Pharmacopuncture for Post-Arthroscopic Peripheral Neuropathy: A Case Report
Teresa Nadia Marpaung, Yoshua Viventius, Wahyuningsih Djaali, Imaniar Swariandina, Dewi RatnasariIntroduction:
Peripheral neuropathy may occur after arthroscopic surgery as a result of mechanical nerve injury during the procedure. Such injuries—including compression, traction, or blunt trauma—can lead to neuropathic pain, numbness, sensory disturbances, and, in severe cases, motor dysfunction. Conventional treatments often provide limited relief and may be associated with undesirable side effects. Pharmacopuncture—an integrative therapy combining acupuncture point stimulation with targeted injections of therapeutic substances—has emerged as a complementary approach for enhancing nerve recovery and alleviating neuropathic pain.
Case Presentation:
A 43-year-old woman presented with persistent pain and numbness in her right foot following arthroscopic excision of a calcaneal spur. These symptoms resulted in impaired ambulation, requiring the patient to use an assistive device in the form of crutches. She was diagnosed with post-arthroscopic peripheral neuropathy and underwent 12 sessions of pharmacopuncture using a mixture of lidocaine, mecobalamin, and 0.9% saline (NaCl) injected at acupuncture points ST36, KI3, GB34, ST41, and BL57 on the affected side. Clinical outcomes were evaluated using the Numeric Rating Scale (NRS), Neuropathy Symptom Score (NSS), Douleur Neuropathique 4 (DN4), and patient-reported sensory-affected area.
Results:
The patient experienced marked reductions in pain intensity, improved plantar foot sensation, and enhanced walking ability following treatment, allowing discontinuation of analgesic medication and walking aids. No adverse effects were observed. Both DN4 and NSS scores showed clinically meaningful reductions, accompanied by a noticeable decrease in the sensory-affected area. These findings suggest potential applicability of pharmacopuncture in selected cases of peripheral neuropathy, warranting further investigation.
Conclusion:
Pharmacopuncture appears to be a safe and effective complementary therapy for managing post-arthroscopy peripheral neuropathy. By integrating targeted pharmacological intervention with acupuncture-point stimulation, this approach may promote nerve recovery and relieve neuropathic pain. This case highlights a novel application of pharmacopuncture for post-arthroscopic peripheral neuropathy, a complication that has been infrequently reported in the acupuncture literature.