Power of Mechanism of Action: The science behind the needles used in the ancient healing of Acupuncture.

Power of Mechanism of Action:

The science behind the needles used in the ancient healing of Acupuncture.

Acupuncture is an Ancient Chinese healing procedure which is both an art and a science. From my research, thanks to Dr. C. Chan Gunn’s work who thought of removing the ancient tool or the needle to determine what is true. He investigated the science behind the action of the needle in the tissues. He then conceived of a procedure he calls Gunn-Intramuscular Stimulation or GunnIMS. His theory is based on the laws of nature and biology. Gunn places the needle into the muscles and tissues to stimulate and active healing. Plus the metallic needle depolarizes or “reboots” the sick contracted muscles thus releasing the muscle so that it can fully heal.

I’ve simply expanded on Gunn’s logic and concept to develop a theory of a possible “Mechanism of Action.”

Why?

The power of a “Mechanism of Action” in acupuncture can improve clinical outcomes and attack the source of long-term pain.

I am presenting this as a story of why it became important for me to do this. This is to go the Medicare and Health and Human Service our governmental agency which produced a law that we as physicians must follow or get fined or imprisoned. The data they use of write these laws are based in fallacy and thus wrong.

My letter:

It is fascinating what scientists are doing today to restore joint cartilage!

It is mind-boggling how chemists can uncover a medicine that will wipe out pain, or give a headache patient respite from pain.

It is fascinating how modern doctors can replace a joint for pain, can repair a slipped disc, fuse vertebrae, drill holes in the skull to pad between a trigeminal nerve and an artery, or reroute a nerve to treat pain.

What is even more mind-boggling is that NONE of those ideas, concepts or procedures is grounded in reality. They are ALL the wrong way to address the original source of the problem that is causing a patient’s pain. The original premises upon which the studies are based are wrong, illogical, and flawed.

So, why are doctors using them? They all were told to do so by an instructor, professor, drug representative, continuing education class, or board examination, and it is the law! They may lose their licences, go to jail, or be sued, if they do not follow the laws laid down by those specialists, special people, and those in charge.

I have found the last piece of the puzzle to understanding and effective treating long-term pain. I now know beyond any doubt:

• The source or root cause of long-term pain.
• Why people have long-term pain.
• Where that long-term pain is located.
• Why the long-term pain is present.
• Why that long-term pain is invisible and hard to find.
• How to use the set of tools to remove the source of long-term pain.
• What the best concept and plan is to remove the source of long-term pain.
• What mechanism of action of the tools is best used to remove the source of long-term pain.
• Did you know that someone in the AMA lodged a defamation campaign against Chiropractors? In my opinion, this was the beginning of the end of reality-based medicine.
• Did you know that this link leads to a regulation that is the “ground zero,” “the smoking gun,” or “nail in the coffin?” This policy contains many incomplete statements and, in essence, imposes barriers between patients and the correct treatment they deserve. In my opinion, this code or policy should be immediately re-assessed and re-written. Click So called “Local Coverage Determination (LCD): Trigger Point Injections (L33648).” This policy regulated the use of the procedure code for Trigger point injections, CPT 20552 or 20553.

We have always known the source of pain and have always had the tools to treat the muscles, which are the source of long-term pain. Thanks to information based on the work of Baldry, Burke, Chaitow, Craig, Cyriax, DiFabio, Gokavi, Gunn, Hackett, Helms, Lennard, Mann, B.J./D.D. Palmer, Pybus, Rachlin, Rapson, Seems, Simons, Starlanyl, Travell, and Wyburn-Mason.

This is where the logical comes from:

James Cyriax, MD:

He coined the term ‘Orthopaedic Medicine”. The basic principles of Orthopaedic Medicine are: 1) Every pain has a source. 2) Treatment must reach the source. 3) Treatment must benefit the source in order to relieve the pain. Most sources of pain in the musculoskeletal system can be localized to a specific tissue. We look carefully in a systematic manner to isolate the cause of pain, and then treat it specifically. A specific diagnosis leads to successful treatment.

