Acupuncture Treatment Guide

Our body is a dynamic environment of interrelating and interconnecting networks. Some of these networks are obvious and others are more subtle. Western science has focused its attention on the obvious networks such as the nervous, blood circulatory, endocrine, and lymphatic systems.

In contrast, Traditional Chinese Medicine has, over the centuries, mapped out the subtle networks and interrelationships that reveal our bodies to be dynamic cellular ecosystems.

Evidence from computer imagings of the brain during an acupuncture treatment shows dynamic activities occuring in many regions and structures within the brain. This modern research has shown that stimulating an acupuncture point causes an increase in the production of endorphins and simultaneously activates the immune and endocrine systems.

Your acupuncturist (or acupuncture doctors) can choose the most effective acupuncture treatment plan to help you obtain your desired health outcome.

Different acupuncture points will be chosen to relieve pain and stress, and to increase vitality. During acupuncture treatment, the acupuncturist will use fine high grade surgical steel needles to stimulate the acupuncture points on your body. For hygiene purposes, these pre-sterilized, disposable needles are only used once
and then disposed away.

Millions of patients have enjoyed the benefits of acupuncture treatment and Traditional Chinese Medicine. They testify to the elimination or reduction of pain, increase in function, and a greater sense of vitality and well-being.

Acupuncture treatment has evolved over thousands of years. It is called empirical science as acupuncture points have been systematically tried and observed for functions and treatment efficacy. This art was started by the use of what Chinese call ‘ashi’ points, or points where there is pain. Bones, sharpened stones, or bamboo were inserted into these ‘ashi acupuncture points’ was found to give relief. Over the next few centuries, Qigong practitioners, doctors, and shamans began to see and map out the system of energetic meridians that course throughout our body. To date this is still being refined. Acupuncture points are specific points on the body which give particular access to this energetic system (known as Qi), performing different functions depending on their locations and the patterns of disease disharmony involved.

The needles are usually retained in the body for 10 minutes to one hour. While the patient is relaxed, the acupuncturist may choose to manipulate particular needles at particular acupuncture points to give desired effects. This action is to either tonify, nourish, or strengthen, or conversely, to drain or subdue.

Electrical stimulation is also applied sometimes and is performed by placing small alligator clips onto the needles and passing a very mild battery generated electrical current through the it.

It should be made known that many conditions can take many months of treatments to obtain desired results. For instance, a person with a chronic low back pain for 10 years may see some very quick results, although, any substantial lasting effects would actually take months or even years of regular acupuncture treatments. The acupuncturist will find out all they can about the particular condition and judge how frequent and how long the acupuncture treatment is required according to the severity of the condition and duration.

The sensations people claim to receive from acupuncture therapy are: dull aching pain, tingling sensation at the points or along the course of a meridian, mild electrical shock, heaviness of the treated limbs, feeling of ant bites etc depending on the condition of the individual.

The patient should exercise caution and common sense in choosing their acupuncturist carefully for acupuncture treatment. The acupuncturist (or acupuncture doctors) should be someone reputable that the patient will feel very comfortable with so that a trusting long-term relationship may be formed.

Medical acupuncture, or using acupuncture for medical purposes, is a very ancient form of healing which existed even before recorded history. Its philosophy is rooted in the Taoist tradition which goes back over 8000 years. During this period, the people would meditate and observe the flow of energy (known as Qi) within the body and outside the surroundings.Many people of this period were also keen to observe man’s relationship with nature and the universe. One of the most legendary man of this period known as Fu Hsi formulated the yin-yang (the 2 major forces in the universe for creation and destruction of life), which forms the backbone of Chinese medicine theory.This subsequently led to the eight trigrams and 64 hexagrams of the I-Ching (Book of Change) which shaped the thinking for years to come and every influential book on Chinese Medicine is based upon its fundamental philosophy.

Generally, the history of China is divided into two time periods – The Old Stone Age (more than 10,000 years ago ) and the New Stone Age (10,000-4000 years ago).During the Old Stone Age, knives were made of stone and were used for certain medical procedures.During the New Stone Age, stones were refined into fine needles and served as instruments of healing. They were named Bian stone – which means use of a sharp edged stone to treat diseases. Many Bian stone needles were excavated from ruins in China dating back to the New Stone Age.

