Acupuncture: The Most Powerful Therapy in Medicine

I began my journey to understand acupuncture in 1997 to help my chronic pain patients feel better. I learned it was the most powerful tool and the most powerful therapy in medicine.

And it’s been this way for five thousand years.

First, let me start by explaining some key words and ideas. When I help my patients, I frequently need to clear up some terms used in modern medicine that have caused some confusion.

Acupuncture: A procedure in which specific body areas associated with peripheral nerves are pierced with fine needles to produce anesthesia, relieve pain, and promote therapy.

Needles or Tool:A thin stainless steel wire, by tradition solid and flexible. But any steel wire will do. An acupuncture needle is a fine thin filament flexible instrument.

The Procedure: The stainless steel needle is inserted into the skin, flesh and muscle, which causes microscopic tissue injury. The injury triggers a natural healing cascade of repair.

bigstock-acupuncture-chinese-medicine-treatment--c-25612319When it enters a muscle, the needle will trigger a muscular re-polarization and the muscle twitches. After the twitch, the muscle will relax. The relaxed muscle will be a little longer and less tense and tight.

The need: Muscles are the engines of movement and locomotion. They are ubiquitous to the human body. They contract and release billions of times consciously and unconsciously.

Muscles function in locomotion and are made up of the fibers of movement, the coverings, the transitions to a ligament and the attachment to bone. This muscular unit is called myofascial tissue.

What happens if the muscle breaks or falters? You get sick!

The key component to most chronic pain issues are trigger points (TPs) that develop in stressed muscle fibers. TPs are discrete, focal, hyper-irritable spots located in skeletal muscle.  When infected with TPs, muscles became shorter, tighter, stiffer and denser. These infected muscles alter the natural function and motion of the body.

Short and stiff myofascial tissue irritate and compress associated nerve fibers, pain fibers, joints, lymphatic tissue, arteries and veins. A shortened muscle will alter the alignment of a joint and cause premature wear and tear.

If this altered alignment is left untreated, it can destroy the natural design of a joint and increase degeneration. The compressed nerve fibers will switch on pain alerts, alarms and alter normal sensations. The broken pain signals will be oppressive and unrelenting as would happen after shingles. Altered sensory fibers will cause a slight pressure to be interpreted as scalding hot or burning. Compressed arteries will choke off nourishment to limbs, leading to cold fingers and toes. Compressed veins that bring blood back to the heart will cause swelling. Myofascial disease leads to fear, anxiety, insomnia and even suicide.

Myofascial pain will masquerade as a number of maladies that can delay therapy for weeks, months and even years. The trigger points will grow in number and spread to others areas of the body.

The TherapyThe  technique to relieve this stressed muscle tissues is called myofascial release therapy (MRT) and is focused on the trigger points that develop in muscles. MRT is already in use today in regular physical therapy, massage therapy, yoga, sports medicine and in chiropractic medicine.  When used correctly, MRT can begin the healing process for patients with complex muscle and skeletal pain issues.

Some myofascial trigger points cannot be effectively released just with stretching and massage. The muscles require an electrical depolarization using an acupuncture needle or a sharp tipped hypodermic needle.

I imagine myofascial tissue as different grades of beef, from filet mignon to a tough leathery hunk of meat. Take a sewing needle, push it through the filet and it goes in easily. Now try to push a sewing needle through a leather belt. It will bend and stick in the dense leather fibers. But if you take a needle with a knife like tip then you can penetrate the belt.

Acupuncture is the most powerful therapy I know of in medicine. It can treat most arthritic pain issues, revitalize degenerating joints, correct misalignments, lower the need for medication, decrease the need for surgery and help contain the rising cost of health care. All with very few side effects.

The ancients incorporated a way of life within a way of health and wellness.

Stephen S. Rodrigues, MD

Stephen S. Rodrigues, MD

Stephen S. Rodrigues, MD, is a family practice physician in Dallas, Texas. He is a graduate of Howard University School of Medicine and interned at Howard University Hospital and D.C. General Hospital. He is certified by the American Board of Family Medicine and studied acupuncture at the Helms Institute of Acupuncture.

Dr. Rodrigues’ website can be found here.

The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that!  It is for informational purposes only and represents the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.

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22 Responses

  1. John Quintner says:

    @ Martin. We are not talking about traditional Chinese acupuncture on this post. Rather it is about using stainless steel needles to create lesions within muscles in order to heal hypothetical ones. This form of “treatment” does in my opinion defy logic!

