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© 2014 Doane US/Doane EU, 18870 8th Ave NE, Poulsbo, WA 98370 Shall not be copied, duplicated or distributed in any form or to be used for teaching without prior written consent of Doane US and/or Doane EU.

Distal Needling Acupuncture (D.N.A.)

For The Treatment Of Pain Lower Body

Sydney, 2015 Robert Doane, EAMP, L.Ac.

Owner, Acupuncture & Wellness Center, P.S. Fellow, American Academy of Pain Management

Websites: doane.us doane.eu

Email: [email protected]


Course Overview INTRODUCTION •  Scientific Explanation of Acupuncture CLINICAL: •  Point specific treatments •  On-site Video Material Viewing and

Discussion •  Herbal therapies for pain Q&A

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How Acupuncture Works •  Chinese medicine

–  Four aspects of a body that need to be func>oning well in order to be healthy

•  Qi (Oxygen) delivery to the >ssues •  Vascular System •  Organ System, especially the heart, the emperor organ •  Nervous System

–  If there is an obstruc>on in the blood flow to a par>cular area of the body, that area of the body will be nega>vely affected, resul>ng in disease or malfunc>on.

–  Any area of the body that is damaged due to trauma or an internal disorder will have difficulty recovering if there is a reduc>on in blood flow to that area.


How Acupuncture Works

•  Chinese medicine – #1 e>ology of TCM: Blood Stasis

•  Vascular func>oning decreases as we age – Body loses its ability to heal itself because all the healing agents of the body are found in the blood

– Blood is not circula>ng sufficiently to the affected area •  Acupuncture helps increase your vascular func>oning

– Major symptoms will disappear

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Scien>fic Explana>on of Acupuncture

•  Pain Pathway –  To feel pain, 2 nerves are involved

•  1. Sensory Pain Nerves (Nociceptors) – Tells the brain there is pain: “ouch”

– 2 types »  A Delta Fibers: sharp, burning pains »  C Fibers: dull, throbbing pains

– Sends signals to L5 à Up the spine à Tract of Lissauer à Midbrain (r.2)


Scien>fic Explana>on of Acupuncture

•  Pain Pathway – To feel pain, 2 nerves are involved

•  2. Propriocep>ve Nerve Fibers – Tells the brain the loca>on of the pain: where the “ouch” is at

– Fires con>nuously at the affected area à Sends signals up the back of the spine à Midbrain

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Scien>fic Explana>on of Acupuncture •  Pain Pathway

–  Midbrain releases endorphins / enkephalins that bind to pain receptors along the spine and the capillary beds where the pain exists in order to reduce pain

•  Pa>ents with chronic pain –  Propriocep>ve neural threshold is too low –  Signal to midbrain is weak

•  Pa>ent cannot pinpoint the EXACT loca>on of pain •  Midbrain does not release endorphins / enkephalins


Scien>fic Explana>on of Acupuncture/Needle Therapy

•  Minute >ssue trauma ac>vates blood coagula>on system to produce bradykinnin and plasmin

•  Bradykinnin triggers local pain sensory fibers and corresponding

propriocep>ve nerves

•  Plasmin ac>vates C3 triggering the immune complement system to sustain vasodilatory phase by histamine, leukotrienes, prostaglandins, and kinin protease which sustains needling response

•  Inac>va>on phase breaks down histamine, releases cor>sol, promotes >ssue healing

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Scien>fic Explana>on of Acupuncture/Needle Therapy

•  Acupuncture creates a strong s>mula>on and “re-‐boots” the propriocep>ve nerve pathway –  The sensa>on created by the needles ‘jumps’ the neural signal threshold and s>mulates the brain to release endorphins / enkephalins

–  Aeer a few hours, the signal gets weak again –  The next day, needle the pa>ent and s>mulate the signal again

•  Keep needling and jumping the threshold un>l the body REMEMBERS and RE-‐ESTABLISHES the normal threshold to signal the brain


Distal Needling •  Distal needling technique is also called the Balance Method or I Ching –  Treat arms / hands & legs / feet based on mirroring / imaging, so pa>ent does not need to disrobe for treatment (>me efficiency)

–  Needles are not inserted directly into the area of pain –  Reduc>on of pain generally begins within 5-‐10 seconds of needle inser>on

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Distal Needling vs. Local Needling

• Which approach is beler? – Pros – Cons


The Chinese discovered the rela>onship between major neural pathways in the body:

•  The lateral vessels of the arms are related to the lateral vessels of the opposite leg and vice versa.

•  The medial vessels of the arms are related to the medial vessels of the opposite leg and vice versa.

•  In addi>on, the lateral vessels of the arms are related to the medial vessels of the opposite arm and vice versa.

•  Also, the lateral vessels of the legs are related to the medial vessels of the opposite leg and vice versa.

