By Richard McMahon
BHSc (Acupuncutre), Dip Remedial Massage
In part 2 of our “Sports Medicine Acupuncture” series, we will look into some of the mechanisms that have been found for the pain relieving effects of acupuncture.
As mentioned in the first part of this article the standard method of treatment of traditional Chinese acupuncture involves needling a combination of local points (at the site of the problem), adjacent points (nearby the site of the problem) and distal points (at the other end of the affected channel on which an injury or dysfunction is found). This combination of local, adjacent and distal needling ties in nicely to western research and its division of local effects, segmental effects and extra segmental system effects.
Local effects include the direct stimulation of local nerve fibres and a subsequent release of pain relieving chemicals. The triggering of a small localised inflammatory process that stimulates the release of the chemicals histamine and bradykinin. These chemicals then cause dilation of the local blood vessels and an increase in blood flow to the area. There is also an increase in collagen remodelling and thus improved healing rates in connective tissue. And if the target tissue is a muscle, needling will improve the length tension relationship after deactivation of painful points or the stimulation of local motor points of the muscle. The effect of acupuncture on connective tissue healing will be further elaborated on in part 3 of this series.
The brain becomes aware of pain and sensory information from our skin and soft tissue through signals received by the dorsal horn of the spinal cord. Segmental effects of acupuncture refer to the needling of points near the injured tissue or along the same dermatome or myotome to moderate and inhibit the transmission of pain signals through the spinal nerve root.
Extra segmental or Central Nervous system effects refer to acupunctures ability to cause changes in the brain itself. These refer to more generalised effects such as general pain relief, improvement in mental state or sleep and it is interesting that for these effects to be measured the traditional transport points are used. These points are found between the hand and the elbow or the foot and the knee and are seen to have a stronger effect on the channel and organ systems as a whole in traditional acupuncture.
In the “Sports Medicine Acupuncture” style that is referred to in these articles it is common practice to needle the target tissue, for example an Achilles tendon (local effects). Other tender motor points in muscles supplied by the same nerve root for example the gastrocnemius and hamstring muscles (segmental effects). These would be accompanied by the points which directly release pressure at the spinal level itself for example the JiaJi points that are adjacent to the L5 nerve root and constitutionally supporting points mostly chosen from the traditional transport points(extra segmental effects).
In part 3 of this series we will look closer at the concept of the San Jiao in traditional Chinese theory and how it is related to the connective tissue support structure in the body. New research is opening a bridge between traditional channel theories and our modern understanding of the importance of fascia in regulating health.
Bradnam L, A Proposed Clinical Reasoning Model for Western Acupuncture, Journal of Physiotherapy –March Vol. 31, 1
Callison M, Lecture notes for module 1 of the Sports Medicine Acupuncture Certification course, AcuSport seminars, October 2014
Hopward V & Donnellan C, Acupuncture in Neurological Conditions, Churchill Livingstone, 2010