  2. Martin Eisele says:

    I love how everyone says that acupuncture doesn’t work because you can’t prove how it works scientifically, and if it does work, then it must be a placebo.
    1. This assumes that nothing ever worked or existed until it was proven by science. One day the Sun was going around the Earth, then one day it suddenly changed and the Earth is going around the Sun. Science caught up to what was already happening.
    2. The “placebo” argument is interesting because we don’t know how a placebo works either. It’s ironic that acupuncture doubters are comfortable with that concept and the fact that millions say that they get benefits from acupuncture.
    3. One of the most common phrases in pharmaceutical literature is “the mechanism of action is unknown”, especially in psych drugs. Does that mean doctors are prescribing placebos and we are all being scammed? no. It just means that though we know they work, we don’t know HOW they work. Science has not caught up.

  3. Kevin says:

    Thanks Stephen, we are on the same page.

    John Q. I want to read more about your views and publications but most of it is locked in journals I need to subscribe to. I would enjoy some links and more direct access to this info.

    Perhaps a link or a book I can buy. But first want to read a little deeper.

  4. @John … all my evidence is imbedded in a few written and video testimonials. I know to a hardcore scientist this these are the most unscientific. This is Ms Rosa, a lady with RA who came in therapy in a wheelchair who had not stood on her feet for 2 yrs. Her husband had to care for her 24/7/365, she could not ever roll over in bed because her body was locked in the fetal position. The video is impromptu and a little long. http://youtu.be/EGpWUXC_akQ

  5. John Quintner says:

    @ Stephen. Extraordinary claims require extraordinary evidence. All we have to go on is a number of opinions that have not been backed up by the sort of evidence that would give them a modicum of scientific credibility.

  6. @Kevin and all
    Yes, I call needle therapy; fine-filament surgery! And the insurance companies call trigger point procedures … surgery. The needle, as a tool, is more precise like a laser. The traditional scalpel causes much more collateral damage to the tissues. Both tools will be vital to the future of medicine.

    Most corrupted intra-articular and periarticular structures that do not interfere with range-of-motion will NOT have to be mended my human hands.

    Travell-Simons realized in the 50’s that most joint pain and dysfunction was not inside the joint proper. Joint pain, misaligned and degeneration is a function of the associated “diseased” myofasical tissues. The internal structures of the joint (knee) are at the mercy of the “joint engines” the muscles. Travell-Simon’s protocols are designed to address the myofascial structures of the leg and thigh and thus the culprit.

    If you read George Hackett, MD’s text on Prolotherapy his focus is on stimulation stronger ligaments with injections of an irritant chemical. The procedure uses a needle and the point of the needle pecks at the ligaments and tendon. Thus stimulation the fibers to proliferate and strengthen the connective tissues. IMO, all you need is the needle and leave out the chemicals.

    If I were King! In my Kingdom, the myofascial specialist, dry needlers, yoga folks, wellness gurus and Acupuncturist would be woven into the fabric of healthcare. Their contributions would be used proactively to ward off deeply seated pain and joint syndromes and mental illnesses. This would save billions in unnecessary, pills, scans, MRI’s and surgeries.

    Gunn ideas are vital to unlocking the most miserable of complex pain cases. He talks about the distant “stress points” and the spinal short rotator muscle therapy. Both are necessary to truly began the healing. I have notice and was surprised that Gunn’s students are a little heavy handed, do not follow what is in his textbook and instructed to halt therapy if no improvement is seen within a number of visits. ???

    The amount it cost to treat a simple stress or strain issues in the beginning is minimal. The cost to treat a complex pain patient is astronomical!! Meds, loss of productivity, loss of vitality and family life, suicide, med toxicities, ER visits, Diagnostic studies, referrals etc

  7. The tools:
    >The beauty of an the acupuncture needle is it’s both diagnostic and therapeutic all in one fell swoop. With no harm. These slender needles will give feedback about the health of muscles and tissues. These needles will not penetrate a super dense TP and will bounce off and thus ineffective no matter how much force you apply. The only other viable logical tool is the hypodermic needle.
    >Hypodermic needles; The sharp point will pierce the TP. Also in certain cases where the TP is so sensitive any touch will evoke pain and fear, so Rachlin suggest a pre-injection injection to quiet the sensitivity for the formal TP injection. Hypodermic are not good at probing because they slice thru tissues without giving feedback.

    The procedures:
    >I’m not wedded to any one technique, I use Acupuncture; French Energetic, auricular and scalp, IMS, Craig-PENS, Travell-TPIs, Mark Seems/superficial needling.
    >Gunn’ ideas are valuable when it comes to how he probes all the paraspinals ie Hua Tuo Jia Ji. vital to treat the Spinal Segment Sensitization phenomena and PTSD. I have his plunger but opt not to use it because it slows me down.

