IntroductionFire needle therapy has a strong warming effect on the meridians. The renowned acupuncturist Professor He Purin has classified it as one of the warming methods in the three methods of treatment, due to its unique efficacy in treating limb pain, making it very popular among patients.1. Fire Needle Therapy for Cervical Muscle SpasmFire needle therapy involves using specially designed needles that are heated until red and then quickly inserted into specific acupuncture points or areas of the body to achieve therapeutic effects. The principles include dispelling wind and cold, warming the meridians, and unblocking the channels; Acupuncture points include Ah Shi points, Xuanli (Suspended Umbilicus), and Jianjing (Shoulder Well). Procedure: After routine disinfection, ignite an alcohol lamp, move the lamp close to the acupuncture point with the left hand, hold the needle like a pen with the right hand, heat the needle until red, quickly and accurately insert it into the point, then immediately withdraw the needle, and apply a disinfected cotton ball to press on the needle hole to ensure closure. Avoid water for three days, with treatments twice a week for two weeks as a course.2. Fire Needle Therapy for Shoulder PeriarthritisKey pain points for shoulder periarthritis include the coracoid process, supraspinatus insertion, rotator cuff insertion, posterior upper arm, infraspinatus, and the long head of the biceps tendon intertubercular groove.Acupuncture points: Ah Shi points. Method: Locate sensitive points above the biceps on the affected shoulder and at the anterior and posterior edges of the deltoid, usually 3-6 sensitive tender points, mark them, and disinfect. Use a tungsten steel fire needle heated to a bright white on an alcohol lamp, quickly prick the marked reaction points. Generally, needle 3-5 points each time, inserting about 1 inch deep, without leaving the needle in place. Treatment is done once every 5-7 days, typically 3-5 treatments can lead to recovery. Some patients may require additional sessions. After fire needle treatment, the area should not come into contact with water for 5 days, and functional exercises should begin the day after treatment.3. Fire Needle Therapy for Rheumatoid ArthritisAcupuncture points include Jiajiao (Jiaji points) and local Ah Shi points. 1.3.2.3 Fire needle method: The Shishi fire needle technique uses a mini alcohol lamp to heat the needle. The practitioner holds the alcohol lamp in the left hand and the needle in a brush-like grip in the right hand. First, heat the base of the needle, then slowly lift it, heating the tip until bright white, and quickly insert and withdraw. Treatment is done once every other day, with 10 treatments as one course. 1.3.2.4 Precautions: After each needle, immediately press the needle hole with an alcohol cotton ball to prevent bleeding, and avoid rubbing. After fire needle buried line treatment, do not wash or wet for 3 days to prevent infection. During treatment, avoid raw, cold, and spicy foods.4. Fire Needle Therapy for CornsFire needle therapy is very effective for treating corns. After heating the needle red, directly prick the corn, generally healing occurs after two treatments, while some severe cases may require 3-4 treatments. Ensure proper disinfection, and avoid water on the needle hole for three days.
5. Fire Needle Therapy for NeurodermatitisFire needle therapy is used for neurodermatitis. Due to the purchased fire needles being relatively thick, patients may find them uncomfortable. I use a 0.5 mm needle, heating it red or white on an alcohol lamp, and then scatter prick the lesions, ensuring disinfection with alcohol. This method is effective for both localized and generalized neurodermatitis, generally reducing itching after one treatment, with many patients feeling quite comfortable during treatment. Although it may be slightly painful, it is much more bearable than itching, and some patients even request additional pricks for more relief. I take Sundays off, so for smaller areas, I treat patients on Mondays, Wednesdays, and Fridays, while larger areas are treated twice a week. Generally, after 10 to 20 treatments, most patients can achieve recovery.6. Fire Needle Therapy for Chronic Erysipelas of the Lower LegTwo patients had chronic erysipelas with acute flare-ups, treated with various antibiotics and herbal medicine. I tried fire needle therapy with good results. The method involves disinfecting the lesion area with 75% alcohol, heating a fine needle until red on an alcohol lamp, and then pricking the lesion to a depth of 0.5 inches, followed by cupping for 10 minutes (using 3-5 small cups, as large cups are not suitable and may fall off). A lot of light yellow viscous fluid is drawn out, and the patient experiences light yellow fluid seeping from the needle hole for several hours after treatment. Treatment is done daily for 3 days, then every 3 days thereafter. During treatment, antibiotics are not used. Patients report reduced swelling the day after treatment, and after 5-7 treatments, they recover. During treatment, patients should rest, elevate the affected limb at 30-40 degrees, drink plenty of water, and keep the lesion area clean.7. Fire Needle Therapy for Breast MassesBreast masses can vary in size and shape, with unclear boundaries with surrounding tissue, movable upon palpation; they may be painful and enlarge 3-4 days before menstruation, with pain reducing