Biomechanical response to acupuncture  needling in humans

Langevin, Hélène M.; Churchill, David L.; Fox, James R.; Badger, Gary J.; Garra, Brian S.; Krag, Martin H.

doi:10.1152/jappl.2001.91.6.2471

Cited by 210 publications

(139 citation statements)

References 22 publications

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“…Moreover, there was a greater pullout force following uni-and bidirectional winding compared to needle insertion without manipulation [77,78]. By using trichrome staining, Langevin further demonstrated that pullout force is due to the mechanical coupling of collagen fibers to the needle [77].…”

Section: The Physiology and Relevance Of Needle Mechanotransductionmentioning

confidence: 94%

“…Through a series of elegant studies, Langevin et al found that a greater pullout force is required to remove a needle from tissue when the needle is wound in one direction compared to when it is wound in both directions [76,78]. Moreover, there was a greater pullout force following uni-and bidirectional winding compared to needle insertion without manipulation [77,78].…”

Section: The Physiology and Relevance Of Needle Mechanotransductionmentioning

confidence: 99%

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Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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There are a number of biochemical, biomechanical, endocrinological and neurovascular mechanisms underpinning the anti-nociceptive and anti-inflammatory effects of dry needling (DN). While myofascial trigger points likely play a role in peripheral pain, a diagnostic tool for localizing them has not been validated, and DN studies that have targeted trigger points to elicit localized twitch responses have reported mixed results. Therefore, the mechanism responsible for DN-mediated analgesia may be more complicated. DN activates opioid-based pain reduction, mediated by endogenous cannabinoids and the sympathetic nervous system, and non-opioid pain relief via serotonin and norepinephrine from the brain stem. DN also triggers the hypothalamic-pituitary-adrenal axis centrally and the corticotropin releasing hormone-proopiomelanocortin-corticosteroid axis locally to inhibit cox-2, reducing inflammatory cytokines. Recent studies demonstrate that DN combined with mechanical and/or electrical stimulation may reverse PKC-mediated peripheral hyperalgesic priming by normalizing nociceptive channels, to include TRPV, ASIC, TTX and P2X/Y. Electrical DN (EDN) stimulates immune cells, fibroblasts and keratinocytes to release CGRP and substance-P, altering the stimulation of TTX receptors to reverse hyperalgesia. It also encourages the supraoptic nucleus to release oxytocin to quiet ASIC receptors peripherally and stimulate opioid interneurons spinally. Moreover, EDN inhibits ERK1/2 kinase pathways of inflammation in the spinal cord and stimulates Aδ fibers and N/OFQ to reverse C-fiber mediated central changes. Mechanotransduction of fibroblasts and peripheral nerves via TRPV1 and P2X/Y-mediated intracellular Ca 2+ wave propagation and subsequent activation of the nucleus accumbens inhibits spinal pain transmission via glycinergic and opioidergic interneurons. The increased ATP is metabolized to adenosine, which activates P1 purinergic receptors, events considered key to DN analgesia and rho kinase-based tissue remodeling. Mechanotransduction-mediated release of histamine further explains analgesia secondary to needling points distal to pain. DN-mediated analgesia is dependent on a number of synergistic physiologic events involving biochemical and mechanical processes in neural, connective and muscle tissue.

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Section: The Physiology and Relevance Of Needle Mechanotransductionmentioning

confidence: 94%

Section: The Physiology and Relevance Of Needle Mechanotransductionmentioning

confidence: 99%

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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“…Some practitioners of acupuncture refer to de-qi as "needle grasp, " a biomechanical phenomenon characterized by an increase in the force necessary to pull the needle out of the tissue. It has been proposed that the sensation of needle grasp is due to the contraction of skeletal muscle [126] or winding of connective tissue around the needle during needle rotation [127]. By using electric impedance, Lin showed that muscle layers were the major site of de-qi in the 22 acupoints in the back [128].…”

Section: Discussionmentioning

confidence: 99%

Measuring the Thickness of the Abdominal Wall at Abdominal Acupoints Using Ultrasonography and Analyzing Correlations with Physical Examination Values in Functional Dyspepsia Patients

