Acupuncture needle techniques design is the key issue in ACU treatment.
In this chapter is introducing some different needle techniques, which are common, applied for clinical practices.
- Ling-Shu-Jing needle techniques
Today, in China, in general clinical practice, practitioners follow the original LING-SHU text, especially in needle techniques.
There are two popular techniques found in the Ling-Shu-Jing:
The preferred technique is known as the ‘Three Section Needle Insertion Technique’. The needle is inserted into the skin, goes through the muscle and terminates at the bone. Originally, (four thousand years ago), Ling-Shu-Jing used anatomical terminology to describe the needle technique.
In the ‘Five SHU’ Needle Insertion Technique’, needle insertion is connected with one of the five Zang.
- Needle insertion into the skin is connected with the lungs.
- Needle insertion into the small blood vessel is connected with the heart.
- Needle insertion into the tendon that is attached to the joint is connected to the liver.
- Needle insertion between two muscles is connected with the spleen.
- Needle insertions into the periosteum, or on the side of the bone, are connected with the kidney.
The criteria of needle techniques:
- Reinforces the deficiency
- Reduction of overstress
- Releases the obstruction
- Released blood and lymphatic stasis
The following are needle techniques from LING-SHU:
1-1. Nine Needle Insertion Techniques
- ‘Shu’ Insertion Technique
The needle is inserted into the Five-Shu Points, such as, Jing-Well, Yu-Spring, Shu-Stream, Jing-River and He-Sea points of the hand and leg.
- ‘Long Distance’ Insertion Technique
When illness appears in the upper section of the body, such as the head, the needle is inserted into the point such as LR 1, which is located on the lower section of the body.
- ‘Jing’ Insertion Technique
The needle is inserted into the Lou point that is connected with the ‘Large Jing’.
- ‘Lou’ Insertion Technique
The needle is inserted into the small blood vessel. (Needling to the blood vessel wall or prick a droop of blood from the vessel.)
- ‘Divided’ Insertion Technique
The needle is inserted into the fascia between the two muscles separated the adhesion.
- ‘Large Xie’ Insertion Technique
Using needle insertion technique to make a few holes opens up the superficial layer of the skin to allow the pus to excrete from the body.
- ‘Skin Insertion Technique’
The needle is inserted into the the skin.
- ‘Great’ Insertion Techniques
When the disorder appears on the left side of the body, the needle is inserted into the point located on the right side of the body.
- ‘Fire/Burning’ Insertion Technique
After burning the needle, it is inserted into the point.
1-2. Twelve Needle Insertion Techniques
- ‘Opposite’ two needle Insertion Technique
One needle is inserted into the point located on the front of the body, such as the chest, and another is inserted into a point located on the back just opposite to the front. (Opposite in Chinese can mean: upper and lower, front and back, left and right.) One needle is inserted obliquely following meridian QI flow another needle is opposite or reveres the QI flow.
- ‘Pau’ Insertion Technique
When the pain syndrome is not located on a specific point, the needle is inserted into a local point and focuses on the pain area. Then the needle is withdrawn and inserted again.
- ‘Hui’ Insertion Technique
The needle is inserted into the point perpendicularly and then the needle tip is turned to another location. Continue needling into the different angle.
- ‘Triple Needles’ Insertion Technique
One needle is inserted into the centre of the point perpendicularly and another two needles are inserted obliquely.
- ‘Five Needles’ Insertion Technique
One needle is inserted into the centre of the point perpendicularly and another four needles inserted obliquely into the area around it.
- ‘Direct’ Insertion Techniques
May be called ‘Subcutaneous’ insertion technique. The helping hand pulls up the skin as the needle is inserted perpendicularly into the point.
- ‘Shu’ Insertion Technique
The needle is inserted deep into the interior tissue perpendicularly, gently manipulated and then immediately withdrawn.
