Reading various opinions and observing clinical cases.
—– Jie Er
Ku Xilong
The article is long but very practical and excellent. The author mentions situations that often occur in clinical practice, such as knee pain treated at the Quchi (LI11) point, where needling any point one inch in front, back, left, or right of Quchi is effective. Similarly, for ankle sprains, needling the wrist at either Yangchi (SI5) or Hegu (LI4) is effective. I believe we should not ignore point selection just because there is no statistical difference; it is like ignoring suffering just because a condition is self-limiting or attributing success to others. My experience is that for acute pain and acute onset diseases, when needling distal points, as long as the general area is correct, it is effective. However, we must never neglect pattern differentiation and treatment.
Dr. Huang Key. Wong
Random needling actually refers to proximal local point selection, which is indeed effective. But would you dare to randomly needle distal points? For example, when treating acne, the Neiting (ST44) point must be accurately located to clear stomach heat. Similarly, for tinnitus, the Zhizhu (TH5) point must also be accurately located to open the Sanjiao.
Yi Mi Yang Guang
I really like this article and have repeatedly listened to Dr. Wu’s lectures. I also enjoy random needling and have indeed gained from it!
De Ren Tang Ji Sheng Fang ● Yan’s TCM
The beauty of acupuncture lies in its fear; without fear, it cannot be used effectively. Fear causes Qi to descend, and contention for Qi occurs above, while harmony resides below; this is not just about illness but also about life.
A TCM practitioner, Dr. Li
Waiting for experts to comment.
De Ren Tang Ji Sheng Fang ● Yan’s TCM
Among all symptoms, pain is the easiest to resolve because people are deeply affected by pain, and when Qi is urgent, it is easy to alleviate. Among all things, people fear needles the most, as needles penetrate deeply into the body. Where the needle goes, it can move the spirit, disperse intention, alleviate Qi, and harmonize blood.
After Li Xin 13769366655
The path is simple; the author has grasped the essence of national medicine!
The dilemma of national medicine lies in everyone doing addition, while no one does subtraction. This article has given me a joyful slap in the face! /smile
Famous in Medicine
Understanding the organs and pressing the meridians to find tender points below the elbows and knees is often effective.
Li Dongjie
I read a third of it but copied and printed it out. This article on pain treatment, using pain as a guide, is appealing, but for complex diseases that are not pain-related, differentiation is necessary, whether through acupuncture or herbal formulas.
Liaoning Jiashan Water Landscape Municipal Horticultural Engineering Co., Ltd.
Heavenly principles combined with human principles can cure all diseases /smile
Dream Chaser
Similar to the Qian family’s “Vertical and Horizontal Needle Technique.”
Jing Shui Shen Yuan * Xing He Hao Han
Through the refinement of returning to the basics, only those who are capable can achieve it; those without learning do not need to learn!
Yeah! Dear (Ye Qing)
Very practical, no nonsense, thank you!
Dr. Ma
Very good article; I have been reading it since 8 AM and have gone through it several times. If acupuncture and myofascial release techniques are combined, would there be better efficacy? /smile
Dr. Zhang
Such high-level skills without pretension are rare.
Remarkable yet unpretentious, indicating that the source is a true hero, I admire it.
Famous in Medicine
To add a point: one must differentiate the organs; after clarifying the organs, press the corresponding meridians to find the tender points, and acupuncture will be effective. For example, a student in Lianyungang encountered a postpartum woman with no milk on one side. After a phone inquiry, I thought the nipple belonged to the liver, and taught her to press the liver meridian to find the tender point for acupuncture, resulting in a cure after one treatment.
Dr. Zhang
Experts follow their hearts, traversing east and west.
Sunshine, with a small internal storage, temporarily does not want to join groups or chat.
The article is well written, but it does not clearly state where the patient with 20 years of insomnia was treated, which is a bit of a regret. In any case, I am grateful! /strong/strong/strong
Cui Guobao Yi Chu 13653736163
The writing is good, the clinical practice is good, and it has inspired me and broadened my horizons!
Dr. Zhang Yuxuan Henri Chong
This article is indeed excellent; regardless of the content, it has reached the realm of seeing mountains as mountains again! There is no fixed method; it is free and unrestrained!
San Bai Ju Zhu Ren
The meridians passed through, the main treatment areas, the acupoints as large as plates…
🙏 Dan Zeng Zhuo Ma ~ 🌺 Hu Shan Qi
Random needling is also a cumulative experience /rose/rose/rose/rose
Di Du Ye Yi
Very good article; I was captivated and read it carefully, with reasoning, evidence, and cases, very useful. I read it on my way to work, and it took me 15 minutes to read half of it, so I rushed to comment before continuing. Thank you, teacher /smile
Li Da Lei Bozhou TCM, Rehabilitation
Try treating shingles; I currently have a case that can be wrapped.