or disappearing afterward, and the mass shrinking. After routine disinfection of the lesion area, a medium-sized coarse fire needle is heated to red on the outer flame of an alcohol lamp. The practitioner uses the thumb and index finger of the left hand to stabilize the mass, quickly pricking the heated needle into the center and around the mass, without leaving the needle in place, and immediately pressing the needle hole with a disinfected cotton ball to prevent infection. Treatment is done once every other day, with 20 treatments as one course.Often caused by liver qi stagnation due to anger, spleen deficiency from overthinking, leading to phlegm dampness accumulation, resulting in damage to both liver and spleen, kidney deficiency, and disharmony of the Chong and Ren channels, with yang deficiency and phlegm dampness accumulation causing this condition. Fire needle therapy has a warming effect that aids yang, stimulates the flow of qi, unblocks the meridians, invigorates blood circulation, and eliminates accumulations; it also helps yang transform qi, facilitating the smooth flow of qi and body fluids, thus resolving stagnation and phlegm dampness. Fire needle therapy is particularly effective for short-term conditions and masses with a diameter of less than 2.5 cm; for longer-term conditions or larger masses, the treatment course should be extended.8. Fire Needle Therapy for Ankle SprainsIn clinical practice, I often encounter patients with ankle sprains. As long as X-rays confirm no fractures, fire needle therapy can be used. Most patients come in needing assistance to walk, but after treatment, they can walk out on their own, demonstrating its effectiveness. After heating the needle red, I prick 4 to 8 needles at the most swollen and painful area of the ankle, allowing the blood stasis to naturally drain out, after which a plaster can be applied, and recovery occurs in 3 days.
9. Fire Needle Therapy for Ganglion CystsA ganglion cyst is a cystic mass that occurs in the tendon area, usually found on the wrist or the dorsal side of the foot, varying in size, soft or hard upon palpation, and is more common in young women. It develops slowly, often presenting as a half-spherical mass on the wrist, fixed at the base, elastic, mostly asymptomatic, with occasional sensations of soreness and weakness, and severe cases can affect normal life.Common treatments include: 1. External force to rupture, break, or squeeze the cyst wall for self-absorption; 2. Using a thick needle to puncture, aspirate the gelatinous fluid, and inject hydrocortisone or prednisone, followed by pressure bandaging; 3. Surgical treatment, which not only has a large wound area but also leaves scars on the hand or foot. All these methods have a high recurrence rate.Fire needle therapy for ganglion cysts is quick-acting and has a low recurrence rate! Treatment method: The patient sits or lies down, exposing the affected area, disinfecting routinely, then using a coarse fire needle heated red on an alcohol lamp to quickly prick the base of the cyst, quickly inserting and withdrawing 3-5 times to expel the thick gelatinous substance inside, then covering with a band-aid, treating once every 15 days. Generally, 1-2 treatments are sufficient.Ganglion cysts fall under the TCM categories of “Wrist Tendon Knot” and “Tendon Accumulation,” often caused by overexertion or trauma, leading to tendon strain and obstruction of qi and blood flow in the area. Fire needle therapy aims to use external fire to assist internal fire, enhancing the driving force of qi and blood circulation, warming and dispersing accumulations, and unblocking the meridians to achieve therapeutic goals. Additionally, fire needles can directly destroy the cyst wall tissue with their high temperature, eliminating the ability for regeneration, thus reducing the likelihood of recurrence.10. Fire Needle and Cupping Therapy for Skin NumbnessFor the lateral thigh, acupuncture points include the Du meridian from L1 to L5, Jiajiao, and the affected area; for the face, points from Fengfu to C7 of the Du meridian, Jiajiao, and the affected area; for the abdomen, points from T10 to L2 of the Du meridian, Jiajiao, and the affected area; for the perineum, points from L3 to the sacral region of the Du meridian, Jiajiao, and the perineum.For the corresponding areas (excluding face and perineum), cupping is applied for 15-20 minutes. After routine disinfection, the practitioner holds the ignited alcohol lamp in the left hand and a self-made fire needle (a No. 2 steel sewing needle with the tip cut to make it flat, and the tail wrapped with tape) in the right hand, heating the needle until it glows red, quickly pricking the Du meridian, Jiajiao, and the affected area. The sequence is: healthy side Jiajiao from top to bottom, Du meridian from bottom to top, affected side Jiajiao from top to bottom, and the affected area from the periphery of numbness towards the center. The needle depth is about 0.5 mm. After the procedure, routine disinfection with iodine is performed.Patients should avoid wetting the needle site, scratching, or applying plasters, and should stop other treatment methods. Treatments are done every 3 days, with 6 treatments as one course.In a study of 126 cases, the cure rate was 79%, and the effective rate was 95%.11. Fire Needle Therapy for Varicose VeinsIn TCM, this is referred to as “Tendon Accumulation,” believed to be caused by prolonged