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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 Franklin’s 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 Kissinger’s 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 Finkelstein’s 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. Finkelstein’s specialized locations of acupuncture/trigger points
• A hand held micro-current device to release fascia, muscle, joint & rib restrictions at key points
• Dr. Finkelstein’s unique acupressure/tuina stretch and optimal body positioning to gently realign soft tissue
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 patients Qi
• Needle phobic patients can be treated with MPT. Hands, face, feet, very sensitive areas for needles can be treated by MPT.
• MPT deals effectively with entire patterns of restriction
Results?
• In 15 years of incorporating MPT with acupuncture and the experience of hundreds of MPT students: • Significantly faster, more profoundly positive
results than acupuncture for pain of all regions. The majority of patients see significant positive change in 3-6 sessions.
• Examples: Patients not having results with other modalities, including acupuncture by itself, often have a good response with MPT/acupuncture combination.