  8. John Quintner says:

    @ Kevin. I appreciate your insights. Yes, there is a missing link (or two). In our 1994 we raised the possibility that there were other more rational explanations for the observed phenomena attributed to “myofascial” trigger points. These have been totally largely ignored by those who embraced the writings of Travell, Simons, Gunn, Milbrandt and more recently of Chaitow and Dommerholt. The obvious reason for this lapse in scientific rigour is, to my mind, the apparent simplicity of the dry needling approach. The fact that this form of treatment has not been shown to work has not in the slightest daunted the enthusiasm of the practitioners. Fortunately, health funds have realized that their health dollars would be better spent elsewhere, and are limiting the number of needle insertions for which they will pay. This cannot happen too soon, in my opinion.

  9. Kevin says:

    I have had many clients post Gunn and the cost is larger than acupuncture and most clients are told to expect a few months of treatment to get results. As an acupuncturist unlike MDs and others people have to pay for our service and so if we don’t get results as painlessly as possible and in the first treatment we lose the client.
    Despite the science or the woo you have to hand it to any traditional acupuncturist who is still in business. They have got something figured out. Most MDs would be doing odd jobs if it were not for health care plans and free medical.
    I say this only because there are few oriental practitioners who follow tradition and rely on results that is pain relief in clients only to survive. This has to be acknowledged by the scientific community and people who study pain. I cringe when I think of some of the old teachers who dedicated decades to acupuncture on small incomes long days only to be called fools and quacks. I hope we don’t lose their wisdom as we focus on the science. Its all important as we progress. Lastly I think those fascia needs to enter into the discussion have not seen it yet.

  10. Kevin says:

    Thanks John, I learned much from your articles. I also have noted in a number of clients with pain TrPs do not always work. So there is a missing link. I have tried to use hypnosis to address the psychological factors. Always thought pain is 5 parts mind and only one part body. So trigger point therapy is really only 1 part of 6 not that it does not effect the mental aspects.
    Stephen, I also see the needle as scalpel and it is the main component. However, me so therapy seems to work very well too with the small waddles and on sensitive clients is superior.
    Some research cited in Peter Baldry’s myofascial pain text concludes its not clear if shallow insertion over the TrP is any better than deep needing into tight muscle bands. This is very interesting considering the chance of harm is less and the recovery is minimal. The Japanese use the shallow method and considering their love of shiatsu it is surprising they conclude deep needling is unessesary.
    Lastly, I enjoy the sturdyness and safety of hollow injection needles but still find in clinics where I am unable to use these methods I can have great results with meridian balancing techniques. Like contralateral tender points on knee for shoulder. The range of motion increase is always amazing.
    Most oriental acupuncturists find Gunns style to be archane and unessesarily painful and

  11. @ Kevin
    The needle (In-My-Opinion) is doing all the work when it comes to injection therapy. Triggering the healing cascade and activating the muscle twitch response.

    The substances injected into a trigger is a smaller part of the therapy. Substances can bog the healing as per Travell, by blocking the healing cascade w steroids, paralyzing muscle as with botox and adding a toxic substance as with prolo.

    Edward Rachlin, MD determined that a “twitch response” is not mandatory with TP therapy. Oh yes during the injections, the muscle twitch response my be obvious or not to the provider and patient. You still have to find “infected and sick” muscles to treat them aggressively.

    Because you can NOT easily simulate a prick and a deep ache within the muscle, IMO you can’t sham acupuncture. IMPOSSIBLE. You can compare different types of needle therapy but needle to pills NO. Even so why would you want to prove a truth??!!

    The beauty of needles is that anyone can perform “puncture” … no higher education or degrees needed. This opens a can of worms for general use, sale and DIY “punture” at home by patients.

  12. @ Mark
    Thanks for clarification on the history of this noble discipline. The history is of paramount importance for posterity purposes.

    My journey to understanding Acupuncture was difficult because I was trying to overlay French Energetic Acupuncture with my general medical practice. I found this to be complex and time consuming translating thoughts and therapies additionally my success rates were low.

    Then I found C. Chan Gunn, MD who offered a parallel therapy paradigm called Intramuscular Stimulation. Gunn-IMS is the use of the acupuncture needle in modern medicine. With Gunn and not with Acupuncture.
    >You need a medical diagnosis.
    >Medical Exams are imperative.
    >The needles are used as both a diagnostic tool and therapy simultaneously. (no meridians)
    >Anatomy knowledge is mandatory.
    >Immediate feedback is expected both from the patient and as observed by the effects of the needle.
    So Gunn was able to take the tool away from the ancient tradition and use it to effect cures. Turning on the healing cascade and “rebooting” lock up tight muscles infected with trigger points.