standing, leading to poor qi and blood flow in the lower limbs, resulting in slow blood circulation and stagnation of the vessels. Treatment focuses on regulating qi, invigorating blood, and unblocking the meridians.Types: (1) Liver qi stagnation and spleen deficiency (2) Qi stagnation and blood stasis (3) Liver and kidney yin deficiency (4) Blood stasis obstructing the vesselsAcupuncture points: Ah Shi points, Xuehai (Blood Sea).Method: For Ah Shi points, use fire needles to prick the varicose veins. For severe cases, apply a tourniquet above the lesion, then use fire needles to prick the lesion to expel the stagnant blood, release the tourniquet, and then use fine needles to prick the Xuehai point.12. Fire Needle Therapy for Patellar Ligament Injury NodulesA patient presented with a large nodule the size of a jujube on the left knee after trauma for over a month. I was unsure what it would be called in Western medicine, but I thought fire needle therapy would be effective. After obtaining the patient’s consent, I began my fire needle practice, pricking the nodule over ten times, asking the patient to return in three days. The patient returned on the fourth day, and it was incredible; the original “jujube” was nearly invisible to the naked eye, feeling only a small base.
13. Fire Needle Therapy for Herpes ZosterThe specific operational method for fire needle therapy is as follows:(1) The patient lies down with the herpes facing up, disinfect the herpes and surrounding skin with iodine cotton balls, then gently dry with a disinfected cotton ball to fully expose the herpes for clear visibility.(2) Explain to the patient and encourage cooperation to alleviate fear.(3) Use a fire needle (or a straightened paperclip as a makeshift fire needle), heat one end over an alcohol lamp until red, and prick the tense, shiny areas of the herpes wall, avoiding excessive depth. The herpes fluid vaporizes due to the high temperature, and occasionally, the sound of the herpes wall breaking can be heard, with minimal pain felt by the patient. After pricking, the skin at the prick site will contract and become slightly red. Smaller herpes lesions may become clean and dry after vaporization, while larger blisters can be pricked multiple times, but the prick area should not exceed the base, and any excess fluid should be wiped away with a disinfected cotton swab.(4) For numerous herpes lesions or extensive areas, it is advisable to prick in stages, not pricking too many at once. Start with the tense, shiny herpes or larger blisters, and continue with the remaining lesions the next day. If the patient has a poor constitution, intervals of 2-3 days may be used, along with supportive therapies such as BCG polysaccharide-nucleic acid injections to enhance immunity.(5) After pricking the herpes with the fire needle, disinfect the wound with iodine cotton balls, and apply acyclovir ointment or other astringent medications.(6) Fire needle pricking therapy is particularly effective for early-stage herpes zoster when lesions are small.14. Fire Needle Therapy for Common WartsAfter heating the needle red on an alcohol lamp, the method involves directing the needle at the center of the wart, quickly burning until reaching the base; or quickly pricking the base of the wart, with a depth of about 2/3 of the wart’s base, using a cross pattern to ensure the wart root turns grayish-white. After 7-14 days, the wart may fall off on its own. During the burning process, the fire needle may need to be reheated multiple times. For filiform warts, pull the wart outward before quickly cutting it off with the heated needle, which can be done in seconds, followed by iodine application and covering with a dressing, secured with tape. The area should not be wet until fully healed.15. Fire Needle Therapy for Facial TelangiectasiaUsing a 0.45*55mm fire needle, after heating it red, quickly prick the center of the telangiectasia, causing it to disappear immediately. Generally, treat about 10 at a time. Patients should avoid washing their faces for 24 hours.16. Fire Needle Therapy for Tennis ElbowMethod 2.1 Acupuncture points: The patient lies supine with the elbow flexed to fully expose the affected area, or sits on a sofa with the forearm resting on the armrest to expose the affected area. The practitioner supports the affected limb with one hand and presses the lateral epicondyle of the humerus with the thumb of the other hand, marking the size of the lesion based on the hard lump and pain for the next step.2.2 Procedure: After routine disinfection, the practitioner holds the ignited alcohol lamp in the left hand and a medium-thick fire needle in the right hand, heating the needle tip 1-1.5 cm from the affected area until it turns red, then quickly pricking the lesion, generally making three pricks in a triangular pattern, with the distance between pricks determined by the size of the lesion. Afterward, disinfect the needle hole with an alcohol cotton ball and instruct the patient to keep the area clean and dry for 24 hours. Treatments are done once every 3 days, with 3 treatments as one course. For patients with severe pain radiating to the forearm, additional fine needle pricks at the points of Sanli (Stomach 36) and Hegu (Large Intestine 4) may be used; for those showing signs of qi deficiency and insufficient blood, internal herbal medicine may be prescribed, such as Huangqi Guizhi Wuwu Decoction with modifications.
