Acupuncture

Disruption of Qi Energy:
Energy imbalance, Qi energy being blocked – pain and illness
- Balance of yin and yang coming back to normal through needling specific
acupuncture points
- By targeting specific points you unblock specific points (patient can move better)
12 channels (6 positives and 6 negatives)

Balance the channels e.g. treating spleen to help stomach (one yin one yang)

Physiological effects:
Peri-aqueductal grey: manipulative, provides an analgesia
Descending modulation pathway, equivalent to manipulation
Insula – pain processing (anterior is for emotion of pain, posterior somatosensory region of
pain and also ascending visceral symptoms)
Directs signals to the ANS
Hypothalamus, amygdala (emotional responses to acute and persistent pain, chronic pain
makes them think about them all the time): acupuncture can depress the pain
Cellular and monocular substrates: endorphin, serotonin, pain modulation agent

Autonomic system:
SNS – yang of the body (agitated)
PNS – Yin side of the body (inside)
Regulates autonomic responses – BP, skin conductants, temperature, muscle and HR
variability

Substantia Nigra (areas are suppressed when during acupuncture)– treatment for
Parkinson’s Disease

Clinical applications:
Pain,
Parkinson
Fibromyalgia
Overactive bladders
Stress urinary incontinence

Dry Needling + Myofascial Pain

Trigger point:
Muscle contraction, increased irritability in tissue (hypersensitive to stimulation)

Myofascial pain (trigger point in muscle or fascia)

Pathophysiology  muscle tight, squeezes blood vessels, hypoxia, muscle responds with
inflammatory mediators causes pain (Energy crisis)
Dry needling reduces AcH release (reduces inflammatory mediators)

Evidence-based practice:

Migraine – one side of the head, pain worsens with activity, last 2-72hrs per episode

Tension-type headache: both sides of the heads, tightening in quality, does not worsen with
activity
Several days per month/or daily basis

Cochrane review:

Chronic neck pain: acupuncture effective in ST

More effective in pain relief and increasing ROMs
And QoL than sham treatment

Acute Neck upper trap pain:

- Strong evidence for pain
-