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Abstract : Background: Adhesive Capsulitis (Frozen Shoulder) is characterized by pain and limited range of motion (ROM) in the shoulder, often caused by fibrosis and adhesions in the articular capsule. Ultrasound-guided interventions, particularly acupotomy, offer a minimally invasive approach to managing these conditions by targeting specific anatomical structures under visualization. Objectives: This study aimed to develop a standardized protocol for ultrasound-guided posterior shoulder capsule acupotomy in patients with adhesive capsulitis, focusing on precise localization and safe execution. Methods: The protocol involved identifying key anatomical structures such as the Axillary Pouch, Posterior Glenohumeral Joint Capsule, and Superior Glenohumeral Joint Capsule using ultrasound. Patients with ROM limitations were categorized based on their movement restrictions, and acupotomy was performed under ultrasound guidance at specific target sites. Key safety measures, including avoiding nerves and vessels, were integrated. Results: The protocol demonstrated effective localization of target structures and improved ROM in patients with adhesive capsulitis. No complications such as vascular or neural injury were observed. The use of ultrasound enhanced procedural precision and safety. Conclusion: Ultrasound-guided acupotomy provides a reliable and safe method for treating Adhesive Capsulitis, particularly during the frozen phase. By offering clear visualization and accurate targeting, this protocol enhances the efficacy and safety of interventions, addressing limitations of traditional techniques. Further research is needed to validate this protocol across diverse patient populations.

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Abstract : Background: The aim of this article is to propose a method for diagnosing and treating Quadrilateral Space Syndrome (QSS) using acupotomy. Methods: The proposed points for diagnosing and treating QSS were established based on the anatomical structures of Quadrilateral Space, especially Axillary nerve. Results: The diagnostic procedure should be conducted through thorough tenderness palpation for tenderness and a pinch-roll test. The proposed points include the Axillary nerve, the Quadrilateral Space, Teres minor muscle, and Teres major muscle. Conclusion: This study presents diagnostic and treatment points for QSS that are both effective and efficient.

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Abstract : Objectives: This study proposes the use of cervical X-ray imaging, including static and dynamic views, to improve precision and effectiveness in selecting treatment points for acupotomy in cervical spine disorders. Methods: We propose a method for conducting diagnostic assessments using both static and dynamic cervical X-rays. Static X-rays, including lateral, anteroposterior, open mouse and oblique views, are suggested to observe structural abnormalities. Dynamic X-rays, through flexion-extension views, could enable the identification of cervical instability and alignment issues. These imaging techniques are intended to guide the selection of specific acupotomy treatment points, ensuring safe insertion depth and enhancing treatment precision. Results: The use of X-ray imaging is expected to allow for accurate diagnosis of cervical abnormalities, such as forward head posture and segmental instability, and may enable safer and more effective insertion in targeted treatment areas. Dynamic X-rays, in particular, could be beneficial in detecting functional instabilities not evident in static images, thereby aiding in the selection of personalized treatment plans. Conclusion: Incorporating both static and dynamic X-rays in acupotomy treatment for cervical spine disorders provides a more reliable and objective method for selecting treatment points, enhancing safety, precision, and treatment outcomes. Further clinical studies are required to verify the long-term efficacy of this approach.

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Abstract : Objectives: This study proposes an X-ray-based acupotomy treatment for lumbar spine and pelvic disorders. Methods: Utilizing static and dynamic X-ray imaging, a diagnostic and acupotomy treatment proposal was developed to address spinal and pelvic subluxations by targeting pathological muscles and ligaments. Results: The proposal is expected to allow effective identification and treatment of conditions such as lumbar disc herniation, spinal stenosis, and spondylolisthesis, and various soft tissue injuries and autonomic nervous system symptoms improving clinical outcomes. Conclusion: Incorporating both static and dynamic X-rays in acupotomy treatment for lumbar spine and pelvic disorders is thought to provide a more effective method for selecting acupotomy points, thereby enhancing the effect, precision, and overall treatment outcomes.

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Abstract : Background: Posterior tibial tendinopathy (PTT) is a degenerative condition impacting the posterior tibial tendon, often leading to pain, impaired mobility, and potential deformities like flatfoot. While traditional therapies such as physical therapy, orthotics, and NSAIDs are common, minimally invasive techniques like ultrasound-guided hydrodissection are emerging as promising alternatives. Objectives: This study aims to evaluate the efficacy and safety of ultrasound-guided hydrodissection in treating posterior tibial tendinopathy, offering a non-steroidal, minimally invasive treatment option. Methods: Three patients diagnosed with posterior tibial tendinopathy underwent ultrasound-guided hydrodissection using 5% dextrose solution. The procedure involved injecting the solution between the tendon and sheath to break adhesions and improve gliding function. Pain levels were assessed using the Numerical Rating Scale (NRS), and functional outcomes were measured via clinical tests like plantar flexion, inversion, and the single-heel rise test. Results: All patients reported significant pain reduction, with NRS scores dropping from 6–7 to 0. Functional improvements were noted, with restored mobility and resolution of symptoms. No adverse effects were observed during or after the treatments, which required only 2–3 sessions for full recovery. Conclusion: Ultrasound-guided hydrodissection is an effective and safe treatment for posterior tibial tendinopathy. This minimally invasive approach addresses adhesions and improves tendon function, providing a viable alternative to steroid injections or surgical interventions. Future studies with larger samples and standardized protocols are recommended to validate these findings.