Ronny
I feel that what the author is talking about is floating needles and intradermal needles; the operation is quite similar.
Qu Bin
Are there any TCM treatments for leukemia? I’m anxious, thank you!
Yun Jie
It should be about not leaving the meridian while leaving the acupoint; if it is not on the meridian of the lesion, the effect may not be good~
Wise! (General)
Random needling is not that simple!
Qu Shan Zhong
A few days ago, I watched Teacher Wu’s treatment of shingles with “Dou Dou Fei”; clinical trials showed that for superficial cases, the pain stopped immediately after the procedure, but the next day it almost returned to the original level__ continuing to hurt. May I ask Teacher Wu what the situation is in clinical practice, and what is the specific operation and treatment course? Please advise, Teacher Wu!
Bu Yi Zhi Jiao
One needle cured shingles in the chest and ribs < Huiyin point >
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Using Pain as a Guide, Random Needling
“Using pain as a guide” comes from the Ling Shu, used to treat muscle stiffness. The Ling Shu: Jing Jin Pian states: “Treat with burning needle and stabbing, using knowledge as a number, using pain as a guide.” In my clinical practice, I have used this method to treat various diseases and found satisfactory results. So why can we say that using pain as a guide allows for random needling?
Theoretical Basis
The Qian Jin Fang states: “For every 101 diseases, some can heal without treatment; some require treatment to heal; some are difficult to heal even with treatment; and some are truly dead and cannot be treated.” This means that some diseases can heal without treatment, while some can heal with simple treatment. However, there are also some that are very difficult to treat. Zhong Sheng also expressed the sentiment of “not being able to completely cure all diseases” and lamented that “it is truly difficult to separate life from death.” This is discussed from a textual and logical perspective.
Next, let’s discuss from a clinical experimental perspective. In September 2007, the ARCH INTERN MED published a study report titled “Acupuncture Treatment for Chronic Low Back Pain: A Randomized, Multicenter, Blinded, Parallel Group Trial” from Germany. The results showed that the treatment response rates (effectiveness) for the three groups were 47.6% for the acupuncture group, 44.2% for the sham acupuncture group, and 27.4% for the conventional therapy group. Both acupuncture groups showed statistically significant differences compared to the conventional therapy group, while there was no statistical difference between the two acupuncture groups. Needling at acupoints, with the technique producing a sensation of Qi, and needling other points according to the symptoms, showed no statistical difference in efficacy compared to needling at non-acupoints with a depth of only 1-3 mm and no technique applied. In 2006, another clinical trial study on acupuncture for knee osteoarthritis in Germany also showed no significant difference in efficacy between the acupuncture group and the sham acupuncture group.
A Brazilian clinical study on acupuncture for preventing migraine attacks also indicated no difference between acupuncture and sham acupuncture in reducing migraine frequency. Some people believe that because acupuncture and sham acupuncture have similar effects, acupuncture is ineffective. However, I believe that the efficacy of acupuncture is so good that random needling can be effective. If these three diseases can accurately find the tender points and use pain as a guide, random needling will yield even better results.
Furthermore, some have conducted literature studies on acupuncture points for treating shoulder periarthritis, such as Zhongping, Tiaoshan, and Jiantong, and hypothesized that stimulating a large area on the fibular side below Zusanli (ST36) would be effective for shoulder periarthritis. This article is titled “Current Status of Acupuncture Point Selection for Treating Shoulder Periarthritis.” Teacher Huang Longxiang clearly pointed out in the article “From Three Famous Cases to See the Complexity of Acupuncture Clinical Research” that Tiaoshan was originally for treating low back pain, and using it for shoulder stiffness was a case of misapplication; the actual situation is that distal needling is effective when the affected area is mobilized.
Additionally, there is a post online about bloodletting treatment for mastitis. The acupoint selection requires the patient to place their palm facing up, with the arm flat on the table, and the first needle is inserted at the first transverse line behind the wrist (at the Dalung point). Then, using the length of the patient’s little finger as one inch, a non-retractable grass stick or bamboo stick is used to measure and cut a ruler (note that the fingernail is not counted). Starting from the first needle, measure one inch up the midline of the forearm, inserting a needle for a total of seven needles. It also points out precautions: the first needle is exactly at the Dalung point, and it must not be mistaken; this point is crucial, and if it is wrong, the other points will naturally be wrong, emphasizing the need for accurate point selection; otherwise, it may be ineffective. I have used this method, and it is indeed effective; some patients have been cured after one treatment. However, I have also found that random needling in the forearm or directly venous bloodletting is also very effective.