- ‘Short’ Insertion Techniques
The needle is inserted deep into the periosteum, and then a gentle short movement or manipulation of the needle at the same point is used to massage the bone.
- ‘Floating’ Insertion Techniques
The needle is inserted obliquely into the tissue allowing the needle to “float” in the point.
- ‘Yin’ Insertion Technique
The needle is inserted into the point from the Yin side through to the Yang side, such as KD 3 to BL 60.
- ‘Oblique’ Insertion Techniques
One needle is inserted into the point perpendicularly and another obliquely.
- ‘Chan’ Insertion Technique
Perpendicularly insert the needle into the point at the superficial layer of the skin, then lift and thrust the needle a few times, immediately withdraw the needle and allow the point to bleed.
1-3. The Insertion Techniques involving ‘Five Zang’
- ‘Half’-Insertion Technique involved with the Skin – Lung
The needle is inserted into the skin as a prick, the needle does not touch the muscle, and it is limited to the skin.
- ‘Big Cat Skin’ Insertion Technique involved with the Blood – Heart
The needle is inserted into the four corners that surround the point involved with the Jing-Luo.
- ‘Kuan’ Insertion Technique involved with the Joint – Liver
The needle is inserted into the point located in the tendon that attaches to the joint.
- ‘He-ku’ Insertion Technique involved with the Spleen
The needle is inserted into both sides of the muscle’s fascia.
- ‘Skin’ Insertion Technique involved with the Bone – Kidney
The needle is inserted deep into the periosteum perpendicularly. After the needle is inserted into the point it is immediately withdrawn.
Some of the acupuncture points in the Main Meridians have specific functions and produce particular results in acupuncture treatment. They are grouped into ten categories.
- Five-SHU points.
These points lie between the apex of the fingers and the elbow, and between the apex of the toes and the knee. The traditional Chinese belief was that QI flow in a meridian was similar to the motion of the water and was expressed as:
1-1. Where QI starts to bubble: Jing-Well points. Jing-Well points are very sensitive. They have a strong influence on the Qi flow. They are used for reviving someone from a state of unconsciousness and for bringing mental and physical Qi together. In clinical practice they are used for treating mental illness, and difficulty breathing of the chest.
1-2. Where Qi flow begins to flourish: Ying-Spring points. Ying-Spring points are used for treating fever.
1-3. Where Qi movement increases: Shu-Stream points. Shu-Stream points are used for pain relief and for the feeling of heaviness in the body.
1-4. Where Qi flow is abundant: Jing-River points. Jing-River points are often used for dyspnoea, coughing and throat disorders.
1-5. Where all the Qi accumulates: He-Sea points. He-Sea points are used to treat disorders of the Fu organs (i.e. stomach, small and large intestines, bladder and gall bladder).
Clinically, there are two different ideas concerning the understanding and use of the Five-Shu points, or the Five Element Acupuncture Points. They are as follows:
Following the Five Element Theory to select points for acupuncture treatment.
Following the Qi flow concept to select the points.
The Chinese versions, and the medical sciences’ understanding, are:
The points on the apex of fingers or toes, JING-WELL points, are very sensitive. They are utilised for reviving someone from a state of unconsciousness, and for bringing mental and physical Qi together.
The cerebral motor cortex is controls of the distal part of the extremities’ activities. Practically, the needle is inserted into JING-WELL point LU11 for example, this could revive someone from a state of unconsciousness. The result of needle insertion is connected to the lung and cerebral cortex. Acupuncture clinical practice is similar to the medical sciences.
The points from the toes to the knee that seem to go with the muscle and tendon, such as the ST36, which is located at the origin of the anterior tibialis, and runs across the ankle end to the great toe. The points are along the side of the muscle, such as ST37, ST38 and ST39. The points ST41, ST42, ST43, ST44 and ST45 are on the side of the extensor digitorum longus tendon.
