Initial acc treatment
ACC details
ACC45 No:
Read code:
Date of Accident:
Subjective findings
Reason for visit:
Finger pain
Previous surgery or fractures:
Nil
Previous illnesses:
Nil
Medication and/or supplements:
not known
Subjective Findings:(patient’s description of injury)
When pulling the lawnmower cord, I sprained my back.
Lifting a heavy box above the head, whilst turning the head, twisted and sprained the neck.
Whiplash to the neck after being hit in the rear by another car
Whilst playing football, I was tripped by another player and fell sideways, straining the knee.
Onset and progression:
Felt sharp pain for one day after the injury, followed by an ongoing dull ache since then, experiencing intermittent sharp pain with certain movements.
Aggravated by:
Open the jar
Stretching the finger
Relieved by:
heat pack/rest
Yellow flags(psychological or emotional factors):
N/A
Red flags(potential serious complications):
N/A
Previous treatment:
physio for 1 session
Objective Findings:
Observation: no swelling, no bruising
Numerical Pain Rating Scale (NPRS): most of the time 5/10, 7/10 at worst
Patient-Specific Functional Scale (PSFS) :
To be able to open doors with knob 6/10
To be able to open a jar 6/10
To be able to use fork/spoon 6/10
Range of movement:
Metacarpophalangeal (MCP) 掌指骨
These joints are where your finger bones meet your hand bones. 手指骨与手骨相连的地方
Abduction: 25°
Adduction: 20°
Flexion: 80°
Extension: 30°
Interphalangeal Proximal (PIP) Joint of the Finger 手指指间近端（PIP）关节
These are the middle knuckles中指 of your fingers. 手指的中指关节
Flexion: 120°
Extension: 120°
Interphalangeal Distal (DIP) Joint of the Finger 手指指间远端（DIP）关节
These are the knuckles just below your fingernails. 指甲下方的指关节
Flexion: 80°
Extension: 80°
Metacarpophalangeal Joint of the Thumb 拇指掌指关节
This is where your thumb meets your hand bones. 拇指与手骨相遇的地方
Abduction: 50°
Adduction: 40°
Flexion: 60°
Extension: 60°
Interphalangeal Joint of the Thumb 拇指指间关节
This is the middle knuckle of your thumb. 拇指的中间关节
Flexion: 80°
Extension: 90°
palpation:
tender to touch around the local injured area.
Tongue: Dark Red Tongue with White Coating
Pulse: Wiry
Diagnosis:
read code(blood stasis and qi Stagnation)
Treatment Principle:
promote Qi and remove blood stasis to relieve the pain
The goal for treatment:
To be able to open doors with knob without pain
To be able to open a jar without pain
To be able to use a fork/spoon without pain
Treatment Plan:
acupuncture and cupping 1-2times/week
Estimated time frame :
6 weeks/12 weeks
Today’s treatment:
Acupuncture 60 mins
Ashipoints, yemen,hegu,wangu
Post-treatment advice:
Avoid lifting heavy objects.
Keep warm
2nd visit acc treatment
Subjective
Results/Progress:
The patient reports that
The pain has slightly decreased compared to the last visit. However, it worsens after long hours of using the hand at work. The patient experiences intermittent sharp pain along with a constant dull ache, particularly noticeable without movement.
Numerical Pain Rating Scale (NPRS): Most of the time 5/10, 7/10 at worst
Patient-Specific Functional Scale (PSFS):
To be able to open doors with knob 6/10
To be able to open a jar 6/10
To be able to use fork/spoon 6/10
Objective
MSK exam
Observation: No swelling, no bruising
tender to touch around the local injured area.
Range of movement:
Metacarpophalangeal (MCP)
These joints are where your finger bones meet your hand bones.
Abduction: 25°
Adduction: 20°
Flexion: 80°
Extension: 30°
Interphalangeal Proximal (PIP) Joint of the Finger
These are the middle knuckles of your fingers.
Flexion: 120°
Extension: 120°
Interphalangeal Distal (DIP) Joint of the Finger
These are the knuckles just below your fingernails.
Flexion: 80°
Extension: 80°
Metacarpophalangeal Joint of the Thumb
This is where your thumb meets your hand bones.
Abduction: 50°
Adduction: 40°
Flexion: 60°
Extension: 60°
Interphalangeal Joint of the Thumb
This is the middle knuckle of your thumb.
Flexion: 80°
Extension: 90°
TCM exam
Tongue: Dark Red Tongue with White Coating
Pulse: Wiry
Plan
Today’s treatment
Ashipoints, yemen,hegu,wangu
Post-treatment advice
Avoid lifting heavy objects.
Keep warm
3rd visit acc treatment
Subjective
Results/Progress:
The patient reports that
Can perform more flexible movements compared to before. Still sore, but not as much. Experiences constant pain most of the time and sharp pain with certain movements.
