Electroacupuncture is a technique that involves inserting needles into acupuncture points and then applying a low-frequency pulsed electric current that closely resembles the body’s bioelectricity. This method combines both needle and electrical stimulation to prevent and treat diseases, commonly used in various chronic conditions and neurological disorders.
1. Common Instruments and Basic Operation Methods
(1) Common Instruments
Filiform needles, electroacupuncture device.
(2) Selection of Acupuncture Points
1. When selecting acupuncture points, traditional acupuncture theory can be followed, either by meridian selection or pattern differentiation.
Each treatment must select at least two acupuncture points, with the main point paired with corresponding auxiliary points, generally choosing 1 to 3 pairs of points on the same side of the body.
2. Points can also be selected based on nerve distribution.
For the head and face: Tinghui (SI19), Yifeng (SJ17) (facial nerve distribution area), Xiaguan (ST7), Yangbai (ST2), Sibai (ST4), Jiachengjiang (ST6) (trigeminal nerve distribution area).
For the upper limb: C6-C7 Jiaji points, Tianding (LI16) (brachial plexus distribution area), Qingling (LI11), Xiaohai (HT3) (ulnar nerve distribution area); Shouwuli (LI5), Quchi (LI11) (radial nerve distribution area), Quze (PC3), Ximen (PC6) (median nerve distribution area).
For the lower limb: Huantiao (GB30), Yinmen (GB29) (sciatic nerve distribution area), Weizhong (BL40) (tibial nerve distribution area), Yanglingquan (GB34) (common peroneal nerve distribution area); Chongmen (SP12) (femoral nerve distribution area).
For the lumbar and sacral region: Qihaiyu (BL24) (lumbar nerve distribution area), Bayao (BL31-BL34) (sacral nerve distribution area).
Ashe points can also be used as electroacupuncture stimulation points.
3. Points can be selected based on the affected area.
For facial nerve paralysis: use Tinghui or Yifeng as the main points, with Yangbai for the forehead, Qianliao for the cheek, Dica for the mouth corner, and Tongziliao for the eyelid. For upper limb paralysis: use Tianding or Quepen as the main points, with Jianliao or Shouzhong for the deltoid, Humerus triceps for the Humerus meeting point, and Biceps for Tianfu; for wrist flexors and finger extensors, use Quchi as the main point, paired with Shouwuli or Sidu.
For lower limb paralysis: use Chongmen or Yinxian for the anterior thigh, paired with Biguan or Jimen; for the buttocks and posterior thigh, use Huantiao or Zhibian as the main points, with Weizhong for the posterior calf and Yanglingquan for the lateral calf.
(3) Basic Operation Methods
Before using the electroacupuncture device, first set the intensity adjustment knob to zero. After inserting the needles and achieving Qi sensation, connect each pair of output electrodes from the device to the two filiform needles, with the negative electrode on the main point and the positive electrode on the auxiliary point, generally connecting the same pair of output electrodes on the same side of the body. If performing electroacupuncture on adjacent points, use dry cotton balls to separate the two needles to avoid short-circuiting. Finally, turn on the power switch, select the waveform, and adjust the stimulation amount from none to a comfortable level for the patient.
1. Selection of Waveform
(1) Sparse-Dense Wave
The sparse-dense wave is a waveform where sparse and dense waves alternate automatically. Its dynamic effect is significant, with a predominance of excitatory effects during treatment. It can increase metabolism, promote Qi and blood circulation, improve tissue nutrition, and eliminate inflammatory edema. Commonly used for sprains, periarthritis, sciatica, facial paralysis, muscle weakness, and local frostbite.
(2) Intermittent Wave
The intermittent wave is a rhythmic waveform that appears intermittently. Its dynamic effect is strong, enhancing the excitability of muscle tissue and providing good stimulation for striated muscle contraction. Commonly used for treating atrophy and paralysis.
(3) Continuous Wave
Also known as adjustable wave, it is a waveform formed by combining single pulses in different ways. Its excitatory effect is significant, with strong stimulation, commonly used for treating atrophy and various muscle, joint, ligament, and tendon injuries.
2. Electroacupuncture Intensity
When the current reaches a certain intensity, the patient may feel numbness or tingling, referred to as the “sensation threshold.” If the current intensity is slightly increased, the patient may suddenly feel a sharp pain, known as the “pain threshold.” The intensity varies from person to person and can differ significantly under various pathological conditions. Generally, the current intensity between the sensation threshold and pain threshold is the most suitable for treatment.
(4) Treatment Duration
The duration of electrical stimulation is generally around 15 to 30 minutes. Acupuncture anesthesia can last longer.