- YUAN (SOURCE) points
These points are located where Yuan Qi passes through, or accumulates. There is a Yuan (Source) point for each of the Twelve Main Meridians. All are found in the extremities. A specific sensation is always felt at the associated points when disease attacks the body’s internal (Zang/Fu) organs. The Yuan (Source) points are therefore significant in the diagnosis and treatment of some of the disorders affecting the Zang and Fu organs.
The Chinese medicine believed that the QI regulated all vital activities of the body movement and metabolism.
- Yuan QI—primary QI (Congenital QI)
- Zong QI—pectoral QI
- Ying QI—nutrient QI
Wei QI—defensive QI
The cooperated Congenital QI and Acquired QI is the Congenital QI promotes Acquired QI in turn Acquired QI nourishes Congenital QI
According these perceptions in the body wall tissues or points in which is existing the specific point that can activated the action potential to regenerate the special power or strength to strengthen the body or organs function. Such as a healthy person the ZONG QI is abundant reveal a deep and strong voice. UNDERSTAND NONE OF THIS!
- YUAN (SOURCE POINTS)
|TWELVE YUAN (SOURCE) POINTS|
Meridians of Hand
|Three Yin Meridians of Foot||Spleen
|Three Yang Meridians of Hand||Large Intestine
|Three Yang Meridians of the Foot||Stomach
- Fifteen LUO points
Each of the Fourteen Meridians has a Luo Point. The Spleen Meridian has an extra point called ‘Major Luo’ (SP 21)*, making fifteen in all. The main function of these points is to connect the Qi flows of the Yin and Yang meridians. For example, LU 7 is a Luo point, which connects the Qi flow of the Lung to that of the Large Intestine. A Luo point is used for treating diseases that involve two (external and internal) related Meridians, and for treating disorders in the regions served by them.
* Major Luo (Sp 21)
|FIFTEEN LUO POINTS|
|Three Yin Meridians of Hand||Lung
|Three Yin Meridians of Foot||Spleen
|Three Yang Meridians of Hand||Large Intestine
|Three Yang Meridians of the Foot||Stomach
|Extra Meridians||Conception Vessel
- Sixteen XI points
A Xi (Cleft) point is located deep between two separate body tissues where meridian Qi is concentrated. Altogether there are sixteen Xi points in the body’s extremities: one in each of the Twelve Main Meridians, and one in each of the Four Extra Meridians (Yin Wei, Yang Wei, Yin Qiao and Yang Qiao). The Xi points are often used for treating acute disorders. When massaged, the points can feel painful because of the disorders in their respective Meridians and in their connecting organs. Hence, Xi points can be used for diagnosing disorders in those organs.
|SIXTEEN XI POINTS|
|Three Yin Meridians of Hand||Lung
|Three Yin Meridians of Foot||Spleen
|Three Yang Meridians of Hand||Large Intestine
|Three Yang Meridians of the Foot||Stomach
|Four Extra Meridians||Yin Wei
- Eight Confluence Points of The “EIGHT EXTRA MERIDIANS”
Within the Twelve Main Meridians there are Eight Confluence Points in the extremities, which communicate with the Eight Extra Meridians. Although the latter do not directly circulate in the extremities, their Qi are connected to the Qi flows of the Twelve Main Meridians. Therefore, these points are used for treating disorders related to the Twelve Main Meridians, and to the Eight Extra Meridians.
In clinical practice, combinations of the Eight Confluence Points are necessary for total treatment. For example, points of the upper extremities (PC 6) are combined with those of the lower (SP 4) in order to treat disorders of the heart, chest or stomach region
|EIGHT CONFLUENCE POINTS|
Blood Vessel (Pulse)
- Eight Influential Points
The Eight Influential Points in the Fourteen Meridians have special functions connected to certain related organs, and their functions. These functions are always described in terms of Chinese medicine.
