-Olivier Roy, Acupuncturist:
Following an injury, I wonder as an acupuncturist, at what stages of pain and inflammation can the osteopath intervene?
-Valérie Léonard, Osteopath:
Our work as an osteopath consists of finding the cause of pain and inflammation in order to normalize it and help the body recover its normal function. We operate somewhat like a mechanic. When your vehicle starts making a noise, you take it to the garage so that with an inspection, we can find and fix the source of the problem. As an osteopath, we perform clinical tests to determine the source of pain and inflammation in order to intervene at the level of the problematic structures.
We intervene at all stages of pain and inflammation. However, it is their intensity that will determine the type of osteopathic intervention. If the condition is more acute, we will probably adopt a more tissue, visceral, or cranial approach, and if the condition has become chronic, different interventions will be prioritized.
In all cases, we work with our patient's body to help them regain alignment and mobility in the affected structures.
You take your car to the garage when you have mechanical problems. The osteopath is a professional who adjusts your body's mechanical function.
-Olivier Roy, Acupuncturist:
Very interesting, Valérie. By what osteopathic mechanisms can you help relieve pain in your clients?
-Valérie Léonard, Osteopath:
The fundamental principles of osteopathy were articulated by Andrew Taylor Still.
Andrew Taylor Still, Osteopath (1914)
1. The role of the artery is absolute: Just like the nervous system, the circulatory system (arterial, venous, and lymphatic) must function well in order to keep our body healthy. The body's structures must be well vascularized and nourished to perform their work adequately.
2. Structure governs function (and vice-versa): There is a very close relationship between a structure and its function. When a structure is affected by a lack of mobility or otherwise, this results in a disruption of its function. Similarly, if a function of a tissue or organ is not optimal, the structure may change to adapt to the modified function.
3. The body is a functional unit: In the body, everything is interconnected; all structures, on all their levels (physical, physiological, and psychological) are interdependent on one another. A disturbance in one tissue (muscular, bony, nervous, visceral) will have repercussions on all planes of the human body.
4. The body has a natural tendency toward self-healing: The body is in constant search of its homeostasis (state of balance in the body at all levels). With osteopathic interventions provided, the body takes what it needs to rebalance itself and return to a state of equilibrium so that it has optimal function to continue defending and healing itself.
Some physiological effects of osteopathy demonstrated by science
Tissue injury according to the osteopath would actually be an obstruction of the flow of body fluids, characterized by a change in the size, texture, or function of a tissue of the human body. Multiple clinical studies have demonstrated that myofascial techniques allow for reduced pain and increased movement of structures by increasing the number of fibroblasts in tissues and decreasing the quantity of pro-inflammatory interleukins secreted by lymphocytes.
T Lymphocyte of the immune system of a healthy person. Image obtained from a micrograph of a scanning electron microscope.
In doing so, there is also an increase in the capacity of tissues to heal the traumas they have suffered. These techniques also allow for balancing of membranous and cranial tensions, which helps treat chronic somatic dysfunctions.
Cranial techniques have themselves demonstrated effects on cortical plasticity and on modulation of autonomic nervous system signals, which helps treat, among other things, fibromyalgia in osteopathy. Furthermore, it has been attested by electroencephalogram (EEG) and neuroimaging that cranial techniques have an immediate effect in normalizing pain processing and modulation centers.
Cranial osteopathy
As for structural techniques, it has been proven through heart rate variability testing that by restoring optimal mobility to certain structures—the cervical vertebrae and sacrum, for example—we can have an effect on the autonomic nervous system by restoring sympathico-vagal balance, and there are also positive effects on the mobility of all other structures related to these (ligaments, muscles, membranes, peripheral nerves, viscera innervated by the autonomic nervous system).
Positive effects of osteopathy on mental health have also been noted by multiple clients over several years, but more in-depth studies are necessary to validate the mechanisms of action of osteopathic techniques on this subject.