Baldry, Janet Travell and Edward Rachlin:

These physician understood that pain was stored in the muscle. “All long-term pain and dysfunctions should be considered in the muscles and connective tissues or myofascial tissues until proven otherwise with Therapy." This means that sick MUSCLES are the source of all all long-term pain, malfunctions, dysfunctions, conundrums, misery without a cause, or “you look ok, why do you keep complaining.”

Muscles are the only organ system that need help from the owners to keep them free of stress and strains known as “micro-scars.” Micro-scars build up over time to cause pain and as time goes on without the proper care, these scars will devolve the hemodynamics of the muscles. This is where all the malfunctioning and dysfunctioning of many invisible illness comes are derived.

This is the flow of logic:

1. Every pain has a source.
2. Treatment must reach the source.
3. Treatment must benefit the source in order to relieve the pain.
4. The most common sources of everyday pain, aches and stiffness are muscles and connective tissues, the so-called “myofascial tissues.”
5. The cause of the source of muscle pain are from life’s stresses, strains, wearing, tears, rips, and micro-scars, the so-called “myofascial tissues.”
6. The most common presentations of MFP are knots, bands, sore spots, and tender spots in the muscles. These micro-scars accumulate and coalesce into these painful knotted patterns that you can feel with your fingers. These are called trigger points of myofascial pain (MF).
7. MF pain will project from a trigger point farther away from the point of maximum micro-scarring. Referral patterns must be considered and compared for confirmation.
8. These micro-scars in the myofascial tissues will further accumulate, and once a certain density is reached, will corrupt normal muscle functions, leading to uneven muscle movement. Also, these muscles will become renegade and contract, spasm, and tighten without reason and out of control. At this stage, the muscles then will cause pain that forms in known patterns. The most common known patterns are headaches, jaw pain, neck pain, shoulder pain, backaches, as well as knee, wrist, and foot pain syndromes. So, Migraines headaches are the direct result of the progressions of micro-scars in the muscles and the connective tissues.
9. As these micro-scars continue to grow in density and spread all over the body, they then will make the person feel sick. This stage of muscle disease is the most common cause of medical conundrums or invisible pain syndromes. So-called Fibromyalgia, Chronic Fatigue, and Chronic Pain Syndromes are all known as Myofascial Pain and Dysfunction (MFP&D) and should be treated until proven otherwise.
10. MFP&D is a progressive pain disease, and it will progress from innocent daily aches pains and stiffness into Complex Regional Pain Syndromes.
11. There are only 3 types of treatment options for Myofascial Pain and Dysfunction syndrome; A. hands-on and manipulative options, B. Thin needling, C. Hypodermic needling.
12. The best way to use these treatment options is in a Therapy Package.
13. The best way to find pain is by talking, touching, and using a needle, which is used as a probe or tool.
14. The best Therapy Package should include many holistic, self and assisted care options.
15. The best guide for the Therapy Package is the patient.
16. The best way to apply the Therapy Package is for the provider and the patient to have the freedom to personalize and customize the Therapy Package to meet the patient’s needs.
17. The provider must apply enough of the Therapy Package in order to relieve the pain.
18. If the Therapy Package fails to restore the patient to a healthier state of well-being, the provider must apply more intensity and effort into the therapy and/or go back to the drawing board.
19. Physicians should be on the frontlines to demand that these Therapy Packages are used at the beginning of a patient’s pain difficulties.

Gunn linked all the metallic needle tools to Cannon’s Law of Denervation. The stainless steel surgical tools could safely and effectively “re-injure,” plus (de)repolarize, tight, stubborn, and contracted muscles, which release and triggered them to relax and elongate. So, these tools can be viewed as safe, nontoxic, metal, wire-like probes and surgical tools.

Repeated-Reinjury-Reprogramming-Reconstruction-Reprocessing-Restoring is the only way to reverse the micro-scarring and refresh the stale intramuscular environment. These feats can only be accomplished with extramuscular stimulation with kneading, pulling, and twisting.

Extramuscular stimulation works in the early stages of the muscle disease. After a certain point extramuscular will be less effective at restoration. In these cases you will need an additional tool.

Intramuscular stimulation with by thin needling intramuscular tissues by poking, jabbing, stabbing and breaking up of the microscars and dense tissues. After a certain point then the thin needling will be less efficient at restoration. In these cases you will need an additional tool.