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Abstract : Background: This case study evaluates the effectiveness of acupotomy and herbal treatments, in managing sudden sensorineural hearing loss (SSNHL) that did not respond to conventional steroid therapy. Methods: A 61-year-old female with right-side SSNHL underwent acupotomy treatment and Bokchong-tang, Cheongshin-san. over a four-week period. Results: Following treatment, the patient’s numerical rating scale score for hearing loss decreased from 10 to 1, with full resolution of hyperacusis and autophony. Audiometric evaluations confirmed significant hearing improvement. Conclusion: Korean Medicine interventions, including acupotomy and herbal medicine, may provide an effective alternative treatment for SSNHL cases resistant to standard steroid treatment, supporting hearing recovery and symptom relief.

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Abstract : Objectives: The aim of this study is to report the effect of Korean medicine treatment focused on bee venom pharmacopuncture for a patient with cervical myelopathy. Methods: A patient who had suffered from pain of neck and numbness, motor dysfunction, sensory loss of upper extremity, diagnosed with cervical myelopathy, was treated with acupuncture, bee venom, pharmacopuncture and herbal therapy. The effect of treatment was assessed by Visual Analogue Scale (VAS), modified Japanese Orthopaedic Association scale (mJOA scale) and Grip & release test. Also Digital Infrared Thermal Imaging (DITI) of upper extremity was used to evaluate the improvement. Results: After treatments, the functional status of patient improved from moderate to mild, with improved motor dysfunction, local sensation and level of pain. Also improvement of upper extremity temperature was found by DITI. Conclusion: This report suggests that Korean medicine treatment focused on bee venom pharmacopuncture can be effective in symptoms such as pain, motor dysfunction and loss of sensory related to cervical myelopathy.

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Abstract : Background: Tinnitus and hearing loss can severely impact children’s development and social interactions. This case report examines the effects of Korean Medicine on a 13-year-old boy with left-sided tinnitus and hearing loss unresponsive to conventional treatments. Methods: The patient received acupotomy, acupuncture treatment, Samso-um herbal decoctions once a week over 10 weeks. Results: Significant improvement in numerical rating scale scores for aural fullness and tinnitus was observed, with almost symptom resolution by week 10. Conclusion: Traditional Korean Medicine, including acupotomy, acupuncture and herbal decoctions, may offer effective complementary treatment for pediatric tinnitus and hearing loss cases resistant to conventional methods.

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Abstract : Objectives: The aim of this study is to report the effectiveness of an lumbopelvic-hip complex (LPHC)-targeted treatment in a patient with chronic low back pain (CLBP). Methods: A 54-year-old male with chronic low back pain and hip pain, unresponsive to prior treatments and without significant radiological findings, was treated over 10 weeks using acupuncture, acupotomy, snake venom pharmacopuncture and magnetic heat acupuncture therapy. Pain reduction and functional improvement were evaluated through patient-reported outcomes, focusing on sitting tolerance and pain during movement. Results: The patient’s sitting tolerance improved from 5 to over 30 minutes without discomfort, and pain during standing transitions decreased significantly. Conclusion: This report suggest that LPHC-focused treatment is effective in managing CLBP.

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Abstract : Objectives: This study aimed to demonstrate the diagnostic value of ultrasound and the therapeutic effects of ultrasound-guided Acupotomy and Pharmacopuncture in treating cervical radiculopathy with associated shoulder pain, a condition severe enough to warrant surgical consideration. Methods: A 48-year-old female with cervical radiculopathy (C5-C6) and shoulder pain was treated at Esbon Korean Medicine Clinic from October to November 2024. Ultrasound-guided Acupotomy was administered to address fibrotic adhesions, and Pharmacopuncture (5% dextrose) was injected near the C5 and C6 nerve roots, suprascapular nerve, axillary nerve, and shoulder joint capsule. Pain severity was assessed using the Numerical Rating Scale (NRS) and the Shoulder Pain and Disability Index (SPADI), and shoulder range of motion (ROM) was evaluated for abduction, flexion, and extension. Results: After 15 sessions, the patient’s active shoulder abduction improved from 30° to 170°, and flexion increased from 30° to 170°. Passive abduction also normalized. Pain resolved completely, with the NRS score decreasing from 9 to 0, and the SPADI score improving from 78.5% to 27.7%. No adverse effects were observed during treatment. Conclusion: This case highlights the diagnostic precision and therapeutic effectiveness of ultrasound-guided interventions in treating cervical radiculopathy and associated shoulder pain. Ultrasound guidance enhanced procedural accuracy, minimized risks, and improved clinical outcomes. This report suggests that ultrasound-guided Acupotomy and Pharmacopuncture can be effective non-surgical options for managing severe cervical radiculopathy.

