Sunday, October 28, 2012

BIOPUNCTURE A CURE FOR PAIN

This is an article taken from Lee Wolfer, MD

An Alternative Cure for Pain: Biopuncture

The National Center for Health Statistics reports that approximately 4 in 10, or 75 million, Americans live with chronic pain (back pain, arthritis, joint pain, tendonitis, shoulder pain, nerve pain, overuse injuries etc). To put this into perspective, pain afflicts more people than diabetes, heart disease/stroke and cancer combined according to American Academy of Pain Medicine. Among other factors, we know that pain is more common in women, with increasing age, and also after traumatic injuries. Arguably, chronic pain needs to be on every physician’s short list of the top health issues facing patients.

Further research tells us that pain is one of the top 3 reasons for a patient to visit their doctor. What is wrong with this picture? What are we missing? The lack of effectiveness, as well as numerous, often serious, side effects of conventional treatments for chronic pain (e.g. medications, cortisone shots or surgery) are primary reasons that 40 million Americans look for a complementary alternative medicine (CAM) practitioner to help them find relief from pain. Common CAM therapies include: massage, manipulation, acupuncture, reiki, herbal medicines, homeopathy, vitamins, supplements, yoga, pilates, tai chi, qigong, etc.

New to such therapies is biopuncture, a recently introduced European injection therapy used to treat common pain and inflammatory problems. Although many injection-based therapies have been in existence for decades in Europe and the United States, the term biopuncture was coined by its founder, Belgian family practice physician Jan Kersschot, MD, in 1991. He introduced biopuncture to the United States in 2008.

Biopuncture is grounded in conventional diagnosis. Based on several decades of clinical experience and research, biopuncture is a safe, effective new tool to fight pain. It can be used alongside conventional treatments or when conventional or alternative treatments fall short. It is not a stand-alone treatment. Typically, in a sport, spine and pain practice, the best results occur when the patient can combine biopuncture with good nutrition, which improves their body’s ability to heal and lessen tissue inflammation. Exercise and physical therapy are important treatments used alongside biopuncture to give patients strength, endurance and better posture so the problem does not return.


How does biopuncture work?
Biopuncture is a therapy using mostly plant-based ultra-low dilution product formulas which are injected into specific body regions to relieve pain and inflammation. The majority of injections are micro-injections with a very small needle just under the skin or into the muscle. One of the benefits of directly injecting the area of pain appears to be a “turbo effect,” or a much faster healing response.

In conventional medicine, the drug you take suppresses your symptoms immediately. That is why you need to take high doses of chemical substances in order to suppress pain or inflammation. But as soon as the medication stops working, you have to take another pill to “kill the pain” again.

However, in biopuncture, small doses of products are injected in order to stimulate or “wake up” the natural healing processes. The healing effect comes from “inside” your body – not from the products themselves. It’s the reaction of your immune system, which will produce the proper reactions to regain natural healing.

What is injected?
The two most commonly injected products are ultra-low doses (ULDs or “micro-doses”) of mainly medicinal plant and mineral-based products and/or glucose. The plant and mineral derived formulas were introduced in Germany in the 1930s. Currently, more than 100 million injectable vials are used per year throughout Europe, and in the United States.

Glucose has been injected by primarily United States physicians for over 50 years for both its pain-relieving and inflammatory-regulating effect. Traumeel® is also thought to inhibit the release of pain- and inflammation-causing chemicals from nerves. Glucose stimulates the release of growth factors to repair tissue. Injections given just under the skin and into the muscle affect the peripheral nervous system, which is in charge of tissue repair and degeneration. The top neuroscience researchers are targeting the nerves in a pain region as the primary players responsible for directing the delicate balance between tissue repair and dysfunction.


How is biopuncture different from acupuncture?
Biopuncture is not the injection of homeopathic formulas into acupuncture points. Biopuncture does not follow acupuncture meridians; the skilled practitioner instead looks for local “pain points” and “origin points” in the affected region. A pain point is likely to be a tender superficial nerve, inflammed tissue or trigger point (muscle knot).

What are the most common micro-dose formulas used in the US?
The most common products used in sports medicine and pain practices are Traumeel®. Lymphomyosot®, Spascupreel® and Zeel®. Traumeel® is used to reduce pain and swelling. Lymphomyosot is used for lymphatic drainage. Zeel® is used for arthritis. Spascupreel® is used for muscle spasm. Each of these formulas contains a combination of botanical and mineral ingredients, i.e. Traumeel ® has arnica montana to reduce swelling, comfrey to decrease joint pain, chamomile and St. John’s Wort to reduce pain, and calendula (marigold) and echinacea to stimulate the immune system. The product which is best researched and most widely used in oral, topical and injectable forms is Traumeel®. (Ed. note: The author has no financial relationship with Traumeel®; however, much of the published research focuses on this product.)