-Olivier Roy, Acupuncturist:
When do you think to refer to acupuncture, Valérie?
-Valérie Léonard, Osteopath:
Clients are referred to acupuncture by the osteopath for several reasons:
First, during the acute painful phase accompanied by inflammatory reactions in clients when their body is in hyper-reaction and when the sympathetic and parasympathetic systems would need to be balanced before beginning more manual interventions.
Acute sports injuries respond well to acupuncture treatment.
Second, during the chronic pain phase, when the client's nervous system sometimes needs to respond to a new approach upon reaching a therapeutic plateau in osteopathy.
Also, many clients experience beneficial effects of acupuncture when they have problems with headaches, sleep, anxiety, digestive issues, respiratory problems (such as asthma or allergies) and even for various diagnosed hormonal imbalances.
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-Valérie Léonard, Osteopath:
When is it optimal to intervene with acupuncture for pain that appears following an injury?
-Olivier Roy, Acupuncturist:
Acupuncture is useful for both acute and chronic pain. In a study conducted in an emergency department, acupuncture was demonstrated to be superior to intravenous morphine for acute pain in terms of safety, effectiveness, and speed of action. As for chronic pain, people are often surprised at what a series of acupuncture treatments can achieve in terms of results. The effectiveness and durability of acupuncture treatment seem to be related to dosage—that is, most studies testing acupuncture evaluate its effectiveness over approximately 15 treatments. It has been demonstrated that 90% of the positive effects of a series of acupuncture treatments are maintained 1 year after the final follow-up."
-Valérie Léonard, Osteopath:
When do you think to refer to osteopathy as an acupuncturist, Olivier?
-Olivier Roy, Acupuncturist:
I regularly refer patients to osteopathy who are experiencing episodes of pain, whether acute or chronic. In fact, whenever I suspect a problem related to primary respiratory mechanisms—that is, a situation where the patient has received a physical shock—I will systematically recommend having the regularity of cerebrospinal fluid circulation checked by an osteopath. The effect of acupuncture on blood circulation and the regulation of inflammation and pain will be directly enhanced. I also frequently refer young children and pregnant women to complement their acupuncture follow-up with an osteopathy consultation.
-Valérie Léonard, Osteopath:
What are the mechanisms that explain how acupuncture treatment works on pain?
-Olivier Roy, Acupuncturist:
Pain control
Acupuncture acts on pain through different modulation pathways. The most impressive mechanism brought to light certainly concerns the—permanent—reconnection of new electrical networks in the brain following acupuncture treatments. A study targeting the treatment of carpal tunnel syndrome made it possible to highlight this spectacular mechanism, thanks to functional magnetic resonance imaging.
Neural pathways used by the stimulation of acupuncture points have been identified, from the spinal column to the deactivation of brain pain centers. A number of biochemical regulators involved in pain reduction are influenced by the stimulation of acupuncture points, including the activation of endogenous opioid substances secreted by the body, the modulation of ATP, adenosine, substance P, Natural Killer Cells, to name a few. Acupuncture would even modulate the expression of genetic code.
The modulation of inflammation
The effect of acupuncture on inflammation has been evidenced by various markers, including certain pro-inflammatory cytokines. LASER acupuncture would notably be responsible for the downward modulation of prostaglandin E2, C-reactive protein, as well as interleukin-6.
The stimulation of tissue regeneration
Studies on humans, as well as on mice, cats, dogs, and horses have demonstrated that electroacupuncture—that is, electrical stimulation on needles—allows for stimulation of the circulation of mesenchymal stem cells in the bloodstream.
Dr. Huisheng Xie training students here in the administration of electroacupuncture in horses. He collaborated on the U.S. Department of Veterans Affairs study, signed by Dr. Fletcher White and his colleagues. Their work focused on the specific mechanisms of electroacupuncture.(Photo: ©Chi Institute/2016-2017)**
This means that undifferentiated cells of the organism, normally stored in the bone marrow, are made available to regenerate injured tissues.
