joint movement immediately after 1 to 2 sessions. LESSONS: Although our report is a single case study, our results indicate that TA pharmacopuncture can be effective in treating various acute sprains and is a potential acupuncture method for the treatment of patients with AAVR.