Intramuscular stimulation with a cutting tipped hypodermic needles the dense tissue by

cutting, mincing, dicing and slicing of the dense microscars for reprocessing.

Combining all the actions into a Mechanism of Action Theory, one can envision 6 events happening simultaneously to reverse the damages collected within diseased myofascial tissues:

1. These surgical tools are an advantage to only using your hands in the touch and palpation part of the examination. The examiner can effectively “reach into” the deeper layers of the muscles and fasciae. The examiner can thus “feel” these tissues to assess how they respond to the touch of the needles.
2. These tools are more valuable than MRIs because this is “real time” internal data and not data that is days old. All this is done via a pinhole incision which leaves no scar.
3. These surgical tools depolarize the contracted muscles, which causes them to relax, as per Cannon’s Law of Denervation. The result is that a relaxed muscle releases and does not apply compressive forces onto arteries, veins, nerves, which improves flow.
4. These surgical tools prep, break up, cut into, stir, and agitate the subcellular environment, which will improve the effectiveness of these healing cycles. Again, via a pinhole incision which leaves no scarring.
5. These surgical tools can also be used to examine distant areas that are prone to infection via spreading, and the metastatic tendency of diseased myofascial cells.
6. These surgical tools can stimulate the stiff, tight, muscle tissues through the pinhole to stimulate and agitate the healing cascade. The metallic needle tools are like “keys” that will ignite the natural healing cascade of wound repair.

http://en.wikipedia.org/wiki/Coagulation

http://en.wikipedia.org/wiki/Wound_healing

http://en.wikipedia.org/wiki/Platelet

I’ve simply expanded Gunn’s Intramuscular Stimulation procedure and separated all of the possible variations:

1. Fine filament intramuscular stimulative needling.
2. Fine filament tendon and ligament stimulative needling.
3. Fine filament tendon and ligament-attachment stimulative needling.
4. Fine filament periosteal stimulative needling.
5. Hypodermic intramuscular stimulative needling.
6. Hypodermic tendon and ligament stimulative needling.
7. Hypodermic tendon and ligament-attachment stimulative needling.
8. Hypodermic periosteal stimulative needling.
9. Biopuncture or Substance Hypodermic stimulative needling.

Vital point for completeness as it related to preventive proactive care of you muscles. I call this the:

The Holistic Healing Recipe-Self Care: In many advanced ancient cultures wellness and proactive care was a standard concept. Keeping balanced, harmonized, tending to the subtle requests of your body’s needs early on in the course of everyday pain. Daily self-care with a wholesome diet, herbs, extra vitamins and Magnesium supplements, exercise, stretching, yoga, heating with pads, hot tubs, hot springs, mineral springs, Epsom soaking, massage, kneading, rolling, scraping, acupoint or acupressure treatments, strain-counterstrain, unwinding, active release techniques, chiropractic spinal adjustments, traction and most importantly sleep hygiene. These self or assisted application of muscle maintenance care I will call:

• Selfcare hands-on with only manual labor extramuscular stimulative kneading.
• Selfcare hands-on with bars, balls and doohickies extramuscular stimulative kneading.
• Professional assisted hands-on with only manual labor extramuscular stimulative kneading.
• Professional assisted hands-on with bars, balls and doohickies extramuscular stimulative kneading.

****Do not be misguided, if extramuscular stimulative kneading does not restore you to peace and quiet, you must step-up you therapy and use metallic intramuscular needling.

The goal of therapy is restoration of your muscle back to a healthier state. NO so much just to maintain a holding pattern. It is 100% possible to restore muscles back to the best that nature can accomplish. We as owners of the body must not give into the limits placed by foolish folks. The “stainless steel wires” will assist the innate healing with the the additional benefit of depolarization and relaxation effect on contracted muscles as per Gunn-Cannon’s mechanism of action.

