Successful Treatment of Medial Tibial Stress Syndrome with Interosseous Membrane Acupuncture: A Case Series

Abstract

Background: Medial tibial stress syndrome (MTSS), otherwise known as shin splints, frequently causes pain and disability in the physically active population and can be recalcitrant to treatment. Interventional and alternative therapies, specifically acupuncture, for treatment of MTSS have been poorly described in the literature. The aim of this case series is to describe an acupuncture technique for the treatment of MTSS. Cases: Patients who received the diagnosis of MTSS were treated in an outpatient military treatment facility. One Hwato^® 0.30 mm × 75 mm needle was placed 1 cun distal and 1 cun lateral to the tibial tuberosity of the affected leg and was inserted deeply through the plane of the interosseous membrane. A second needle was then placed 2 cun distal to the first needle in the same trajectory and at the same depth. Needles were then irregularly stimulated for 5 minutes before needle removal. After treatment, the patient vigorously moved the affected leg before reassessing pain. Results: Both patients noted a clinically significant decrease in pain immediately after intervention, which lasted for 4 weeks. Conclusions: Interosseous membrane acupuncture is a clinically significant, effective means to decrease MTSS-associated pain in physically active adults. This case series demonstrates a technique to augment conservative therapy of patients with MTSS.

Keywords: acupuncture; interosseous membrane; medial tibial stress syndrome; military.

FIG. 1.

Second Hwato^® 0.30 mm × 75 mm needle placed 2 cun distal to the first needle in the same trajectory inserted deeply through the plane of the interosseous membrane.

FIG. 2.

Pretreatment and post-treatment numeric pain rating scores.