Pain is the number one reason most people are introduced to acupuncture as a therapy. Acupuncture has been used in pain management for centuries and continues to this day in modern China. Hospitals and acupuncture clinics are always effectively handling pain and creating management plans for individuals who are in distress. Acupuncture is excellent at diminishing pain levels right on the spot and can have instantaneous results at reducing pain levels.
The methods used within distal acupuncture have been described in Traditional Chinese medical texts for well over a millennium. Distal acupuncture involves inserting needles away from the painful areas, going distant/distal from the injured site as opposed to proximal/close or needling the target area. For instance, for back pain you may needle a hand and forearm or foot and calf. If the points are inserted correctly and at the precise location, a change should be felt on the spot. The pain level should start diminishing with flexibility increasing, as muscles are softened or loosened and an increased sense of wellbeing at the targeted site of discomfort is achieved.
Distal Acupuncture works using the meridian system and modern anatomy through targeting specific muscle groups and areas of pain. It allows the injured or sore area to relax and heal without causing any further trauma to the area.
These systems focus on using the correlation between the muscles and the meridian. This is the distal treatment which improves blood flow, oxygen, nutrients, and anti-inflammatory chemicals that your body needs to heal. – Brad Whisnant author of numerous books on distal acupuncture.
The two main pioneers of distal acupuncture were Master Tung with his family lineage of specific acupuncture points now known as “Tung Acupuncture” and Dr Richard Tan who created what is now known as the “Balance Method” based on the I-Ching and Traditional Chinese Medicine meridian theory. It is through a combination of these two systems using distal methods of acupuncture which allows a practitioner to shift and change pain at a specific area on the body.
Using the Balance Method and Tung Acupuncture for pain allows you to observe any changes in the condition straight away. Distal acupuncture generally requires a few treatments to determine how low the pain can be reduced and as with all acupuncture treatments the therapy has a cumulative effect with all prior treatments building momentum on the condition. The main benefit of these systems is you should feel some relief from your pain instantly within the treatment session.
Here’s an interesting piece of new research about Hot Flashes in women with breast cancer that came out of Italy and was published in the Journal of Clinical Oncology recently and reported in Reuters. Click on the links to both articles are below.
Reuters reported the following in their article commenting on the journal HERE.
By the end of the treatments, hot flash scores – the frequency of hot flashes multiplied by their severity – were significantly lower among the women in the acupuncture group.
The enhanced self-care group’s average hot flash score was about 23 at the end of treatment, compared to about 11 in the acupuncture group. The difference would be noticeable, Razzini told Reuters Health in an email.
The difference in hot flash scores between the two groups remained significant three and six months after treatment, the researchers found.
Women who received acupuncture also experienced a better quality of life than those in the enhanced self-care group.
If you would like to read the actual Journal of Clinical Concolog, the link can be found HERE. A summary of the Journal abstract is below.
Purpose: To determine the effectiveness of acupuncture for the management of hot flashes in women with breast cancer.
Results: Of the participants, 105 were randomly assigned to enhanced self-care and 85 to acupuncture plus enhanced self-care. Acupuncture plus enhanced self-care was associated with a significantly lower hot flash score than enhanced self-care at the end of treatment and at 3- and 6-month post-treatment follow-up visits. Acupuncture was also associated with fewer climacteric symptoms and higher quality of life in the vasomotor, physical, and psychosocial dimensions.
Conclusion Acupuncture in association with enhanced self-care is an effective integrative intervention for managing hot flashes and improving quality of life in women with breast cancer.
Children’s Acupuncture or Shonishin is more commonly known as Japanese Paediatric Acupuncture and it literally translates as “Children’s Needle”. Both Traditional Chinese and Japanese acupuncturists have been treating children for centuries. The Shonishin system, more specifically, dates back to the 17th century Japan in the Osaka region and then passed down through the generations until it was popularised through medical journals and publications in 1960s Japan.
Shonishin is designed to be able to treat children up to about 12 or 13 years old in a gentle, comfortable and caring manner, with the child remaining calm and reducing any stress for both the child and parents.
A basic Shonishin treatment involves asking questions, observation of the child, pulse or stomach diagnosis and the treatment. Home treatments are often taught to the parents after one or two sessions so that the Shonishin therapy can continue between sessions. This allows the parents to continue treatment under the supervision of the practitioner with some regularity and also encourages the bond between a parent and their child.
The Shonishin approach uses a range of tools and is generally needle-less. The tools used within Shonishin are often blunt and used for techniques that stroke, tap and press the various meridians of the child. The techniques are gentle and the procedure is often completed fairly quickly without any discomfort or distress to the child.
