Simultaneous stimulation of dual acupoints (SSDA) is a combination of a variety of needling methods per my personal clinical preference. The key point is "simultaneous." Stimulations can be with or without needles.
Among the ancient acupuncture methods, acupuncture with multiple needles at one point includes bang (side) needling, qi (alike) needling and yang (upward) needling.1 Acupuncture at the same time with front and back two acupoints is ou (double needling) / yin-yang needling;1 with two points on the same meridian is dan (carrying) needling.2 In addition, bao (report) needling involves repeated needling after the needle has been withdrawn, plus searching and pressing with your / your assistant's hand.
The acupuncture method used to select points far away from the disease site is yuandao (long-distance) needling, and the acupuncture methods used to select acupoint on the opposite side of the disease site include ju (giant) needling and mu (reverse) needling.1 In Liu's scalp acupuncture classes, needling dual acupoints techniques were taught.*
Clinical Discovery
It took repetitive clinical applications to learn and relearn which technique worked for which clinical manifestation. In one treatment for a patient with neck pain, the tension of the scalene muscle was outstanding and hard to relieve. Due to the difficulty of acupuncture at the anatomical position of the scalene muscle, acupuncture needling was switched to finger needling with one hand; as well as needling and tapping with fingertips at the same time with the other hand along the gallbladder meridians around the ear.
In about one minute, the scalene muscle was completely released under the finger. The transverse cervical processes, which were not palpable before treatment, could be identified one by one. The patient said she felt like "jelly" after the treatment, with the tension and pain in the neck relieved with longer persistence.
After that, the same and similar cases were treated with the same method, resulting in the same effects and effectiveness. Here is a summary of the methods, based on thousands of clinical applications from my practice.
Problems Addressed
SSDA is primarily used for neck pain with high tension of deep muscles and surrounding soft tissues. Often the presentation is related to internal factors, such as long-term mental stress.
Clinical Benefits
Physical Exam Findings
Muscular palpation reviews the level of tenderness, moderate to severe. Pain, increased tension, trigger points or hypertonicity may be noted.
Most related meridians are yangming and shaoyang; most related muscles are scalene, sternocleidomastoid, splenius cervicis, and semispinalis cervicis.
Treatment Methods
Other Applications
Simultaneous stimulation of dual acupoints has been applied to other conditions with some modifications. Most applicable conditions are pain related with increased muscle tension; the focal point(s) are where the pain or tension is, and the stimulation points are varied based on the condition. The rough summary of stimulation points below can be used as a reference:
Note: Needle manipulation, tapping with fingertips, finger needling and acupressure can be used interchangeably.
Take-Home Points
Why it works remains unknown. With SSDA, points stimulated at one time; often more than two or three. The stimulation time exceeds typical acupuncture needle insertion time to achieve tension reduction and pain relief. The simplest way to understand the effectiveness of SSDA is that the acupoint dosage and time dosage are higher than those of typical acupuncture.
Researchers have found that when�two sounds are played,�a single neuron can respond to one sound, then switch to�the second sound. The neuron's response appears to fluctuate between the two sounds. Sometimes the time the neurons takes to switch between two sounds is within a half second; in other cases the switch is slower. In addition, the same switching pattern is revealed when two faces are present.3
These findings may suggest what the brain must feel when more than one needling signal is present at a time with a limited set of pain- and tension-related neurons.
* The specific needling techniques learned from Liu's scalp acupuncture are limited to students in his class. This article is intended only to share my experiences.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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