The parallel relationship between acupuncture and massage

The parallel relationship between acupuncture and massage is essentially a collaborative relationship based on the theory of meridians and viscera of traditional Chinese medicine, with complementary action paths and clinical combination efficiency is usually higher than that of a single therapy, rather than an either-or substitution relationship. There is no unified standard answer for the combination of the two, and the logic of use in different clinical scenarios and different schools of traditional Chinese medicine varies greatly.

Not long ago, I met a programmer who had a stiff neck in the clinic. When he entered the door, his neck was so crooked that it felt as if a lock button had been pressed. When he turned his head, his entire upper body rotated with it. He said that he stayed up late the night before to change code and fell asleep for half the night, leaning on a chair. When he woke up, he couldn't move. I first massaged his neck and shoulders for fifteen minutes, and most of the hard knots on his trapezius muscles were softened. However, he said that when he turned to the left, he still had pain in his back shoulders and could not turn in place. After that, an acupuncture was inserted into the Stochastic Point and Houxi Point on his hand. During the acupuncture, he was asked to slowly try to turn his neck. After only half a minute, he said "Hey" and said that the pulling force suddenly dissipated. Finally, he was given five minutes of relaxation techniques along the meridians of his neck and shoulders. That afternoon, he sent a message saying that he had returned to the meeting normally.

Don't tell me, this combination of "press first, then prick and then press" works smoothly for me, but Dr. Li, who is a practitioner in the clinic next door, doesn't agree with this logic. He always said that when massaging, he rubs the surface layer first, which can easily disperse the qi and blood. When acupuncture is used, the feeling of qi will be much weaker. He prefers to use acupuncture first to open up the inner channels of qi and blood. The mobilized qi and blood will reach the blocked areas, and then use light hands to massage and guide the qi and blood floating on the surface to the deeper muscle layers, so that the effect will be more lasting. We have argued about this matter many times, and we have tried two solutions on the same patients with muscle strain. In the end, we found that both are effective, but the suitability for different people is different - patients who are afraid of needles are massaged first to relax, and there is basically no pain when the needle is inserted, and the compliance rate is very high ； For those who have weak qi and blood and have a poor sense of qi after acupuncture, first acupuncture to mobilize qi and blood and then massage, the probability of subsequent soreness will be much lower.

What’s interesting is that not only is the order controversial, but under what circumstances it can be done in parallel, the opinions of different schools are also very different. Take acute lumbar sprain as an example. Most traditional trauma schools require no massage during the 24-hour acute period. They say that the soft tissue is already edema and congested, and pressing it will only aggravate the leakage. At this time, only the corresponding acupoints such as Renzhong and Weizhong will be pricked to relieve pain. It is safe to wait for 72 hours for the edema to subside before performing relaxing massage. ； But Dr. Zhang, who does flexible bone setting, doesn’t see it that way. When he encounters patients with acute lumbar sprains, he will first use very light kneading to press the muscles around the edema area to loosen the compressed tension, and then use acupuncture to eliminate the edema. Many patients can walk on the same day, and the recovery speed is faster. I have tried it several times myself. As long as the intensity is well controlled, the symptoms will not be aggravated. In the final analysis, it depends on the operator's control of the intensity.

In fact, to put it bluntly, it is easy to understand if you compare the meridians of the human body to the water supply pipes in an old community: massage is a "face" skill, whether it is rolling, kneading or stretching. Most of the effects are on the surface tissues such as muscles and fascia, which is equivalent to first removing the mud and plastic bags wrapped around the outer walls of the water pipes to relieve external compression.； Acupuncture is a "point" breakthrough. The needle tip penetrates into the deep meridian points, which is equivalent to poking twice at the mud blocked in the water pipe to open up the inner blockage. If you put them both together, the water will flow naturally much faster than just one layer. But this is not absolute. If there is just a little dust on the outer wall of the water pipe, it is enough to just wipe the outside and not poke the inside. ； If the inside of the water pipe is tightly blocked but nothing is wrapped around it outside, you can still get through just by poking inside. Just like ordinary shoulder soreness caused by colds, it can be relieved by pressing it for 20 minutes. There is no need for acupuncture. ； For patients in the acute stage of facial paralysis, if the massage intensity is not controlled well, it will irritate the edematous facial nerve. At this time, acupuncture alone is safer than combined massage.

I have been practicing clinical practice for almost ten years, and I have never set any fixed rules for the parallel use of acupuncture and massage. Sometimes I meet a mother who brings her baby. She has a protruding waist and has to hold her baby. I just give her a few quick injections, which saves time and doesn’t require her to take off her clothes and lie down for a long time. ； I met a retired aunt who had a lot of time and was afraid of needles, so I massaged her for a while and inserted two shallow needles at key points. She was not afraid and the effect was not bad.

In the final analysis, the parallel relationship between the two has never been a hard-coded formula in the textbook. The core is always to focus on the needs of the patient, which can make the person suffer less and recover faster. No matter how it is combined, it is right.