After another tasty lunch at the Royal College of Physicians, we took up our seats to take part in the speaker forum. I was expecting plenty of questions to be put forward for discussion and was not disappointed. We had questions relating to the broad range of topics from the morning’s presentations; from purigenic signalling to the role of acupuncture in post-surgical pain to clinical application of auricular acupuncture and more.

Here are some highlights by topic:

Acupuncture and purigenic signalling

According to Professor Geoffrey Burnstock (GB), all cells release ATP. These include endothelial, skin, muscle, neural and immune (e.g mast) cells. ATP acts upon its various receptors creating a purigenic signalling effect, this may have positive effects at the various sites. In the correct doses, facilitated ATP release, for example in response to acupuncture, has been proposed to have a variety of therapeutic physiological effects. These range from autonomic modulation to analgesia, mainly due to its function as a co-transmitter.

In my view, to use medical acupuncture effectively, the needle becomes an extension of our fingers. Our fingers should begin the needling process by carefully palpating, becoming attuned to the patient's tissues, being responsive to feedback.

Such feedback may be a response from the tissues such as altered muscle tone, tension, thickening, congestion, bogginess, stringiness, stiffness, guarding and more. These are loose terms, more descriptive than scientific, not always reliable, but meaningful to the expert clinician.

Medical Acupuncture including Dry Needling helps ease pain, normalise muscle tension, and promotes tissue healing and repair¹. It is also associated with an increase in brain serotonin levels¹ which may partly explain how this technique often leaves my patients feeling in a better mood, more relaxed and at ease.

Similar feelings of well being are often felt after exercise, especially exercise which promotes muscle contractions^2,3 such as PhysioPilates. This may be due to there being a physiological overlap between physical exercise and needling.

I have found that clinically Medical Acupuncture (including Dry Needling) is effective in reducing muscle tone during the rehabilitation phase in those who have suffered from a stroke. It has become an integral part in my approach to treating hemiplegia.

The mechanism is most likely an inhibitory effect at the anterior horn cells when the hypertonic muscles are needled directly. The reason for the hyperactivity at the anterior horn cells, which in turn controls resting muscle tone, may be reduced proximal modulation of the anterior horn cell activity after a stroke, in others words less ‘top down’ control from the brain.

(This post was originally posted on the 24th February 2014 and in light of new research has been updated on the 26th March 2017.)

To assist us in our understanding on the mechanisms of Medical Acupuncture I thoroughly recommend watching a recent presentation by a Professor Lundeberg. You can find the 23min video presentation at the bottom of this article.

In this post I offer some highlights from this presentation.