The most significant milestone in the history of acupuncture therapy occurred during the period of Huang Di – The Yellow Emperor (2697-2597 B.C.). In a famous dialogue between Huang Di and his physician Qi Bo, they discussed the whole spectrum of the Chinese Medical Arts. These conversations would later become the monumental text – The Nei Jing (The Yellow Emperor’s Classic of Internal Medicine). The Nei Jing is the earliest book written on Chinese Medicine. It was compiled around 305-204 B.C. and consists of two parts:

• The Su Wen (Plain Questions) – 9 volumes with 81 chapters. The Su Wen introduces anatomy and physiology, etiology of disease, pathology, diagnosis, differentiation of syndromes, prevention, yin-yang, five elements, treatment, and man’s relationship with nature and the cosmos.
• The Ling Shu (Miraculous Pivot,Spiritual Axis)- 81 Chapters. The Ling Shu’s focus is acupuncture treatment, description of the meridians, functions of the zang-fu organs, nine types of needles, functions of the acupuncture treatment points, needling techniques, types of Qi, location of 160 points.

Approximately 1000 BC, during the Shang Dynasty, hieroglyphs showed evidence of Acupuncture and Moxibustion. Bronze needles were excavated from ruins, but the bian stones remained the main form of acupuncture needles.

During the Warring States Era (421-221 B.C.) metal needles replaced the bian stones. Four gold needles and five silver needles were found in an ancient tomb dating back to 113B.C. The Miraculous Pivot names nine types of Acupuncture needles. Historical records noted many physicians practicing acupuncture treatment during this time. Another milestone for this period was the compilation of the Nan Jing (Book of Difficult Questions). The Nan Jing discusses the five element theory, hard diagnosis, eight extra meridians, and other important topics.

From 260-265 A.D., the famous physician Huang Fu Mi, organized all of the ancient literature into his classic text – Systematic Classics of Acupuncture and Moxibustion. The text is contained in 12 volumes and describes 349 acupuncture treatment points. It is organized according to the theory of: zang fu, Qi and blood, channels and colllaterals, acupuncture points, and clinical application. This book is noted to be one of the most influential text in the history of Chinese Medicine.

Acupuncture treatment was very popular during the Jin, Northern, Southern, Dynasties (265 – 581 A.D.). For generations the Xu Xi family were known as the experts in the art of treatment by acupuncture. During this time period important texts and charts enhanced knowledge and application.

Acupuncture treatment experienced great development during the Sui (581-618 A.D.) and Tang (618-907 A.D.) Dynasties.Upon request from the Tang Government (627-649 A.D.), the famous physician Zhen Quan revised the important Acupuncture texts and charts. Another famous physician of the time, Sun Simio, wrote Prescription with a Thousand Gold for Emergencies (650-692 A.D.). This text includes data on acupuncture treatments from various scholars. During this period acupuncture treatment became a special branch of of medicine and practitioners were named Acupuncturists. Acupuncture schools appeared,and Acupuncture education became part of the Imperial Medical Bureau.

During the Song Dynasty (960-1279),the famous physician Wang Weiyi wrote The Illustrated Manual on Points for Acupuncture and Moxibustion. This book included the description of 657 points. He also casted two bronze statues on which meridians and points were engraved for teaching purposes.

The Ming Dynasty (1568-1644) was the enlightening period for the advancement of acupuncture treatment. Many new developments included:

• Revision of the classic texts
• Refinement of Acupuncture techniques and manipulation
• Development of Moxa sticks for indirect treatment
• Development of extra points outside the main meridians
• The encyclopedic work of 120 volumes- Principle and Practice of Medicine was written by the famous physician Wang Gendung
• 601 – Yang Jizhou wrote Zhenjin Dacheng ( Principles of Acupuncture and Moxibustion. This great treatise on medical acupuncture reinforced the principles of the Nei Jing and Nan Jing. This work was the foundation of the teachings of G.Soulie de Morant who introduced acupuncture treatment into Europe.

From the Qing Dynasty to the Opium Wars (1644-1840), herbal medicine became the main tool of physicians and acupuncture treatment was suppressed.

Following the Revolution of 1911, Western Medicine was introduced and thus acupuncture treatment and Chinese Herbology were suppressed. Due to the large population and need for medical care, Acupuncture and herbs remained popular among the folk people, and the “barefoot doctor” emerged.

Acupuncture treatment was used exclusively during the Long March (1934-35) and despite harsh conditions it helped maintain the health of the army. This led Mao Zedong, the leader of the Communist Party, to ensure that acupuncture treatment remained an important element in China’s medical system. In 1950 Chairman Mao officially united Traditional Chinese Medicine with Western Medicine, and acupuncture treatments became established in many hospitals. In the same year Comrade Zhu De reinforced Traditional Chinese Medicine with his book New Acupuncture.