What conditions are typically treated with biopuncture?
The common factor is pain and inflammation, be that in a soft tissue or joint or in the lining of the respiratory or gastrointestinal tract. Each of these tissues has nerves that become chronically inflamed and cells that secrete chemicals that initiate and maintain pain and inflammation.
  • Musculoskeletal problems: sprains and strains, joint pain, tendonitis, plantar fasciitis, shoulder pain (rotator cuff syndrome, impingement), mild to moderate arthritis, back/neck pain, nerve pain, painful scars, residual pain after surgery
  • Medical problems: asthma, hay fever, irritable bowel, eczema, bronchitis, migraine headaches and irritable bowel syndrome


What kind of physician can practice biopuncture?
Make sure you work with an experienced doctor or skilled and ideally a licenced acupuncturist. The physician must be knowledgeable about biopuncture. They must have superior knowledge of anatomy and great skill with injections and acupuncture. Each case must be individualized.

It is also important to note that plant-based or herbal medications should only be given by a qualified physician or licensed professional. (Remember, just because a product uses the word “natural” does not necessarily make it safe and effective.) In a few states and provinces like BC the medical boards have granted injection privileges to non-MDs, such as licensed acupuncturists. Biopuncture is not covered by insurance at this time and prices vary by the practitioner.

How safe and effective is biopuncture as compared to conventional treatments?
Common over the counter and prescription NSAIDs and steroid injections in fact may not help (particularly in the longterm) and may cause harm. The current best evidence for use of NSAIDs suggests it may be helpful in the short-term for 1-2 weeks, but longterm use is associated with increased risk of gastrointestinal, cardiovascular, kidney complications and death. Also, increasingly, animal research is showing that use of NSAIDs may interfere with the normal tissue repair process and ultimately weaken the tissue and increase the chances of a recurrent problem. In terms of safety and side effects, we know that steroids are sometimes necessary; however, a single knee injection can suppress the immune system for a month.

What can a patient expect if they choose to pursue biopuncture treatment?
Most people, unless they have a true needle phobia, are surprised by how well they tolerate the injections. Very small needles are used for the majority of injections. The number of injections per session depends on the nature and severity of your problem.

An elbow problem typically requires 5-10 specific injections. Common ankle sprains or acute injury heal within a few weeks, usually more quickly than if left without treatment. Chronic pain over many months or years may require several weeks or a few months of treatments. I tell most of my patients that they will have treatments up to about 2 months; usually by week 4, both the patient and I can see objective results. If a patient has significant medical illnesses, the course may be longer or ineffective. This treatment does require more patience than cortisone injections for instance because we are trying to heal the problem and not simply suppress the symptoms. Biopuncture is not meant to treat serious illnesses such as infections or cancer. Patients with severe depression, fibromyalgia, auto immune disease (lupus), multiple sclerosis or other major illness may not respond at all or may only be partial responders.

Symptomatic relief may take a while, especially when the problem has been there for months or years. However, when dealing with fresh injuries, these injections can give results very quickly.

FOR MORE INFORMATION ON BIOPUNCTURE Please email kscrimgeour@hotmail.com

Saturday, October 27, 2012

Myofascial Pain Syndromes and Acupunture Point Injection Therapy




Myofascial Pain Syndromes and Acupuncture Point Injection Therapy

By Kevin Scrimgeour R.Ac. 

NOTE: The following I have used the term trigger point this is not the same as standard anatomical trigger points. These are acupunture ashi or tender points related to stagnation of energy flow and this creates pain. The term trigger point used here are used for simplicity and I will further explain the difference between what an acupunturist means by a trigger point and what a medical person means. Below is more of a medical explanation for simplicity sake and brevity. 

How do I know if I have Myofascial Pain?


