Observation - The practitioner forms an intial impression of the patient and attempts to ascertain the seriousness of the condition based on four main considerations:
the color, complexion, and lustre of the skin
the overall general impression of the patient
the appearance of the face (all the acupuncture meridians flow to the face)
the color of the face (may reveal problems in the functioning of the organs)
black circles under eyes or blue coloring - kidney
red coloring - heart
white coloring - lung
blue-green coloring - liver
distribution of fat, type of build, appearance of body hair, etc.
example - a body with excess fat makes it difficult for Yang to be distributed throughout the body, thus overweight people are more susceptible to cardiac arrest and strokes
expressions show psychological status of the patient
features (eyes, nose, mouth, lips) provide evidence of excess or deficient conditions causing imbalance in the body
The Tongue (color, coating, shape, and texture)
normal tongue - moist, “appropriate” red color
deficiency in qi and blood - light red, pale
alcoholism - thick, purple
dryness, heat, deficiency in yin - cracks in the tongue
Listening and Smelling:
Sound of the voice
loud, assertive - yang pattern
weak, timid - yin pattern
restless, heavy - excess syndrome
shallow - deficient condition
sound of a cough - level of phlegm in the lungs
Odor of the body and its excretions
yang (hot, excess) - rancid, rotten
yin (cold, deficient) - strong, fishy aroma
Details about the patient’s general condition
Full medical history
past illnesses, operations, physical and mental traumas
important insights into the pattern of disharmony existing in the patient
preferences for heat/cold
frequency and consistency of urination and defecation
diet and thirst
menstrual cycle (length, pain, heaviness, etc.)
perspiration (amount, time of day, circumstances)
Location of pain (indicates a blockage of qi within the meridians of the body)
yin - pain relieved by heat
yang - pain relieved by cold
Palpation and Pulse Diagnosis - When properly executed, this is one of the most important and accurate means of diagnosing a patient:
Palpation (feeling or tapping local areas of the body)
Temperature of skin
the index, middle, and ring fingers are placed on the radial artery
three degrees of pressure - light, medium, and heavy - that correspond to the upper, middle, and lower areas of the body
slippery - feels like a rolling pearl in a basin, very fluid and full
choppy - has no strength, irregular
full - large and rounded, can be felt at all levels
empty - hard to detect or felt only slightly at the superficial level when pressure is applied
slow - slower than the normal rate of 4 to 5 beats per breath
rapid - 6 to 7 beats per breath
superficial - easily felt on the skin surfce
deep - only felt with a heavy touch
There are more than 2000 acupuncture points on a body that connect the 12 main meridians and 8 secondary pathways. The practitioner targets specific points based on the diagnosis.
Needle Insertion either feels like a small pinch or nothing at all. Since acupuncture needles are superfine and solid, unlike hypodermic needles, acupuncture feels nothing like getting your blood drawn or getting an injection.
Needle Manipulation, or the way a needle is stimulated after placement in the body, can create a variety of sensations. Commonly, these include heavy, dull, achy, tingling and spreading sensations. Practitioners manipulate needles and then look for these sensations as indications that the body's own healing powers have been activated.
Trigger Point Release using an acupuncture needle feels like a quick spasm or jump of the muscle and the surrounding connective tissue. Sensations commonly travel to the surrounding areas. The immediate effects of treatment can feel like post-workout soreness, but as the soreness fades, the benefits of the therapy are lasting.
Local Effects: Within the vicinity of the needle-there is sensory nerve stimulation due to the insertion of the needle itself. This then causes blood vessel dilation.
Segmental Effects: There is then modulation of the pain processing mechanisms in the dorsal horn of the spinal cord. In addition, there is also modulation of the autonomic nervous system, which includes the blood flow and visceral function.
Distant Effects: Distant effects include the enhancement of the descending inhibition of the dorsal horn of the spinal cord. There is also general pain relief by the release of endorphins and the release of other hormones like ACTH and oxytocin.