*Fluorescence image demonstrating mesenchymal stem cells derived from adult bone marrow. Cell nuclei are shown in blue.
(Photo: Ames Laboratory, U.S. Dept. of Energy)*
-Valérie Léonard, Osteopath:
Is there a unified theory that allows us to explain how acupuncture treatment works in general?
-Olivier Roy, Acupuncturist:
There are actually several theories. Since acupuncture is an integrative medicine called upon to intervene in many very different pathologies, there is not a single theory explaining everything that acupuncture does to the human body. According to my personal interests, since my favorite classes in school have always been physics classes, the more attractive theory from a fundamental point of view in my opinion is the theory based on the 4th fundamental force of the universe—that is: electromagnetism. Everything that exists is expressed by an electromagnetic field that interacts with its environment. By definition, acupuncture points are zones of lesser electrical resistance—zones of weakness, then. Bimetallic needles equipped with a solenoid handle influence the electromagnetic field in living organisms and actually represent a diode—an electrical resistance—in the circuit of the body's bioelectricity.
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Thus, the "resistance-needles," placed on the greatest points of weakness in the human body, restore normal resistance of tissues and coincidentally, optimal circulation within them, capable of generating chain reactions at a distance, for example on a muscle chain. This theory, which I like, is certainly not one that has reached consensus in 2020!
Recently, several scientific articles have been published using titles such as acupuncture "rewires" the brain's electrical connections. Here is a quote from my colleague John McDonald, acupuncturist and researcher.
*Dr. John McDonald PhD
World Acupuncture Day (2018)*
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"Yes, acupuncture is capable of remodeling the somatosensory cortex in cases of chronic pain, as Vitaly Napadow has demonstrated, but we should not 'reduce' the functioning of acupuncture to this discovery. What is clear is that there would be very complex interactions between receptors, mediators, and regulatory pathways in the mechanisms of acupuncture treatment, in addition to the modulation of specific gene expression. It can be very tempting to jump to simplistic conclusions and say:
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"it would actually be the vagus nerve,"
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"it would actually be vasodilators,"
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"it would actually be gasotransmitters,"
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"it would actually be endogenous opioids,"
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"it would actually be adenosine mediation pathways and purinergic receptors,"
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"it would actually be modulation of neuroplasticity,"
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"it would actually be immune modulation"…
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Although all these processes have been clinically demonstrated, there would not yet be a unified theory explaining everything acupuncture can do. For example, the point Zu San Li (Stomach 36) has more than 120 therapeutic indications, involving all the body's organ systems to various degrees, which implies that these 120 actions are all related in some way since they occur in cascade following a single stimulus. If there were only one central pivot element, it could be the circadian cycle, which is expressed in the nucleus of all cells in the body and all these cellular "clocks" communicate in some way with each other through many pathways. There would now be significant evidence that the circadian cycle clock regulates almost all, if not all, organ systems. When acupuncture 'harmonizes' digestive organs, such as the liver and pancreas, perhaps it is actually synchronizing all the cellular clocks of these organs, and when all the cells of the human body function on the same time zone, we experience optimal health. There is now direct evidence from animal experimentation indicating that acupuncture modulates genes and proteins in the suprachiasmatic nucleus, which is actually the master clock of all circadian cycle clocks."
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-John McDonald, Acupuncturist and Researcher
Finding Your X
This is why if I had to make an analogy with another profession, if the osteopath were the mechanic, the acupuncturist is also a mechanic—perhaps more precisely the watchmaker of the human body, the one who adjusts the "timer" of the body's cells, which will activate in unison with the rhythm of circadian cycles, once regularized at their center.
Like the watchmaker, the acupuncturist readjusts the timing of the mitochondria of the living cell.
What these two professions have in common, then, is work on the mechanics of the human body, whether following an injury or for any other reason for consultation. When the straightening and adjustment are done well, the human body returns to its normal functions more easily following an injury.
Acupuncture can help you.
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