Targeted Treatment—Understanding Acupuncture Points
One of the most frequent questions acupuncturists are asked during a treatment is, “why are you putting the needle there, when my pain is here?” I love getting this question because it allows me to more deeply explain how acupuncture works and my personal approach to diagnosis and treatment. All acupuncturists receive similar basic training, but each of us takes a different approach in how we choose to apply treatment within the larger framework of Traditional Chinese Medicine.
Chinese Medicine is based on the concept of meridians in the body through which energy, or qi, flows. These meridians comprise a network of channels throughout the body upon which there are designated points corresponding to various organ systems and parts of the body. The foundation of acupuncture teaches that there are 361 main points, with a few extra points grouped within these traditional 361.
Most points start on fingers or toes and flow along the torso with additional points occurring along these lines or paths. Acupuncture points on fingers and toes have different effects than points midway along the path such as on the upper leg, arm or shoulder, and most points are used for more than one type of treatment. I and other acupuncturists will ask you during your intake visit about your health so that we can begin to trace and tie in your symptoms to the optimal points in your body to focus on for treatment. The relationship of the point on the body to the organ system it represents is how we choose our treatment location.
During treatment, patients often ask a follow up question about why a particular point hurts when pressure is applied. The ancient Chinese spent 1000’s of years studying the human body and its functions. They normally only had access to the exterior of a body to study and diagnose, so they had to speculate as to how the organs functioned and how that related to the symptoms and pain a patient was experiencing. Tying these together and manually testing areas of the body through applying pressure, rubbing, and eventually poking (with sharpened bones and later, needles), they established working theories about the location of acupuncture points that are still successfully used in treatments today.
The Origin of Acupuncture Points
It is difficult for most of us to imagine that a point in the crook of the elbow is related to the lungs, or that a headache is caused by intestinal issues. To better understand these relationships, let’s begin at the beginning. Each of us starts life as a one-celled organism. As this cell divides and multiplies, the new cells begin to form various cell layers, becoming organs and differentiated parts of the body. The very act of the cells differentiating and forming various body parts explains the relationship of the external body to the internal organs.
Without access to the video linked above, the ancient Chinese doctors had to intuit this developmental concept and when each organ, limb, finger and toe was developing. They assigned functions to the points and relationships to their corresponding organs. Through these designations, they believed that the lung meridian starts at the thumb and runs up the arm and into the chest, allowing “communication” with the lung organ to treat a lung complaint such as coughing, by needling points on the thumb, hand and arm.
These ancient practitioners understood that cells have memory and that the arm in this example, which was once a group of cells attached to the chest before becoming an independent and highly functioning collection of skin, nerve, muscle, and blood cells, can help us to understand how the points work and why we choose them. What an incredible amount of intuition and research these explorations took, and with amazingly effective results!
From this original study of the body, many schools of thought on how to treat complaints in TCM resulted, and practitioners today still differ on how they approach treatments. Those original 361+ points are still used and are still highly effective particularly for use in pain management. One treatment approach is utilizing points directly at the location of the pain or illness. If the right thumb is painful, the traditional acupuncture approach is often to place a needle in the corresponding point around that thumb. Another approach and one I often apply in the Acupuncture by Andrea clinic, is distal acupuncture. In this practice, if the right thumb is the area of discomfort, I would place a needle in the opposite hand or the opposite foot on the big toe, which is like a thumb on the foot. The concept of similarity in parts of the body is often applied in the practitioner’s selection of treatment points. Knees and elbows have similar structures, and elbow pain can be alleviated by targeting acupuncture points in the knee.
The concept of familiarity is also often applied in treating an illness or health issue, focusing on the function of a body part to treat another area of the body. The similarity of the body parts further away (distal) from the area of pain works on the concept of “like treats like”. We can treat a complaint of elbow pain that is on the meridian associated with the large intestine, by placing needles on knee points along the stomach and gallbladder meridian because of the similarity of body parts (knees and elbows both have boney structures), and because these meridians are partners and can be used to treat distally or away from the site of pain.
In Traditional Chinese Medicine, we look to the organ systems for diagnosis then we treat the surface body. Organ systems are made up of partners. There are 5 yin and 5 yang organs making up 10 partnerships which are represented on the body by the meridians. Two additional partner systems are the yin meridian that runs up the front of the body and the yang meridian that runs up the back of the body. These represent the original cleaving of the one-celled organism from which we began, and are can treat digestive issues as this line of division became the alimentary canal leading from the mouth to the stomach, into the intestines, ending at the rectum. Digestion was an important diagnostic tool for the ancient doctors because it represented life. Much of the pain and illness our body exhibits is an outward result of a digestive issue. Some practitioners would directly treat the elbow pain mentioned previously, whereas my approach is to look further back in the patient’s digestive history and treat the stomach meridian through points on the knee, to get optimal results.
Knee pain can be treated on the middle finger or the scalp or at the deltoid muscle. The exact point depends on the type of knee pain—over exertion, sprain, lack of circulation, or inflammation—along with the practitioners’ understanding of the complaint and their diagnosis. Sometimes the patient feels a sensation in the painful area when this distal point is needled—that is exciting for both the patient and the practitioner because it happens in real time!
Despite being an ancient practice in China and the East, acupuncture is still a new and not very well understood modality in the United States and the West. Trying to wrap your brain around 5000 years of scientific and medical development takes time. Most acupuncturists welcome questions about the why and how of the treatment you’re receiving, and there are many great resources on the subject including the books Between Heaven and Earth and The Layman’s Guide to Acupuncture.
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I love what I do and I am still constantly fascinated by the power of acupuncture to diagnose illness, relieve pain, and heal bodies. Please get in touch with me anytime with your questions about this ancient and effective practice.