Here are the modern versions on this ancient needling therapy, which, in my opinion, validate the true mechanism of action of needle-based therapy:

1. Acupuncture.
2. Dry needling: http://dryneedlingcourse.com/what-is-dry-needling
3. Tendon and Ligament Injections as per Conventional Medicine.
4. Prolotherapy: http://en.wikipedia.org/wiki/Prolotherapy
5. Platelet Rich Plasma Injection Therapy: http://en.wikipedia.org/wiki/Platelet-rich_plasma
6. Stem Cell Injection Therapy: http://en.wikipedia.org/wiki/Wound_healing#Stem_cells_and_cellular_plasticity
7. Any modern procedure which uses a needle or steel probe or rods or doohickey is using this same MoA.
8. Here is another modern version of that is a travesty of science and humanity. This version uses a scalpel to cut into the myofascial tissue to fix something that is seen on a scanner. These back pain surgical procedures is based on flawed and implausible scientific evidence.

Human hands cannot “fix” long-term myofascial pain with corrective, rearrangement, removing parts, removing defects or reconfiguring surgeries. They are misguided and do not fit into reality-based, common sense-based, science-based, or evidence-based medicine. These surgeries should be put on hold until further notice.

In the meanwhile, we can apply the more realistic-based Therapy.

Vital Notes!

Pain can not primarily come from skeletal parts like joints, bone, cartilage, disc, menisci, bone spurs, joint space narrowing or stenosis. By this logic, all degenerative skeletal disease and disabilities are secondary to the primary contractile forces of the the sick muscles.

Pain can not primarily come from the vascular or circulatory systems as associated with an artery or vein.

Pain can not primarily come from nerves be they periperal, out the spinal foramen or within the skull. By this logic, Trigeminal Neuralgia, Occipital Neuralgia, Facial Pain Syndromes, Carpal Tunnel Syndrome, Tarsal Tunnel Syndrome, Diabetic Neuropathy, Peripheral Neuropathy all must be considered secondary to the primary muscle dysfunction and treated with MFRT until proven otherwise.

ALL cannot and are not the primary source of long-term pain.

Why Do You Feel Your Pain in the Bone or in a Joint?

The pain is not originating in your joint. You are experiencing a referred pain pattern. Myofascial pain will project into the joint as a 3-D image and make everyone believe it is in the "joint." NO! The pain is somewhere else. (Doctors ignore this fact.)

How Can Muscles Cause Joint Degeneration and Nerve Pain?

Myofascial micro-scarring drives pain and will shorten or contract muscles, pulling joints out of alignment, which causes them to function improperly. This causes the wearing, tearing and ulcerations on the cartilage.

So, if you insert something, such as a thin needle, into these misaligned joints, the forces of muscle movement will push the needle out of place, and the needle will not leave any lasting effects. Thus, the correct treatment for joint wearing, tearing, and misalignment is to treat the source of the pain and the pulling action. The source is the muscles!

Once you apply the proper therapy using hands-on manipulation and needling options the muscles will restore and become quiet and cooperative. Nature will automatically allow the knee joint to realign, thus allowing the wearing and tearing to heal.

Nature designed human joints to last for more than a 100 years, as long as we are proactive with caring for our muscles. Muscles are the only organ system of the 11 that needs to be kneaded.

Conclusion

If the full forces of Myofascial Release therapies are properly utilized to treat the source of pain, such as massage, kneading, stretching, thin and hypodermic needling, and injections, patients will not have to worry about long-term pain or  secondary and tertiary damages.

(Copyright 2015, Stephen S. Rodrigues, MD. All rights reserved)

All known therapies, principles and concepts must be apply to restore a patient back to a normal state of wellbeing.

Long-term pain treatment failures are the direct result of negating a huge amount of knowledge, science, protocols, treatment options, concepts, experiences and wisdom from these masters of medicine of the last century: Baldry, Burke, Chaitow, Craig, Cyriax, DiFabio, Gokavi, Gunn, Hackett, Helms, Lennard, Hamm, B.J./D.D. Palmer, Pybus, Rachlin, Rapson, Seems, Simons, Travell, Wyburn-Mason.

Any article that does not have within it these names should be considered incomplete and thus suspect in the world of truth, medicine and science.

The experiences of these authors can fill in all the gaps that have been opened up by many who have ignore these names and their work. Here are some of their principles:

All pain has a source.

All pain has a remedy.

All pain can be effectively resolved with the proper remedy.

The remedy has to reach to source.

The remedy has to benefit the source.

The remedy has to remove the source.

The remedy has to restore the source.

