04 Sep Local vs Distal Needling; why my Acupuncturist doesn’t put needling into a painful area
Acupuncture aims to increase blood flow to an area of Pain or Injury but did you know that there are many ways of doing this! It may surprise you to know that if you visited two different Acupuncturists for the same issue, you may receive two very different, and yet highly effective Acupuncture treatments.
So lets look at the two most common forms of Acupuncture; Local & Distal Acupuncture
Local Acupuncture is when Acupuncture needles are inserted into site close or on the site of pain. Local needling aims to initiate a local immune response; forcing a local vasodilation and increase of white blood cells in the area. The white blood cells particularly the macrophages, will heal the needle damage and the existing damage from injury. However the question remains, why didn’t the white blood cells heal the local area? Why did we need to re-injure the local are with an Acupuncture needle to initiate this healing?
Our belief is that there is poor circulation in this area. Why?
There could be arterial damage in the area, a weak heart, blocked vessels OR another big problem. If the brain is receiving constant pain signals from an area then the circulation and motor function of this area will be inhibited. This is often why an area feels still and difficult to use, this prevents your from re-inuring an area through movement.
We know that Local Acupuncture can over a series of session resolve pain, it is thought it does this by a local effect not involving the midbrain. However there are also con’s of using this style of Acupuncture for me in particular that in many cases the pain is worse before it gets better. I generally like my clients to feel better as quickly as possible so I prefer the distal method.
Distal needling is when we use Acupuncture needles at a distant site to the area of pain. The area is a careful chosen area of dense nervous tissue, often near wrists and ankles. This provides signals to the midbrain via the central nervous system to release endogenous opioids (natural pain-killing chemicals) such as enkephalins, beta-endorphins, norepinephrine, and acetylcholine, and to stimulate blood flow to the site of pain. When the pain stops (thank you endogenous opioids!) the blood vessels open up and bring nutrients and oxygen to the injured area which allows the area to heal.
So in short, needling areas of higher nerve density = more brain stimulation = quicker pain relief and faster healing.
This style of Acupuncture allows our patients to move the area of discomfort in a prescribed manner if needed (something we call “Active Mobilization Technique” or AMT) while the needles are in place. Moving the area of discomfort, along with taking a few slow, deep breaths, helps to guide fresh blood and oxygen to the injured area. This in turn will decrease local inflammation and pain quickly. Importantly by using this method you won’t have more pain after your Acupuncture session!
- Some patients report immediate pain relief once the needles are inserted.
- For others a more usual effect is for a response to be delayed for a few hours or days.
- Patients who respond generally have greater and more prolonged pain relief with each subsequent treatment.
- The maximum response is usually achieved after 3–6 treatment sessions done in close secession.
- Needle insertion can cause various sensations such as heaviness, tingling, warmth and relaxation.
- Not all acupuncture points are trigger points and not all acupuncture points are tender.
- Sometimes needling of a trigger point must be specific for an effect but at other times the effective treatment area is quite variable and large; at times needling distant from the area of pain can give response (1).
Unfortunately there is no good quality studies of the two different methods, but the fantastic thing about Acupuncture is that every different style can be effective in the hands of a skilled practitioner. Some research suggest that even a combination could be effective (3).
There is no “best” form of acupuncture, there is only what works well for you. At Balanced Life Health Care we use and have a preference for the Distal Acupuncture Method, based on the teachings of Dr Tan, and use this effectively on a daily basis to get our patients feeling better quicker.
- D. Pyne and N. G. Shenker (2008); Demystifying acupuncture; Rheumatology 2008;47:1132–1136 doi:10.1093 Advance Access publication 6 May 2008. Found here
YU Peixun (喻培勋), GAO Bing (高冰), XIA Yujun (夏玉军) (2018); Meta-analysis of the effect of distal or local point selection on acupuncture efficacy; https://doi.org/10.1016/j.wjam.2018.05.005
About the author
Lauren Lanzoni is the Acupuncturist, Chinese Herbalist and owner of Balanced Life Health Care. To find out more about Lauren click here and to make an appointment to see Lauren at her clinic in Ferntree Gully click here