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  • MPT & Acupuncture

    An Innovative Approach to Treating Musculo-skeletal Pain

    Malvin Finkelstein, L.Ac. OMD

    Primary Care Conference June 8, 2013

  • In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support: Slides, abstracts and/or handouts provided

    by me do not contain any advertising trade name or a product-group message, business log etc.

    I do not have any relevant financial relationships to disclose.

  • Acupuncture History

    2,000 to 5,000 year history Originally in China Spread to Japan, Korea and South East Asia

  • Acupuncture in the West In 1825, Franklin Bache,

    Benjamin Franklins great grandson wrote the first US treatise called Memoirs on Acupuncture

    Acupuncture was used during the Civil War

    1892, Sir William Osler in The Principles and Practice of Medicine recommended acupuncture for lumbago and sciatica

  • Henry Kissingers trip to China

    July 1971, James Reston of the New York Times had an emergency appendicitis operation

    Chinese Doctors used acupuncture for post-surgical care

    President Nixon and James Reston

  • Diseases, symptoms or conditions for which acupuncture has been proved - through controlled trials - to be an effective treatment: MUSCULO-SKELETAL

    Arthritis Back pain Neck pain Muscle pain Muscle weakness Muscle cramping Sciatica DIGESTIVE Abdominal pain Constipation Diarrhea Indigestion

    EMOTIONAL Anxiety Depression Insomnia Nervousness Neurosis EYE-EAR-NOSE-THROAT Cataracts Poor vision Toothache Gingivitis Tinnitus

  • RESPIRATORY Asthma Bronchitis Common cold, Sinusitis Smoking cessation Tonsillitis NEUROLOGICAL Headaches Migraines Neurogenic bladder dysfunction Parkinson's disease Post-operative pain Stroke

    GYNECOLOGICAL

    Premenstrual syndrome Menopausal symptoms Infertility Endometrioses MISCELLANEOUS Addiction control Athletic performance Blood pressure regulation Chronic fatigue Immune system toning Stress reduction

  • Acupuncture & Trigger Point Therapy

    Acupuncture points often correlate with trigger points.

    Acupuncture meridians often correlate with referral patterns of standard trigger point therapy.

  • Acupuncture & Trigger Point Therapy A survey by Peter T. Dorsher,

    MD, of the Mayo Clinic found that 238 (93.3%) of the 255 common trigger points have corresponding locations to acupuncture points.

    In 76% of corresponding points, he found complete or near-complete agreement in the distributions of the myofascial referred-pain patterns and acupuncture meridians

  • How pain is addressed with Acupuncture

    Typical approaches to treatment of musculo-skeletal pain: local needling combined with distal needling.

    Objective is to loosen tight, restricted areas, and assist the body in restoring healthy flow of energy down (or up) the meridian.

  • Microcurrent Positional Technique (MPT)

    Malvin Finkelsteins 35 years of acupuncture practice led him to develop the MPT system A simple and effective method

    for: Relieving pain Increasing range of motion Accelerating healing

    Effective for acute and chronic pain throughout the body

    Provides fast, long lasting results

  • What is the MPT system?

    Dr. Finkelsteins specialized locations of acupuncture/trigger points

    A hand held micro-current device to release fascia, muscle, joint & rib restrictions at key points

    Dr. Finkelsteins unique acupressure/tuina stretch and optimal body positioning to gently realign soft tissue

  • THE ESSENCE OF MPT

  • Postural Compensation Repetitive strain and acute trauma cause

    injury to muscles and other soft tissue Continuing to use injured muscles repeated

    over a period of time creates postural compensation (i.e. neck forward)

    This puts strain on the parts of the muscle that are furthest from their correct position and makes those fibers work harder and tighten (i.e. anterior fibers of trapezius)

    These are typically close to the fascial edge of the muscle

  • Adhesions, shortening, restrictions

    These stressed muscle fibers recruit their neighbor muscle fibers and surrounding muscles and fascia to adhese together to make a stronger unit

    This part of the muscle shortens, which solidifies the incorrect posture of that region (i.e. forward neck becomes the normal posture)

