Chronic pain and insomnia are two of the most challenging conditions to treat. Due to the recalcitrant nature of these conditions, patients often become extremely drained both physically and emotionally, which consequently leads to significant kidney deficiency and deep-seated blood stasis, and a downward spiral that can be extremely challenging to shift.
In cases of chronic pain and chronic insomnia in which the standard protocols of differential diagnosis provide only temporary relief of symptoms, I use a three-point acupuncture prescription, inspired by my practice of Zhan Zhuang Qi Gong, which has shown to provide significant improvement. The three-point formula I use for these stubborn-to-treat issues is:
Kid 1 + LI 11 + Du 20
This acupuncture prescription treats a wide array of recalcitrant conditions that are not responding to standard acupuncture protocols. However, I have found it to be particularly effective for chronic pain (regardless of the location) and chronic insomnia.
Kid 1 has the actions of descending excess from the head, calming the spirit, and reviving consciousness / rescuing yang. Kid 1 is frequently used clinically for uprising of liver yang, liver fire, or liver wind; disharmony of the heart and kidneys; and lower body pain. This is just a small selection of issues this powerful point can treat.
LI 11 is a Sun Si Miao ghost point / Ma Dan-Yang Heavenly Star point and has the actions of clearing heat, cooling the blood, eliminating wind, draining damp, stopping itching, regulating the qi / blood, activating the channel, and alleviating pain. Yangming channels are traditionally considered to be “abundant / full of qi and blood” and have powerful systemic effects throughout the body, much like Kid 1.
Du 20 is the meeting point of the Governing Vessel with the Bladder, Gallbladder, Sanjiao, and Liver channels, and is a point of the “Sea of Marrow.” Du 20 has the actions of pacifying wind, subduing / raising yang (regulating yang), benefiting the head / sense organs, nourishing the Sea of Marrow, benefiting the brain, and calming the spirit. Much like Kid 1, Du 20 has powerful systemic effects throughout the body.
When these three powerful points are combined, I have found significant clinical results in resolving chronic pain and chronic insomnia. Although a sensitive point due to the location, with gentle and focused needle technique, Kid 1 can be surprisingly pain free. Typically, I needle Kid 1 and Du 20 in sequence and achieve the arrival of qi; and then administer no more needle stimulation.
LI 11 is then needled. On this point, I often drain heavily with strong needle sensation, particularly in cases of chronic pain with significant signs of qi / blood stagnation. As blood stasis is often not apparent based on tongue and pulse examination, I tend to almost always administer strong draining needle manipulation for two to three minutes and then let the patient rest for 15-20 minutes.
Patients will often experience a dramatic reduction in pain and a significant calming effect after the administration of this three-point prescription. For long-standing cases, I will use this three-point combination twice a week for two weeks, occasionally adding the point Du 16 if the patient is also experiencing strong emotional symptoms due to chronic pain / chronic insomnia. Du 16 is a Sun Si Miao ghost point, a Window of Heaven point, and the meeting point of the Governing and Yang linking vessels. It has the actions of eliminating wind, nourishing the Sea of Marrow, benefiting the head / neck, and calming the spirit. For patients who are not open to the needling of Kid 1, I will substitute Kid 3; however, I feel Kid 1 is more clinically effective, and can be easily needled with minimal discomfort with a gentle and caring hand.
I hope this discussion helps inspire clinicians to use this acupuncture formula for difficult-to-resolve cases and think creatively to help patients reach a state of balance.