Clinically, LR 13 can be used for treating disorders of the five Zang (Lungs, Heart, Liver, Spleen and Kidneys). Point CV 17, a centre of Qi, can be treated with moxa to balance and increase the body Qi level.
|EIGHT INFLUENTIAL POINTS|
|Main Meridians||Eight Influent Points||Eight Extra Meridians||Principal Areas of Treatment|
|Heart, chest, stomach|
|Eyes, neck, ear, bladder, shoulder, small intestine|
|Eyes, ear, cheek, neck, shoulder|
|Lungs, throat, chest|
- Back-SHU points
These points are at the back of the body in the Bladder Meridian, 1.5 cun lateral to the Governor Vessel. Their special function is in relation to the internal organs (Zang and Fu), whose Qi accumulates in some of the Back-Shu Points.
In clinical practice, any disorders of the Zang and Fu manifest themselves in the corresponding Back-Shu points, through symptoms such as tenderness, lumps, swelling and aches. These points play an important role in disease diagnosis. Good results will be obtained from treatment after needling into these areas.
In practical terms, as well as following the philosophy of Yang balancing Yin, the Back-Shu Points (Yang) are used mostly for treating disorders of the Zang organs (Yin), whereas the Front-Mu Points (Yin) are more frequently used when treating disorders of the Fu organs (Yang).
|TWELVE BACK-SHU POINTS|
- Front-MU points
These points are located on the front of the body, in the chest and abdomen and serve the same functions as the Back-Shu Points. In some of these Front-Mu points, the Qi of the related Zang and Fu accumulate. Disorders in the Zang and Fu reveal themselves in these points, making them useful for diagnosis and treatment.
Likewise, following the philosophy of Yin balancing Yang, the Front-Mu Points (Yin) are preferred when treating disorders of the Fu organs (Yang) whereas, for the disorders of the Zang organs (Yin), the Back-Shu Points (Yang) are more frequently used.
The general rules for selecting Back-Shu and Front-Mu points are:
Disorders of the Zang organs, Back-Shu Points
Disorders of the Fu organs, Front-Mu Points
Acute diseases, Back-Shu Points
Chronic diseases, Front-Mu Points
Shi (excess) syndromes, Back-Shu Points
Xu (deficiency) syndromes, Front-Mu Points
The result of Front-MU point combination with Back-SHU point in treating lower back pain is significant. (If go with the muscles coordinated movement perception in which is equilibrium between the abdominal wall and the erector spinae muscles.)
|TWELVE FRONT-MU POINTS|
|Lateral Aspects of Chest and Abdomen|
|Midline of the Chest and Abdomen|
- Meeting points
The point of intersection of two or more Meridians is known as the Meeting or Crossing point. Such points are used to treat disorders not only in one Meridian, but also disorders of the other Meridians crossing through it. For example:
CV 4 is the Meeting Point of three Yin Meridians of the Foot. Thus, it is used to treat disorders of the Conception Vessel Meridian, as well as those of the Spleen, Liver and Kidney Meridians.
SP 6 is where the Kidney and Liver Meridians cross. Therefore, it is used to treat disorders of the Spleen Meridian, as well as those of the Kidney and Liver Meridians.
In clinical practice, more often, the two muscles or tendons crossing point is an occurred pain symptom, which is caused by post- trauma tissue adhesion obstructing the muscles movement. A needle inserted into the point immediately eases the symptom.
- HE-SEA points
These points, which are part of the Five Shu Points, are important for treating disorders of the Fu organs. For example, BL 39 is used for treating urine retention, ST 37 for treating colitis and ST 39 for treating spasm of the small intestine. Each of the Six Fu has a He-Sea Point in the three Yang Meridians of the Foot. (The three Yang Meridians of the Hand have three inferior He-Sea Points in the Yang Meridians of the Foot.)
|SIX HE-SEA POINTS|
‘Golden Needle’ Technique
This needle Technique is described in the book called “Golden Needle”. The book dates from the Ming Dynasty, 1368-1644.