    This restricts some motion of each adhesed muscle and muscle fiber, which restricts movement of: The muscle Joints attached to the muscle - causing restricted

    range of motion

  • Weakening

    The normal action of muscles is to contract When muscles are shortened to their maximum and

    keep trying to contract They are unable to contract Instead, they weaken

  • End Results

    A fixed postural compensation that becomes the new normal posture

    Muscles Are tight, shortened and weak With adhesed knots and bands

    Joints Are restricted With reduced range of motion

  • This is the underlying cause of most pain diagnoses

    Arthritis, bursitis, tendonitis Spine - Disc ruptures, herniations, degenerative disc

    disease, radiculopathy Knee - Meniscus tears, bone on bone Foot Plantar fasciitis Shoulder - Impingements, frozen shoulder Wrist Carpal tunnel syndrome Headaches

  • Specialized Point Locations - 1 To correct tightness and restriction, we

    work on the adhesions that restrict motion in muscles, tendons and fascia resulting in restricted motion in joints

    Muscles/Fascia: At the mid-point of the muscle belly,

    mid-way between the 2 muscle tendon junctions

    In the fascial plane between 2 muscles

  • Specialized Point Locations - 2 Tendons:

    Muscle tendon junction (MTJ) Joint (TPJ-tendino-periostial

    junction) In the fascial plane surrounding the

    MTJ or TPJ Other points in muscles that are

    responses to particular postural or traumatic stresses

  • Treatment Technique - 1 We position the patient to

    stretch or contract muscles to more fully release these muscles

    At the treatment points: We gently stretch each

    muscle or joint toward its correct postural position

    We use microcurrent at the angle that produces the greatest sensation

  • Treatment Technique - 2 At the treatment points:

    We use microcurrent to feed the tissue which: Nourishes the muscles and fascia with oxygen

    and nutrients and increases ATP production* Promotes blood circulation

    This allows the adhesive, tight tissue to soften - similar to how a dried out sponge softens when water is poured on it

    *The Effects of Electric Currents on ATP Generation, Protein

    Synthesis, and Membrane Transport (Cheng 1982)

  • Treatment Technique - 3 As the tight tissue softens:

    It regains elasticity We can gently stretch each muscle or joint

    further toward its correct postural position This cycle is repeated until normalcy is reached in

    tissue texture, elasticity and motion Patient is asked to repeat initial range of motion

    restriction to determine change

  • Treatment Goals Practitioner will feel:

    Muscle change Adhesions in tight muscles soften Shortened muscles lengthen and return to

    normal movement Joint change

    Joint restrictions lessen and disappear Joint motion increase to normal

    Patient and practitioner will observe range of motion increase

    Postural compensations will reduce and eventually disappear

  • Patient Self Care After MPT treatment, the muscles are still weak To correct this, the patient must participate in their

    healing process by: Not re-tightening these muscles

    Learning correct ergonomics Not over-doing daily activities and exercise

    Keeping the muscles loose Learning stretches such as Postural Qigong

    SLOWLY strengthening the muscles Daily activities Learning gentle strengthening exercises such as

    Postural Qigong

  • Multi-disciplinary MPT is currently being used by many health care

    professionals who use hands on and electrical treatment Acupuncturists Physical Therapists, Occupational Therapists Massage Therapists MDs, Nurses Chiropractors, Naturopaths

    It is a good complementary therapy to use in conjunction with other treatments for pain

  • What is significant about MPT? Typically, MPT is performed first, an acupuncture

    treatment follows. The combined methods consistently yield a better

    result than acupuncture when used by itself for treatment of musculo-skeletal pain.

    MPT used in this manner, can accomplish things acupuncture cannot, or cannot do nearly as well.

    Acupuncture following an MPT treatment can accomplish more than it would have alone, using fewer needles and less intense stimulation.

  • MPT vs Acupuncture

    MPT can effectively address restrictions in joints and tendons. Acupuncture is not typically focused on these directly

    MPT, because of its dynamic, interactive nature generates significantly higher patient awareness

    Allows patient to become a partner in their own process of healing

    Ergonomic adjustments become second nature for those who choose.

  • MPT vs Acupuncture

    Acupuncture tends to work deeper, MPT wider Acupuncture supports the patient constitutionally

    by helping to promote a deep relaxation and balancing