A Shonishin session uses these tools in combinations to stroke, massage, press and tap over a range of meridian lines or specific acupuncture points known to promote health and balance within the child. An experienced practitioner knows how to use these techniques to produce a variety of gentle stimulation and sensations within the child and this allows healing through the return to homeostasis.
Some of the tools used in Shonishin (from left to right) is the Spring loaded Teishin which is used to stimulate acupuncture points without needling, for rubbing the Enshin is used and looks like a metal ball on a stick that glides over the meridians, the Yoneyama is used for tapping or rubbing certain parts of the body and finally the standard Teishin which is a non-inserting blunt needle used to press or stimulate acupuncture points.
Whilst it is common for Shonishin to be totally needle free, there are occasions where absolutely pain free, gentle needling is used extremely superficially with extremely thin acupuncture needles designed for children. The technique is no more then a few seconds long and is generally completed before the child even realises what is going on.
Along with the Shonishin treatment involving rubbing, tapping and pressing, gentle cupping or indirect moxibustion may be used to complement the treatment. This will depend on the symptoms of the child and the condition being treated.
Shonishin, like Traditional Chinese Medicine, is a holistic means of treating an individual. This means that each child coming in will be differentiated and treated as a unique case and have their treatment tailored specifically for them.
Young Children are considered within the philosophies of Oriental Medicine to be in a more “Yang” phase of development and this means their “Qi” moves and responds a lot quicker in comparison to adults. A growing child’s body will naturally consume a lot more “Qi” or energy to allow for all the extra growth and development that is occurring. This often can deplete the organs responsible for producing “Qi” and in combination with other factors within our environment can leave a child open for a range of health issues.
There are many things to consider when administering a Shonishin treatment. The frequency, dosage and strength will depend on the age, health or illness of the child and presenting symptoms. Keep in mind that because Children are considered more “Yang”, that the treatment will often be shorter in duration and generally only take a few minutes to administer. The technique is most effective when combined with a home treatment that can be completed using household items and is taught using a spoon for rubbing or a toothpick for tapping.
You should always use Shonishin in combination and consultation with your paediatrician or General Practitioner. If your child has a fever and the body temperature is 37.8°C or higher (moderate or high fever) it is generally advised to see your child’s doctor or wait till the fever has subsided before coming in to administer a Shonishin treatment.
Shonishin is a wonderfully gentle and therapeutic method to promote healing within children and tackles numerous conditions or problems in a gentle, holistic and caring manner. If you have any questions about Shonishin or the treatment of children, please feel free to contact us for further information or to book an appointment visit Mornington Chinese Medicine for more information.
Here’s a little article about Acupuncture and constipation taken from healthcmi.com a great TCM news site. It basically describes a new study that shows Acupuncture as an effective option for relieving slow transit constipation. Acupuncture is an excellent modality to treat a wide range of symptoms relating to disorders involving digetsion and gut functions such as IBS. The study used a range of standard acupuncture points that are commonly used in the clinic on a regular basis. Read the snippet below and please comment if you have anything to say:
Acupuncture is effective for relieving slow transit constipation (STC). Slow transit refers to the slow passage of feces through the large intestine. Acupoint ST25, Tianshu, and CV12, Zhongwan. STC is a type of functional constipation that is present in approximately 15 to 30% of constipated individuals and is characterized by strained bowel movements with lumpy or hard stools. STC involves fewer than three bowel movements per week and is accompanied by a sensation of incomplete evacuation. There may be concomitant abdominal pain, nausea, and low appetite. The incidence of STC increases with age.
Acupuncture and Traditional Chinese Medicine works, there is no doubt about that. Often there is talk about the placebo effect, however, this really gets squashed when we talk about healing and animals. Animals are not aware if the therapy that is being performed is good for them, bad for them or has any impact on their systems. They are generally speaking known to be free from placebo effects.
This is great news for the Singapore Zoo who have been using Acupuncture and Traditional Chinese Medicine on their animals when Western Biomedicine has failed to achieve the results that they were after.
Around 200 animals, including giraffes, elephants, horses, pythons and sea lions, have successfully been treated with acupuncture and traditional herb-based Chinese medicine in the past decade, although Western medicine remains the first line of treatment in the zoo.
“The Western medicine did not always work, so we had to find other solutions,” Oh Soon Hock, a senior veterinarian at the zoo told Reuters on Friday.
Seeing an elephant getting acupuncture is quite an amazing phenomenon. We are seeing more uses for veterinarian acupuncture both at Zoo’s and specialised VETs treating our furry friends. Dogs with spinal issues have benefited from acupuncture as well as cats and horses. Horse acupuncture is becoming more popular as Horse owners recognise the benefits acupuncture offers. When our pets have acupuncture needles inserted into their body they often calm down, relax and don’t move around much. Animals will just sit there and enjoy the experience as a lot of people do too. If you have an animal that requires Acupuncture there are often registered veterinarians in your city or town that can offer this service for your pets and loved ones.