There are eleven different types of needle insertion techniques, also called The Complex Reduction and Reinforcement Needle Technique.
1-1. ‘Fire Burning the Mountain’; Pure Reinforcement Techniques
‘Fire Burning the Mountain’
The depth of the point is determined, and mentally divided into three levels: Heaven, Man and Earth. The Needle is slowly inserted through the skin, thrust firmly into the first level and lifted gently back to just under the skin. At each of the three levels, the needle is firmly thrust and lifted gently back to just beneath the skin. At each of the three levels, the needle is firmly thrust and gently lifted nine times. On completion, the needle is quickly withdrawn from the third (deepest) and the point sealed with the fingers.
If correctly applied, the patient feels a warm sensation at the local areas. If this is not so, the entire procedure may be repeated, but not more than three times, before the needle is completely withdrawn.
Failure to warm the point may be due to poor technique or disease in the local area. This method is often used for local cold disorders.
Because the translated name for this technique is ‘Fire Burning the Mountain’, this is often referred to as the ‘volcano technique’
This is suitable only for points at musculature regions or where the connective tissue is deep, and should not be applied to the face or dorsal aspects of the hands and feet. Gentle manipulation is also desirable at sensitive points and for sensitive patients.
1-2. ‘Penetration of Celestial Freshness’; pure reduction technique.
‘Penetration of Celestial Freshness’
The depth of the point is determined, and mentally divided into three levels (Heaven, Man, Earth). The needle is rapidly inserted into the point, penetrating directly to the third (deepest) level. The needle is then thrust gently and lifted firmly, a further six times at each level. On completion the needle is withdrawn slowly though the skins surface from the first (most superficial) level, and the point left unsealed.
After treatment, the tissue surrounding the point feels cold (‘as cool as mountain air’ according to the ancients). If not, the entire procedure may be repeated, but not more than twice, before the needle is withdrawn completely. This method is used for excessive heat in the body.
This method is suitable only for points at muscular regions or where the connective tissue is deep, and should not be applied to the face or dorsal aspects of the hands and feet. Gentle manipulation is also desirable at sensitive points and for sensitive patients.
1-3. ‘Shadow of Yin between the Yang’; Combination of reinforcement and reduction techniques
‘Shadow of Yin between the Yang
The depth of the point is determined, and mentally divided into two equal parts. The reinforcement aspect is applied at the upper level. The needle is thrust, and firmly lifted gently and slowly nine times.
The reduction aspect is used at the lower level. The needle is thrust gently and lifted firmly six times, slowly retracted into the upper level, then slowly withdrawn. The point is left unsealed.
This method is used for treating a cold disorder which has been followed by heat symptoms, or for a disease causing body weakness and giving rise to heat symptoms. The reinforcement aspect first strengthens the body and the reduction aspect removes the heat.
1-4. ‘Shadow of Yang between the Yin’; Combination of reduction and reinforcement techniques
‘Shadow of Yang between the Yin’
The depth of the point is determined mentally, and divided into two equal parts. Reduction is used in the lower half. The needle is inserted directly into the deepest level, then lifted firmly and thrust gently six times.
The needle is retracted into the upper level for reinforcement, which involves gently lifting and firmly thrusting the needle nine times. The needle is quickly withdrawn and the point sealed with the fingers.
This method is used for treating the patient who has suffered from a heat disorder which has weakened the body condition, and created a cold disorder. The reduction aspect removes the excess heat, producing a cool sensation after which the reinforcement aspect strengthens the body by providing warmth.
1-5. ‘Battle of the Dragon and Tiger’; Combination of reduction and reinforcement technique through needle rotation
The needle is inserted into the point. When it ‘receives Qi’ and gives the ‘acupuncture sensation’, the needle is rotated clockwise nine times in the direction of Meridian Qi flow; this is followed by rotation anti-clockwise six times.
On completion, the needle is left in the point for twenty to thirty minutes. When the pain has been relieved, the needle is quickly withdrawn and the point sealed.