한¹,

박²,

김³

2016

J Int Korean Med

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Objective. To explore the existing scientific information regarding safe needling depth of acupuncture points and the needling depth of clinical efficacy. Methods. We searched the PubMed, EMBASE, Cochrane, Allied and Complementary Medicine (AMED), The National Center for Complementary and Alternative Medicine (NCCAM), and China National Knowledge Infrastructure (CNKI) databases to identify relevant monographs and related references from 1991 to 2013. Chinese journals and theses/dissertations were hand searched. Results. 47 studies were recruited and divided into 6 groups by measuring tools, that is, MRI, in vivo evaluation, CT, ultrasound, dissected specimen of cadavers, and another group with clinical efficacy. Each research was analyzed for study design, definition of safe depth, and factors that would affect the measured depths. Depths of clinical efficacy were discussed from the perspective of de-qi and other clinical observations. Conclusions. Great inconsistency in depth of each point measured from different subject groups and tools exists. The definition of safe depth should be established through standardization. There is also lack of researches to compare the clinical efficacy. A well-designed clinical trial selecting proper measuring tools to decide the actual and advisable needling depth for each point, to avoid adverse effects or complications and promote optimal clinical efficacy, is a top priority.

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“…Findings indicate a relationship among APs and myofascial trigger points [14,15], connective tissue planes [16], and nerve-vessel bundles penetrating the superficial fasciae [17]; however, given the high occurrence of these structures, it remains unclear which of them are specific for APs. A significantly larger needle grasp [18] and larger blood supply into the microvascular beds [19] at APs when compared to other areas has been observed. Additionally, conflicting results also exist about APs being spots characterized by a high density of neural receptors [20,21] or a distinct electrical skin resistance [22][23][24].…”

Section: Introductionmentioning

confidence: 93%

Acupuncture point localization varies among acupuncturists

König¹,

Bäumler²,

Simang

et al. 2012

Deutsche Zeitschrift für Akupunktur

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SummaryBackground: Studies assessing the point-specific effect of acupuncture or the characteristics of acupuncture points (APs) tend to yield inconclusive results. In order to identify a possible confounding factor, we aimed to examine the variability in AP localization by means of a survey. Material and Methods: Attendees of the 14th ICMART (International Council of Medical Acupuncture and Related Techniques) congress as well as DÄGfA (German Medical Society of Acupuncture) lecturers and students were asked to locate and mark the APs LI 10 and TH 5 on a research assistant's arm. Identified points were transferred into a coordinate system, and the respective bivariate distribution function was calculated. Additionally, participants filled out a questionnaire about their acupuncture education and experience, the acupuncture style and point localization techniques used most frequently, and their estimation of the size of an AP. Results: The areas of the ellipses, theoretically containing 95% of AP localizations, varied between 44.49 and 5.18 cm 2 . The largest distance between 2 identified points was 8.45 cm for LI 10 and 5.3 cm for TH 5. Apart from being trained at the same school, no other factor could be identified that determined the variability in AP localization. Conclusion: Our results indicate that congruity of AP localization among experienced acupuncturists might be low. Although there are some limitations to our results, this possible bias should be taken into account when conducting acupuncture trials and interpreting results of previous acupuncture studies. Schlüsselwörter Material and Methods ParticipantsSurveys were performed at the 14th Congress of the ICMART (International Council of Medical Acupuncture and Related Techniques) in Riga, Latvia, in May 2010, and at the DÄGfA (German Medical Society of Acupuncture, Deutsche Ärztegesellschaft für Akupunktur) central office in Munich, Germany, during an acupuncture seminar and a meeting of the DÄGfA scientific committee in June 2010. The ICMART congress was characterized by an international ambience with therapists attending from all over the world. All acupuncturists present on the second occasion had studied acupuncture at the DÄGfA or were part of the DÄGFA faculty. Participants took part voluntarily, were over 18 years of age, held an acupuncture degree, and had a good command of written and spoken English. Overall, we polled 30 acupuncturists at the ICMART congress and 12 at the DÄGfA central office. DesignParticipants were asked to localize the APs LI 10 and TH 5 on the left arm of a member of the study staff and to mark them with a makeup pen. According to the textbooks, LI 10 is located 2 cun distally from LI 11 on the connecting line of LI 5 and Li 11, and TH 5 is found 2 cun proximal to the dorsal wrist crease between the radius and the ulna [28,29]. The person on whom the localization was performed was the same throughout the entire survey. Indicated locations for LI 10 and TH 5 were transferred immediately onto transparent plastic sheets ...

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Biomechanical response to acupuncture needling in humans

Cited by 210 publications

References 22 publications

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Measuring the Thickness of the Abdominal Wall at Abdominal Acupoints Using Ultrasonography and Analyzing Correlations with Physical Examination Values in Functional Dyspepsia Patients

Acupuncture point localization varies among acupuncturists

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