In the late 1950’s to the 1960’s Acupuncture research continued with – further study of the ancient texts, clinical effect on various diseases, acupuncture anesthesia, and acupuncture’s effect on the internal organs.

From the 1970’s to the present, acupuncture therapy continues to play an important role in China’s medical system. China has taken the lead in researching all aspects of acupuncture’s application and clinical effects. Although acupuncture treatment has become modernized, it will never lose its connection to a philosophy established thousands of years ago.

When you visit the acupuncturist for acupuncture treatment, the acupuncturist will decide on the method of treatment by observing and questioning the patient in order to make a diagnosis. This diagnostic process involves 4 areas, which is known as the Four Examinations, and they are: Inspection, Auscultation and Olfaction, Inquiring, and Palpation.

• Inspection focuses on the patient’s face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge.
• Auscultation and olfaction refer, respectively, to listening for particular sounds (such as wheezing) or breathing, and attending to body odor or breath ordour.
• Inquiring focuses on the “seven inquiries”, which are: chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea. During the first visit, the acupuncturist will spend a considerable amount of time asking the patient for details about his/ her general condition so as to have a more complete picture.
• Palpation includes feeling the body for tender “ashi” points, and palpation of the left and right radial pulses at two levels of pressure (superficial and deep) and three positions Cun, Guan, Chi (immediately proximal to the wrist crease, and one and two fingers’ breadth proximally, usually palpated with the index, middle and ring fingers). 14 different pulse characteristics (slow, rapid, full, empty) are compared with each of the 12 pulses, and they can be used to determine which of the patient’s organ is not functioning properly.

After that, the acupuncturist will prescribe treatment to restore the patient’s yin and yang balance and this may include just acupuncture treatment alone, or acupuncture treatment together with herbal rememdies, exercise, diet or massage or a combination.

In ancient times, the number of acupuncture treatment points was established to be the same as the number of days in the year i.e. 365. These points were mapped to 14 major meridian lines, one meridian for each of the 12 inner organs, one meridian along the spine (called the governing vessel), and another along the midline of the abdomen (called the conception vessel). More recently, the number of points identified by acupuncturists has exploded. There are extra meridians (some of them outlined in ancient times, others modern) with their own sets of points, there are special points (off meridians), and there are complete mappings of body structures and functions by points along the outer ears, on the nose, in the scalp, on the hands, on the feet, and at the wrists and ankles. Despite the growing number of treatment zones, most acupuncturists still utilize the traditionally-identified points on the 14 main meridians. On each meridian there are a small number of points used repeatedly, because of their versatility, for a wide variety of patients and diseases. One such point on each major meridian is mentioned below, sometimes with a second point also briefly described, for a total of 21. It is important to recognize that although a list of disorders and diseases treated by each point can be given, sometimes the points are selected entirely or primarily on the basis of the Chinese  medicine theory of balancing the flow in the meridians, so that the point might be used for other kinds of disorders, aside from those listed, because of its usefulness in this balancing process. For points not on the central line of the body, each point has a left and right side reflected location (the point is counted only once for enumeration purposes). For each point in this presentation, the name of the meridian, the number of the point, the number of standard points on the meridian, its designation by one of the number-based classification systems (two letters and the point number), and the Chinese name are given.

1) Large Intestine Meridian, point #4 of 20: LI4, Hegu

This acupuncture treatment point is located on the back side of the hand between the thumb and first finger. The dominant uses are to relieve pain and to treat constipation or other bowel disorders. However, this point is also utilized in the treatment of inflammatory and feverish diseases which have symptoms in the throat and head, because the large intestine meridian runs from the hand to the face. Another key point on this meridian is LI11 (Quchi), located at the elbow. It is used for many upper body disorders, such as sore throat, eye pain, lymphatic swellings, rashes, and difficulty moving the arms, and for intestinal disorders, such as diarrhea and intestinal cramping.

2) Lung Meridian, point #7 of 11: LU7, Lieque

This acupuncture treatment point is located above the wrist on the inside of the arm. It is used to treat several disorders of the upper
body, including headache, neck stiffness, cough, asthma, sore throat, facial paralysis, and wrist problems.