In order to understand if one has myofascial pain (MP) one should know that 70% of all pain problems seen in any doctors office are MP syndromes. The remaining 30% is from other causes but always has a secondary MP component. Hard to get away from these stats. Myofascial simply means originating in the muscle and its related tissues. Muscle comprises 40% of the total body mass and makes up most of our physical body. We all have tight bands of muscle that can cause injury and pain it is a part of aging. Where these tight bands are sensitive it is designated as a trigger point. These can exist at different levels of sensitivity, not so tender are called latent and very sore would be called active. These problematic triggered muscles can cause all types of pain and often are overlooked by most physicians. For example foot pain could be referred from a muscle that is chronically tight and sore in the calf or even hip. MP can be the main cause of aggravation to a tendon or joint and even strangulation of a nerve or blood vessel resulting pain, numbness or slow recovery. Trigger point injection therapy is a short term solution to treat pain permanently not manage it for a long period.

Why get Point Injections why not just use massage or other less invasive treatments for Muscle or Myofascial Pain.

Good question and yes you should get massage, stretch, use hot packs, exercise the muscle, see a podarthist, physio or a podiatrist they can all help with myofascial pain as well. However and this is a big however, Janet Travell (MD) who was the originator of the term trigger point (and was also the first female to be head physician to the president of the US, John F. Kennedy) and she researched with a team, many medical treatments to clear Myofascial Pain Syndromes. She realized many patients after surgery, physio, massage and a variety of other interventions still had myofascial pain. The only technique that worked when all else failed was injections into the trigger points themselves. So if you have tried many other treatments and still keep getting the same type of pain then trigger point injections are often the only thing that will be able to resolve and treat your pain. Also if you want to increase your recovery time with other inventions trigger point therapy will help with that too. Since most injuries or pain will create an active or latent muscle problem as well.

Are trigger point injections painful and do they always help?

Neurotherapy injections are painless and available if one is worried about deeper injections. Trigger point injection therapy when done by a licensed and well trained sensitive and attentive therapist are often interesting in sensation as you feel the muscle being released. The muscle will twitch and some people really enjoy the feeling. It can be uncomfortable which is why every measure is taken for safety and comfort. The results are worth it, frequently instant and significant. It is often the only treatment available that can move an injury from pain management to pain treatment.

Yes they always will help. However, in chronic or difficult cases it takes time for the muscle to regain its normal function and one treatment is not realistic. Clearing a trigger point is the first step and all that is needed If the muscle is properly mobilized, stretched, gets adequate nutrition, is not stressed, and rested properly at night. If you have or are able to create this therapeutic environment for your injury then more treatments will not be necessary.

EXAMPLES OF ACTIVE AND LATENT TRIGGER POINTS?

Active myofascial trigger point
  • Refers a pattern of pain at rest or at motion.
  • Usually refers pain on direct compression.
  • Mediates a local twitch response.
  • Tender to palpation.
  • Prevents full lengthening of muscle.Weakens the muscle.

Latent myofascial trigger point.



  • Clinically quiescent with respect to spontaneous pain.
  • May refer pain.
  • Tender to palpation.
  • Prevents full lengthening of muscle.
  • Weakens the muscle.
  • They accumulate from all of the vast number of physical things that happen to us.
  • If all our trigger points remain latent we gradually become stiffer and weaker.
  • If some become active we experience myofascial pain.

How does Myofacial Pain relate to the cause of sports injuries?

Myofascial theory sees almost all injuries as due to tight bands in the muscles. Muscle tearing can be present as a result of a fall or other event. The tear is seen as self limiting it will heal itself but the true cause is the tight band and treatment should be directed there. Otherwise the muscle will not work nor will the joint it is connected with. The tear a result of poor flexibility or strength of the muscle due to a tight band. Sports injuries are a good example because the person is healthy otherwise and so not other factors are present other than a stress on the joint or muscle in the event of an injury.

Treatment for any sports injury is heat, never Ice, stretch, massage, mobilization and trigger point injections. Massage, orthotics, acupunture, herbs, nutrition all will support the healing process and slow the formation of future tight bands. Injection for almost 20 years is seen to be the most effective way to clear problematic tight muscle bands.


How are common Myofascial Pain Syndromes treated?

Simple problems: Can begin treatment immediately and see what happens. Sports injuries for example require about 30 minutes or a half session. Injection(B12 and procaine) with heat and stretches with home stretches. Most will recover in 1 to 3 sessions.

Difficult problems: If a complex history of treatment but healthy otherwise can begin treatment immediately may take anywhere from 1 to 5 or more sessions depending on other health factors and what medical treatments have been tried previously.

Complex problems: Severe accidents or illness as well as pain. Need to examine all the other factors that perpetuate trigger points, diet, sleep, stress ect. A good therapeutic environment, communication with family doctor and other professionals and detailed history must be established before proceeding.