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HOW TO TREAT PAIN: Lower Body: (all bilateral points)


Front of the Body

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Abdomen Location Vessels to Treat Internal or External Oblique GB, LV, HT, and SJ

Rectus or Illiacus ST, SP, P, and LI Gluteus Medius or Minimus GB, LV, HT, and SJ

Tensor Fascia Latae GB, LV, HT, and SJ

Illiatibial Tract GB, LV, HT, or SJ

Biceps Femoris (short head) GB, LV, HT, and SJ

Peroneus Tertius, Extensor Digitorum Brevis or 4th Dorsal Interosseous

GB, LV, HT, and SJ


Foot Yangming Stomach Anterior Lateral Foot

足

陽

明

© Dao of Chinese Medicine, Donald E. Kendall, Oxford University Press

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Foot Shaoyang Gallbladder Mid Lateral Foot

足

少

陽



Foot Jueyin Liver Mid Medial Foot

足

厥

陰


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Carey-‐Acupuncture-‐Liver Transplant-‐Hypochondriac Pain


Jan-‐Acupuncture-‐Menstrual Pain-‐Knee-‐Calf

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Groin Location Vessels to Treat Pectineus or Satorius LU, SP, ST, SJ, HT, and SI Gracillis or Pubococcygeus LV, GB, P, LU, LI, and SI


Psoas Location Vessels to Treat Psoas ST, SP, P, and LI

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Anne-‐Acupuncture-‐Colon Cancer since 13 years ago-‐Lower back spine pain toward groin


Front and Side of Legs Location Vessels to Treat Vastus Intermedius and Lateralis and Rectus Femorus

ST, SP, P, and LI

Tibialis Anterior ST, SP, P, and LI Exgensor Digitorum Lingus or Extensor Hallucus Brevis

ST, SP, P, and LI

2nd or 3rd Dorsal Interosseous ST, SP, P, and LI Vastus Medius ST, SP, HT, LU, SJ, and SI Common Tendon of Quadriceps Femoris ST, SP, HT, LU, SJ, and SI Tibialis Posterior or Flexor Digitorum Lingus or Flexor Hallucis Longus or Abductor Hallucis

ST, SP, HT, LU, SI and LU

Extensor Hallucis Longus or Ist Dorsal Interosseus LV, GB, P, LU, LI, and SI

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Foot Shaoyang Gallbladder Mid Lateral Foot

足

少

陽




足

陽

明


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Foot Taiyin Spleen Anterior Medial Foot

足

太

陰



Foot Jueyin Liver Mid Medial Foot

足

厥

陰


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Aaron-‐Acupuncture-‐Knee


Joyce-‐Acupuncture-‐Knee Pain-‐Pneumonia

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Dan-‐Herbs-‐Tibial Ulcer


Back of the Body

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Mid to Lower Back Location Vessels to Treat Latissimus Dorsi UB, K, SI, and LU Piriformis, Gemellus Superior, Obturator Intemus, Genellus Inferior, Quadratus Femorus

UB, K, SI, and LU

Serratus Posterior Inferior, Illiocostalis Lumborum or Gluteus Maximus

UB, K, SI, and LU

Intertransvewrsarii (C1 to Sacrum) K, UB, HT, P, LI, and SJ

Quadratus Lumborum K, UB, HT, P, LI, and SJ

Multifidus K, UB, HT, P, LI, and SJ Coccygeus or Iliococcygeus K, UB, HT, P, LI, and SJ



Foot Taiyang Urinary Bladder Posterior Lateral Foot

足

太

陽

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Foot Shaoyin Kidney Posterior Medial Foot

足

少

陰



Keith-‐Acup-‐Hip-‐LBP

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Paul-‐Herbs-‐LV Cirrhosis-‐Hepa>>s C-‐ Plus Wife-‐ Osteoarthri>s


Back of the Leg Location Vessels to Treat Adductor Longus or Simimembranosus K, UB, HT, P, LI, and SJ

Adductor Brevis or Adductor Magnus K, UB, HT, P, LI, and SJ

Medial Gastrocnemius or Medial Soleus K, UB, HT, P, LI, and SJ

Long Head Biceps Femoris or Semitendinosus

UB, K, SI, and LU

Lateral Gastrocnemius UB, K, SI, and LU

Peroneus Longus, Peroneus Brevis, Flexor Digiti Minimi Brevis, or Abductor Digiti Minimi

UB, K, SI, and LU

Plantaris, Popliteus, or Lateral Soleus UB, K, SI, and LU

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足

太

陽

**Please find enlarged versions of muscle images at

the end of the lecture notes



足

少

陰


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Arthur-‐Acupuncture-‐Ankle-‐Heel


Diane-‐Acupuncture-‐Dorsal Feet Pain

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Roger-‐Acupuncture-‐Neck-‐Back-‐Leg


Carlene-‐Herbs-‐Foot Neuropathy

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In order to know where to treat the above vessels just draw a line from where the pain is

and where that line intersects the arms when the pa>ent is standing or lying. That is exactly where you should needle the appropriate vessel. That area on the arm should then be transferred to the leg and those vessels should be needled in

that area.


Always remember to spread the image and to use needles in pairs and triplets. Also layer the images and the vessels for best

results.

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Vessel-‐ Muscle Rela7onships Figures




足

太

陽

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Hand Taiyang Small Intestine Posterior Lateral Hand

手

太

陽



Foot Shaoyang Gallbladder Lateral Foot

足

少

陽


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Hand Shaoyang San Jiao Internal Membrane (Triple Heater) Lateral Hand

手

少

陽




足

陽

明


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Hand Yangming Large Intestine Anterior Lateral Hand

手

陽

明



Foot Taiyin Spleen Anterior Medial Foot

足

太

陰


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Hand Taiyin Lung Anterior Medial Hand

手

太

陰




足

少

陰


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Hand Shaoyin Heart Posterior Medial Hand

手

少

陰



Foot Jueyin Liver Medial Foot

足

厥

陰


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Hand Jueyin Pericardium Medial Hand

手厥陰



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