Ashi Acupuncture: Treatment of Neuromuscular Trigger Points

Ashi acupuncture is the treatment performed to release tension within painful knots within muscles, known as myofascial trigger points. 

Trigger points frequently cause pain that can radiate from tender spots within a muscle to broader areas, sometimes quite faraway from these points. The phenomenon of trigger points are firmly established in Western medicine.

Treatment of trigger points varies. It may involve manual massage, mechanical vibration, ultrasound therapy, electrical stimulation, manual compression, anesthetic medicine, steroid injection, cold laser therapy, stretching techniques, and of course, acupuncture.   

Is Ashi acupuncture similar to what is being called dry needling?

I say the answer is yes. Dry needling is claimed to be different from acupuncture because the needles are not placed according to Chinese energy meridian points, but rather in trigger points. Dry needling is performed by Western medical practitioners, often physical therapists. Many physical therapists justify calling dry needling is distinct from acupuncture because it doesn't involved discussion of improving energy flow within the body's meridians (energy channels), as in Traditional Chinese medicine. The needles are being used directly in problem areas. 

Many acupuncturists tend to passionately disagree with the term dry needing because of the simple fact that acupuncture needles are being inserted into the skin for pain relief. In my opinion, dry needling is an acupuncture method performed by non-acupuncturists, disguised as a Western medicine innovation. 

Is this important? I don’t think so. Patients don't care what we call our treatment techniques; you care whether we can help, or not! 

There are a tremendous number of acupuncture techniques that have been used throughout the world over thousands of years. However, I generally don’t like when conventional Western medicine takes things they’ve criticized as “alternative medicine” and rename or repurpose it with the claim of a new treatment. 

The term trigger point was coined in 1942 by Dr. Janet Travell. However, ashi points were established thousands of years ago as the point of most tenderness in Traditional Chinese Medicine. 

The intention of relieving pain is shared regardless of the language used or the philosophy behind the methods. Although I am licensed in acupuncture by the Virginia Board of Medicine, I am not trained in Traditional Chinese Medicine (TCM) type of acupuncture. 

I am an ear acupuncturist, who knows a few techniques from TCM. I deeply respect the art and science of acupuncture, regardless of each practitioner’s intention or methods. TCM is not my background, nor is it my interest. I am fond of the ashi acupuncture approach to trigger points because it fits my chiropractic approaches better than TCM. More importantly, my patients appreciate the results, which are achieved often very rapidly. However, I simply do not like acupuncture of trigger points being called dry needling. 

Quite frankly, I think it fiendishly deceptive. The public is given the impression that conventional Western medical practitioners have invented or discovered something new. 

It is arrogant to suggest that because it is being performed under the banner of modern Western medical science that it is not a form of acupuncture. The noble profession of acupuncture has brought relief and healing to millions of people for thousands of years. Practitioners of acupuncture (likely the FIRST medicine!) have suffered the indignity of their incredible healing art being labeled as alternative medicine. 

It is hypocritical to bash acupuncture and other drug-free methods for hundreds of years, and suddenly hijack it and practice it by marketing it to the public under another name. The philosophies and intent are different... but it is still acupuncture! I think it is a silly argument, not worth any further energy. I only addressed this controversy in this article because patients ask me about it. 

Ashi acupuncture performed on trigger points of the upper back and lower neck muscles has been beneficial to my patients. It is not one of my frontline treatment methods because patients rarely need it. My chiropractic, laser, and ear acupuncture treatments work so well; my patients rarely need Ashi. When I do it, I insert between one and six acupuncture needles. They remain in place while I perform other treatments, such as cold laser therapy, piezoelectric stimulation, and auricular therapy. In some cases, I maneuver the needless in and out of the trigger point.