  13. John Quintner says:

    @ Kevin. My opinions, whether or not you decide they are rational ones, have been published in the peer-reviewed medical literature. Here are some that are relevant to this conversation:

    Quintner JL, Cohen ML. Referred pain of peripheral neural origin: an alternative to the “Myofascial Pain” construct. Clin J Pain 1994; 10: 243-251.

    Quintner JL, Bove G. From neuralgia to peripheral neuropathic pain: evolution of a concept. Regional Anaesthesia and Pain Medicine 2001; 26: 368-372.

    Quintner JL, Cohen ML. Response to Gerald Aronoff (“Myofascial pain syndrome and fibromyalgia: a critical assessment and alternate view”) [letter]. Clin J Pain 1999; 15: 155-157.

    Cohen ML, Quintner JL. The horse is dead: let myofascial pain syndrome rest in peace [letter]. Pain Medicine 2008; 9: 464-465.

  14. rose arimado says:

    acupuncture is so amazing,it is good in our body that no side effect,most of our patient in the church,most holy trinity parish in balic-balic sampaloc mla.is a stroke n paralyze patient,they come in the clinic wd thier wheelchair,after 7 to 10 session they can recover nd they dont need their wheelchair any more,they can walk again…..wd the help of cane for thier protection in walking…..we are a volunteer acupuncturist in our church……in the phillipines……

  15. Kevin says:

    Hey John,
    I follow this debate quite closely. I am unsure where it has been discredited other than the usual sham acupuncture studies. However, it is still seen placebo or not as equal to or better than many types of pain meds. Also the grades of beef is not a pleasing analogy but can you offer a better one for muscle. Arguing against a therapy without offering any sort of reference is not proper form for a scientific debate. Your opinion means nothing without some form of fact behind it.
    Most reasonable scientists agree acupuncture works for pain. It has been clearly demonstrated in hundreds of studies. The question is why. Is it placebo, is it a simple release of neuro chemicals. The chinese theory is of course seen as super woo but the fact remains it seems to work. Currently, most would agree with a medical doctor doing it like we see here not a chinese acupunturist.
    The muscle twitches and prolo injections into tendon attachments seem to work most of the time in my experience. If we could combine with ultrasound guidance as well as ensuring people followed a healthy diet and physio routine the results would increase even more.
    Not sure where your getting your opinions from but they are clearly emotional not rational.

  16. Mark Houston says:

    This is an interesting article, with much truth, and maybe s a little propaganda. I’ve practiced acupuncture for 30 years, in Hong Kong, and would just like to make a correction.

    Acupuncture is not 5 thousand yrs old. We know this because the oldest medical books from China (mawangdui medical manuscripts – http://en.wikipedia.org/wiki/Mawangdui), have no mention of acupuncture. There is mention of the jing luo (meridians), but the jing lou mentioned have no relationship to the modern meridian system created in France in the early 20th Century, and adopted and tweaked by Maoist Physicians, In China, during the Cultural Revolution. In truth, the modern meridian system, is a quasi science, created to promote the glory of Chairman’s Mao and the greatness of ancient China. The reality is, that the ancient Chinese used the Jing Lou as a memory tag for metaphors, established to give reason to observations made during practice. The mawangdui medical manuscripts, only mention moxa as a therapeutic agent during the Western Han Dynasty (202 BC – 9 AD), and this makes sense, because from what we now know, about bacterial infection, logically, acupuncture needles, used before modern times, and sterilization techniques, would have caused a high number of deaths, through infection.

    So, how old is acupuncture:

    1. Maybe, from around 700AD, there were experiments with acupuncture like treatments, but with unsophisticated metallurgy, the ancient Chinese were never able to create the type of needles now used in a modern practice, and most certainly, the ancient Chinese used few needles per treatment, because of the pain caused by thick, blunt needles.

    2. Modern acupuncture more than liked started around the 18th Century, after Jesuits introduced European needles to China, but even still, it would not be until the discovery of germ theory and sterilization, that acupuncture boomed, after 1950, when the French in Indo China, and the Americans in Korea, witnessed acupuncture in use, with high quality needles.

    One final point. Marco Polo, the most famous traveler of the 13th Century, has no mention of acupuncture in any of his writings. I find this very unusual, since, historically, medical knowledge, was at the time (like today) a highly rewarding commodity.

  17. You have to treatment entire patient, as per Travell-Simons, Gunn and Rachlin, you have to unlock ALL tighten paravertebral and small rotators muscles. Plus seek and destroy all possible secondary or quiet points; Jaw, temporalis,traps, Pects, Rectus, adductors and calves.