Numerical Pain Rating Scale (NPRS): Most of the time 5/10, 7/10 at worst
Patient-Specific Functional Scale (PSFS):
To be able to open doors with knob 7/10
To be able to open a jar 7/10
To be able to use fork/spoon 7/10
Objective
MSK exam
Observation: No swelling, no bruising
tender to touch around the local injured area.
Range of movement:
Metacarpophalangeal (MCP)
These joints are where your finger bones meet your hand bones.
Abduction: 25°
Adduction: 20°
Flexion: 80°
Extension: 30°
Interphalangeal Proximal (PIP) Joint of the Finger
These are the middle knuckles of your fingers.
Flexion: 120°
Extension: 120°
Interphalangeal Distal (DIP) Joint of the Finger
These are the knuckles just below your fingernails.
Flexion: 80°
Extension: 80°
Metacarpophalangeal Joint of the Thumb
This is where your thumb meets your hand bones.
Abduction: 50°
Adduction: 40°
Flexion: 60°
Extension: 60°
Interphalangeal Joint of the Thumb
This is the middle knuckle of your thumb.
Flexion: 80°
Extension: 90°
TCM exam
Tongue: Dark Red Tongue with White Coating
Pulse: Wiry
Plan
Today’s treatment
Acupuncture 60 mins
Ashipoints,yemen,hegu,wangu
Post-treatment advice
Avoid lifting heavy objects.
Keep warm
4th visit acc treatment
Subjective
Results/Progress:
The patient reports that
The pain returned one day after the last treatment, and there is still significant discomfort in the local area. However, the pain is now more localized, presenting as intermittent sensations of pain.
Numerical Pain Rating Scale (NPRS): Most of the time 4/10, 6/10 at worst
Patient-Specific Functional Scale (PSFS):
To be able to open doors with knob 7/10
To be able to open a jar 7/10
To be able to use fork/spoon 7/10
Objective
MSK exam
Observation: No swelling, no bruising
tender to touch around the local injured area.
Range of movement:
Metacarpophalangeal (MCP) 掌指骨
These joints are where your finger bones meet your hand bones. 手指骨与手骨相连的地方
Abduction: 25°
Adduction: 20°
Flexion: 80°
Extension: 30°
Interphalangeal Proximal (PIP) Joint of the Finger 手指指间近端（PIP）关节
These are the middle knuckles中指 of your fingers. 手指的中指关节
Flexion: 120°
Extension: 120°
Interphalangeal Distal (DIP) Joint of the Finger 手指指间远端（DIP）关节
These are the knuckles just below your fingernails. 指甲下方的指关节
Flexion: 80°
Extension: 80°
Metacarpophalangeal Joint of the Thumb 拇指掌指关节
This is where your thumb meets your hand bones. 拇指与手骨相遇的地方
Abduction: 50°
Adduction: 40°
Flexion: 60°
Extension: 60°
Interphalangeal Joint of the Thumb 拇指指间关节
This is the middle knuckle of your thumb. 拇指的中间关节
Flexion: 80°
Extension: 90°
TCM exam
Tongue: Dark Red Tongue with White Coating
Pulse: Wiry
Plan
Today’s treatment
Acupuncture 60 mins
Ashipoints,shaochong,shaoze,zhongchong,taichong,lidui
Post-treatment advice
Avoid lifting heavy objects.
Keep warm
5th visit acc treatment
Subjective
Results/Progress:
The patient reports that
The movement is much more flexible now. The pain is quite localised, presenting as a constant dull ache most of the time.
Numerical Pain Rating Scale (NPRS): Most of the time 5/10, 7/10 at worst
Patient-Specific Functional Scale (PSFS):
To be able to open doors with knob 8/10
To be able to open a jar 8/10
To be able to use fork/spoon 8/10
Objective
MSK exam
Observation: No swelling, no bruising
tender to touch around the local injured area.
Range of movement:
Metacarpophalangeal (MCP)
These joints are where your finger bones meet your hand bones.
Abduction: 25°
Adduction: 20°
Flexion: 80°
Extension: 30°
Interphalangeal Proximal (PIP) Joint of the Finger
These are the middle knuckles of your fingers.
Flexion: 120°
Extension: 120°
Interphalangeal Distal (DIP) Joint of the Finger
These are the knuckles just below your fingernails.
Flexion: 80°
Extension: 80°
Metacarpophalangeal Joint of the Thumb
This is where your thumb meets your hand bones.
Abduction: 50°
Adduction: 40°
Flexion: 60°
Extension: 60°
Interphalangeal Joint of the Thumb
This is the middle knuckle of your thumb.
Flexion: 80°
Extension: 90°
TCM exam
Tongue: Dark Red Tongue with White Coating
Pulse: Wiry
Plan
Today’s treatment
Acupuncture 60 mins
Ashipoints, yemen,hegu,wangu
Post-treatment advice
Avoid lifting heavy objects.
Keep warm