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How Can Acupuncture & Integrative Medicine Help You?
Philadelphia’s Most-Trusted Acupuncture Clinic
Compassionate Medicine. Effective Results.
How Can Acupuncture & Integrative Medicine Help You?
Philadelphia’s Most-Trusted Acupuncture Clinic
Compassionate Medicine. Effective Results.
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Trigger Point Acupuncture (aka ‘Dry Needling’) has gained traction in recent years in the US, becoming a more commonly-used acupuncture-based mechanism to relieve myo-fascial pain.  In Trigger Point Acupuncture (aka ‘Dry Needling’), hair-thin acupuncture needles are inserted into the body in areas where muscle tissue and fascia have become painful, knotted or compromised in some way.

Dry Needling, however,  is far from new.  For thousands of years, what is now known as ‘Dry Needling’ has been known in China as ‘Ashi’ or ‘Ashixue’ (阿是穴) acupuncture.  ‘Ashi’ style acupuncture has been but one simple technique within the multifaceted- and more complex- system of acupuncture.

What IS new about ‘Dry Needling’, however, is that modern science has begun to unravel the scientific basis behind how this type of acupuncture works.  Chinese Medicine Physicians- who had been performing this technique for millennia- could not have known on a chemical or molecular level how their practice of Ashi acupuncture was working.  Theories behind it’s efficacy were explained via Chinese Medicine diagnostic terms.

What we know today about how myo-fascial trigger points develop and how they are relieved through the use of acupuncture is largely based on the work of Janet Travell and David Simons.  There are many layers of explanation involved in illuminating the pathogenesis and alleviation of Trigger Points.  The following is a short summary of the basics.

Put simply, Trigger Points are constant/consistent sources of pain in specific areas of muscle and fascial tissue where tight bands of contracted or knotted tissue are found.  Normal muscle tissue is free of ‘contraction knots’ within the muscle fibers.  When these ‘contraction knots’ occur, the brain receives pain signals resulting in a somatic awareness of specific areas of physical pain.  There are two types of trigger points:  active and latent.  Both types can cause range of motion issues, muscle dysfunction or weakness.

According to Dommerholt’s research* found in the Journal of Manual Manipulation Therapy, “Dry needling can not only reverse some aspects of central sensitization, it reduces local and referred pain, improves range of motion and muscle activation pattern, and alters the chemical environment of trigger points.”

Another scientific journal** lists some of the common pain conditions that have been associated with myo-fascial trigger points.   These include:  migraines, tension type headaches, carpal tunnel syndrome, disk pathology, radiculopathies, tendonitis, craniomandibular dysfunction, joint dysfunction, spinal dysfunction, computer-related disorders, whiplash-associated disorders, pelvic pain and other urologic syndromes, complex regional pain syndrome and post-herpetic neuralgia.

A comprehensive understanding of the scientific details behind the pathogenesis and alleviation of myo-fascial Trigger Points would require a much larger platform than a blog post like this can accommodate.  However, I hope that all of you have at least learned some of the basics regarding this very effective form of treatment for the numerous pain conditions that can be relieved through Trigger Point Acupuncture (aka ‘Dry Needling’).

A final note:  Since acupuncturists receive several years of acupuncture-specific training, they are very well-equipped to perform this type of technique.  However, not all acupuncturists perform Trigger Point acupuncture within their own practice, so it is best to inquire ahead of time when looking for an acupuncturist in your area.

May you all be healthy, happy and full of vitality!

Sources:

*https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201653/

**https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508225/

 

Mind-Body Acupuncture & Integrative Medicine is kicking off a new video blog series called, “Two Minutes to Better Health”.   In this first video blog in the series, Dr Aaron tells the story of his first acupuncture treatment 23 years ago and how it changed the course of his life, leading to over 5 years in Asia and a career in holistic medicine.

Interested in learning more about holistic medicine, acupuncture and the world of natural health?

If so, please subscribe to Mind-Body’s YouTube channel, by clicking the “Subscribe” button located above the video.

May you all be healthy, happy and full of vitality!

To watch the video, please click on the following link:

Two Minutes to Better Health: Mind-Body Acupuncture & Integrative Medicine

A growing body of Randomized Controlled Trials (RCTs) continues to prove that the millennia-old practice of acupuncture can be an effective treatment for numerous conditions and illnesses.  Because of a burgeoning interest in acupuncture research among some of the world’s top medical research centers such as Stanford, Harvard, UCSF, etc, it has become known that acupuncture does work.  The question, however, remains how?

Acupuncture has been shown to create various physiological and biological changes in the body on numerous levels simultaneously, therefore, mapping out its systemic effect on the mind-body is quite a complex process.  It is a common belief that the concept of energetic channels within the body (meridians), which convey and transport subtle bodily mechanisms thoughout was developed thousands of years ago by sages and ascetics who could feel these subtle processes within their own bodies.

Acupuncture points, in general, were considered way stations along these energetic highways (meridians) where Qi or energy congregated or pooled in larger quantity in relation to other places along the meridians (places along the meridians where no points were designated).  Generally-speaking, these places where Qi tends to pool along a meridian (acu-points) are considered more therapeutic than non-Qi-pooling places.