(5) Types of Electroacupuncture Devices
1. Buzzer-type electroacupuncture device: This device uses the principle of electric bell oscillation to convert direct current into pulsed current. This type of pulsed current has a narrow waveform, resembling a needle tip, and is asymmetric. Due to high power consumption and noise, it is rarely used now.
2. Voltage-reducing alternating current electroacupuncture device: This device uses a standard AC power source, reducing the voltage to below 25V through a transformer, and then regulates the output through resistors and potentiometers to achieve appropriate stimulation intensity. Due to non-adjustable frequency, it is also rarely used.
3. Audio-frequency oscillation electroacupuncture device: This device uses an audio-frequency oscillator to generate a frequency-adjustable sine wave electroacupuncture device within the range of 20 to 200 Hz. Although both frequency and output intensity can be adjusted, the waveform is simple, and the therapeutic effect is poor. This type of electroacupuncture device is also rarely used.
4. Transistor noise-type electroacupuncture device: This type of device operates on a direct current of 6V, with a noise frequency of 15000 to 20000 Hz, and a modulation frequency of 3 to 30 Hz, with an output voltage of 0 to 50V. The E1332 electroacupuncture device belongs to this type, mainly suitable for acupuncture anesthesia and analgesia treatment.
5. Sonic electroacupuncture device: This device combines various sound sources generated by a sound wave generator, such as music, drama, songs, and broadcasts, inputting them into the electroacupuncture device, outputting through wires connected to the needle handle inserted into the acupuncture points, thus producing a complex, irregular, and randomly changing composite sound wave stimulation, making it less likely to cause adaptation in the body, allowing for prolonged treatment without diminishing effect. Due to the absence of strong fundamental wave interference, the stimulation is more comfortable and better tolerated by patients. Sonic currents have better analgesic effects than general pulsed waves.
6. Pulsed electroacupuncture device: This type of device has been widely used in recent years both domestically and internationally. A typical model is G6805. It uses an intermittent oscillator as a pulse generator, with variable resistors changing the time constant of the circuit to control pulse frequency. Multiple isolated output windings are wound on the oscillating transformer, and the output of the auxiliary winding is divided through a potentiometer. The multi-harmonic oscillator outputs square waves, allowing for sparse-dense waves, intermittent waves, and pulse waveforms. However, the frequency of these two waveforms is not adjustable, and the square wave generates fluctuating signals that can modulate their amplitude, allowing for fluctuating waves and sawtooth waves.
2. Common Diseases Treated with Electroacupuncture
(1) Facial Paralysis (Peripheral Facial Paralysis)
Facial paralysis is often caused by external invasion of wind and cold, affecting the facial meridians, characterized by paralysis of one side of the face, disappearance of forehead wrinkles, widening of the eye fissure, tearing, shallow nasolabial groove, and deviation of the mouth corner towards the healthy side. Some patients may initially experience pain behind the ear. This is often due to deficiency of righteous Qi, allowing wind evil to invade the meridians, leading to obstruction of Qi and blood, resulting in insufficient nourishment of the facial muscles, causing the muscles to become slack and unresponsive.
【Treatment Principles】Disperse wind and open the meridians, promote Qi and invigorate blood.
【Point Selection】During the recovery phase of facial paralysis: use Dica, Daying, Jiachengjiang, Yangbai, Sibai, Taiyang, Yifeng, and Hegu points; during the sequelae phase: based on the above points, add Koushe for upper lip deviation, and Jiacheng for lower lip deviation; if unable to flare the nostrils, use Yingxiang; if unable to wrinkle the brow, use Yiyao and Cuanzhu.
【Operation】Select 0.35mm × 50mm stainless steel needles for rapid insertion into the skin, either horizontally or obliquely, ensuring Dica and Jiachengjiang points are connected, while the remaining points are inserted to a depth of about 25mm, leaving the needles in place until a sensation of soreness and distension is felt. For electroacupuncture treatment, one group is placed on Dica and Jiachengjiang, while another group is placed on Yangbai and Sibai. The output intensity should be adjusted to achieve slight movement in the facial muscles, with continuous stimulation for 20 minutes, once daily, for a total of 7 sessions as one treatment course.
(2) Stiff Neck (Cervical Spondylosis)
Stiff neck is often caused by damage to the Du meridian, Qi and blood deficiency, or invasion of external pathogens, leading to obstruction of the meridians, characterized by neck and back pain, upper limb weakness, finger numbness, lower limb fatigue, difficulty walking, dizziness, nausea, vomiting, and even blurred vision, tachycardia, and difficulty swallowing.
【Treatment Principles】Disperse tendons and open the meridians.
【Point Selection】Main points: C2-C7 Jiaji points. Auxiliary points: Yanglao, Tianzhu, Dazhui, Shenyu, Dachangyu, Quchi, Waiguan, Hegu, Yanglingquan, Zhibian.
