Dynamic Physiology Of Acureflex Points

Acu-reflex points have different anatomic characteristics in different parts of the human body. However, all acu-reflex points have one element in common: They become sensitized, or even painful, when there are pathologic conditions such as external injury or internal disease. Research data and clinical observation have improved the understanding of why acu-reflex points become sensitive.16,17 Table 7-1 lists a number of pain-producing substances that appear in the sensitized spots. An examination of the biochemical environment of those sensitized spots reveals that the pain-producing substances are almost the

Physiologic Parameters of Sensitized Acu-Reflex Points

Measurement of Biochemical Substances

Active TrPs* in Comparison with Latent TrPs and Normal Muscles

Pressure pain threshold

i P < 0.08

pH

i P < 0.03

Substance P

T p < 0.01

Calcitonin gene-related

T p < 0.01

peptide

T p < 0.01

Bradykinin

Serotonin

T p < 0.01

Norepinephrine

T p < 0.01

Tumor necrosis factor a

T p < 0.001

Interleukin-1ß

T p < 0.001

* TrPs, Trigger points.

From Shah JP, Philips T, Danoff J, et al: Novel microanalytical technique distinguishes three clinically distinct groups:

(1) subject without pain and without myofascial trigger points;

(2) subject without pain with myofascial trigger points; (3) subject with pain and myofascial trigger points [Abstract], Am J Phys Med Rehabil 83:231, 2004.

* TrPs, Trigger points.

From Shah JP, Philips T, Danoff J, et al: Novel microanalytical technique distinguishes three clinically distinct groups:

(1) subject without pain and without myofascial trigger points;

(2) subject without pain with myofascial trigger points; (3) subject with pain and myofascial trigger points [Abstract], Am J Phys Med Rehabil 83:231, 2004.

same as the biochemical substances released from injured tissue as mentioned in the previous chapter. The biochemical similarity between sensitized acu-reflex points and injured tissue indicates a physiologic matching between these two conditions, and it is possible that the sensitization of acu-reflex points is caused by inflammatory mechanisms similar to those that cause tissue injury.

Because acu-reflex points are distributed all over the body, their anatomic configurations are varied and depend on their location. For example, some acu-reflex points are themselves motor points; therefore they are neuromuscular in nature. Some are associated with nerve trunks and blood vessels; therefore they may be considered neurovascular in nature. Some are located in the bone foramina with nerves and blood vessels, and some are associated with ligaments and tendons innervated by both sensory and motor nerve fibers. Because of such diverse configurations, they have been given many different names, such as trigger points,2 acu-reflex points, neuropoints, and dermopoints. From the clinical perspective of needling therapy, all the points are termed acu-reflex points, because needling causes axon reflex responses at different levels of the nervous system. The prefix "acu-" indicates that many of the points are classic acupuncture points, although they are trigger points as well (acus means "needle" in Latin). In this way modern, biomedically based trigger-point medicine and the empirical wisdom of traditional acupuncture are combined into the INMARPS.

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