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Abstract : Objectives: This study aims to evaluate the clinical effects of ultrasound-guided Acupotomy and Pharmacopuncture in patients experiencing complications after rotator cuff repair surgery, specifically addressing pain, fibrosis, and limited shoulder mobility. Methods: A 71-year-old female patient who underwent supraspinatus tendon repair in 2017 presented with persistent shoulder pain and restricted motion despite prior physiotherapy. Ultrasound-guided interventions were employed, including Acupotomy for adhesions and scar tissue and Pharmacopuncture injections (5% dextrose) targeting the lateral pectoral nerve, suprascapular nerve, and posterior shoulder capsule. Pain intensity was assessed using the Numerical Rating Scale (NRS) before and after treatment over 6 weeks across nine sessions. Results: After treatment, the patient experienced complete resolution of end-range shoulder pain. Follow-up one year post-treatment showed minimal recurrence of mild pain (NRS 1-2) with extensive shoulder use, but no significant functional impairment or severe pain relapse. Conclusion: Ultrasound-guided Acoupotomy and Pharmacopuncture effectively addressed postoperative complications such as fibrosis and neuropathic pain following rotator cuff surgery. Ultrasound guidance improved procedural accuracy, reducing risks of vascular or nerve injury and enhancing therapeutic outcomes. This case highlights the potential for these combined interventions to safely and effectively manage post-surgical complications.

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Abstract : Background: The aim of this study is to report the effect of Korean medicine treatment for a patient with interdigital abscess of foot. Methods: The patient was treated by acupuncture, pharmacopuncture, bloodletting, and herbal medicine. The improvement of the patient’s symptoms was assessed by subjective reports. Results: Before treatment, the patient experienced severe pain and difficulty in walking due to an abscess on the foot. After treatment, the abscess resolved, resulting in the alleviation of pain and difficulty in walking. Conclusion: These results suggest Korean medicine treatment is effective on soft tissue abscess.

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Abstract : Background: The aim of this article is to propose the safe and effective protocol for ultrasound- guided acupotomy procedure at the third lumbar transverse process syndrome. Needling at the third lumbar transverse process syndrome can cause side effects such as kidney damage. In this regard, the need to present a safer and more accurate method of needling at the third lumbar transverse process is enhanced. Methods: The procedure method was introduced along with the ultrasound image by applying ultrasound-guided acupotomy. Ultrasound machine was used with Samsung V7 and CA1-7SD convex probe. Results: A safe ultrasound procedure was presented. Conclusion: If the third lumbar transverse syndrome is treated in this way, the patient may be treated in a small invasive and effective way.

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Abstract : Objectives: Fungal infections are the leading cause of foot lesions in diabetics. However, oral and topical antifungal therapies require prolonged use and are often difficult to implement in polypharmacy situations due to the risk of drug interactions and poor patient compliance. This study presents the case of a diabetic patient treated for long-standing tinea pedis without the use of antifungal drugs. The treatment relied solely on herbal ointments and pharmacopuncture. Methods: The patient used two kinds of herbal ointments daily, and acupuncture was performed on the affected area approximately every 10 days via home-visiting healthcare service. Results: Approximately 1 month after treatment initiation, clearance of moccasin-type tinea pedis was observed. High patient satisfaction was reported, with decreased pain on walking and a half-point improvement in the Bates-Jensen wound assessment tool score. Conclusion: Effective short-term treatment of tinea pedis in a diabetic patient was achieved using herbal topicals and acupuncture, without the use of antifungal medication.

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Abstract : Objectives: The aim of this report is to report the effect of Acupotomy and rTMS on tinnitus. Methods: A total of 23 patients who visited the clinic for tinnitus symptoms received treatment, which included rTMS stimulation on the temporoparietal cortex and acupotomy treatment on the transverse processes of the cervical vertebrae. Rectus capitis posterior major, Rectus capitis posterior minor and TE17 for 10 times. Results: The average NRS of patients before receiving rTMS and acupuncture treatment was 7.61±1.12 points, which decreased to an average of 3.09±1.53 points after treatment, with statistical significance. Conclusion: This research suggests that rTMS and acupotomy treatment may be effective therapeutic methods for alleviating tinnitus symptoms.