Combining these two techniques through needle rotation balances the Jing and Wei Qi flows, and removes local Qi obstructions. Clinically it is used for pain relief.
1-6. ‘Descent and Ascent of the Dragon and Tiger’; Combination and reinforcement and reduction techniques through needle rotation and lift and thrust
The depth of the point is determined and mentally divided into three levels (Heaven, Man, Earth). The needle is inserted into the uppermost level and, following the direction of the meridian Qi flow, rotated 180 degrees clockwise.
The needle is firmly thrust into the middle level, gently retracted back to the uppermost level and rotated 180 degrees clockwise. This procedure is repeated nine times and results in the Yang Qi of the uppermost level being sent down to the middle level. The Chinese called this the ‘Dragon Descending’.
The next step is for the needle to be gently thrust from the middle to the deepest level, rotated 360 degrees anti-clockwise, then firmly lifted back to the middle level. Holding the body of the needle, this procedure is repeated six times and results in excess Qi being brought to the surface. This, the Chinese call the ‘Tiger ascending’ (While the dragon descends the tiger ascends; in other words Yang Qi is sent downwards and excess Qi is brought upwards). The needle is then retracted to the surface, slowly withdrawn and the point left unsealed.
This strong needle stimulation is mostly used for balancing Yin and Yang Qi flows, removing energy obstructions in the Meridians and, especially, removing any local blood stases and local energy obstruction. Clinically, it is used for relieving severe pain, this type of stimulation balances the pain and quickly relieves it. Pain is not felt from the needle.
1-7. ‘Pounding the Meridian in Mortar’; Combination of reinforcement and reduction techniques through needle rotation and simultaneous lift and thrust
The needle is inserted into the point and manipulated until the ‘needle sensation’ is attained. The needle is then firmly thrust and gently lifted at the same time, as it is rotated 180 degrees clockwise in the direction of the Qi flow. This is repeated nine times.
The needle is then gently thrust and firmly lifted at the same time as it is rotated 360 degrees anti-clockwise in the direction opposite to that of meridian Qi flow. After six repetitions, the needle is slowly withdrawn and the point left unsealed.
This method is used to balance Yin and Yang Qi flows, remove Qi obstruction in the Meridians and to treat water retention.
1-8. ‘Wagging the Tail of the Dragon’
The needle is inserted into the point, when it has ‘acquired QI’ its tip is turned obliquely in the direction of the disorder. The needle is left in the tissue, taking care not to move the body of the needle.
Holding the handle and tail of the needle, a slow and gentle movement is made from back to front (as in rowing a boat), (3 x 9) twenty-seven times. The needle is quickly withdrawn and the point sealed.
This method increases the Qi flow throughout the region of the disorder (which is caused by body weakness and Qi obstructions in the local area).
1-9. ‘White tiger shakes his head’; Reduction through manipulation of the tail of the needle
The needle is inserted straight in to the point and gently thrust at the same time as it is rotated anti-clockwise in the direction opposite to that of the Meridian Qi flow. The needle is then firmly lifted at the same time as it is rotated anti-clockwise, eighteen (3 x 6) times.
The needle is left in the point and, while holding only its handle and tail, manipulated from left to right (as if ringing a bell) eighteen (3 x 6) times. The needle is slowly withdrawn and the point left unsealed. This technique is used for removing blood stasis in the Luo Meridian.
1-10. ‘Tortoise Detects the Point’; Multidirectional placement of the needle for reinforcement
The depth of the point is determined and mentally divided into three levels. The needle is inserted slowly through the skin, gently rotated and firmly thrust into the tissue from the uppermost level to the middle and then to the deepest.
The needle is then lifted gently and then rapidly back to just beneath the skin surface and the direction of the needle changed. This movement from left to right to be repeated until the needle has punctured a large area around the point. The needle is then quickly withdrawn and point sealed.
