Bursitis and Tendonitis

by John G. Connor, M.Ac., L.Ac. edited by Barbara Connor, M.Ac., L.Ac.

TABLE OF CONTENTS
Introduction
Research on How Acupuncture Benefits Tennis Elbow (Epicondylitis)
Research on How Acupuncture Benefits Frozen Shoulder
Highly Recommended Foods
Foods to Avoid
Nutritional Support
References

INTRODUCTION
Barbara and I see many patients with bursitis, tendonitis, tennis elbow, frozen shoulder, etc and we get very good results treating these conditions with a combination of acupuncture, craniosacral therapy, Chinese herbs and nutritional supplements.  By using acupuncture and craniosacral acupuncture we are able to effect energetic and physiological mobilization, fluid exchange, improved delivery of nutrients and removal of metabolic waste products in the affected areas which helps your body to heal naturally.  The addition of specific herbs and supplements helps reduce the inflammation and rebuild damaged tissues without the harmful side effects of drugs.  In order to facilitate the healing process in those who suffer from these conditions we have compiled a list of useful foods, foods to avoid and helpful supplements below for your information.

RESEARCH ON HOW ACUPUNCTURE BENEFITS TENNIS ELBOW  (EPICONDYLITIS)
The results of a study published in Rheumatology (Oxford) 1999 Apr; 38( 4): 346-54 by Berman et al entitled “A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the knee” concluded that acupuncture is an effective and safe adjunctive therapy to conventional care for patients with osteoarthritis of the knee.

The results of a study published in Forsch Komplementarmed Klass Naturheilkd 2002 Aug;9(4):210-5 by Fink et al entitled “Chronic epicondylitis: effects of real and sham acupuncture treatment: a randomized controlled patient- and examiner- blinded long-term trial” concluded that in the treatment of chronic epicondylitis, the selection of so-called real acupuncture points gives better results than invasive sham acupuncture at early follow-up.

The results of a study published in Rheumatology (Oxford) 2002 Feb;41(2):205-9 by Fink et al entitled “Acupuncture in chronic epicondylitis: a randomized controlled trial” concluded that in the treatment of chronic epicondylopathia lateralis humeri, acupuncture in which real acupuncture points were selected and stimulated was superior to non-specific acupuncture with respect to reduction in pain and improvement in the functioning of the arm.

The results of a study published in Br J Rheumatol 1994 Dec;33(12):1162-5 by Molsberger and Hille entitled “The analgesic effect of acupuncture in chronic tennis elbow pain” concluded that their results were statistically significant and that it showed that non segmental verum (real) acupuncture has an intrinsic analgesic effect in the clinical treatment of tennis elbow pain which exceeds that of placebo acupuncture. 

RESEARCH ON HOW ACUPUNCTURE BENEFITS FROZEN SHOULDER
A study entitled “Acupuncture for frozen shoulder” which was published by Sun et al in Hong Kong Med J. 2001 Dec;7(4):381-91  involving 35 patients with a diagnosis of frozen shoulder who were randomly allocated to an exercise group or an exercise group plus an acupuncture group and treated for a period for 6 weeks concluded that the combination of acupuncture with shoulder exercise may offer effective treatment for frozen shoulder. 

Another study done by Lin et al entitled “A comparison between the pain relief effect of electroacupuncture, regional nerve block and electroacupuncture plus regional nerve block in frozen shoulder” published in Acta Anaesthesiol Sin. 1994 Dec;32(4):237-42 concluded that the combined electroacupuncture and regional nerve block method had significantly higher pain control quality, longer duration and better range of movement of the shoulder joint than that of electroacupuncture or regional nerve block performed alone.

A study done by He et al entitled “Effect of acupuncture treatment on chronic neck and shoulder pain in sedentary female workers: a 6-month and 3-year follow-up study” published in  Pain 2004 Jun;109(3):299-307 concluded that adequate acupuncture treatment may reduce chronic pain in the neck and shoulders and also related headache.  They found that the effect lasted for 3 years.

HIGHLY RECOMMENDED FOODS
Barley and wheat grass, omega-3 and GLA fatty acids, whole alfalfa or alfalfa tablets or tea, oatmeal, brown rice, wheat, rye, fresh pineapple, oat bran, rice bran or ground flaxseed, sprouts, legumes, algae, asparagus, onions, carrots and most other vegetables and fruits except those mentioned below to avoid.  Fresh pineapple contains bromelain, which reduces inflammation.