The remedy has to benefit the patient as a person with a mind, body and spirit all within a complex life.

The muscular organ system is the only logical system of the 11 which can PRIMARILY store stress and produce pain signals. (So nerves, bone, joints, disc, cartilage can not produce pain primarily. These structures can only produce pain secondarily)

• The muscular system produces an erratic, invisible pain signal. Meaning no blood or radiologic evidence of this pain. This pain is in the “itch effect stage.” How do you help someone who is complaining of an itch on their back? You must assist that person request as an obedient servant.
• The sickness in the muscular system can degrade to secondarily cause total system dysfunctions. ie Erratic BP or pulse, metabolic errors and immune issues. Then these muscles can contract and crush nerves and joint structures which can then be seen on technology instrumentation.

The patient is the only purveyor of the exact locations of the source of pain and where to apply the remedy.

The patient is the only purveyor who can confirm the source has been removed and the remedy is beneficial.

There are only 3 known effective remedies which are safe, logical, evidence-based, science-based and reality-based which can reach, benefit, remove and restore the source within involved muscles: 1. External to the muscles as in hands-on therapies with tools and manual labor. 2. Internal to the muscle bundles as with thin needling as per GunnIMS, myofascial acupuncture and dry needling. 3. Internally into the muscle bundles as with a hypodermic needling as per Travell/Hackett/Rachlin et al.

In my experience, the most efficient way to return a patient back to a state of total well being is to apply all 3 remedy concepts at the same time, weekly, until the patient is satisfied.

http://www.pudendalnerve.com.au/2015/05/30/dr-doidge-are-some-brains-more-plastic-than-others/#comment-151063

Your hands and Needles are the best set of tools in the history of medicine!

Your hands and Needles are the best set of tools in the history of medicine!

Thanks to C. Chan Gunn, MD and Dr. W. B. Cannon

Your hands and Needles are the best set of tools in the history of medicine!

I've been in medicine for 30 yrs and have studied many Masters of Medicine who contributed to the pain therapy. So if this comment sound arrogant, it is not. It is actually very reasonable, practical, logical and reality based.

Throughout history physicians used their hands to examine and collect the evidence to make assessments. Without the hands on examination the physician is literally working blinded. This is especially important in the history and physical examination of chronic pain patients where real time data can trump any evidence that is older that a few days.

The thin needle is the best single surgical tool in modern medicine for the treatment of pain that originates in muscles and connective tissues.

There have been many Master Healers in the last century who focused on chronic pain who have drawn similar conclusions. Chronic pain lived within muscles and connective tissues. They also realize that pain medications and repair surgery were fraught with haphazard results. The then discovered and concluded that injection therapy was much more predictable and curative without the rick and failures of amputation surgery.

One notable physician was C. Chan Gunn, MD who studied acupuncture was bold enough to rethink the action of the therapy and the needle. He found an older study on muscles that concluded that a muscle that was denervated could be caused to relax when short circuited. Gunn applied the concept to a stainless steel wire or needle. Thus linking the effects of the needles with real concrete data. When a scientist can linking a present concept with historical concepts of the past, this should give more validity to the new concept.

If needling therapies concepts could be incorporated into today’s Conventional Medicine treatment options for chronic pain health care cost would plummet as chronic pain problems would drop!!! Then overall well being rates would raise substantially.

Chronic pain treatments were known to live in muscles and connective tissues and had known possible treatment options. This was obvious and well accepted in the last century by many renowned physicians such as Gunn, Travell & Simons', Rachlin, Baldry, Seems, Helms, Rapson, Starlanyl, Hackett, Cyriax, Craig, Gokavi, Lennard, Burke, DiFabio and Pybus, B.J./D.D. Palmer, Wyburn-Mason and Chaitow.

These physicians knew that long-term or chronic pain was caused by stressed and damaged muscles. Over long periods of time these muscles collected damages and then coalesces into what we called trigger points (TrPs). TrPs can develop in any skeletal muscle, tendon, ligament, skin or bony attachments. TrPs generate pain signals, make muscles work erratically, contract onto nerves and spasm.

These tissues are called myofascial tissues and the pain is called myofascial pain and dysfunctions. These tissues cause undetectable or “invisible” types of pain syndromes. Invisible meaning that the evidence is not reality abiele for confirmation as with a tumor.

