Clinical Handbook of Acupuncture

Acupuncture Halos, Heredia, Herejias, Hicarte

BACKGROUND AND THEORY OF TRADITIONAL CHINESE MEDICINE

Acupuncture • Acupuncture is an important component procedure in traditional Chinese medicine which prevents and treats disease by puncturing certain points in the body with needles. Of marked efficacy and requiring but simple equipment, they have been widely popular in china and elsewhere for thousands of years.

Acupuncture • 200 BC – basic tenets of Chinese medicine were recorded in “Huang Di Nei Jing” (The Yellow Emperor’s textbook of physical medicine • Man was seen as an integral part of nature and in a state of intensive interaction with his environment. • It was regarded as the expression of inherent conformity with a natural law (TAO)

Tao • 5th century BC by Laotse in the Tao Te King • “Tao creates the One, the One creates the Two, the Two generates the Three, but the Three creates all things” • All things in nature develop within the field of tension between Yin and Yang – Tao remains as the continuous, creative force and the basis of all dynamic creation and transformation

Yin and Yang • Yang is the sunny side of the hill, while Yin symbolizes the shady side • Law of Unity of Opposites: – Inter-consuming-supporting Relation • Consuming – implies losing or weakening • Supporting- implies gaining or strengthening

– Inter-transforming Relation • Once a certain limit is reached, a change to the opposite direction is inevitable

The Vital Energy, Life Force: Qi • vital energy or life force is omnipresent in nature and is apparent in all life in the form of change and movement. • Every life process, every organic function is an expression of the action and movement of the vital energy. • Qi accumulates in the organs and flows in channels or meridians that are called Jing and Luo in Chinese.

Forms of Qi – seen in various levels of density in the human body: • LUNG QI- Qi is received from the respiratory air. – called “Zong Qi” “Chest Qi,” “Big Qi,” or “Yang Qi” – Dynamic – also called the “gathering Qi” and is formed in the interaction with the nutrient Qi;

• YING QI – The digestive process transforms food into nutrient Qi or Yin Qi (Ying Qi)

• YUAN QI - “source Qi” “hereditary Qi” – the vital energy each person inherits from his or her parents and which brings about the person’s growth and development.

Forms of Qi • The three forms of Qi combine in the body. • Jing Qi is the vital energy that flows through the channels (Jing) • The functions of the organs are brought about by the Qi inherent in each.

The Aim of Chinese Acupuncture • harmonize the flow of Qi by dissolving blockages and stagnation in the organs and channels • If the Qi of an organ is weakend: incomplete or faulty function • If Qi is present in excess: excessive function. • Acupuncture can balance the conditions of excess or deficiency in the organs and thus achieve an undisturbed function • Qi Gong: Qi can be felt by the practitioner as a tingling, vibration or flow during acupuncture session • De Qi: felt by the patient after insertion of the needles or through manual stimulation of the needles

The Aim of Chinese Acupuncture • Since the preponderance of diseases is the outcome of imbalance between yin and yang, acupuncture is aimed at reconciling the two and restoring them to a condition that is of relative balance.

MECHANISM OF ACUPUNCTURE

Acupuncture Theory • At the basis of acupuncture, is the theory that the body has a constant energy force running through it. • This energy force is known as Qi. • The Qi consists of all essential life activities which include the spiritual, emotional, mental and the physical aspects of life. • People who practice and receive acupuncture therapy believe that a person's health is influenced by the flow of Qi in the body.

Acupuncture Theory • It is believed that energy constantly flows up and down pathways in the body called Meridians. • When these pathways become obstructed, deficient, excessive, or just unbalanced, Yin and Yang (positive and negative energy in every person) are said to be thrown out of balance. This causes illness. • Acupuncture is said to restore the balance.

Acupuncture Theory • It is believed that energy constantly flows up and down pathways in the body called Meridians. • When these pathways become obstructed, deficient, excessive, or just unbalanced, Yin and Yang (positive and negative energy in every person) are said to be thrown out of balance. This causes illness.

Acupuncture Theory • Meridians are described as special pathways of energy. • The Meridians, or channels, are the same on both sides of the body. • The acupuncture points for each disorder are specific locations where the Meridians come to the surface of the skin, and are easily accessible by "needling." • Electroacupunture - method of acupuncture usually used for pain relief and prevention – funnels very small electrical impulses through the acupuncture needles

ACUPUNCTURE IN ANALGESIA

Acupuncture in Analgesia • Pain treatment - one of the most consistently supported uses of acupuncture therapy • Acupuncture generates its analgesic effects through afferent sensory stimulation. • Large A-Beta fibers which mainly carry touch sensation will inhibit transmission of small A-Beta C fibers which have been found to transmit pain.

Acupuncture in Analgesia • Acupuncture analgesia is caused through endogenous opioids that are released from the anterior pituitary such as Beta-endorphin. • Beta-endorphin binds to analgesic receptors in the dorsal horn of the spinal cord causing pain inhibition. • Additionally, acupuncture's analgesic effects have found to be diminished by administration of naloxone.