To read more about this interesting situation please visit:
All credit for this article goes to Kristen Horner Warren. She has graciously given me permission to repost her excellent article about the differences between Acupuncture and Dry Needling. To see her original article please click on the link in her name under the heading.
Keep Acupuncture Real: What You Must Know Before You Try Dry Needling
To this point I have not spoken out about this issue because I didn’t want to get embroiled in an ugly fight, but it has come to the point that I cannot in good conscience remain quiet about a serious threat to public safety and the integrity of a profession that I love. What is that threat? It is so-called dry needling, which is another name for acupuncture performed by physical therapists, occupational therapists, massage therapists, athletic trainers, physician’s assistants, and other allied health professionals, typically after 20-30 hours of training.
I feel that I have something unique to contribute to this discussion, given that I invested the time and money required to complete a 30-hour certification in “Dry Needling for Pain Management”. This experience gave me an inside look at the training that practitioners of dry needling receive in contrast with my training as a licensed acupuncturist. The bottom line? I am gravely concerned and see dry needling as a serious threat to public safety.
This is not about defending territory
When I first learned about dry needling I was open-minded. I am not by nature territorial or competitive. My primary goal is to offer my patients the most effective treatment and I am willing to entertain the possibility that people outside of my profession could have something clinically useful to contribute to my knowledge base. In the aftermath of a major car accident [http://www.liveoakacupuncture.com/my-story] in 2003 I worked closely with a physical therapist for about six months and was extraordinarily impressed his knowledge and skill. This experience caused me to have a generally positive attitude toward physical therapy as a profession.
In an effort to make a fair assessment of dry needling and out of a desire to learn, I traveled to Phoenix in 2012 to attend a three-day “Dry Needling for Pain Management Certification” course. The instructor is well-known in the field and is the author of two textbooks on the topic and I was eager to learn more about his “neurophysiological” approach to treatment.
My experience at the “Dry Needling Certification” course
There were approximately 60 other practitioners in attendance. Most of them were physical therapists, a few were chiropractors, two were physicians, and there was one other licensed acupuncturist. Friday and Saturday were devoted to lecture and the material was interesting and useful. I scribbled copious notes (we were prohibited from using laptop computers out of concern that we would surreptitiously record the class), was fascinated by the in-depth theoretical discussion surrounding how acupuncture works neurophysiologically, and was impressed by the knowledge and enthusiasm of the other students.
The practical portion of the course is where things got scary
Sunday was the practical portion of the course. We were given boxes of cheap acupuncture needles in lengths ranging from 30 to 50 millimeters. The entire group of 60 gathered around one massage table and stood on tip-toe to try to get a good view of the instructor as he needled a series of points on a volunteer subject. Then we broke off into groups of three or four to practice. Because there was only one instructor for the whole group, within a matter of moments I became the informal guide for my side of the room.
Like many things, acupuncture looks simple and easy when done by an expert yet is a lot more complicated than meets the untrained eye. Most of the other practitioners in attendance had never handled acupuncture needles before, so they were fumbling with basic skills such as how to open needle packages and handle guide tubes. This seems like a minor point but is not — clumsy handling of acupuncture needles and associated equipment can easily result in contamination of the needles and risk for infection.
As the day of needling practice proceeded, I became more and more concerned. In Chinese medicine school we spent over a year in the classroom learning about safety considerations surrounding acupuncture before we so much as touched needles. Like high school students in driver’s ed who are forced to view videos of high speed collisions and look at photographs of the mangled wreckage of a drunk driver’s cars, we spent weeks studying cases (rare as they are) of people who had been harmed by inappropriate needling.
We examined dozens of CT scans which showed how very close the apex of the lungs are to the underside of the trapezius muscles. We palpated the bodies of our classmates, learning to locate critical structures by feel. We discussed the fact that movements associated with respiration and/or digestion can cause a needle placement that was initially safe to become unsafe as the patient rests with the needles in place. We were encouraged to plan our treatments to make use of lower risk points on the extremities whenever possible.
In Chinese medicine school, when we did start needling, it was under the very close supervision of an expert. I inserted hundreds of needles in my own hands, feet, and legs before I touched another person and I inserted thousands of needles in my classmates’ hands, feet, and legs before I started practicing on points on the torso, neck, and face. I had been working with needles for two years (and hundreds of hours) by the time I touched a patient.