Consider an anti-inflammatory diet such as this one outlined by Andrew Weil:  Emphasize monosaturated fats (found in olive oil, canola oil, avocado and nuts) and omega-3 fatty acids (in fish, walnuts and flax) and eliminate polyunsaturated and trans fats (in many processed foods).  Plus consider taking a daily fish-oil supplement; try 2 grams per day of a product with both EPA and DHA.

Supplementation with omega-3 fatty acids may reduce inflammation by changing the balance of prostaglandins and leukotrienes (which are powerful mediators of inflammation). (Moncada et al, 1986)  Omega-3 fatty acids are highest in cold water fish such as herring, mackerel and salmon.

FOODS TO AVOID
Avoid excess meat or protein from any source, intoxicants (alcohol, tobacco, coffee, etc.), refined sugar, too many sweets, excess salt, rhubarb, cranberry, plum, chard, beet greens, spinach, tomatoes, eggplant, bell peppers and potato, all nuts, oil-rich seeds, nut butters, etc., except almonds and omega-3 / GLA rich seeds, alfalfa seeds and sprouts. 

Reduce the amount of fat in your diet. Avoid milk and dairy products.  Avoid citrus fruits and paprika.  Do not take iron supplements as iron is suspected of being involved in pain, swelling and joint destruction.  Consume iron in foods, instead.

NUTRITIONAL SUPPORT   
Glucosamine sulfate (relieves pain and inflammation in osteoarthritis & exerts a protective effect against joint destruction)
· D-Glucuronic Acid (provides antioxidant protection of synovial tissues)
· Boron (for better calcium absorption)
· Bromelain (stimulates production of prostaglandins)
· Pantothenic acid (vital for the production of steroids in the adrenal gland)
· Primrose oil or salmon oil (helps control pain & inflammation)
· Sea cucumber (helps lubricate the joints)
· Silica (helps in rebuilding of connective tissue and bone)
· Superoxide dismutase (protects the fluid in the joints from destruction by free radicals)
· Vitamin E (protects the joints from damage by free radicals)
· Calcium (prevents bone loss) and
· Magnesium (needed to balance with calcium) plus·
Copper (a cofactor for lysyl oxidase that strengthens connective tissue) and
· Zinc (for bone growth, is an anti-oxidant & reduces wound healing time)
· Coenzyme Q10 (increases tissue oxygenation to aid in repair of connective tissue)
· Manganese (needed for normal bone growth)  Do not take manganese and calcium at the same time as they compete for absorption.
· Selenium (a powerful antioxidant)
· Vitamin B complex (B vitamins work best when taken together)
· Vitamin B6 (reduces swelling in tissue)
· PABA (good for swelling)
· Vitamin C (destroys free radicals and is anti-inflammatory)
· Amino acids (to supply protein needed for tissue repair)
· Flavonoids, e.g., Quercetin (reduce inflammation, prevent free radical damage)
· D-Phenylalanine – may protect peripheral enkephalin or other endorphins generated from the adrenal medulla where high concentration of precursors are present and may also inhibit enkephalinases in joints.  Both of these actions would result in accumulation of endorphins in synovial fluid, counteracting the effects of prostaglandin-mediated inflammation. (Millinger, 1986)·

For more information on herbs and supplements which can help in relieving pain please read our article entitled Pain Management on our website.

REFERENCES

Balch, James F, M.D. & Balch, Phyllis A, C.N.C, Prescription for Nutritional Healing New York: Avery Publishing Group. 1997
Ma, Shou-Chun, MTCM, Chinese Nutrition Class Notes from Northwest Institute of Acupuncture and Oriental Medicine, Seattle, 1994
Maciocia, Giovanni, The Foundations of Chinese Medicine, Edinburgh: Churchill Livingston, 1989
Millinger, G. S., “Neutral amino acid therapy for the management of chronic pain” Cranio 4(2):156-63, 1986
Moncada S et al, “Leucocytes and tissue injury: The use of eicosapentaenoic acid in the control of white cell activation, Wein Klin Wochenschr 98(4):104-6, 1986
Pitchford, Paul, Healing with Whole Foods, Berkeley, CA: North Atlantic Books, 1993
Weil, Andrew, M.D., “Coping with Chemotherapy and Radiation” Self Healing, July 2004
Werbach. Melvyn R, M.D, Nutritional Influences on Illness. Tarzana: Third Line Press, 1996

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Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-309-7753.

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