3) Stomach Meridian, point #36 of 45: ST36, Zusanli

This acupuncture treatment point is located on the front of the leg, just below the knee. It is helpful for digestive disorders, including nausea, vomiting, gastralgia, and abdominal distention, and also for general weakness. Recently, numerous clinical trials have been conducted with treatment of this point alone, demonstrating positive effects in treating anemia, immune deficiency, fatigue, and numerous diseases.

4) Stomach Meridian, point #36 of 45: ST36, Zusanli

This acupuncture treatment point is located on the inner side of the leg just above the ankle. Although it is on the spleen meridian, which
generally influences the digestive system, this point is also valuable for treating hormonal disorders (irregular menstruation, impotence) and immune disorders. Another key point on this meridian is SP9 (Yinlingquan), located just below the knee. It is used in the treatment of urinary diseases, especially with fluid retention, abdominal and back pain, and female reproductive system disorders.

5) Gallbladder Meridian, point #20 of 44: GB20, Fengchi

This acupunture treatment point is located at the base of the skull where it joins the neck in back. It used in the treatment of acute disorders, such as common cold, influenza, headache, neck pain, and fever. In addition, it lowers blood pressure and relaxes tension in the area of the eyes. Another key point on this meridian is GB34 (Yanglingquan), located on the outer side of the knee, and used for treating a wide range of injuries and disorders of the muscles and tendons.

6) Liver Meridian, point #3 of 14: LV3, Taichong

This acupuncture treatment point is located on the top of the foot, between the first and second toes. It is used to balance emotional energy, to regulate menstruation, to reduce tension and pain in the chest, treat eye disorders, alleviate headaches, and reduce high blood pressure. The adjacent point in the meridian, LV2 (Xingjian), at the webbing between the toes, is also considered quite important and is frequently needled along with LV3; it has similar uses, but is also incorporated into the treatment of lower abdominal disorders, such as urinary problems.

7) Pericardium Meridian, point #6 of 9: PC6, Neiguan

This acupuncture treatment point is located on the inner arm, just above the wrist. Like other points on this meridian, it is useful for cardiac disorders, such as heart palpitation and angina pectoris. It is also useful for nausea, vomiting, spasms, and convulsions.

8) Heart Meridian, point #7 of 9: HT7, Shenmen

This acupuncture treatment point is located on the outer side of the wrist. It is used in the treatment of a variety of mental disorders, such as absent mindedness, insomnia, disturbing dreams, hysteria, depression, agitation, and mental illness. It is also used in the treatment of heart disease and fatigue.

9) Urinary Bladder Meridian, point #40 of 67: BL40, Weizhong

This acupuncture treatment point is located at the back of the knee. It is utilized in the treatment of back pain, hip impairment, muscular atrophy, leg pain and immobility, abdominal pain, vomiting, diarrhea, and a host of other symptoms. Another important point on the bladder meridian is BL23 (Shenshu), in the lumbar area (hip level) near the spine; it is used in treatment of a wide range of disorders, including urinary problems, impotence, menstrual disorders, low back pain, knee weakness, dizziness, ringing in the ears, blurred vision, edema, asthma, and diarrhea. A large section of the bladder meridian is of importance because, as it flows along either side of the spine (in two parallel lines on each side), it associates with the internal organs in the vicinity.

10) Kidney Meridian, point #3 of 27: KI3, Taixi

This acupuncture point is located just behind the inner ankle. It is used for disorders in several areas of the body, including sore throat and toothache, deafness and tinnitus, dizziness, asthma, thirst, insomnia, impotence, frequency urination, pain in the lower back, and menstrual irregularities.

11) Triple Burner Meridian, point #5 of 23: TB5, Waiguan

The triple burner is considered to be a special type of organ system that spans the entire torso. This acupuncture point on the meridian is located on the outer side of the arm, above the wrist. It is mainly used in treatment of disorders along the pathway of this meridian, that is, of the fingers, hand, arms, neck, ears, cheek, and top of the head.

12) Small Intestine Meridian, point #3 of 19: SI3, Houxi

This acupuncture point is located on the side of the hand, below the little finger. It is used for treating mental disorders, stiffness and pain in the neck, chest, and lumbar region, seizures, night sweats, and fevers.

13) Governing Vessel, point #20 of 28: GV20, Bahui

This acupuncture treatment point is located at the top of the head. It is traditionally applied in the treatment of various mental disorders, and for problems that occur in the head: headache, vertigo, ringing in the ears, nasal obstruction, difficulty with speech, etc. It is also used to treat prolapse, such as that of the rectum and uterus. Another key point on this meridian is GV14 (Dazhui), located just below the seventh cervical vertebrae (shoulder level); it is used for treating neck and upper back problems, feverish diseases, convulsions, cough, asthma, and common cold.

