Understanding Distal Acupuncture for Musculoskeletal Conditions
Acupuncture is a practice that has puzzled many, especially when needles are placed in areas far from the site of pain or injury and still manage to provide relief. A common response at Yin, when using these distal pain management techniques is a look of surprise (and relief) on people’s faces. This is usually followed with questions like “how does that work?”, and then us trying to explain many years of study in a few sentences. So we thought it would be helpful to explain distal acupuncture techniques here in a bit more detail.
When seeking relief from musculoskeletal issues like back pain, arthritis, or shoulder discomfort, patients often expect the needles to be inserted directly into the affected area. For those who have experienced dry needling, this local needling approach can be the sole focus of the treatment. Acupuncturists are also trained in this local needling approach (ie dry needling), however, this is just one of the techniques we may choose to use when treating musculoskeletal pain. As registered acupuncturists, we will almost always incorporate distal acupuncture techniques, based on our Chinese Medicine training. (More on dry needling later).
But How Does Distal Acupuncture Work?
To understand why we, as acupuncturists, might use various (and seemingly unrelated) parts of the body to treat the area of pain, it’s important to grasp the basics of meridian theory in Traditional Chinese Medicine (TCM).
In TCM, we see the body as a network of meridians or channels through which Qi (vital energy) flows. Each meridian is associated with specific organs and functions, and disruptions in the flow of Qi can lead to pain and illness. Musculoskeletal pain, from a TCM perspective, often results from blockages or imbalances in these meridians, or even from unprocessed trauma and emotions. While it might seem logical to treat pain by needling the area of discomfort directly, skilled acupuncturists understand that stimulating points on meridians that correspond to the affected area can be just as, if not more, effective. Recent research supports the efficacy of these distal needling techniques. A study published in Evidence-Based Complementary and Alternative Medicine (1) in 2021 examined the difference in effectiveness between distal and proximal acupuncture points in the treatment of knee osteoarthritis. The study found that the use of distal acupoints gave better pain relief and improved range of motion than the proximal acupoints. This suggests that the systemic effects of acupuncture can be activated by distal points. But how?
This approach, though initially seeming counter intuitive, is rooted in the rich traditions of Chinese medicine and acupuncture, and can be further enhanced using systems of acupuncture such as the Dr. Tan Balance Method and Master Tung’s acupuncture. In practice this may mean we are needling a point on your hand to treat a headache because it lies on a meridian connected to the head. We might also treat your back pain via various points on your arm, leg, head, or even ear, based on the relationship between these corresponding meridians and images.
Dr. Tan’s Balance Method
One of the methods that exemplifies this approach is Dr. Richard Tan’s Balance Method. This system is based on the concept of mirroring and imaging, where the body is seen as a hologram. For example, pain in the right knee might be treated by placing needles in the left elbow, as these areas are seen as reflections of each other on the body’s map. Dr. Tan’s method emphasises the importance of treating the entire meridian system, rather than focusing solely on the site of pain. The result can be almost immediate relief, even when the needles are placed far from the affected area.
Master Tung’s Acupuncture
Another influential method that employs distal needling is Master Tung’s acupuncture. Master Tung was a renowned acupuncturist known for his unique and highly effective system of acupuncture points, many of which are located far from the site of pain. These points are often referred to as “magic points” due to their ability to bring about rapid relief. Master Tung’s method utilises a small number of needles to create a significant therapeutic effect, often by targeting points on the arms or legs that correspond to the problem area.
Both the Dr Tan and Master Tung’s systems of acupuncture also treat what we call “internal” conditions. In practice, at Yin, this means we also use these techniques and systems to treat a range of non-pain related conditions – eg menstrual related phases (irregular periods, preconception, fertility support, menopause), sleep complaints, digestive issues and emotional wellbeing.
Back To That Comment About Dry Needling
We established above that dry needling is just one aspect of acupuncture (and is a technique used by acupuncturists, amongst others) but how is it different? Whilst Chinese medicine and acupuncture is an ancient tradition, dry needling is a more modern technique (and term) primarily used to treat musculoskeletal pain by targeting trigger points in the muscles.
As discussed, acupuncturists are also trained in these local needling techniques, however, this is just one approach used by registered acupuncturists. As Yin acupuncturists, we tend to take a more gentle approach and will almost always include a distal method as described above when treating pain. With our training in a whole systems Chinese medicine, our assessment of the body and your pain will take a more holistic view to consider any other imbalances may be occurring in your body (thinking back to the meridian system explained above). This can often mean a “bonus outcome” of your acupuncture treatment – ie you have come in for pain relief and then may find that another area of health improves (such as better sleep or digestion).
Another important consideration is the training requirement discrepancy between acupuncturists and dry needling practitioners. Whilst we have no doubt there are many very experienced and skilled practitioners of dry needling, we do have concerns about the minimal training requirement and lack of registering body.
Dry needling practitioners require as little as 16 hours in training before a practitioner can be qualified to perform the practice. There is no registering body and no legal requirements, except for local government regulations regarding the premises facilities where skin penetration is being performed. In contrast, acupuncturists are required to be registered with AHPRA and have significantly more training in acupuncture (and dry needling) as this is our primary modality. We would like to see a more rigorous training and registration approach to dry needling.
At Yin, all of our acupuncturists are degree qualified. We have all studied a four year Bachelor of Health Science, requiring hundreds of hours of anatomy and physiology, point location, safe needling techniques and years of supervised practice.
Why Acupuncturists Use Distal Needling
So, why might your acupuncturist place a needle in your hand when your knee is in pain? Apart from the fact that we are keen to use the training above and see the surprised look on your face…the answer lies in the understanding that the body is an interconnected system.
Pain is often not just a localised issue but a symptom of a broader imbalance in the body’s energy and meridian system. By needling distal points, acupuncturists aim to correct these imbalances along the meridians, which we believe leads to a more comprehensive and lasting relief from pain.
Acupuncture is a profound and complex system of healing that goes beyond merely addressing the site of pain. Techniques like Dr. Tan’s Balance Method and Master Tung’s acupuncture demonstrate that needling distal points can be highly effective for treating musculoskeletal conditions. By understanding the principles behind these methods, we hope you can appreciate the holistic approach of acupuncture and trust in the process, even when the needles go in places that seem unrelated to the pain they are experiencing.
References
Yu WZ, Huang CM, Ng HP, Lee YC. Distal Acupoints Outperform Proximal Acupoints in Treating Knee Osteoarthritis: A Randomized Controlled Trial. Evid Based Complement Alternat Med. 2021 Aug 18;2021:4827123. doi: 10.1155/2021/4827123. PMID: 34457022; PMCID: PMC8387169.