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What is Fire Needle Therapy?
Fire needle therapy involves the use of heated needles to directly introduce heat into the muscle knots, rapidly alleviating or improving pathological phenomena such as local tissue edema and congestion. The fire needle delivers high temperature directly to the lesion, serving to dispel cold and detoxify, warm the meridians, relieve pain, relax joints, and eliminate inflammation with a low recurrence rate. It can be considered a comprehensive treatment that is both simple and effective.
▲ Fire needle + cupping resulting in yellow fluid
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Indications and Efficacy
Indicated for bi pain or paralysis caused by wind-cold muscle spasms. The needle is quickly inserted and withdrawn, and pressing on the hole can stop the pain; if not pressed, it can be extremely painful. For abdominal masses due to cold accumulation, the needle is inserted slowly and withdrawn while rotating to allow the impurities to flow out. For back abscesses with pus but no head, the needle is inserted to allow the pus to flow out without pressing on the hole. When using fire needles, they should not be inserted too deeply to avoid damaging the meridians, nor too shallowly, or the disease will not be eliminated. This method should not be used on the face or during hot and humid summer conditions.
Method: Fill a small bowl with sesame oil, use fourteen strands of lampwick to light the lamp, coat the needle multiple times with sesame oil, and heat it over the lamp until it glows red before use. If the needle is not heated red or has cooled down, it can harm the patient and will not relieve pain.
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Needling Techniques and Procedures
Needling Techniques
1. Select 22-28 gauge stainless steel needles, wrapping the handle with cloth to prevent heat conduction. During the procedure, disinfect the affected area and surrounding skin with iodine or alcohol, then use 2%-10% procaine (which can be mixed with 0.2% hydrochloric acid epinephrine to prevent bleeding) for infiltration anesthesia. After about 2 minutes, heat the needle over an alcohol lamp until it glows red, hold the affected area with the left hand, and quickly insert the needle with the right hand into the affected area or its surroundings, then immediately withdraw the needle.
2. The depth of needle insertion depends on the type of ulcer and the depth of the lesion. The number of needles used each time depends on the size of the affected area, generally 1-3 needles.
3. The interval between needle treatments should be 1-2 weeks.
Contraindications
1. Fire needle stimulation is intense; it is contraindicated for pregnant women and the elderly or weak individuals.
2. It is not suitable for hot syndrome and local redness and swelling.
3. Contraindicated for hypertension, heart disease, malignant tumors, etc.
Operational Methods
1. Point selection and disinfection: The selection of points for fire needles follows the same basic principles as for filiform needles, determined by the specific symptoms. After selecting the acupoints, appropriate positioning is necessary to prevent the patient from changing positions, which could affect the accuracy of point selection. The number of points selected should be minimal, and for solid conditions and young patients, slightly more points may be selected. After determining the points, thorough disinfection is required. The disinfection method should first use iodine, followed by alcohol cotton balls to remove iodine to prevent infection.
2. Heating the needle: Heating the needle is a critical step in using fire needles. The “Great Compendium of Acupuncture and Moxibustion: Fire Needle” states, “Heat over the lamp until it glows red; this is effective. If not red, it cannot treat the disease and may harm the patient.” Therefore, the needle must be heated red before use.
A convenient method is to use an alcohol lamp to heat the needle, but there are drawbacks; some practitioners use lighters and disposable 5ml syringes (with needle tips) for fire needle treatment of spinal injuries and pediatric cerebral palsy with confirmed efficacy.
3. Needle insertion and depth: When inserting the needle, use the heated needle to quickly puncture the selected acupoint and then swiftly withdraw it. Regarding the depth of insertion, the “Great Compendium of Acupuncture and Moxibustion: Fire Needle” states: “Avoid inserting too deeply, as it may injure the meridians; too shallow will not treat the disease, only a moderate depth is appropriate.” The depth of fire needle insertion should be determined based on the condition, constitution, age, and the thickness of the muscle and depth of blood vessels at the insertion site. Generally, for limbs and lower back, the needle can be inserted slightly deeper, about 2-5 fen; for chest and back acupoints, it should be shallower, about 1-2 fen; and for the Jiaji points, it can be inserted 3-5 fen deep.