These tissues also susceptible to further degradation to cause even more pain plus cause many odd medical malfunctions and conundrums.

The treatment of myofascial pain and dysfunctions is called MF release therapies. The release is actually a type of microscopic re-injury process. You can release myofascial tissues with hands as with massage, with leverage as with yoga or spinal adjustments and finally with with metallic wires or needles.

All these authors used either hands-on, leverage options like kneading, pulling, stretching, unwinding and traction. Some used the metallic thin or hypodermic needles to effectively release or “re-injure” the diseased tissues, ignite healing and thus reverse muscles pain with automatic healing.

Gunn studied Acupuncture but then with logical and reasoning separated the thin needle away from the philosophy of Chinese Acupuncture. The metallic needle surgical tool is the key to the science and biology which can be formulated into a mechanism of action. With a mechanism of action (MoA), a provider can better understand how best to improve clinical outcomes.

Gunn thus linked all the metallic needle tools to the Cannon’s Law of Denervation. The stainless steel surgical tools could safely and effectively “re-injure” plus (de)repolarize tight, stubborn and contracted muscles which release and triggered them to relax and elongate. So these set of tools can be viewed as safe nontoxic metal wire-like probes and surgical tools.

Combining all the actions into a Mechanism of Action Theory, one can envision 6 events happening simultaneously to reverse the damages collected within diseased myofascial tissues:

1. These surgical tools are in an advantage to only using your hands in the touch and palpation part of the examination. The examiner can effectively “reach into” the deeper layers of muscles and fasciae. The examiner can thus “feel” these tissue to assess how they respond to the touch of the needles.  
2. These tools are more valuable than MRIs because this is real time internal data and not days old. All this is done via a pin hole incision with leaves no scar.
3. These surgical tools depolarizes the contracted muscles which causes them to relax as per Cannon’s Law of Denervation. The result is that a relaxed muscle releases and does not apply compression forces onto arteries, veins, nerves and improved flow.
4. These surgical tools preps, breaks up, cut into, stirs and agitate the subcellular environment which will improve the effectiveness of these healing cycles. Again via a pinhole incision which leaves no scarring.
5. These surgical tools can also be used to examine distant areas that are prone to infection via spreading and the metastatic tendency of diseased myofascial cells.
6. These surgical tools can stimulate the stiff, tight muscle tissues through the pinhole to stimulate and agitate the healing cascade. The metallic needle tools are like “keys” which will ignite the natural healing cascade of wound repair.

http://en.wikipedia.org/wiki/Coagulation

http://en.wikipedia.org/wiki/Wound_healing

http://en.wikipedia.org/wiki/Platelet

Here is 3- three modern takes on this ancient needle therapy. In my opinion validating the true mechanism of action of needle-based therapy:

1. Prolotherapy: http://en.wikipedia.org/wiki/Prolotherapy

2. Platelet Rich Plasma Injection Therapy: http://en.wikipedia.org/wiki/Platelet-rich_plasma

3. Stem Cell Injection Therapy: http://en.wikipedia.org/wiki/Wound_healing#Stem_cells_and_cellular_plasticity

This concept is a shocker to Conventional Medical physician and researchers!!

Any stainless surgical tool can be used in place of an acupuncture needle. Many if not all surgical instruments must  be it a surgical scalpel or an arthroscope. If the surgeon cuts and proves with any surgical tool he or she is inadvertently using Gunn-Cannon’s Concept of Healing.

Since the intended use of these tools is totally different, the results will be less than expected and the outcomes will be haphazard with tragic consequences. This is what we have in all aspects of the use of surgery to treat long-term pain.

Gunn’s insights are amazingly profound, safe, low-tech, highly effective and follows all the known laws of biology, physic and nature. http://www.istop.org/drgunn.html

Cannon WB, Rosenblueth A. The Supersensitivity of Denervated Structures: A Law of Denervation.New York: MacMillan; 1949.

http://books.google.com/books/about/The_supersensitivity_of_denervated_struc.html?id=kpQIAAAAMAAJ

http://www.theprovince.com/Pain+relief+pioneer+donates+million+sports+medicine+centre/10861226/story.html