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.
Further feedback may be provided verbally by the patient, ‘that’s my pain’ is my favourite. How this response may be interpreted from a neurophysiological point is view is for another post. It is usually clinically relevant, especially to the needler.
Interaction with the patient and the patient's tissues would guide the location of the needle. The aim is should be to consider what we understand of the physiological mechanisms which explain the therapeutic needling effects, and use these to the benefit of the patient. Pain relief, local healing, normalisation of muscle tone and function, improved mobility, the reduction of fear and avoidance and becoming at ease with the body are the sort of outcomes I seek to achieve. This is aided by, but not limited to the local, segmental, extra-segmental and central regulatory effects of medical acupuncture.1
When inserting the needle, it should be as near to the perceived source of pain as possible without making it worse. I start there, including further points as needed. This helps make the treatment real and meaningful to the patient. When the patient is relaxed and receptive under the influence of the needle, an opportunity to discuss the cognitive aspects of pain management2, if relevant, presents itself.
Upon removal of the needles, the tissue response should be established. How do the needled muscles feel for example, both to me and the patient. Can they be used more effectively to create movement, confident, fluid type of movement. I may need to facilitate, a mobilisation with movement technique works well.3
Medical acupuncture makes it easier for my patients to take home simple, functional exercises to sustain and further improve what was achieved in session, one technique complements the other.
Medical acupuncture in a physiotherapy context should rarely be used in isolation. It is most effective when used as part of a hands on interaction with the patient. This is how I achieve my excellent clinical results.
1. White, A., & Editorial Board of Acupuncture in Medicine. (2009). Western medical acupuncture: a definition. Acupuncture in Medicine, 27(1), 33.
2. Butler, D. S., & Moseley, G. L. (2013). Explain Pain 2nd Edn. Noigroup Publications.
3. Vicenzino, B., Hing, W., Hall, T., & Rivett, D. (2011). Mobilisation with movement: the art and the science. Elsevier Australia.