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Get More Out of Your Zang Fu Treatments: Emphasis on the Middle Jiao
This short article, which is focused on getting more out of your Zang Fu treatments, encourages acupuncturists to learn a very effective point combination and simple thoracic vertebral mobilization technique for middle jiao disharmonies.
Figure 1. Spinal nerve pathway innervating the HTJJ, UB bladder lines and the front mu point.
As a licensed acupuncturist for 30 years, I have found that there are a few stand out treatments for middle jiao disharmonies.
This particular acupuncture point combination and vertebral mobilization technique on the fixated segment achieves significant clinical results.
This article will focus on the T8-T9 segment, but the needle techniques and vertebral mobilizations described can be applied to the thoracic spinal region level with the back-shu points of the affected organs.
Acupuncture treatment to the HTJJ, the back-shu and front-mu points of the affected organs, also known as Yin-Yang Therapy, is a very useful treatment method because these points all communicate with the organ due to their inherent neural connections (Fig. 1).
The HTJJ and inner bladder line are innervated by the dorsal rami spinal nerve. An anterior branch off of this nerve travels along the intercostal space to innervate the tissues of the front mu point. Acupuncture to these points signal the organ via the prevertebral sympathetic ganglion.
Figure 2. Side view of the vertebral column on a cadaver specimen, deep view. Skin and erector spinae tissue has been removed. 1.5-inch needle is inserted through the supraspinous ligament and into the interspinous ligament (IP). The finger is indicating
For an increased needle stimulation, needling the Du Mai tissues level with the vertebral fixation is another powerful technique to add to the point prescription.
When needling the tissues of the Du Mai, the needle depth is very important. More times than not, when needling into the interspinous ligament and applying needle technique, the qi sensation is propagated either up or down the spinal column and Du Mai trajectory.
When needling the Du Mai point, the needle will pass through subcutaneous tissue, the superficial fascia, into the supraspinous ligament and then deeper into the interspinous ligament (Fig. 2). Average needle depth for an adult thoracic spine is 0.75-1.15 inches.
The supraspinous and interspinous ligaments are innervated by the dorsal rami and are rich with proprioceptive nerve endings, which compliments the point prescription discussed previously.
This point prescription is up to the discretion of the practitioner and is to be combined with other body points to become a comprehensive treatment protocol.
In addition, when the spinal level associated with affected organ back-shu points is fixated (locked facets joints of 2-3 vertebral segments that decrease vertebral motion), this could directly affect the neural signal and communication to the organ.
I continue to be impressed by the combination of Yin-Yang Therapy point combination and using the simple manual method of mobilizing the thoracic vertebrae, for middle jiao organ patterns. Check out this video for a mobilization of T8-T9 vertebrae:
Matt Callison is the president of the Sports Medicine Acupuncture Certification program. He has been combining sports medicine and traditional Chinese medicine (TCM) for over 26 years. He is the author of the Motor Point and Acupuncture Meridians Chart, the Motor Point Index, The Sports Medicine Acupuncture textbook and many articles on the combination of sports medicine and TCM.