Trigger point acupuncture

[Guest guest]

Karen:

 

Yes, trigger point acupuncture can be miraculous sometimes. I have had patients

literally crawl into my office with acute back pain and spasm, and walk out

upright. I happen to be a very results-oriented practitioner and love the

immediacy of the results. I find no conflict with the TCM paradigm because I

tend to do more meridian acupuncture than anything else.

 

To my way of thinking you are treating more the " branch " here. Personally, I

have no problem being a " pain doctor " because one can make a fine living at

that, especially in treating a condition that is often undetectable by imaging

methods, or that continues to plague the patient despite muscle relaxers, PT,

chiro adjustments, and supplements. Give the patient relief first, and then pay

attention to underlying deficiencies that may be contributing to the problem.

Get them out of pain and they will come back........and send their friends.

 

I have been studying with Matt Callison for quite some time. Matt is a

tremendous teacher who teaches motor point/trigger point acupuncture around the

country.......even occasionally in Boston at NESA. Check out his seminar

schedule and his materials at:  www.acusporthealth.com

 

Kay King, DC, MS, LAc

 

 

[Guest guest]

Hi Karen,

 

Trigger points are what we can " ah-shi " points in TCM.

Remember the saying - " where there's pain, there's blockage " and when it is

unblocked there will be no pain.

 

Blockage in and of itself is an excess condition. However, the underlying

reason for the blockage can be due to deficiency or excess. Some of the

underlying factors --

Qi deficiency

Blood deficiency

Yin deficiency

Yang deficiency

Phlegm/damp stagnation.

Wind-cold, Wind-heat, Wind-damp, or some combo, etc...

 

You get the idea. So TCM's true power lies in the differential diagnosis of

the underlying constitution that lead to the pain and blockage. Needling the

ah-shi point may given instant relieve, but as you already know, the

condition usually will not be 100% resolved until the root is also

addressed.

 

Some practitioners never needle the ahshi, they only needle upstream or

downstream and get excellent results. Others always needle the ahshi and

claim equally excellent results.

 

For me, I learned in school this way of thinking which I find helpful --

 

1) acute phase is usually excess, hot, inflammed and quite irritated. So I

do NOT needle locally when the area is already inflammed and angry looking.

In this case, always needle distally. You want to bring the blood flow

THROUGH the area, to decrease the inflammation. That's the thinking of

bleeding jingwell points to release heat from channel, or bleeding UB40 for

acute back pain.

 

2) subacute phase, can needle adjacently. (Or I might needle locally, but

always combine with some distal points to make sure i do not re-inflame the

area too much. This becomes more an art, usual needling technique and

intuition to make sure you do not reinflame or re-traumatize the area.)

 

3) chronic phase, the injured/painful area is usually quite Qi & Blood

deficiency. In western terms, you can say the tissue has suffered long-term

oxygen deprivation due to prolonged blockage in circulation. So we should

needle locally to bring nourishment TO the painful injured area.

 

I, too, am a huge fan of Callison's HuaTuoJiaJi plus motor-point approach.

Acupuncturists who collaborate with chiropractors, such as yourself, will

have a very easy time explaining this to Chiros as it is exactly the way

they approach things. Many chiros do ART or Myofascial Release to deal with

the " branch " and then adjust the spinal segment associated with the myotome

of the affected area, to bring better nourishment to the injured/painful

tissue.

 

In my own practice, I have weaved in Callison's approach of HuaTuo Jia Ji,

plus motor point, plus using channel balancing technique. (the idea of

distal, adjacent, vs. local treatment). I also select points to address the

constitutional issues, such as dampness, or blood deficiency. In this way,

I leverage the full offering of TCM in treating patient in a wholistic way.

The brilliance and elegance of TCM never ceases to amaze me. And the

results have been consistently good and long-lasting.

 

Many of my patients come in after seeing chiros, ART, myofascial release

practitioners and their progress has plateaued. Perhaps you have similar

experience... Often in those cases, it's nolonger because of the

trigger-point need to be released. It is the underlying consitution that

needs to be addressed. So even as a pain or neuro-muscular specialist, it is

important to understand how to address the root from TCM perspective, not

just the branch.

 

Hope this helps!

 

~edith

 

 

 

--

Edith Chan, L.Ac.

Doctoral Fellow

Ph: 415.298.5324

www.EdithChanAcupuncture.com

 

 

 

[Guest guest]

Edith.......

 

Elegant and succinct explanation! Thanks!

 

And yes, John, I too am a fan of Alon's. Big fan! Some say that Matt learned

much of what he knows from Alon. However, Matt makes this a fulltime

business and teaches in various parts of the country, thus more people have

access to his teachings than to Alon's.

 

Kay

 

 

[Guest guest]

A few comments re. the Trigger Points discussion:

 

Thank you, V. Hobbs for the link to your excellent article at

www.aaaomonline.info/qiunity/08/07/3b.html

 

( Interesting that you were trained by J.Skoin and W. Reeves, familiar

names at CAC in the mid eighties, along with a DC LAc who brought his

direct studies with Travell to two elective courses at the school.)

 

The 1999 edition of Travell and Simmons TrP Manual (by far the most

professional level books on the subject) was a substantial rewrite of

the first volume, which had been published in 1983. Some

definitions were added and modified, the neurophysiology was greatly

elaborated on, and Perpetuating Factors were given greater emphasis.

 

Some of my notes:

 

Perpetuating Factors specific to Myofascial TrPs can be outlined as:

a) mechanical / structural / postural - ( the biomechanics that DCs

and PTs are typically much better trained in than ACs, but programs

like NBAO help somewhat )

( proper resolution of these issues also unfortunately tends to veer

outside the curriculum of AC schools, IMO )

b) psychological

c) metabolic and endocrine

d) infections

e) sleep and dietary inadaquacies

History, Exam, and Lab are notably important in ascertaining status.

( The question remains if this needs to be by modern western med

standards, but that would be my bias.)

 

MYOFASCIAL TrPs are * (quote) to be distinguished from a cutaneous,

ligamentous, periosteal, or any other nonmuscular trigger point

(unquote) *, whereas sites of named or ahshi acupuncture points can

include all of these locations.

 

Pincer-style palpation is not (ever?) used to locate acupuncture

points, but it is the only way to find many myofascial TrPs.

 

The definition of referred TrP pain states * distribution rarely

coincides entirely with the distribution of a peripheral nerve or

dermatomal segment *

 

I find it peculiar that in the long history of acupuncture

development, no one ever PREVIOUSLY mapped out the referred pain

patterns that have come to characterize Travell / Simmons work. Maybe

someone has found greater correspondance, but I don't see much to

directly match the channels of CM (including extra, divergent, and

tendinomuscle).

 

Anyway, it's a huge study to take on, and insurance coverage issues

aside, I think anyone who really learns the material and the EXTENSIVE

manual skills necessary to be effective, should be able to practice

without concern for whether their nominal licensure is LAc, DC, PT, (

or Quack like me ! )

 

joe reid

www.jreidomd.blogspot.com