【Operation】Insert 50mm filiform needles at a 45° angle towards the spine at the main points until the sensation is transmitted, and achieve Qi at the auxiliary points. Use even tonification and reduction for 1 minute, then connect the electroacupuncture device, with the negative electrode on the main point and the positive electrode on the auxiliary point, using a continuous wave at a frequency of 120-250 times/minute, with the current intensity adjusted to a comfortable level for the patient, generally between 1-1.5 mA.
【Special Reminder】The current intensity for electroacupuncture should not be too high, and the patient’s sensations during treatment should be monitored.
(3) Lumbar Disc Herniation
Lumbar disc herniation is often caused by acute injury, damage to the Du meridian, or invasion of cold pathogens, leading to obstruction of the meridians, characterized by low back pain, numbness, and pain in one or both lower limbs.
【Treatment Principles】Invigorate blood and open the meridians.
【Point Selection】Main points: Shenyu, Dachangyu, Zhibian, Weizhong, Huantiao, Chengshan, or Ashe points. Auxiliary points: for cold dampness with wind, add Yaoyangguan; for overuse, add Geiyu and Cilia; for kidney deficiency, add Mingmen and Taixi; for acute lumbar sprains, can use Shuigou and Houxi.
【Operation】After routine disinfection of the acupuncture points, select 3-4 main points based on the condition, using different filiform needles to achieve Qi at the corresponding points, then connect the electrotherapy device, using a continuous wave at a frequency of 80-100 times/minute, with the intensity adjusted to a level the patient can tolerate.
【Special Reminder】The duration of each treatment should not be too long to avoid affecting the therapeutic effect.
(4) Chorea Minor
Chorea minor, also known as rheumatic chorea, is a neurological manifestation of acute rheumatic fever, characterized by irregular, involuntary dance-like movements, decreased muscle tone, weakened muscle strength, motor disturbances, and emotional changes.
【Point Selection】Use points from the scalp acupuncture technique, focusing on the dance tremor area. Auxiliary points: motor area, vestibular area (see Figure 1).
Figure 1: Schematic of the Vestibular Area
【Operation】For those primarily experiencing tremors, only the main points are selected; for those with enhanced muscle strength, add the motor area. For those experiencing dizziness or adverse reactions from medication, add the vestibular area. In the early stages, if tremors or enhanced muscle strength are observed in one limb, only the corresponding scalp acupuncture area on the opposite side is selected. In later stages, if symptoms appear bilaterally, select both sides. Based on the different affected areas of the limbs, select the corresponding regions, such as the motor area for significant upper limb symptoms, etc. Use 0.32mm filiform needles for rapid insertion to the desired depth, and electroacupuncture can be applied with a frequency of 240-280 times/minute, using a continuous wave, with intensity adjusted to a level the patient can tolerate, for 20 minutes. If warmth, numbness, or distension occurs in the opposite limb, it is considered favorable.
3. Contraindications
1. Avoid using electroacupuncture near the heart, especially for patients with severe heart disease, to prevent the current circuit from passing through the heart; do not connect electrodes across the spinal cord and heart to avoid damaging the spinal cord or causing spinal shock.
2. For patients with mental illnesses, as they cannot articulate sensations and may be agitated, electroacupuncture should be avoided.
3. For critically ill patients, pregnant women, those who are overly fatigued, hungry, or intoxicated.
4. Precautions
1. Before each treatment, check that the electroacupuncture device is functioning properly. After treatment, all output adjustment knobs should be returned to zero, and then the power should be turned off and the wires removed.
2. The sensation of electroacupuncture is strong, and muscle contractions will occur after stimulation, so patients should be informed in advance to prepare mentally for better cooperation during treatment. The intensity of electroacupuncture should gradually increase from low to high; do not suddenly increase it to avoid fainting, bending needles, or breaking needles.
3. When using electroacupuncture on symmetrical points on both sides of the scalp, if one side feels too strong, the output electrodes can be switched. If the sensation changes from strong to weak or vice versa, it is due to the performance of the electroacupuncture device; if there is no change, it is due to the different anatomical locations of the needles.
Previous Articles:
【TCM Feature 01】 Acupuncture Techniques – Filiform Needles
【TCM Feature 02】 Acupuncture Techniques – Scalp Acupuncture
【TCM Feature 03】 Acupuncture Techniques – Auricular Acupuncture
【TCM Feature 04】 Acupuncture Techniques – Wrist and Ankle Acupuncture
【TCM Feature 05】 Acupuncture Techniques – Fire Needles
【TCM Feature 06】 Acupuncture Techniques – Skin Needles
【TCM Feature 07】 Acupuncture Techniques – Point Injection
【TCM Feature 08】 Acupuncture Techniques – Thread Embedding Technique