This strong reinforcement technique is used for increased Qi flow in the Meridian.
1-11. ‘Peacock’s Fantail’; Reinforcement technique
The depth of the point is determined and mentally divided into three levels. The needle is inserted slowly through the skin, gently rotated and firmly thrust into the deepest level. When the needle acquires the ‘needle sensation’, it is retracted gently and rapidly to the uppermost level.
When the needle again responds, it is gently rotated and firmly thrust into the middle level, rotated 180 degrees clockwise, then gently lifted and firmly thrust several times. Finally, the needle is withdrawn quickly and the point sealed.
When Luo Meridian Qi is obstructed, this technique increases Qi and starts it flowing again.
Needle Technique Collection
Acupuncture needle insertion into the point, first contacts is the skin. When the needle is inserted into the dermis, where the receptors are located, a pain sensation occurs.
If the tip of the needle is rapidly inserted over the dermis, after needle insertion, in a few seconds the pain is gone.
In clinical practices, the pain could be part of an acupuncture treatment, however, the pain sensation should be diminished. There is no necessity for acupuncture to cause great pain.
- diminish pain Sensations
1-1. When inserting the needle into the point: the needle should be inserted directly into the skin, rapidly passing through the dermis, the pain will soon diminish.
1-2. Before needle insertion, talk to the patient, relax them and use a finger press on the skin where the practitioner will insert the needle. Also let the patient know which points are to be needled.
1-3. For a new patient’s first acupuncture, select a less sensitive point for needling, such as LI11. Talk to the patient, and while the patient is unaware, rapidly insert the needle into the point. After needling, talk to the patient and explain that the sensation occurs for only a second and then it is gone. So the participant has no need to fear with the needle.
1-4. Acupuncture inserts a sharp needle into the living body: a sensation of pain will occur, which is a normal response, unless the patient is unconscious or has lost skin sensation.
1-5. In many instances, in acupuncture treatment, when the needle is inserted into the sensitive point, some pain will occur, but that is required of the treatment. In this case, practitioners need to warn their patients and ask them to do deep breathing exercises to reduce the local pain sensation.
The use of hypersensitive point treatment is generally only used on a patient that has lost consciousness, or in paralysis.
1-6. In physiology, a sharp needle stimulates the receptor, the free nerve ending. If the stimulation is large enough it can produce an action potential in which can regenerate the nerve impulses go with the axon—afferent ascending track send the message to the CNS. The response from the motor cortex, for example will via descending track effects to the motor neuron in the spinal cord and react to the motor end plate the involved muscle will contract.
1-7. Acupuncture is a form of medical treatment, or natural healing practice. If the patient fears the needle, then suggest that the patient chooses another form of treatment, unless acupuncture is the only option.
- The Needle Direction and Depth
According to traditional Chinese acupuncture clinical practice, there are two needle insertion techniques commonly used: the needle insertion into the point, which is dependent upon the needle insertion resulting in ‘Acquired QI’, no matter how deep the needle is going. That could be shallow, or deep.
The other conception is the ‘Heaven, Man and Earth’, three layer needle technique.
In general clinical practice, which needs to discover where illness is located, the illness can be located at skin level, or deep in the periosteum. The needling focuses on the illness location may be in the skin, or in the tendon.
It is preferable to use medical science to locate the point, whether it is located at the skin, the joint or the tendon. The superficial illness the needle is focuses on the skin level, and not necessary needling deep into the lower layers.
The acupuncturists realized that the direction and depth of needle insertion is important in their clinical practice. Such as the point near the blood vessel ST9, ST30 or SP12, where only a few mm difference in the needle’s direction and depth of insertion can cause an accident, and needle insertion into the large blood vessel would be, of course, extremely dangerous.
If the needle is not precisely inserted into the point of the inflammation lump, then the pain cannot be released.
Acupuncture texts stress the importance of the needle direction and the needle depth, although the experienced practitioner in clinical practice may alter the direction and depth written in the texts.
