Part II-–What is an acupoint?
As I wrote in a previous article, I’m trying to clarify the difference between an acupoint and trigger point because it seems these two terms are often used interchangeably.
Briefly, a trigger point is a hyperirritable point that is located within a taut band of muscular tissue. Its presence indicates there has been some strain or stress to the muscle within which it is located, resulting in a shortened band of tissue. The effect is a muscle that is weak and whose function is compromised. There may be pain that is radiating away from the affected muscle, and there may be reduced range of motion of the joints that are acted upon by that muscle. Unless the trigger point is located and reduced through direct pressure or needling techniques followed by focal stretching, it will not be eliminated. Trigger points account for the vast majority of chronic pain our patients/clients encounter.
An acupoint is quite different. Acupoints are points that are located along pathways, called meridians, that have been defined within the context of Oriental medicine. (Meridians are sometimes called pathways or channels, and these terms will be used interchangeably in this article.) Fifty-four channels have been defined, forming an extensive network, or web, that allows access to the interior of the body from its surface. There are 12 organ channels, the primary channels, each one named for an organ or function. Each is responsible for a specific physiological function and process.
Every primary pathway has a superficial aspect and an internal aspect. The superficial aspect runs in clearly charted “lines” along the outside of the body. These are the pathways with which most practitioners are already familiar, but there are also internal pathways which branch off these superficial pathways. These internal, or deep, pathways connect to the organ for which the channel is named—at least one and often several other organs—as well as the pathways of other channels. The eight extraordinary vessels are considered to be lakes or ponds into which excess energy is stored and from which energy can be used to supply the primary channels. There are six divergent channels that link several channels deep within the system, 16 luo channels that connect the primary channels with one another and 12 tendinomuscular channels. Specific acupoints along the superficial pathways on each channel correspond with and are used to treat disease and dysfunction within the organ system.
Try to picture within your mind’s eye the web that is formed throughout and within the body when you consider the 54 pathways and their extensive connections with one another. Can you imagine the structure that is formed? It’s almost like a three-dimensional spider web.
This web-like system given to us from the Orient thousands of years ago bears remarkable similarity to another fascinating structure that has been studied as a whole within the last 15 to 20 years. I am referring to the network of connective tissues that exists within and throughout the body: the fasciae. Superficial fascia, lying just under the skin, covers the entire body; deep fascia lines the body wall and the extremities. It separates the musculature into functional groups before it differentiates to wrap individual muscles. It then further differentiates to enwrap bundles of muscle (fascicles) and then even further to enwrap each muscle cell. In addition to forming a network around and within the musculature, connective tissue permeates all other tissues and organs. The fascia allows for the movement of the musculature, it assists in support and stabilization, it carries nerves and blood vessels, and facilitates circulation of the lymphatic and venous systems. In his book Craniosacral Therapy, John Upledger, D.O. describes the fascia as “a maze which allows travel from one place in the body to any other place without ever leaving the fascia.” (Upledger and Vredevoogd, Eastland Press, 1983; p. 239).
Oriental medicine holds that it is through this system of “fat, greasy membranes” that one part of the body is connected to all other parts of the body. (Unshuld, PU, Nan Ching: Berkeley: University of California Press; 1986). In other words, the meridian system is based on and moves through the vast web created by the connective tissue. Studies conducted by Dr. Helene M. Langevin and Jason Jandow have found that the sites of acupoints have a direct correspondence to the locations of connective tissues planes. They have also identified a form of mechanical signaling that takes place through these tissue planes. In other words, they have, through modern scientific methods, identified the relationship between acupoints and connective tissue planes and the method by which acupuncture and acupressure work to affect a change in areas distant from the acupoints themselves (The Anatomical Record, 269:257-265, 2002).
Palpating along the meridians allows you to feel the fascial planes as the “spaces in between the muscles.” Palpating the meridians allows the practiced hand to assess qualities of the meridian, such as fullness or emptiness, and heat or cold, which then guides the practiced therapist’s treatment. With light palpation, acupoints will feel like little hollows or holes into which your finger falls. The studied use of acupoints produces specific effects on internal organs or systems.
So, let’s recap: Trigger points are focal points within a taut band of muscle tissue that produce changes in the muscle, such as weakness, reduced range of motion and aching pain, that radiate away from the muscle that houses the trigger point. Trigger points account for a vast majority of chronic pain patients/clients experience. Trigger points can be palpated as discrete nodules within a taut band of muscle tissue. Acupoints are specific points that lie along pathways (meridians) that have been defined thousands of years ago within the context of Oriental healing arts. The effects of acupoints are far reaching, affecting both organ and function. They are used in the treatment of disease and health maintenance. Acupoints can be palpated along a meridian pathway and will often be located in a tiny hollow into which your palpating finger will fall.
Acupoints and trigger points are very different, and they are used to treat very different things. Herein lie the very specific difference between acupoints and trigger points. When you are treating acupoints, you are looking at the body through the lens of the Oriental healing arts; you are working to alter the internal dynamic and affect a change in your patient’s health status. Trigger points are most often used in the treatment of pain and reduction of muscular injury.
Precision of thought guides precision of action: our touch, our treatments and by extension, the outcomes of our treatments. Acupoints and trigger points exist in two different realms of thought; they are viewed through two different lenses through which we see the patient/client. Each has its place; each has its use. When used appropriately, they are both extremely powerful healing aids.
Donna Finando, L.Ac., L.M.T. is co-author with Steven Finando of Trigger Point Therapy for Myofascial Pain, The Practice of Informed Touch (Healing Arts Press, 1999, 2005). She is the author of Trigger Point Self-Care Manual (Healing Arts Press, 2005) and Acupoint and Trigger Point Therapy for Babies and Children (Healing Arts Press, 2008). Finando maintains a private practice on Long Island, New York, where she’s lived and worked for more than 30 years.