Acupuncture in Analgesia • Meridians that are so full of energy are closely related to the gap junctions of neurons. • It is thought that these synapses that connect neurons are the places of highest energy in the nervous system and thus the place when Meridians must lie. • This suggestion links acupuncture to pharmacology. Many drugs, including psychotropic and pain relievers have their effects at the synapses of neurons as a reuptake mechanism or prolonging effect. This theory would suggest that acupuncture works on the nervous system by a similar mechanism to create analgesia.

SCIENTIFIC EVIDENCE OF ACUPUNCTURE

Scientific Evidence • Twelve patients were monitored using a functional magnetic resonance imaging (fMRI), a technology that reveals what parts of the brain are receiving increased blood flow. • The patients were subjected to pain in the form of a tiny filament used to prick the inside or outside of their upper lip. • Seven subjects received traditional acupuncture at the Hegu point (LI4) – thumb and index finger • Remaining five subjects received electroacupuncture at the Hegu point

Scientific Evidence • fMRI showed considerably decreased levels of brain activity associated with the pain – The study found activity subsided in 60 to 70 percent of the entire brain

• The response was even greater among those who received electroacupuncture – Those subjects showed a greater tolerance to pain than those who received traditional acupuncture treatment

Scientific Evidence • Duke University Study (acupuncture for headaches) – 4,000 participants – 62% showed significant pain reduction after acupuncture – 45% showed significant pain reduction with pharmaceuticals – Acupuncture produces fewer harmful sign effects versus pharmaceuticals – Acupuncture and fMRI study confirms acupuncture and neurological response

Scientific Evidence • Outcome measure: Findings on fMRI imaging in the anterior cingulate cortex and thalamic areas.

Scientific Evidence • Conclusion: – Acupuncture appears to inactivate brain regions involved in the transmission and perception of pain.

ACUPUNCTURE METHODOLOGY

Acupuncture Methodology • Varied approaches to practice of acupuncture • Meridians and points are universally accepted • Each approach differs in choice of points and method of stimulation • Goal: To restore the flow of Qi

Acupuncture Methodology • Classical acupuncture is the traditional practice according to the principles of Taoism. – – – – – – –

French/Vietnamese meridian energetics Aurical acupuncture Korean hand acupuncture Japanese acupuncture Scalp acupuncture Tendinomuscular acupuncture Electroacupuncture

TECHNIQUES IN ACUPUNCTURE

Techniques in Acupunture • Tonification for deficient energy requires form of needle stimulation – Manually by intermittent twirling, rotation or up and down thrusting of the needle – Electrical stimulation – Moxibustion – Cupping

Acupuncture Methodology • Tonification for deficient energy requires form of needle stimulation – Manually by intermittent twirling, rotation or up and down thrusting of the needle – Electrical stimulation – Moxibustion – Cupping

BENEFITS OF ACUPUNCTURE

Benefits of Acupuncture • Improvement of Health and Quality of life and stress reduction – balances the body’s energy system through acupuncture points. These acupuncture points are gateways to the body’s energy (Qi) flow.

• Pain reduction – relieves arthritis, neck pain, back pain, menstrual pain, carpal tunnel, plantar fasciitis, joint sprains & strains, digestive pain etc. As well as migraine, and kinds of headaches.

• Improved and Faster Recovery from Injury, Illness and Surgery – circulation, reduce inflammation and reduce scaring. Many professional sports teams have staff acupuncturists – Surgery as compared to general anesthesia produces no adverse effect.

Benefits of Acupuncture • Emotional Balance – Comparable with amitryptiline – More effective than psychotherapy – Depression, anxiety, frustration, and worry

• Respiratory health – More effective than antihistamine drugs – Allergies, asthma, sinusitis, rhinitis

• Insomnia Relief – Insomnia and other sleep issues

• Strengthening Your immune system – balancing the body’s energy system.

Benefits of Acupuncture • Premenstrual (PMS) Menopausal Symptom Relief – Common symptoms such as headaches, cramping, sleep disturbances, mood swings, night sweats, cycle length, duration and pimples – It also releives dysmenorrhea • Relieves pain and regulates motility of uterus

• Reduction of Side Effects of Chemo and Radiation Therapies – No controlled trials has been proven but known to be helpful in relieving the pain and controlling adverse effects of radio and chemotherapy

RESEARCH FINDINGS

Research Findings

Research Findings

Research Findings

Research Findings

CONTRAINDICATIONS

Benefits of Acupuncture • Acupuncture in the first trimester of pregnancy and certain points to be avoided thereafter. Some of the forbidden points are anatomically related to the uterus, and some are powerful autonomic switches, so caution is reasonable

Benefits of Acupuncture • Acupuncture during menses is relatively contraindicated, as it may not be as effective during this period • Initiating acupuncture while a patient is taking medication, particularly corticosteroids, benzodiazepines, and narcotics, may reduce its effectiveness

Benefits of Acupuncture • Relative contraindications may include extreme frailty and concurrent febrile illness. • Local skin infection or breakdown dictates that points in the area of skin involvement not be used.