From a neuroanatomic perspective, the features of acu-reflex points can be summarized as follows:
1. Acu-reflex points exist in tandem with sensory nerves or tissues innervated by sensory nerves. Sensory nerve fibers are extensively distributed all over the body, except in the nails, hair, and part of the cornea. Where there are sensory nerve fibers, there are acu-reflex points.
2. The anatomic structure of acu-reflex points varies according to their location on the body, but the common structural element of all acu-reflex points is sensory nerve receptors.
3. The neuroanatomic configuration of acu-reflex points determines their pathophysiologic dynamics; thus some acu-reflex points are more likely to become sensitized than others.
4. Acu-reflex points are not discrete, static points; instead, they are dynamically changing structures. They appear and grow in certain pathophysiologic conditions. After healing is completed, some of them remain, although with reduced sensitivity, and some disappear.
5. The sensitivity of acu-reflex points may indicate injury to peripheral tissues, such as inflammation of the nerves, muscles, ligaments, joint capsules, and bones, or it may indicate that the sensitized neurons in the central nervous system have provoked sensitivity in the periphery.
6. The pattern according to which sensitized acu-reflex points appear is related to the anatomic distribution of the peripheral nerve trunks (on the limbs) and nerve fibers. Thus acu-reflex points on the arm or leg become sensitive in a linear pattern along the nerve trunk, primarily along the cutaneous nerves, whereas acu-reflex points on the back or face become sensitive in an area that follows the nerve endings of different nerve branches.
Pathophysiologically, there are three types of acu-reflex points:
1. Homeostatic acu-reflex points (HAs)
2. Symptomatic acu-reflex points (SAs)
3. Paravertebral acu-reflex points (PAs)
Each type of acu-reflex point has its own particular pathologic mechanism. However, the way each type has been defined is not absolute. A homeostatic acu-reflex point can also be a symptomatic point.
For example, the H8 infraspinatus acu-reflex point (see description under "Feature 5") is a homeostatic point, but for patients with shoulder pain, this point becomes more sensitive and is clearly a symptomatic acu-reflex point.
Paravertebral acu-reflex points merit special attention. Paravertebral acu-reflex points are located along both sides of the spine on the back muscles from the base of the skull down to the sacral area. These points consist of the nerve fibers from the posterior primary rami of the spinal nerves. Paravertebral acu-reflex points are closer to the roots of spinal nerves and sympathetic trunk ganglia. According to clinical evidence, these acu-reflex points may be more effective than other acu-reflex points in balancing the activity of the autonomic nervous system, even though every acu-reflex point in the body does balance autonomic activity to some extent. Needling paravertebral acu-reflex points also relaxes the back muscles, which eases pressure on the vertebral joints. This function is of benefit for most of the symptoms related to the back muscles and the spine, such as radiculopathy and osteoporosis. Sometimes a particular grouping of the paravertebral acu-reflex points may become sensitive, in which case the points in this section can also be regarded as symptomatic points. For example, in a patient with a stomach ulcer, sensitive points are palpable around the xiphoid process in front, but sensitive points may also appear on one or both sides of the spine from T7 to T12.
From a clinical perspective, paravertebral acu-reflex points do not have exact locations as homeo-static acu-reflex points and symptomatic acu-reflex points do, because the cutaneous branches of neighboring spinal nerves overlap each other. To achieve maximal results from needling, it is better to needle all the neighboring spinal nerves. For example, if postherpetic pain is related to spinal nerves from T5 to T6, needling is recommended from T4 to T7.
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