Points protocol formulation and needling technique - needle, active needle, tonify, or pacify?? Cupping?

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Points protocol formulation and needling technique - needle, active needle, tonify, or pacify?? Cupping?

Published on 09-14-2022

"anon240040" has authored 1 other post.

Hello folks, I am working on learning into moving beyond merely needling points in my points protocols when appropriate. Most of the time I will needle, bring de-qi, then just retain the needle for 20-30 minutes. I'm wondering whether it could be usually correct to tonify the points that influence a weak part of the body and pacify those associated with an excess pattern. An example would be liver invading the spleen, to tonify the spleen points and pacify the liver points.

In the title I also have "active needle," which as it was described to me in the instructions for a protocol recently, basically to agitate the needle a bit up and down in after insertion and possibly during retention. I also may have the option of using a TENS  to give electro-acupuncture but I haven't tried it out yet.

So I'm introducing the topic of how does one decide whether and when to tonify or sedate or just needle or active needle/electro-acupuncture. It certainly would not surprise me if everyone responds with "there is no set rule, it depends on the point and the patient." I'm hesitant to do it at my level unless the protocol specifically calls for doing that.

Also I would love if people share their method for tonifying and pacifying points, I have read a lot of conflicting info.

Currently I'm looking at a protocol for 'liver fire invading the stomach' and the protocol calls for me to "drain" the points, which I assume is the same as pacifying. Presenting symptoms are liver fire and slow stomach emptying.

Another thing I am thinking about is for a point on my back, could I have a friend set a cup on it instead of a needle? Or might that have unintended consequences?

Thank you.

This post has the following associations:

Patterns: stomach food stagnation

Comments / Discussions:

comment by "ChadD" (acupuncturist)
on Sep 2022

You were right - to quote you, the answer is "there is no set rule, it depends on the point and the patient."  Even further, it also depends on the system/sub-system you are using.  In some systems those concepts are not used at all, in others they are a primary technique.  From the pure acupuncture perspective, this is really what the schooling and experience is all about.  Anyone can learn to needle someone relatively safely for most points in a matter of days/weeks.  

The reason, in the US at least, that acupunture schools are multi-year graduate programs is because it really matters what you are doing and why in extremely precise terms.  There are are a few schools that respected this so much that they didn't allow student to do any treatments until their clinical rotations in the 3rd year, while others allowed student to student "treatments" and practice fairly quickly.  There are advantages to both sides.

To provide some answer to your question, however, I find the Japanese acupuncture discussions regarding tonification and sedation the most graceful and functionally useful in relative terms.  Our japanese acupuncture section has good introductions to those systems.

Personally, I never used "techniques" to tonify and sedate - just even needling.  But I also relied on medical qi gong techniques, strong utilization of tuina, herbal medicine, etc.  So I'm not saying those techniques do not have merit, I'm just saying they can be uncomfortable to the patient and if you can get the results with more straightforward and comfortable approaches that are easier for you and for your patients, then that is arguably something worth striving for.

What ultimately matters is whether you get results or not and if you can get those results in a reasonable time frame consistently.  That is what every practitioner is generally striving for.  This only comes with first, understanding at least a bit of many systems and approaches and their theoretical back-drops so you are not limited in your thinking and potential, folllowing actual published research on whatever techniques you can find to judge merit in relative terms, and then your own and your colleagues clinical experiences.

As for your other question, cupping and needling have different functions, so that is also unanswerable as asked.  In the most general terms possible for back pain, if it is coming from deficiency then needling and/or moxa may be best, if it's from excess, cupping may be best - in many cases some combination of both are best - in others manual therapies instead of needling or cupping is best.


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comment by "StephenS" (acupuncturist)
on Oct 2022

Do NOT use a TENS unit to do electro acupuncture unless the unit was specifically designed to do both. The output voltage and amperage of a TENS unit is likely to be much higher - by an order of magnitude or more - than an electro acupuncture machine. You could potentially cause tissue damage and/or very painful experience to the patient. 

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