The parallel relationship between acupuncture and massage

The parallel relationship between acupuncture and massage is essentially a collaborative relationship that complements each other and adapts to different disease stages in the external treatment system of traditional Chinese medicine. It is by no means a simple superposition of effects, and there is no either-or competition. The benefits of combining the two are much higher than a single method, but it is not applicable to all scenarios.

I met a young man with a stiff neck a while ago. He was a 32-year-old businessman. When he came, his neck was so stiff that it seemed like it was stuck with 502. When he turned his face, his whole upper body moved. I touched the sternocleidomastoid muscle on the side of his neck. It was as hard as a sun-drenched old bamboo pole. I pressed him and he hissed in pain. In the past, I would have directly inserted the Stiff Neck Point and the Ah Shi Point, but that day the masseur happened to be free, so I asked him to use the rolling method on the young man's shoulders and neck for five minutes, and softened most of the tight ropes before inserting the needle. I was so angry that I pressed his tense trapezius muscle during the 20 minutes while the needle was in place. He could turn his head 80 degrees on the spot after the needle was applied.

Don't tell me, there are really big differences in how different schools match the two. In my early years, I studied with an old orthopedic surgeon in Shandong. He always insisted on "pressing first and then acupuncture" all his life. He said that when the tendons are blocked, the acupuncture points are wrapped by tight muscles, and the patient's breath will be slowed down when inserted. But later I went to the South to attend an academic conference, and the acupuncture school there did not recognize this principle. They felt that it was impossible to touch during the acute pain period. For example, patients with acute attacks of gout and postherpetic neuralgia would jump at the slightest touch. At this time, it would be safer to insert acupuncture first to reduce the pain area, and then massage to smooth out the surrounding qi and blood after the patient can withstand the touch. I have tried both of these ideas, and they do have their own reasons. No one is right or wrong, it all depends on the patient's situation.

Of course there are dissenting voices.

Many doctors in the Western medicine rehabilitation department feel that the mechanism of action of acupuncture is not yet fully understood. If the intensity of massage is not well controlled, it will cause soft tissue damage. The two together are equivalent to superimposing risks, which is unnecessary. I have also encountered patients who had problems with random combinations. Last time, a girl finished the Hegu injection at home to treat dysmenorrhea, and then went to a massage parlor to massage her shoulders and neck for half an hour. It was just ordinary menstrual backache, but her shoulders and neck became swollen the next day. She was almost crying when she came to see me. When I asked, I found out that she had not done a good job of disinfecting the injection, and the massage dispersed the small local bleeding, causing a subcutaneous hematoma, which took almost a week to disappear.

In fact, to put it bluntly, the relationship between the two is very much like unblocking a clogged sewer: acupuncture is equivalent to breaking open the hard lumps that are blocked in the sewer, while massage is to remove the heavy objects that are pressing on the water pipes. Sometimes, just by breaking out the hard lumps, the pressure on them is too strong, and the water still cannot flow.； Even after removing the heavy object, the hard lumps inside were not removed and the water flow was still small. Our outpatient clinic is currently making plans for patients with chronic strain, such as those in the remission stage of lumbar disc herniation. Generally, acupuncture points such as Yaoyangguan and Shenshu are first inserted. During the 20 minutes of leaving the needle, the Weizhong and Chengshan of the lower limbs, as well as the tight piriformis muscle of the buttocks, are massaged. After the needle is removed, a three-minute lumbar spine stretching method is performed. The recovery rate after follow-up is at least 30% faster than acupuncture alone or massage alone.

Of course, contraindications must also be clearly understood. Patients with coagulation disorders and skin ulcers should not touch them.； For people with severe osteoporosis, do not use brute force for massage or deep needling for acupuncture. ； If an acute sprain occurs within 48 hours, do not massage blindly. It is more serious to perform acupuncture first to reduce swelling and pain.

There is no 100% perfect combination. It is all adjusted according to the patient's condition. Just like when eating dumplings, some people like vinegar and others like garlic. Suitability is the most important thing.