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Frequently Asked Questions

 

What is the difference between ahshi point and trigger point?
The notion of trigger point comes from a western medical approach developed by the pioneer work of the late Janet Travell, MD. A trigger point is a hyperirritable spot found in a muscle. That spot is tender on palpation and is accompanied by a taut band.
An ahshi point is a traditional Chinese concept which simply means a tender spot found during palpation. The term “ahshi” simply signifies the patient's reaction from the palpation of the tender spot. Ahshi point usually comes from a blockage of qi (energy) and xue (blood) circulation and can be found in any tissue (muscle, ligament, tendon, scar etc.).
It seems evident that many ahshi points found during an acupuncture treatment also fulfill the criteria of a trigger point. From a clinical point of view, there is not much difference between an ahshi point and a trigger point; they are merely two different concepts describing the same phenomenon.

How does a trigger point develop?
According to the so-called integrated hypothesis of Simons, a trigger point develops from a dysfunction at the neuromuscular junction creating a contraction knot in the muscular fibers. The contraction knot causes vascular congestion and, combined with the muscular dysfunction, it causes a metabolic crisis that perpetuates the trigger point.
The traditional acupuncture explanation of blockage of qi (energy) and xue (blood) circulation about an ahshi point does not lie very far from the scientific explanation of a trigger point.

What is a myofascial pain?
It means pain originating from a trigger point located in a muscle or its associated fascia. Myofascial pain is a common source of musculoskeletal pain. It also suggests that the alleviation of musculoskeletal pain often goes along with trigger point (or ahshi point) inactivation .

How can we relieve myofascial pain? In other words, how can we inactivate the trigger point?
There are many ways to treat myofascial pain such as stretching, massage or manual pressure techniques. However, only intramuscular needling provides the advantage of a direct contact with the trigger point. The patient’s energy profile is also an important factor in the efficient treatment of myofascial pain.

Why is deep needling important for the treatment of musculoskeletal pain?
Several studies have shown that better results are obtained through deep needling in comparison with superficial needling, especially in the long term follow-up. Deep needling generally means intramuscular, whereas superficial needling means subcutaneous. Other studies suggest that precise needling into the trigger point (or into the ahshi point) is necessary for the alleviation of musculoskeletal pain, whether the tender spot is located in the first muscular layer or in a deeper layer.

What are the dangers of deep intramuscular needling?
In many cases, the tender spot is located in a deep muscular layer or close to an important anatomical structure. Extensive knowledge of anatomy is necessary to make sure the acupuncture needle does not injure any structure such as an artery, a nerve or a viscera. For each ahshi point area, a strict needling procedure is strongly advocated. The procedure includes angle and direction of needling, needle length and a safe “landing site”, such as a bone, if possible. Knowledge of artery and nerve pathways in the vicinity of the tender point is also crucial.

 
         
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