Now I found myself in a room full of minimally supervised individuals who were being encouraged to needle “assertively” into high-risk points located over internal organs less than 20 minutes after they touched an acupuncture needle for the very first time. I scurried between groups, answering questions, clarifying point locations or correcting angle of insertion, and exclaiming “hold on a sec, don’t do it that way!!!” over and over again. Although the other students were all experts in anatomy and musculoskeletal pathology, what they lacked entirely was the very subtle “feel” that is required to needle skillfully, safely, and painlessly.
Needling is a subtle skill that takes years to master
In Chinese medicine school, my early needling training was at the hands of a man who is the tenth generation acupuncturist in his family who had begun his own training in needling at age nine. He taught me that the acupuncture needle is a delicate instrument similar to the proboscis of a mosquito. He explained that, in the hands of a master acupuncturist, a needle is a living thing, an extension of the fingertips. The skilled and mindful acupuncturist can feel very clearly what is going on at the tip of the needle at all times. With this very careful attention, it is possible to feel when one’s needle tip is approaching structures that ought not be penetrated, such as nerves, blood vessels, the periosteum (the membrane surrounding bones), or the membrane surrounding internal organs.
The nature of the dry needling course made instruction in these types of subtleties impossible. One of the advantages being so busy answering questions during the practical portion of the course is that I was not subject to much needling myself. The exclamations of those who were being needled made it clear, however, that “painless” is not a description that could be attached to the techniques that were being used. I saw several rapidly developing bruises resulting from blood vessels that had been nicked, as well as heard the howls of a couple of practice subjects whose delicate periosteum had been plowed into by an incorrectly angled or too-deep needle.
Ignorant people overestimate their knowledge and skill because they are so ignorant that they don’t know they are ignorant
By the end of the day most of the students had needled each point no more than a few times (and clumsily at that), yet in his closing comments the instructor encouraged all of us to leap into the practice of dry needling the next morning at our respective clinics. My heart sank at the thought of how many patients these new “practitioners” would come into contact with. At best they would provide a painful and ineffective experience with acupuncture and at worst they could cause serious injury.
There was no discussion of the fact that three days of training is a tiny drop in the bucket of what is required to become competent with needles. The other professionals in that weekend course left on Sunday evening believing that they were fully qualified at something that I am well aware that I have still not mastered after nearly four years of formal education and over twelve years of full time clinical practice.
The whole experience made me think of the Dunning-Kruger Effect. According to the Journal of Personality and Social Psychology:
The Dunning–Kruger effect is a cognitive bias wherein unskilled individuals suffer from illusory superiority, mistakenly assessing their ability to be much higher than is accurate. This bias is attributed to a metacognitive inability of the unskilled to recognize their ineptitude. Conversely, highly skilled individuals tend to underestimate their relative competence, erroneously assuming that tasks which are easy for them are also easy for others.
In plain English: Ignorant people overestimate their knowledge and skill because they are so ignorant that they don’t know they are ignorant.
Based on my experience attending a dry needling certification, this explains exactly what is going on with physical therapists and other professionals who are practicing (and teaching) dry needling — having made no effort to understand the rich history, subtle skill, and extensive training involved with real acupuncture, practitioners of dry needling assume that the training of Licensed Acupuncturists is limited to “superstitious” or “archaic” notions such as Qi, meridians, Yin, and Yang. Having made this assumption, they further assume that a physical therapist’s extensive knowledge of anatomy qualifies them to wield needles with nothing more than a weekend’s training.
It is dangerous when any medical professional overestimates their ability
This state of affairs is dangerous, a fact that has been borne out by several recent cases in which high-profile patients have been injured by practitioners of dry needling (although a couple of these articles refer to “acupuncture” as opposed to “dry needling” the training of the practitioners involved is similar to what I experienced in the dry needling course). You can read about these cases here:
Dry Needling and Violations of the U.S. Food, Drug, and Cosmetic Act (FDCA) and Food and Drug Association Rules [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/2014_02_28_09_23_12-2.pdf]
Asian Medicine and Acupuncture Society of Arizona Position on Physical Therapists and Non-Licensees Using Dry Needling [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/Arizona-position-paper.pdf]
CPT Assistant: Coding Clarification – Trigger Point Injections Using “Dry Needling” Technique [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/CPT-Assistant-Oct-2014-page-9.pdf]
National Chiropractic Council letter to Oregon Medical Board [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/National-Chiropractic-Council.pdf]
Doctor fined $35,000 for Medicare fraud related to dry needling [http://www.rutlandherald.com/article/20111025/NEWS01/710259964/0/business]
American Physical Therapy Association: Physical Therapy & the Performance of Dry Needling [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/DryNeedlingResourcePaper1.pdf]
Oregon Board Physical Therapist Licensing Board: Updated Statement Related to Physical Therapists Using the Intervention of Dry Needling [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/Oregon-Board1.pdf]