Great care is necessary in achieving the correct needle insertion direction and depth: Especially, if the point is near the large blood vessel. Such as ST9 and LI18.
Location: At medial of the sternocleidomastoid muscle, level with tip of thyroid cartilage (Adam’s Apple), just on line with the common carotid artery.
Method of treatment:
Needle: 0.1-0.3 cm perpendicularly
Location: On lateral side of the neck, at the level of the tip of the thyroid cartilage (Adam’s apple), between sternal and clavicular heads of sternocleidomastoid muscle
Method of treatment:
Needle: 0.3-0.5 cm perpendicularly
Anatomy and Pathophysiology of LI 18 and ST9
The points, LI 18, and ST 9, are located at the tip of the thyroid cartilage (Adam’s apple), on the side of the sternocleidomastoid muscle. ST 9 is located on the medial side, while LI 18 is on the lateral side. The omohyoid and sternohyoid muscles are inferior of the sternocleidomastoid and platysma muscle covers on the superficial level.
At this level (Adam’s apple), the carotid artery and internal jugular vein are located. The common carotid artery at this level consists of the internal carotid and external carotid artery. The carotid sinus (carotid baroreceptors) is located in the internal carotid artery. The carotid body is located in the external carotid artery. Both are connected to CN IX—Glossopharyngeal nerve, and CNX—Vagus nerve.
The omohyoid and sternohyoid muscles are attached to the hyoid bone the stylohyoid and digestic muscles are attached above the hyoid bone.
The omohyoid inferior belly and digestive posterior belly run across the carotid artery on the superior and inferior section. The tension of the surrounding musculature can interfere with the function of the carotid artery. The tension of the carotid artery may, via the barorecaptor, cause a change in the body’s blood pressure, fearfulness, coughing and palpitation symptoms.
There are several acupuncture points such as LI 17, LI 18, ST 9, ST 10, ST 11, TH 16, TH 17, SI 16 and SI 17 in which are involved the treatment of illness in this region or point. All these points’ locations are situated in the sternocleidomastoid, omohyoid, stylohyoid, and digastic muscles.
Needle Insertion Method for LI 18
The needle is inserted into the side of the muscle fibers to relieve the muscle tension, thus relieving the tension in the carotid artery. The needle insertion depth is limited to 0.3 cm.
According to clinical observation, more often the disorder is an interruption in the skin, or the fascia of the muscle.
The needle is inserted to a depth of 3mm, which stimulates the receptors and releases the tension in the skin or muscle.
If the needle insertion discovers obstructive tissue, the needle may focus on removal the obstructive tissues. The practitioners have to be cautious due to the proximity of the carotid artery and the reflex activities.
- The needle diameter
The small diameter needle inserted into the body causes less pain then the large diameter needle, but the large diameter needle is easier to insert and more sensitive. The design and clinical selection of different diameter mainly is for the needle stimulation or/and needle operation.
Relaxation treatment is part of the general acupuncture treatment.
Relaxation can maintain mental and physical wellbeing, thus in general acupuncture treatment, a quiet environment and an expert relaxation needle technique is necessary.
Stress management, and the relief of tension type headaches, is helped by the gentle needle insertion technique, administered in a quiet and peaceful environment is. Facial and cranial ACU points, and distal points of the hand and foot are commonly used, such as, BL2, TAI YANG, CV24, LI4, and Liv3.
- Needle Techniques Involved Nervous System
The ACU needle has a sharp tip, designed to stimulate the skin receptors. The needle is a stimulus for treating illness by detecting the body’s sensitive points, the free nerve endings.
The nervous system regulates the body’s mental and physical wellbeing.
To achieve the desired results, acupuncture practitioners require neurosciences and combination with ACU needle techniques, the needles are inserted into the skin and muscle receptors, largely through the nervous system neural network reflexes mechanism achieve the out come.