Acupuncture, medical acupuncture, dry needling...call it what you want...has been shown to activate proprioceptive afferent receptors in muscle tissue, in particular the type 11 (flower spray type) which which contribute to numbing feeling associated with the needle sensation or ‘de qi’.1,2 Given the pain modulatory benefits of acupuncture are mainly attributed to sensory effects, the activation of these proprioceptors may be important from a mechanisms point of view.2
Manual therapy also activates proprioceptors (sometimes referred to as ergo or mechanoreceptors) about the muscle spindles and articular structures.3 When looking at the manual therapy literature and listening to experts4 discuss the proposed mechanisms which underpin its benefits, the role of proprioceptor activation is considered not only in terms of contribution to pain modulation, but also from functional point of view. In other words, manual therapy is associated with pain modulation, but can also be used to facilitate movement and exercise, help normalise faulty movement patterns etc.
So, my musing for this morning is should acupuncture research be focussing more on functional effects? i.e to what extent may acupuncture impact on specific functional outcomes which assess mobility, strength and control etc? Is acupuncture when combined with specific exercise more effective than one or the other on it’s own? What happens when manual therapy, exercise and acupuncture are combined?