Canadian RMT Magazine Spring 2016 Volume 1 - Page 22

Neurofunctional Acupuncture: A mechanism-based model for pain treatment By Alejandro Elorriaga Claraco, MD (Spain), Director McMaster Contemporary Acupuncture Program P ain problems involve a complex combination of movement dysfunctions, sensory signals, and emotions. To treat pain successfully we need a treatment model that considers all relevant contributions by the nervous system such as peripheral and central sensitization phenomena. A great contemporary therapeutic intervention based on that model is neurofunctional acupuncture, a science-based modality with multiple effects in the central and peripheral nervous system. In a simple definition, neurofunctional acupuncture consists of the stimulation of peripheral nerves and their receptors with acupuncture needles and electricity for therapeutic purposes. Effects to this stimulation include the production of analgesia in muscle pain by at least two specific mechanisms: 1) improvement of perfusion in the painful muscle mediated by autonomic vascular reflexes and the release of nitric oxide; 2) activation of central endogenous pain inhibitory systems that modulate nociceptive traffic at the spinal cord. Based on a review of 228 basic research studies, professor Bruce Pomeranz offers this explanation of acupuncture analgesic effects: acupuncture needles stimulate small myelinated A-delta fibers and the type II-III muscle sensory afferents, triggering the release of different neuropeptides and neurohormones such as beta-endorphine, ACTH, and others with the overall effect of general modulation of pain and the regulation of several neuroendocrine and immune functions in the central and peripheral nervous system (spinal cord, supraspinal centers in the mid-brain, the hypothalamus, and the pituitary gland). In addition there are well-described potent anti-inflammatory effect in response to neurofunctional acupuncture, as well as regulatory effects on digestive function, cardiovascular system, and other autonomic nervous system controlled functions. The wide array of effects is due to the multilevel response— local, spinal segmental, and supraspinal—induced by the stimulation of relevant neuroreactive sites to the problem (dermatomal, myotomal and sclerotomal sites). Most important neuroreactive sites are: neurovascular bundles on the limbs, sensory nerve trunks, muscle bellies where muscle spindles are, motor points, muscletendon junctions (Golgi tendon organs), teno-periosteal attachments, and joint capsules and ligaments (with different mechanoreceptors). Neurofunctional acupuncture is the ideal modality to integrate with manual techniques such as massage therapy, as it combines sciencebased neuroanatomical and neurofunctional approaches. The neurofunctional approach is mechanismbased and consists on a simple three level modulation model: peripheral nervous system modulation, central nervous system spinal and supraspinal modulation, and neurohumoral and neuroendocrine effects for systemic regulation. Each level of modulation is accomplished using specific stimulation parameters, including location of the insertion and electrical frequency used. The full model provides a perfect platform for the future evolution of massage therapy approaches to the complex task of helping pain sufferers. To learn more about neurofunctional acupuncture training go to: acupuncturecourses.com or call Valerie at 905-521-2100 ext.75175. 22 Canadian rmt Alenjandro_Feature8.indd 22 2016-03-02 9:17 PM