Even though acupuncture can be very helpful in ridding of pain throughout the human body, there are also some complications that one should be aware of before undergoing acupuncture treatments. Some simple complications can occur if the practitioner is not qualified and does not know how to safely carry out acupuncture procedures. Thus, it is vital to determine whether or not the practitioner you are visiting is qualified in acupuncture treatments or not. It is important to be sure that the needles aren’t placed improperly and there aren’t defects in the needles. These can cause soreness during acupuncture treatment. Also, it is vital that the patient does not move the areas of the body in which the needles are being placed. Movement of those areas can also lead to tenderness and discomfort.
Common minor problems that can occur after acupuncture treatments include:
Pain can occur during or after a treatment and usually fades away in a short period of time with over the counter medications.
Local Bleeding usually stops quickly with firm pressure after a few minutes.
Fainting can occur when a patient is nervous, which is why the first treatment is usually performed sitting or lying on a couch.
Sweating is a normal response in some patients due to effects on the autonomic nervous system.
Sedation occurs because of the release of endorphins in the central nervous system. If it occurs, patients should not drive immediately afterwards.
Bruising is most noticeable after facial acupuncture. Firm pressure after treatment may reduce it. However, it appears to be nothing more than a slight irritation.
Stuck needle can occur mostly during acupuncture of the large spinal muscles when they are in severe spasm. The needle can be removed after a series of relaxation techniques and patience.
Some uncommon minor problems that can possibly occur after acupuncture treatments are:
Local infection usually develops when indwelling needles are used in the ear in treatments for addiction and smoking.
Broken needles occur if there are sudden powerful muscle contractions; most common in those who are likely to move unexpectedly during treatment.
Burns can occur during electro-acupuncture or during “hot needle” acupuncture.
Contact dermatitis usually occurs when cheap needles are utilized during treatment; can transpire in those that show allergic symptoms towards nickel, chromium, or zinc.
Neuropathy or nerve symptoms occur because of needles that are placed near a peripheral nerve; they are rare usually not permanent.
Some uncommon major and potentially deadly problems if not taken care of immediately that can result from acupuncture treatment are:
Cardiac Tamponade occurs when some patients have a small defect in the front part of the sternal bone, allowing a needle to pass through it into the outer lining of the heart (pericardium). There is a possibility of the heart stopping if sufficient bleeding occurs into this space. Prompt surgical removal of the clot is the necessary treatment.
Pneumothorax occurs when needling over the ribs can sometimes cause a small hole in the outer lining of the lungs (pleura). Leakage of air can cause severe difficulty breathing and can occasionally be fatal. Prompt treatment with the insertion of a chest drain to relieve the excess air is vital.
Infection, such as bacterial endocarditis, can occur in patients with indwelling needles in the ear. Hepatitis and HIV are risk factors if needles are re-used. Modern practice with single-use needles should prevent this.
Pacemakers can be caused to malfunction by electro-acupuncture. This technique should not be used over the heart or front of the neck. Ordinary acupuncture is safe in these sites.
During pregnancy, there is little or no evidence that acupuncture can cause harm to a mother and an unborn child. However, one should consult a doctor before undergoing acupuncture treatments if they are pregnant. The safest periods in which to receive treatments if one is pregnant are during the middle three months of the pregnancy. The risks of miscarriage can increase before or after that period. Acupuncture treatments on the wrist to cure mourning sickness are accepted to be un-harmful.
Treatment in the West
The practice of acupuncture in the west often involves searching for and treating the most prominent trigger points within muscles. Initially no more than 5 needles are inserted, but more can be used when the patient has become used to the technique. Treatments are given in weekly intervals, which allows any local soreness to settle between visits to the practitioner. When the needle is inserted into the skin there is a small "pricking" sensation. Most practitioners press firmly on the skin with the plastic tube that the needle comes in, which causes pressure analgesia in the skin before inserting the needle. Once the needle is through the skin, it is inserted about 1 to
2 cm further. Different sensations are perceived once the needle enters the
pain-inflicted muscle. Once the needle has been placed in the correct position, the strength of the stimulus is increased by moving the needle or heating the
needle (moxibustion). Electro-acupuncture is a technique used to electrically
stimulate the muscles.