A Case Study Using the Hua Tuo Arc

I would like to acknowledge and thank both Matt Callison and Jeremy Steiner for their tireless work and dedication to advancing this medicine. This article is combining the work from Matt Callison and the SMAC program training and also lessons learned from Jeremy Steiner and his electroacupuncture training.

It is usually on day three of a weekend of SMAC classes where a hand goes up, then it goes back down, then it goes back up, then it goes back down, Matt looks at the student, smiles and asks if they have a question or are they just testing their range of motion in shoulder abduction. A light laugh, then the student asks, “How long does it take to use all of this information in clinic?” Then, the room buzzes with sound as multiple other students echo the question.

To understand and practice, SMAC takes dedication and time, it takes practice and most of all it takes a lot of studying. There are no shortcuts to know how to diagnose and treat the multitude of injuries that Matt has in his book, however, there are approaches to compartmentalizing your treatment to get the maximum results while you are mastering the rest of SMAC.

This is my attempt to give you a way of treating an injury in stages, while you master the diagnosis and treatment styles taught in SMAC.

Case Study: Treating anterior shoulder pain using the Hua Tuo Arc with a mixed approach of SMAC and EAM

Patient: 36yo Female

CC: Pain-L. Anterior shoulder, hurts more when raising the arm over the head, hurts when lying on the L. Side in bed. No loss of strength. No loss of sensation, no tingling in arm or fingers.

Pt. Hx:  Ex-college swimmer, 200m Medley. Has not swum in years, but is a computer programmer and has been writing code all the time. Hates to admit it, but she has been using a lot more caffeine than she would like and her diet is “not as good as it could be.” Studied music college and played violin professionally for the first 10 years after college. Recently started painting her guest room at home because she wants to make it a formal home office.

Exam

Pain when she raises the arm about 15 degrees over the shoulder.

Bilateral forward shoulders, forward neck, L. Scapula Elevated, R. Ilium elevated, bilateral forward pelvis tilt. Upper cross syndrome.

Manual Muscle tests: Weak L. Supraspinatus and caused pain at LI15.  Could not get her arm into position for L. Infraspinatus test. Patient felt too much pain.  L. Sub scapular is and Teres Minor tested normal.  Pain along L. Bicep tendon and L. Anterior shoulder when Bicep MMT was performed.

Working Diagnosis

Upper Cross Syndrome with Supraspinatus tendinitis or Qi and Blood stagnation in the upper Shao Yang Zone.

Treatment

Hua Tuo Arc

Needles: 

Prone Needles can all be done at the same time. Sensation in e-stim is light to moderate.

C3, C5, C7, T1 Bilateral with 2hz e-stim for 20min

Motor Points: Levator L. (Dijia), L. Si 13, L. Infraspintaus, L. Supra Spinatus – estim 2hz 10min, 150hz 8min

Supine Treatment: L. Pec minor, L. Pec Major x 2, L. Bicep, L. Anterior Deltoid estim-10hz

Discussion

This treatment can be broken down into stages:

Stage 1: The Hua Tuo Arc Points: This could be your entire treatment.  If you are pressed for time or you have not learned how to safely needle all fo the motor points, this eight needle combination can be enough to get relief from pain and discomfort for your patient.  The frequency of 2hz is going to release natural pain relievers, work as a neuroinhibitor and release anti-inflammatory signals to all the muscles along the myotomes of C3-T1.

Stage 2: Local Muscle Motor Points.  The MPs are selected based on palpation or other diagnostic testing such as MMT or Orthopedic tests.  Using a 2hz frequency first, relaxes the muscles and reduces the pain sensations in the muscles.  Adding the 150hz then increases blood flow and proprioception to the muscles.  I use this frequency combination for muscles that have been locked long or have lost their proprioception.

Stage 3: Completing the Hua Tuo Arc. The muscles in the anterior chest, bicep and deltoid are all part of the Upper Cross Syndrome and are locked short. The 10hz frequency in the MPs of these muscles is good for relaxing a locked short muscle.  The sensation should be medium, there might be light twitches, but you do not want to see the muscles jumping.  Too much stimulation will cause the muscles to have a negative reaction.  Always err on the side of to light.

Conclusion

This combination can be used on any part of the body, the key elements are to first identify which myotome you are working with.  Then through palpation or testing decide which two or three muscles are locked long and which are locked short.  USe 2hz at the Hua Tuo Arc points, 2hz/15ohz for the locked long muscles and 10hz for the locked short muscles.

About the author(s):

Darren Maynard

Certified in Sports Medicine Acupuncture® at Maynard Clinic of Acupuncture | Website