The M.D. in this video doing acupuncture for trigger point pain is going to hurt his own back if he does not improve his bio-mechanics. If I were him i would use a wheeled stool, which is what I use in my own acupuncture practice here in San Diego. This report makes reference to trigger point pain, which is what the woman being treated for back and leg/buttock pain is being given acupuncture for.
Trigger points are a significant factor in a huge percentage of acute and chronic pain conditions, but its critical when first meeting a patient to differentiate between the possible causes of your pain. Is your pain due to nerve entrapment from inflammation in a small space such as in carpal tunnel syndrome? Is it pain due to nerve entrapment by shortened muscles as in forearm pain or piriformis syndromes? Is it sciatic pain due to a herniated disc? Or is it back, buttock and leg pain that looks like sciatic pain due to herniation, but that is actually due to active trigger points in the back combined with shortened quadratus femoris muscle entrapping and irritating the sciatic nerve?
Why Is Diagnosis So Important in Chinese Medicine/Acupuncture/Physical Medicine
Acupuncture is an amazing treatment for all kinds of pain, but trigger point pain is often mis-diagnosed as neurological pain by family practice or internal medicine M.D.s who don’t focus on physical medicine, or even by rushed, busy, occupational medicine orthopedists, because like sciatic pain and other nerve pains, trigger points have referral patterns that mimic neurological referral patterns. But trigger point pain is easy to differentiate from nerve pain, which is why a very thorough clinical exam and history is so important in your first visit.
You cannot treat something effectively without first identifying what it is. And the acupuncture treatment of neurological conditions like sciatic nerve pain, or carpal tunnel pain from nerve impingement, is has difference from the treatment of trigger point pain with myofascial style acupuncture.. What kind of acupuncture needles we use, where we place the acupuncture needles in the body, what secondary modalities like cupping or heat therapy we use, are all determined by the source of the pain.
Herniated Disc vs. Trigger Point Pain
One of the biggest mistakes I see with some of my colleagues in acupuncture, yoga, and massage therapy is not being able to differentiate between back and leg pain that is due to nerve impingement involving a disc bulge or herniated disc, and back/leg pain that is trigger point induced. Herniated disc and trigger point pain require very different treatments, and especially with massage, a lot of harm can be done if you treat a herniated disc aggressively, especially with twisting or straight leg raising.
Yoga is quite risky for people with herniated discs in the acute phase. if there is pain from a disc bulge, Yoga, especially inverted poses like the head stand/Sirasana, or forward flexion/compression poses such as plough/halasana are really risky and should be avoided. Whereas yoga is excellent for trigger point pain and muscle tension.
What Are Trigger Points?
Active trigger points produce and are associated with the kind of generalized sore, achy, tight muscles that most of us at some point feel in our neck and shoulders from overuse at tasks involving forward translation of our heads, necks, forearms, like typing, reading from a computer screen, driving, etc. All near-vision tasks. Whereas as hunter-gatherers, we actually evolved to spend large amounts of time gazing out at the distant horizon. I have found trigger points to be involve in many kinds of pain from TMJ temporal-mandibular joint pain, to esoteric foot pain in ballerinas. When muscles shorten, which is what occurs with trigger points, bad things happen to joints–they tighten too. Now you have compressive forces working on a joint that should be loose. Staying loose is what athletes always strive for, because when you are loose, which means relaxed, your muscles lengthen and you are less prone to injury and less sensitive to pain. To be loose, your mind must relax, that is a whole ‘nother story.
How Acupuncture Relieves Trigger Point Pain
Acupuncture is such a good therapy for the tight, shortened, muscles associated with trigger point pain, because when you insert the needle, relatively painlessly, into an active, tightly coiled trigger point, it deactivates it–and it releases like a coil–your whole muscle releases in a twitch response, you get a rush of very pleasant endorphins, your whole body relaxes, your mind relaxes, you breathe more deeply, your blood levels of anti-inflammatory hormones and muscle relaxing, euphoria inducing endorphins elevates, and, key point: your muscles lengthen. And when your muscles lengthen that releases the compressive pressure from the tendons, ligaments, joint capsule, nerves, even arteries and veins–every structure involved in the production of pain. Your whole body relaxes, key point, acupuncture is incredibly relaxing, which is also why it is so fantastic for stress.
Additional Methods: Cupping Therapy
When I treat trigger point pain I often follow up the acupuncture with some passive joint mobilization from Chinese Medical Massage called Tui-Na, I also use some techniques learned from both Trager Method. I follow this upon with my own method of Chinese cupping using Ayurvedic anti-inflammatory oils like Mahanarayan Oil (Source for Ayurvedic Oil), followed by heat therapy. Heat relaxes and lengthens muscles, so it combines very well with acupuncture for trigger point pain. If its an acute injury I do not use heat, but will sometimes utilize Moxabustion therapy. For chronic pain and for recovery from acute injury, I think its really important to learn the correct exercises. I teach them here, both what I have learned from Anthony Carey at Function First, and from Feldenkrais method, but for people who want to take that further, and I am all for it, I love to recommend Anthony and also some local Feldenkrais teachers.
My style of myo-fascial based acupuncture for acute and chronic pain whether from trigger points, motor points, or from some other cause is very effective and in the long run actually quite inexpensive. It is an integral part of a natural living, drug-free, green lifestyle. Pain-killing drugs are just so toxic for the liver, addictive, and generally bad for your health. Whereas Acupuncture is excellent for your health because it places you in the relaxation response, the opposite of the fight or flight adrenalin response with its high blood pressure, insulin, etc.
I ask newcomers to try acupuncturet once. I cannot make anything worse. I cannot hurt you. If you don’t like it, you don’t come back, no pressure ever. But if you like it and find it helpful even 20% after 1 visit, that is huge. Try three treatments and in most cases you will have immense relief by then. Sometimes completely better, sometimes more treatment is needed, but if you are not well on your way to being better by three visits, I usually don’t recommend you continue. Healing is a Process, Not a Pill. Acupuncture is one piece of the puzzle
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