Appropriate Medical conditions for the treatment with
Systemic Trigger Point Acupuncture
- Muscle and tendon pain, injuries or
- Back pain
- Slipped discs
- Post-surgery trauma (pain, swelling,
lack of dexterity and strength)
- Rheumatic conditions and fibromyalgia
- Nerve pain (for example trigeminal
- Whiplash traumas
- Repetitive Strain injury
- Stroke rehabilitation
- Frozen shoulder
- Achilles tendon injuries
- Wrist, Hand or finger problems
- Tennis elbow and other forms of
- Hip, knee and elbow problems
- Alleviation of scoliosis complaints
What is new about Systemic Trigger Point Acupuncture?
Density Needling (PDN)
PDN requires a
skilled needle technique which is both gentle to the patient and allows the
practitioner to perceive the precise insertion of the needle tip into the core
of a Trigger Point. This technique is also a precondition for any comprehensive
structural treatment of Trigger Points.
The PDN needle
technique is simple, yet requires a steady hand and excellent needle tip
perception. Once a Trigger Point is identified the needle tip is rested on the
skin. The patient is asked to breathe in and out. The insertion begins, when
the patient starts to breathe out. Insertion on the outbreath reduces the
likelihood of discomfort and facilitates a gentle needle insertion. The needle
insertion is a smooth, slow and gentle insertion with almost no force and stops
when the needle tip rests in the core of a Trigger Point. The gentle needle
insertion allows blood vessels or nerves to move out of the way. No form of
needle manipulation (needle twisting, repeated dynamic insertions into the
Trigger Point) is appropriate during the needle insertion or once the needle is
inserted. Once the needle tip is inserted it is left undisturbed for the
duration of the treatment.
insertions cannot achieve precise density needling, as it is impossible to
perceive the precise location of the needle tip. Dynamic needle insertions are
also much more likely to cause discomfort and therefore prevent a complete
treatment of Trigger Point Structures.
Even gentler forms
of dynamic needle insertion like tapping are counterproductive for the precise
perception and treatment of Trigger Point cores.
To summarize PDN
is a gentle, steady controlled needle insertion that enables practitioner to
place the needle tip precisely into the core of a Trigger Point. Precise
Density needling prevents unnecessary needle discomfort and trauma to the
treated point and surrounding tissue.
The basis for the
PDN technique is a comprehensive manual diagnosis process. After taking into
account previously performed diagnostic procedures (x rays or scans),
background information and the patients account and demonstration of the
problem the practitioner engages in a process of palpation diagnosis that
consists of two stages.
Systemic Diagnosis of functionally related
skeletal soft tissue
At this stage the
practitioner looks for a general picture of the presenting complaint and
manually investigates the tone of muscles, tendons and ligaments, which are
functionally related to problem. For example: a patient with tendinitis in
elbow joint would call for a palpation of the muscles and tendons of neck,
shoulder, upper arm, elbow and lower arm. During this process the rough
location of individual Trigger Points or Trigger Point structures is
established and a decision about the beginning and sequence of the treatment is
made. As no needles are inserted at this stage, multiple fingers may be used
and the palpation strength can be a little stronger than during the stage that
follows. If deemed appropriate, a gentle massage that loosens the area intended
for treatment may be applied. Generally only a gentle pressure should be
applied that doesn’t irritate the examined area too much. Pinching as a
diagnostic tool is not desirable and should be avoided.
Fingertip diagnosis of individual Trigger
The second stage
of the manual diagnostic process is performed before each individual needle
insertion. The fingertip of the practitioner locates the precise location of a
Trigger Point and then seeks the core of a Trigger Point. The practitioner uses
his most sensitive finger (most commonly the middle finger) for this task.
After locating the
Trigger Point core the needle tip is inserted very gently with the PDN needle
It is very
important that the applied fingertip pressure is very gentle – just enough to
establish contact with the trigger point – in order not irritate the point
intended for treatment and to make sure that already placed needles are not
Treatment of tendon tissue in trouble
Point Acupuncture allows the practitioner to treat tendon tissue directly. The
gentle PDN technique allows multiple needle insertion into tendon tissue when
necessary and most importantly avoids trauma to the treated tissue. As a great
number of painful conditions that involve muscular skeletal dysfunction involve
dysfunctional tendon tissue and great leverage forces are exerted from
tendinous muscle insertions the scope and effectiveness of Trigger Point
treatment with acupuncture treatment is greatly enhanced.
Trigger Points in tendon tissue are considerably smaller than similar
points in muscle tissue. Therefore it takes great diagnostic and needle skills
to find them and treat them precisely.
Emphasis on the systemic treatment of Trigger
rarely occur in the human body as isolated points. The perceptive practitioner
is very likely to find Trigger Points in the context of an “organised”
can be very cluster-like, but also occur along functionally linked skeletal
tissue – i.e. neck, shoulder, upper arm, lower arm, wrist, hand and fingers –
and come in a variety of shapes or concentrations. Some structures are formed
by a relatively small number of Trigger Points other can contain a large number
of individual Points.
Structures enhance the various negative effects of individual Trigger Points
and the correct perception and treatment of these structures is a vital part of
Systemic Trigger Point Acupuncture.
success, which is not only measured by pain relief, but also by restoring
strength and dexterity, is dependent on the correct recognition and treatment
of connected Trigger Point structures. The gentle PDN needle technique makes it
possible to treat small or large Trigger Point structures.
About Uli Wiesmann
Ulli Wiesmann is a specialist acupuncturist at Harley
Street Acupuncture in London. He has 20 years' professional
experience in Systemic Trigger Point Acupuncture, Cosmetic
Acupuncture and Traditional Chinese Acupuncture. Ulli treats acute
and chronic musculoskeletal pain and dysfunction (pain management),
inflammatory conditions, trauma and sport injuries, as well as allergies, lack
of energy, sleeplessness, nervous disease and emotional imbalances.