17. Applications of Fire Needle Therapy for Pain ManagementTian Xiaogang (Acupuncture and Tuina Department, Tianshui Second People’s Hospital, Gansu 741020) Fire needle therapy has a long history, is simple to operate, and shows rapid effects, especially excelling in pain management. In recent years, I have learned valuable experiences from Professor He Purin’s fire needle therapy and applied them clinically with significant results. Here, I present several cases to advocate for this method.Case 1:Liu, female, 61 years old, presented with persistent swelling and pain in the heel for a week, worsening with pressure, sometimes extremely painful, unable to bear weight. After seeking treatment elsewhere, X-rays showed bone spurs, but treatment for the spurs was ineffective and pain worsened. Physical examination revealed significant tenderness over the calcaneal tuberosity with a large area of tenderness, diagnosed as calcaneal fat pad inflammation. Using a medium fire needle, I pricked Chengshan (Bladder 57), Kunlun (Bladder 60), and local tender points, treating once a week for two weeks, with symptoms disappearing, allowing normal walking. Six months later, no recurrence was noted.Case 2:Wang, male, 72 years old, unable to walk for over six months due to left knee pain. Physical examination showed limping, with significant tenderness at the origin of the medial collateral ligament and joint capsule of the left knee, while X-rays showed no abnormalities. Diagnosed with left medial collateral ligament inflammation, I used a fine fire needle to prick Xuehai (Spleen 10), Sanyinjiao (Spleen 6), and the tender points at the origin of the medial collateral ligament and joint capsule, treating once a week for three weeks, with symptoms disappearing, allowing normal walking. Six months later, no recurrence was noted.Case 3:Li, male, 38 years old, presented with pain in the lower back and right hip after lifting heavy objects for over a week. No previous history of back pain. Physical examination revealed difficulty walking, requiring assistance, with significant tenderness at the right L3 transverse process. X-rays showed no abnormalities. Diagnosed with right L3 transverse process syndrome, I used a medium fire needle to prick three times towards the right L3 transverse process from the pain point, then pricked Huantiao (Gallbladder 30) twice, followed by cupping for 5 minutes at the pricked site, wiping away the extracted fluid after cupping. Three days later, pain had completely resolved.Case 4:Zhang, female, 26 years old, presented with soreness and pain in the right scapular area for over two years, sometimes radiating to the right upper limb. Physical examination: I had her place her right hand on her left shoulder to fully expose the right scapular area, where a pain point was found at the T4 level. Pressing this point caused significant discomfort in the right upper limb. Diagnosed with right scapular rib syndrome, I used a medium fire needle to prick the pain point three times (the pricking site is generally on the rib above the pain point, so it is essential to palpate and stabilize the rib with the left hand before pricking to avoid accidents), treating once a week for four weeks, with symptoms disappearing. Follow-up after one year showed no recurrence.Conclusion:Fire needle therapy has a strong warming effect on the meridians, which is why the renowned acupuncturist Professor He Purin classified it as one of the warming methods in the three methods of treatment, due to its unique efficacy in treating limb pain, making it very popular among patients. In recent years, I have discovered through extensive practice that the traditional fire needle therapy often targets the Ah Shi points, which are frequently the origin of pain, and by mastering anatomical knowledge, one can accurately locate treatment points, making the Ah Shi points more precise.In Case 1, in addition to treating the tenderness over the calcaneal tuberosity, I also followed the theory of “where the meridian passes, treat where it affects” by selecting Chengshan and Kunlun points to unblock local qi; in Case 2, besides treating the tender points, I also followed the above theory by selecting Xuehai and Sanyinjiao points to dispel stasis and unblock the meridians; in Case 3, in addition to pricking the L3 transverse process tenderness point to quickly relieve spasms, I also selected Huantiao to facilitate qi flow in the lumbar region, leading to rapid pain relief. In Case 4, although only the Ah Shi point was selected, it is crucial to operate based on familiarity with local anatomy, with special attention to medical safety during the procedure.
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