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Abstract : Background: The aim of this study is to report the effect of Korean medicine treatment for a patient with oculomotor nerve palsy associated with intracranial vascular lesions (flow-related disorder at cavernous portion). Methods: We treated a patient who had suffered from right diplopia, right eye pain, ptosis and diagnosed with right oculomotor nerve palsy, with acupotomy, acupuncture, and herbal therapy. The effect of treatment was assessed by MRD1, MRD2, photographs and videos of eyeball movement. Also brain MRI, DWI and MRA were used to identify the intracranial vascular lesions and evaluate the improvement of venous flow at cavernous portion associated with right oculomotor nerve. Results: After treatment, patient’s symptoms such as diplopia, limitation of eye movement and ptosis were improved and right eye pain, headache, dizziness were decreased. Also probable improvement of cavernous dural arteriovenous fistula (AVF) was found by brain MRA. Conclusion: This report suggests that Korean medicine treatment including acupotomy can be effective in symptoms such as diplopia, ptosis related to oculomotor nerve palsy with flow-related lesions at cavernous portion including intracranial vascular lesions.

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Abstract : Objectives: The aim of this paper is to report a case of improved blepharoptosis following Botulinum Toxin injection on an eyelid, treated solely with acupuncture treatment. Methods: A 40-year-old woman with 2-year-lasted ptosis of right eyelid following a Botox injection was treated with acupuncture. Central and peripheral facial palsy were ruled out using the House-Brackmann scale. The acupuncture treatment targeted muscles and nerves near the orbit, and the progress was evaluated using the Marginal Reflex Distance- 1 (MRD-1). Results: Before the treatment, the MRD-1 of the right eye was 1.5 mm, indicating severe ptosis. And a rice-sized knot was observed on the right eyelid. After two sessions of treatment, the MRD-1 of the right eye has recovered to 3 mm, and the knot was no longer palpable. Conclusion: Acupuncture treatment might be effective for blepharoptosis that occurs after Botox injection.

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Abstract : Background: The aim of this study is to report the effect of Complex Korean Medicine Treatment, which includes Acupotomy, intranasal bloodletting therapy and soft palate bloodletting therapy on tinnitus and aural fullness. Methods: One patient with tinnitus and aural fullness was treated with Korean medicine therapy, including Acupotomy, intranasal bloodletting therapy, and soft palate acupuncture twice a week. Treatment progress was assessed using the Numeral Rating Scale (NRS) and Automated Micro Audiometer Pure-Tone Audiometry (AMA-PTA). Results: The patient’s symptoms of aural fullness and tinnitus disappeared after the treatment, and an improvement in hearing test results was also observed. Conclusion: These results suggest that Complex Korean Medicine Therapy, which includes Acupotomy, intranasal bloodletting therapy, and soft palate bloodletting therapy, could be an effective treatment for long-term tinnitus, hearing loss, and aural fullness.

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Abstract : Background: The aim of this study is to report significant improvement of insomnia treated with Modified Cheongsimyeonja-tang. Methods: A Taeumin patient who complained of insomnia, which began one week after the COVID-19 quarantine, was treated for a month with Modified Cheongsimyeonja-tang. Results: Before treatment, the patient took sleep-inducing drugs and slept for five hours a day. After treatment with Modified Cheongsimyeonja-tang, the patient could sleep for seven to eight hours without taking sleep-inducing drugs. Conclusion: It shows that Modified Cheongsimyeonja-tang is effective for insomnia, which is a aftereffect of COVID-19, in Taeum-in.

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Abstract : Background: Insomnia is a sleep disorder that makes it difficult to fall asleep, stay asleep, or wake up early. The prevalence of insomnia is on the rise in Korea. The purpose of this paper is to propose a new treatment for insomnia. Methods: In this study, the Pittsburgh Quality of Sleep Index was performed on 2 patients complaining of insomnia. It was used to diagnose insomnia and track treatment progress. Golchimdo was performed in two acupoints (Sinbaihui, Gubaihui) on scalp and thoracic intervertebral space. In addition, acupuncture, electro-acupuncture and cupping therapy were performed. The acupoints on the occiput were selected according to the RSN acupuncture method. Results: In both patients, the PSQI-K score returned to the normal range after the treatment. The patient’s discomfort, including sleep duration, time to fall asleep, and arousal during sleep, improved. Conclusion: The patient’s insomnia improved rapidly after receiving treatment, which included Golchimdo therapy. We suggest that Golchimdo therapy is effective in treating insomnia. More studies on Golchimdo mechanisms and treatment studies are needed.