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Scope of Application and Precautions
Scope of Application
Fire needles have the effects of warming the meridians and promoting circulation, dispelling wind and cold. They are mainly used for bi syndrome, gastric prolapse, epigastric pain, diarrhea, dysentery, impotence, scrofula, urticaria, irregular menstruation, dysmenorrhea, pediatric malnutrition, and flat warts, moles, etc.
Precautions
1. Caution should be exercised when applying fire needles to the face. The “Great Compendium of Acupuncture and Moxibustion: Fire Needle” states, “Fire needles can be used on all parts of the body, but should be avoided on the face.” This is because fire needle punctures may leave small scars; therefore, except for treating small areas of vitiligo, moles, and flat warts on the face, fire needles are generally not used.
2. Fire needles should also not be applied to areas with major blood vessels and nerves.
3. After needling, if there is redness or swelling that has not completely subsided, bathing should be avoided to prevent infection.
4. Fire needles are not suitable for febrile conditions.
5. If there is itching at the needle site, do not scratch to prevent infection.
6. Needle hole treatment: If the needle is inserted 1-3 fen deep, no special treatment is needed. If the needle is inserted 4-5 fen deep, apply a sterile gauze dressing and secure it with adhesive tape for 1-2 days to prevent infection. (Note: In acupuncture, “one fen” is equal to the width of one’s thumb nail.)
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Clinical Applications
1. Fire needle and filiform needle treatment for herpes zoster
Xu used a 26-gauge 1.5-inch filiform needle heated over an alcohol lamp, quickly punctured the lesions, and immediately withdrew the needle, applying purple medicine to each blister.
2. Fire needle treatment for shoulder periarthritis
Summer used a 20-22 gauge thick needle or sewing needle, wrapped the base with cotton thread, heated it until it glowed white, quickly and accurately punctured the affected side’s Jianyu point, and then quickly withdrew the needle, applying sterile gauze to the needle hole once a week.
3. Fire needle treatment for incarcerated internal hemorrhoids
Zhang lightly pressed to locate the center of the hemorrhoid, used a 7-gauge injection needle heated over a lamp, quickly punctured the center of the hemorrhoid, and immediately withdrew the needle, applying a gauze dressing externally, followed by a sitz bath with Sichuan pepper water.
4. Fire needle treatment for low back pain
Zheng divided patients into two groups, one group treated at Weizhong, Shenshu, and Yaoyan points, and the other group at Kunlun, Qihai, and Zhishi points. The two groups alternated, using fire needles heated until the needle tip turned red, inserting 3-5 mm deep, and quickly withdrawing.
5. Portable electronic fire needle treatment for surgical conditions
Connect the power supply, turn on the electronic fire needle treatment device indicator light, hold the fire needle handle, press the switch until the needle tip heats up and glows red, then operate. Aim the fire needle at the center of the lesion and quickly burn to the base. For papillomas, first pull the lesion outward with forceps, then place the fire needle horizontally after heating, cutting from the base; this can be removed in seconds. Xu used this method to treat common warts, pigmented moles, papillomas, flat warts, keratoacanthomas, sebaceous adenomas, and corns.
6. Fire needle treatment for pigmented moles and warts
Ma used fire needles developed by Ansteel Automation with diameters of 0.5, 1.0, and 0.25 mm. The needle tip was heated over a lamp, quickly burned the affected area, and repeated until complete destruction.
7. Fire needle combined with cupping for knee joint effusion
After routine disinfection, use a fine fire needle heated to incandescence, quickly puncture at the highest point of the joint; if fluid flows out, puncture 5-7 times; if the fluid is thick and difficult to expel, use a coarse fire needle heated red to puncture, then use the flash fire method for cupping, which may yield light yellow fluid; bandage to secure the knee joint. After the fluid is eliminated, switch to local acupoint treatment.
