Techniques of stimulation of the acupuncture points
ULTRASONIC STIMULATION (US)
US has many adherents in human and vet medicine, especially in treating soft tissue injury (muscle spasm, muscular rheumatism, tendinitis etc). In orthodox use, the US head is applied mainly to the area of pain or inflammation. In the Veterinary Record (1980, 106, 427-431), Lang reported treating 53 horses, and 143 dogs and cats with US. The conditions included sacroiliac, thoracolumbar, cervical, lumbosacral and coccygeal spinal lesions (50/67 successes); limb joint lesions (luxation, trauma, synovitis) (35/45 successes), trauma, lumbar spasm, paresis, swelling etc (29/33 successes); bone and joint lesions in horses (5/10 successes); soft tissue trauma in horses (22/25 successes). The average number of treatments was 2.7 per case. Rapid, complete recovery occurred in 64%.
The overall results are summarised below. Unfortunately these results were uncontrolled and it is not known what percentage of these cases would have recovered without treatment.
Success +++ ++ + Nil Total (n) 127 31 9 31 198 (%) 64.1 15.7 4.5 15.7 100
US, as a method of stimulating the AP points is used by medical more than by vet acupuncturists. It is used for many conditions other than soft tissue injury - US merely replaces the needle - and many of the conditions amenable to treatment by needling are also responsive to US. As with all other types of AP stimulation attention is paid not only to the local area of pain/inflammation but also to the AHSHI points and other APpoints which are active in treating the affected area. One of the advantages of US is that it is a fast method of therapy. American medical acupuncturists recommend 10-30 seconds/point. The manufacturer's instructions on maximum output and duration of treatment should be followed. A contact jelly must be used if the area to be treated can not be immersed in water.
Those of you who already use US in your practice will further increase your success rate and widen the scope for treatment of other conditions if you combine US with APtheory. It is also useful in treating local infection such as in the ears, vagina, nose etc. US therapy is especially good using the AP points on the human ear. In animals, however, we have much to learn about the potential of this method of treatment. As animal Earpoints are not fully documented, it is not possible to use earpoint therapy to the same extent as in humans.
LASER STIMULATION
Laser light (monochromatic, polarised and coherent) is another type of electromagnetic energy but the wavelength frequency is in the light range. The most common type of cold laser (power <50 mW/cm2) is the visible (red) light from He-Nelasers. Red light (ruby laser) is also used. Infra-red (I-R) lasers emit invisible lightbut the clinical effects are marked.
The power of cold lasers varies widely, from 1-50 mW/sq cm. Lasers emitting <10 mW/cm2 are not powerful enough to reach deep trigger points. For large animals, lasers emitting 30-50 mW/cm2 are recommended.
Most He-Ne and I-R lasers, even those emitting <5 mW/cm2, are effective in treating superficial disorders (cuts, bruises, granuloma, ulcers, wounds).
Rapid interruption of the light beam at fixed intervals is called pulsing. Pulsed lasers (especially those interrupted 2000-10000 times/second (Hz) penetrate deeper than unpulsed lasers.
Laser stimulators are available as robust, portable instruments. They are operated by batteries or by mains electricity. The laser probe is held within 0-5 cm from the skin and the laser light is directed to the point. Treatment time depends on emission power. With 30-50 mW lasers, dose time is very short, 10-60 seconds per point. There is no pain or noxious sensation. The method is ideal (if it works !) for treatment of Earpoints (when documented properly !) and all points on nervous or difficult animals, such as the points below the carpus and tarsus of horses. Cats tolerate the laser very well.
The commercial claims are for excellent results. Russian and German workers have used cold laser stimulation of the human AP points for some years now. Since 1984, there are many papers on the method in humans. (See "AP for immune-mediated disorders", Rogers 1990).
The use of cold laser in conventional veterinary practice (as a therapy for tissue trauma, wounds, granuloma, myositis, tendinitis etc) is growing rapidly. Laser is also be used in vet AP (instead of needles) to stimulate the AP points in animals but there are few published studies to date. The author (PAMR) has used a 30 mW I-R laser with similar results to those of EAP or point injection in horses since October 1989. However, there are reports that the lower power lasers (especially those <10 mW/cm2) are not as effective as AP.
Further work is needed to document the uses and limitations of laser, the effects of power, wavelength, different pulse frequencies, different exposure dosage etc. In the next few years, I believe that we will see much more use of electromagnetic types of therapy, including ultrasound, microwave and laser stimulation in medical and vet therapy.