Analogies, N°1, between Mesopuncture (1) and Wet Needling (2).

Analogies, N°1, between Mesopuncture (1) and Wet Needling (2).

 (1) Fluid stimulus of the Acupuncture Point_ AP
(2) Injection in Trigger Point_ TP
Two administration modes of liquid drug: Either in the AP or in the TP.           
Publication in THREE parts. First part

Generalities
Trigger Points_ TPs
They are the most common cause, about 75%, of chronic musculoskeletal pain. TRAVELL and SIMONS, two doctors who described the TPs, define a TP as a tender nodule, a muscle knot in a palpable taut band of skeletal muscle.

·         The data for identifying the TPs are now considered to be:
Reproduction or aggravation of the pain usually experienced by the Patient.
Location of a taut muscle band.
Spot tenderness.

The TP is an irritable spot either spontaneously (active TP) or on digital compression (latent TP) able to generate either local or referred pain to other musculature, motor dysfunction and even autonomic phenomenon such as sweating, swelling, and ‘goose bumps’.

 Note. It is difficult to find ASHI Points with such properties.

These TPs may become activated by a variety of factors such as, poor posture, overuse or muscle imbalance.
TPs exhibit a local twitch response (muscle fasciculation) or a more global response, jump sign (flexion response) in reaction to digital pressure or Dry Needling (DN) or Wet Needling (WN).

Wet Needling_ WN
WN is the original method, proposed by two physicians, Drs. TRAVELL and SIMONS, to deactivate the TP by injection of a liquid drug into.

Acupuncture Point
It is described as a path starting in the epidermis and ending in the connective tissue.

Mesopuncture
Fluid stimulus of the Acupuncture Point_ AP or Mesopuncture is another stimulus mode of the AP proposed by the Chinese medicine, in addition to the metal needle stimulus or classical acupuncture

The fundamentals

In the book, ‘Précis d’ acupuncture Chinoise’ edited in 1977 by the Academy of traditional Chinese medicine from Beijing and intended for French-language students, one can read on page 292,Therapy by injection into acupuncture points,  a detailed description  of the treatment technique  by a liquid drug stimulus of the APs or Mesopuncture. 

In the books published in 1983 and 1999,Myofascial Pain and Dysfunction, the Trigger Point Manual, describing the fundamentals of TRAVELL and SIMONS work, can be found, in the chapter 'Methods to deactivate a trigger point’, among other methods to deactivate a TP, the original description of the WN.

The description of Wet needling treatment on Trigger Points_ TPs is identical to description of Mesopuncture or fluid stimulus on Acupuncture Points_ APs.

Whether it be to stimulate the AP in Mesopuncture or deactivate the TP in WN, we use liquid drugs and a vector of administration.

Liquid drugs used in Mesopuncture and WN.

      The liquid drug used depends on the medical expertise of the Therapist, his qualification in injecting liquid drugs and perfect knowledge of the pharmacology of each liquid drug used.

A variety of fluids have been injected into the TPs, including distilled water, normal saline, local anesthetics (procaine, lidocaine, bupivacaine), vitamin B solutions, long-acting corticosteroids, acetylsalicylate, and botulinum toxin.

It is possible to distinguish, liquid drugs

·         Without therapeutic effect, such as distilled water, saline…

·         With therapeutic effect of very long duration before reaching an efficient level: Trace elements, homeopathic remedies.

·         Whose physicochemical structure makes it possible to extend the duration of effectiveness as with some anti-inflammatory of the Western Pharmacopoeia used in the treatment of chronic TPs, for example or with hyaluronic acid

      The administration mode of liquid drug in Mesopuncture and WN

It should be noted that in Mesopuncture like in WN these are micro doses of liquid drug that are injected locally either directly in the AP or TP or indirectly around the AP or TP.

From the injection point in the skin, the liquid drug has the becoming of local injections:

·         At first, the liquid drug injected into a skin point, near the body area being treated, headed directly to this altered zone.