8. Fire needle treatment for lateral epicondylitis
Locate the tender points between the lateral epicondyle and the radial neck, disinfect, quickly puncture with fire needles 2-3 times, leaving the needle for 1-2 minutes, and then apply cupping for 10 minutes.
9. Fire needle bloodletting treatment for gout
Main points: Xingjian, Taichong, Neiting, and Xian Gu. For damp-heat accumulation, add Qiuxu, Dadu, and Taibai; for blood-heat stagnation, add Xuehai and Ge Shu; for phlegm-damp obstruction, add Fenglong and Pi Shu; for liver and kidney yin deficiency, add Taixi and Sanyinjiao, all on the affected side. Use coarse fire needles for foot points and fine fire needles for other points. After disinfection, quickly puncture with heated fire needles, inserting 0.3-1 inch deep, 1-3 needles per point. For foot points, the amount of blood drawn should be less than 100 ml each time.
10. Fire needle warming method for alopecia areata
Points: Ashi points, Shenshu, and Ganyuan. Use three-headed fire needles for Ashi points and single-headed fire needles for the other two points, disinfect the area, and quickly puncture with the heated fire needle.
11. Fire needle combined with external application at Yongquan point for recurrent oral ulcers
Expose the wound; if the wound is too large or numerous, first perform mucosal anesthesia, then puncture the wound with the heated fire needle, ensuring to clean without damaging normal mucosa. Afterward, mix vinegar with Wu Zhu Yu to form a paste for external application at Yongquan point, securing with musk bone-strengthening plaster for 24 hours.
12. Fire needle as the main treatment for stubborn facial nerve paralysis
Facial points: Yuyao, Sizhu Kong, Zan Zhu, Sibai, Yangbai, Xiaguan, Yingxiang, Dicang, Jiachuan, Taiyang, and Touwei, selecting 5-6 points each time. Body points: Hegu, Zusanli, and Taichong. Use single-headed fire needles (d=0.5mm) heated and punctured at the acupoints, inserting 1-2 fen without retaining the needle; then use filiform needles for puncturing, employing a balanced tonification and sedation method.
13. Fire needle treatment for fluorosis
Points: Jiaji points and Ashi points. Fluorosis is a local disease, and the number of points selected depends on the individual and symptoms. Fire needles should be heated until bright white, quickly inserted and withdrawn, about 1 inch deep, followed by cupping with herbal decoction (warmed), changing when cool, for 30-60 minutes.
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Common Questions
1. Standardization of fire needle instruments
From the above information, it is clear that fire needle instruments are made from various materials, and many practitioners use steel wires or iron wires to make fire needles, making it difficult to ensure the efficacy and safety of fire needles. The author believes that standardized high-quality materials should be used to develop various models of fire needles suitable for multiple diseases to meet clinical needs and facilitate the application and promotion of fire needle therapy.
2. Strengthening research on the mechanisms of fire needle therapy
Any effective therapy has its theoretical and material basis. Fire needle therapy has a long history and unique efficacy, but our understanding of its therapeutic mechanisms is currently limited. Especially, there is a lack of modern scientific research methods to explain its therapeutic mechanisms. Only by clarifying the mechanisms of fire needle therapy can we provide objective and scientific evidence for its application, which will further benefit the development of fire needle therapy.
3. Reducing the pain of fire needle treatment
Further improvements in the quality and thickness of fire needle instruments, enhancing the operational skills of medical personnel, can increase efficacy and safety while minimizing the fear and pain caused to patients during fire needle treatment.
4. Continuing to expand the application range of fire needles and clarifying contraindications in clinical practice, further exploring the indications for fire needle therapy, such as its recent applications in beauty and mole removal, which have also achieved good results.
Reviewed by: Jie Liang
Edited by: Lulu, Xiao He
Content organized by:Lulu