In my humble opinion, modern science is not yet quite sophisticated enough to detect the subtle systemic changes toward health and homeostasis that acupuncture can produce.  To really map out all of the changes produced by one acupuncture session, for instance, modern science would need to invent a machine that can somehow monitor physiological and biological changes within the body for an extended period of time.  A diagnostic device like this- if ever produced- might look like a wear-able functional MRI (fMRI) machine that also can monitor subtle biological and physiological changes such as changes in inflammation levels, hormone and endorphin levels, immune response, etc.

Mapping these physiological changes has started to happen to an extent with Dr. Sean Mackey’s work at Stanford University, using functional MRI (fMRI) machines in conjunction with acupuncture.  However, despite illuminating the fact that physiological and brain activity in the body does occur with the insertion of acupuncture needles, even this type of research does not clearly display how acupuncture works in a simplified way.  This is, in my opinion, the conundrum. It is, seemingly, still too complex to map out as acupuncture creates changes on multiple levels simultaneously.

Despite this complexity, when patients, friends or colleagues ask, I do still often try to explain some of the ways in which acupuncture can effect change within the mind-body continuum.   There are a number of modern theories that explain ways in which acupuncture is thought to effect positive change towards health in humans and animals (vertebrates).

To explain this, I’ve found a helpful article by Netherlands-based acupuncturist, Johanna Biemans, which can be found online here:  https://www.linkedin.com/pulse/top-5-theories-explained-how-acupuncture-works-johanna-biemans/

The following is from acupuncturist Johanna Biemans’ article, ‘Top 5 Theories That Explained How Acupuncture Works‘:

1. Endogenous endorphin release

The all time number one when it comes to explaining how acupuncture could influence our bodies is the triggering of the endogenous endorphin release. Endorphins are our bodies own painkillers and are produced in the midbrain. Bruce Pomeranz was the first to describe the relation between acupuncture and the painstilling effect due to endorphin release. He specifically draw attention to the delay time of 20 min. between stimulation and the onset of the analgesic effect. The time necessary for processing the endorphin from the precursor pro-opiomelanocortin (POMC). The endorphins involved are most likely beta-endorphin.  

2. Triggerpoint deactivation

A definite second place belongs to the popular triggerpoint theory (our bodies expression of pain by hypersensitive knots in striated muscles).  Unlike the endorphin theory, this theory has caused a lot of debate amongst acupuncturists and the so called dry needling therapists about ownership. Basically acupuncturists are familiar with treating painspots or “Ashi”points as it is defined in the original theory. Deactivation of myofascial triggerpoints resolves stifness and pain. This can be achieved by specific needling techniques.

3. Modulation of nerve activity

In third place I chose neuromodulation: acting upon nerves to alter nerve activity. Neuromodulation is a fast growing field and when we consider the therapeutic impact that came along with it. this theory deserves a place in the Top 5. Some of the modalities are originated or closely related to acupuncture. The explanation holds that needling in the close surroundings of mostly peripheral nerves, effects can be evoked at a spinal or supraspinal level. This antidromic stimulation presumably has a modulating effect through a segmental way on organs or body functions. The most known are stimulation of n.medianus in cases of PONV ( Postoperative Nausea and vomiting) and n. tibialis posterior stimulation (PTNS) in the treatment of pelvic disorders. Discussion continues about the frequencies, intensities and duration of stimulation. Because manual needling requires a very precise craft these kind of stimulations are mostly performed with electrical devices: electroacupuncture. Very, very speculative  but worth mentioning is the riddle of “Bagdad’s Batteries”. On a site near Bagdad Archeologists found battery like objects. And in close surroundings some needle like objects. One theory states that they might have been used for electrostimulation according to acupuncture principles.

4. Counterstimulation at spinal level

From the fourth place on choosing becomes harder. If I take into account: “times cited in literature” I guess counteracting deserves a place in the Top 5. Many times in a negative connotation though. Acupuncture is no more than counterstimulation. Counterstimulation is based on the wellknown gate control theory of Melzack and Wall.  Different stimuli from the periphery can inhibit each other at spinal level and thus painful stimuli can be suppressed.

5. Increase of blood flow.

At fifth place I firstly selected ‘balancing the autonomous nerve system” which is frequently quoted. But then I realised that this mode of action comes very close to the ones (3 en 4) mentioned above. And merely is a different angle of referring to similar mechanisms. I considered influencing ‘hormonal balance’ or ‘immune functions’. Then of course I came up with the mostly local effect of increasing the blood flow. The puncturing of soft tissues and muscles brings forward a production of adenosine which binds to the ephitelium of bloodvessels and induces the release of nitrooxygen which causes a vasodilatation of the bloodvessel. It’s usage preferred in local ischaemic conditions.

The most close explanation of acupuncture is likely a combination of mechanisms plus the missing link that is expressed in it’s original concepts.

 

Related article:

http://cim.ucsd.edu/clinical-care/acupuncture.shtml

Dr. Aaron Cashman
Dr. Aaron Cashman
Licensed Acupuncturist & Herbalist
(DAOM, L.OM., M.S., DiplOM, CYT)
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