    Reality Check.
    1. I have an advantage in my office because I can do whatever I need per visit to move the patients forward. So that means “giving away” lots of therapy. This thought grew from a comment Gunn made in one of his lectures. “If it has to be done, he has to do it, because no one else will.” in referring to all the work and all the points. I can’t withhold needed therapy.
    2. Patients have to be seen weekly until they feel comfortable extending the visits to every 2 weeks then monthly. I release at least 5-15 muscles per visit. This first phase may take 3-6 month in the worse cases. It is labor intense!
    3. Some patients are so spent emotionally that you have to take even more time until their fortitude is restored.
    4. The therapy can be painful and intolerable! To get over this lots of dilute lidocaine is used to numb the area(travell-simons), pre-treatment with a tranquilizer or the use of laughing gas in the office.
    5. All treatments and therapy may have the “proper name” but the intent and experience of the provider determines whether you will feel better.
    6. If you have a completed myofascial pain syndrome you can NOT stop therapy!
    IMO and experience. There are 5 levels of density of trigger points … my observation.
    Level 0-zeros are just automatically unlocked naturally with a good night’s sleep.
    Level 1′s require heat and stretching. Plus a good nights sleep.
    Level 2′s require the assistance from another to apply more intense energy with leverage. Plus level 1 and good nights sleep plus magnesium.
    Level 3 level tps will probably not unlock without an electrical mechanical signal from the stainless steel wire. Plus levels 1-2 good nights sleep plus magnesium.
    Level 4 levels will NOT or can’t be unlocked without the wire repolarization. Plus levels 1-3 good nights sleep plus magnesium.
    Level 5 level trigger points will NOT easily be unlocked with a acupuncture tipped needle and will require a cutting tip or beveled tipped hypodermic needle. (travell/simons’ trigger points). Plus levels 1-4 good nights sleep plus magnesium.

    @Quintner. For this therapy to therapy to work, the provider has to be zealous and at time superzealous. If not the TPs will win.

  18. love says:

    Dear dr. I tried 12 sessions of IMS at istop clinic. I have also had acupuncture as well as botox for my back and neck and shoulders and head aches. All has just made the pain. The only thin that helps is gentle massage and heat.

    Thank you.

  19. John Quintner says:

    @ Stephen. Now you are appealing to “truth” to support your case. However, your appeal will be in vain as “truth” flew out the window the moment you entered the room with your stainless steel needles unsheathed and at the ready. There seems to be no limit to human gullibility, which is why society needs to be protected from over zealous practitioners, whether they be medically qualified or otherwise.

  20. @John.
    Muscle density; Gunn noted that when a muscles contracts it density can change from soft to hard as steel. Yes steel! A thin needle will not penetrate! If the needle is already in the muscle after it contracts, you will not easily pulled it from the flesh.

    Muscle Power; google Dennis Rogers. This guy can take a crescent wrench and bend it into a circle. Human skeletal muscle can apply hundreds of pounds of force. Image that force on a blood vessel or nerve or vertebrae compressing a disc. Ouch!

    Sick muscles; TPs will make a muscle contract erratically not automatically or subconsciously. Imagine you having a tug-o-war with a screwdriver. A friend’s finger wrapped around the handle and yours wrapped around the shaft. Both will tussle until one of you release their grip. A sick muscle will not release or it will randomly. Sick muscles can cause profound misery undetectable my today’s technology. (except one the acupuncture needle)

    The beauty of this therapy is that is so close to natural healing you have to be the provider or the patient to feel and witness the effects. I sometimes call this truth medicine because it is felt. In the Toltec traditional about true and truths, what you think, know, see, hear is more influenced by your life experiences and state of mind. But how you feel is more at the center of your soul and is most real. When the patient tells you that, “this is the spot” and after the release they feel better.That is like … wow.

    Truth; This therapy will become commonplace because it is truth. Truths are forever. Old stale ideas will end up in the dustbin, like what YOU think, Flat-Earth ideas, Salem Witch trials and prefrontal lobotomies.

  21. Dennis Kinch says:

    VCery good stuff. We all need as much education as possible of the inner workings of muscles and nerves, in our language! Thanks for your insights and research.

  22. John Quintner says:

    @ Stephen. More about dry needling from you, but this time it is being promoted as the modern day equivalent of the ancient art of acupuncture. I find your analogy of myofascial tissues appearing like “different grades of beef” to be ludicrous. In my opinion, Myofascial Release Therapy can now be deposited in the dustbin containing discredited forms of medical treatment.

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