14) Conception Vessel, point #4 of 24: CV4, Guanyuan

This acupuncture point is located a little below the navel. It is used for all types of lower abdominal disorders, including urination problems, hernia, menstrual disorders, gynecological infections, postpartum bleeding, diarrhea, rectal prolapse, etc. Another important point on this vessel is CV6 (Qihai), half way between CV4 and the navel. The applications are similar, but it is especially used in cases of accompanying fatigue.

Examples of Combining These Points to Produce an Effective Treatment:

In the book Modern Clinic Necessities for Acupuncture and Moxibustion (by Zhang Ren and Dong Zhi Lin), several acupuncture treatment strategies were outlined. For menopausal syndrome, the main points recommended are GV20 and GV14, CV4, BL23,HT7, SP6 and ST36; secondary points include PC6, LV3, and KI3. For bedwetting at night among young children, recommended points include CV4, BL23 and SP6; secondary points include LU7, KI3, CV6, and ST36. For hayfever, recommended points include GB20, LI4, and ST36; secondary points include GV14, LU7, LI11, and SP6. In her book Insights of a Senior Acupuncturist, Miriam Lee described a combination of points that have wide application: ST36,SP6, LI4, LI11, and LU7. This set of points, with slight adjustments (e.g., leaving out one or two, perhaps adding or substituting one or two) is shown to be helpful for the majority of common complaints seen in the Western acupuncture clinic. A popular treatment for injury and stress is to needle the “four gates,” the right and left side points LV3 (feet) and LI4 (hands), which opens circulation throughout the meridians.

So what are some potential side effects and risks associated with acupuncture treatment?

Generally acupuncture treatment is very safe and does not have too many side effects or risks, especially when compared to other forms of therapeutic treatments.

Following other general safety precautions as performed by other medical practitioners, acupuncturists too are required to use sterile needles for all treatments. Some rare adverse reactions had been reported in a few cases that includes bleeding, hematoma, feeling of dizziness, and other vegetative symptoms.

Of course the treatment modalities depend completely upon the experience and expertise of the acupuncturist and if treated by a reputable acupuncturist or by an expert, the patient will not experience any side effects and instead feel completely relaxed and revitalized after their acupuncture treatment.

Some of the common acupuncture side effects or inconveniences experienced by the patient during or after the acupuncture treatment are:

• There might be a continued regular sensation of warmth, tenderness, and tingling sensation when the acupuncture needles reach the acupoint or trigger point.
• There could be a possibility of acupuncture needles causing mild bruising and bleeding due to penetrating through the minute blood capillaries.
• One of the possible acupuncture treatment side effects is the possibility that the patients might experience temporary drop in blood pressure levels or low blood pressure and fatigue. There are even rare instances of patients fainting after their acupuncture treatment.
• Rare cases of allergic reactions to stainless steel acupuncture needles have been experienced by some patients.
• If the acupuncture needles are not sterilized properly, it could result in certain forms of infections.
• Similarly, if the needles are not inserted correctly, it could result in the perforation of some of the vital organs.
• PENS or TENS acupuncture treatment modalities involving electrical stimulation at various key trigger points could result in temporary tingling sensation or pins and needles sensation.
• Employing elecrostimulators that are not working well can result in nerve damage if the electricity is passed on for extended periods of time or is set at a high frequency.
• Herbs used in acupuncture treatment could result in insomnia because of the caffeine content, or allergic reactions, and / or allergies in patients that cannot tolerate certain herbs. Similarly, in moxibustion, if herbs are burnt and held too close to the skin, it could result in burn injuries to the patient.
• In acupuncture treatments involving cupping and guasha, blood drawn close to the skin surface could result in bruising.
• Pressure exerted on any nerves by acupuncture treatment could result in inflammation of the nerves.

The above are some of the possible acupuncture treatment side effects and acupuncture risks that could happen in patients undergoing acupuncture treatments, but these are relatively rare when compared to other forms of treatment. So in conclusion, treatment by acupuncture is generally safe.

Here are some videoclips on acupuncture therapy that may be of interest to you. Hopefully they will help explain some concepts to you that you might not fully understand from reading all the text. A picture or video definitely clearer than a thousand words. Enjoy!