From a holistic perspective, every needle is an overall adjustment. This is not only believed in acupuncture but also emphasized in the Western book “Anatomy Trains”.
Principled Methods
So can we just randomly needle without using pain as a guide? Of course not. Random needling is based on using pain as a guide; without using pain as a guide, there can be no random needling.
How random can random needling be? First, it is related to the depth of the disease; the shallower the disease, the easier it is to treat, and the more random it can be; the deeper the disease, the more accurate it must be. For superficial lesions, random needling may lead to a cure. However, for lesions at the attachment points of skeletal muscles, it is necessary to accurately needle the lesion site. Based on my clinical experience, it is often a matter of millimeters; a slight deviation can lead to significant errors. There was a young female patient with pain in the area above the left scapula. After a week of treatment, there was improvement but not complete recovery. Upon re-examination, I found tenderness above the rib on the scapula; since the patient was relatively thin, I could clearly feel the rib, so I instructed the patient to hold their breath and directly needle the tender point above the rib, resulting in a cure after one treatment. This can be imagined as a funnel shape; the shallower the disease, the larger the funnel, allowing for more random operations, while the deeper the disease, the smaller the funnel, requiring more precision.
Secondly, it is related to the practitioner’s skill level. For example, the oil seller can pour oil effortlessly, while we may not be able to do so even with careful pouring. Similarly, the more familiar the practitioner is with the patient’s issues, the more random the treatment may appear.
Now, where is the “guidance” in using pain as a guide? I believe it requires a three-dimensional coordinate system: vertical, horizontal, and depth, all three determining the treatment. The Nei Jing discusses the differences in acupuncture locations and depths, stating that one should take from the meridian, guarding the sinews at the sinews, and guarding the bones at the bones. Below, I will discuss using pain as a guide from these three levels.
Using the Meridian
Here, the meridian can be understood as the meridians, including the primary and collateral meridians. Using the meridian can be understood as superficial needling. The Ling Shu: Shou Yao Gang Rou states: “Huang Di said: I have heard that there are three changes in needling; what are the three changes? Bo Gao said: There are those who needle the Ying, those who needle the Wei, and those who needle the cold stiffness that lingers in the meridian. Huang Di said: How to needle the three changes? Bo Gao said: Needle the Ying to cause bleeding, needle the Wei to cause Qi, and needle the cold stiffness to cause internal heat.” Here, it can be considered as using the meridian, that is, superficial needling, and there are methods for needling the Ying, needling the Wei, causing bleeding, and causing Qi.
The Su Wen: Acupuncture Essentials and Su Wen: Acupuncture Techniques both suggest that the body’s depth levels range from superficial to deep as skin, flesh, meridians, sinews, and bones. Regardless of the standard, superficial needling can be considered to include the skin, flesh, and meridians; needling at these three levels can all be called superficial needling. Comparing the Nei Jing with modern anatomical structures, I believe that flesh refers to the subcutaneous fat layer, and the meridian certainly includes blood vessels. The subcutaneous tissue is mainly composed of loose connective tissue and adipose tissue, which is also known as superficial fascia in anatomy. There are collateral vessels passing through the subcutaneous tissue, and the flesh and meridian intersect here, hence the two interpretations. The deeper subcutaneous tissue is where the meridians are located between the flesh. The Ling Shu: Jing Mai states: “The twelve meridians run between the flesh, deep and unseen.” “Flesh,” as noted by Wang Bing, can “cover and hide the sinews and bones” and “allow the Wei Qi to flow.” Therefore, superficial needling mainly affects the meridians, collaterals, and the flow of Wei Qi. The Ying flows in the meridian, while the Wei flows outside the meridian. Superficial needling can directly regulate the Qi of Ying and Wei.
Researching modern literature and ancient texts, we can find that superficial needling holds a very important position, especially in the treatment of pain. In ancient times, there was superficial needling; the Ling Shu: Official Needling mentions methods such as collaterals needling, hair needling, half needling, praise needling, leopard pattern needling, and floating needling; additionally, the Ling Shu: Jing Shui and Su Wen: Needle Explanation also record superficial needling. The Ling Shu: Jing Shui states: “For the foot Yangming, needle deep six fen, leave ten breaths. For the foot Taiyang, needle deep five fen, leave seven breaths. For the foot Shaoyang, needle deep four fen, leave five breaths. For the foot Taiyin, needle deep three fen, leave four breaths. For the foot Shaoyin, needle deep two fen, leave three breaths. For the foot Jueyin, needle deep one fen, leave two breaths. For the hand Yin and Yang, the path of Qi is close, the Qi comes quickly, and the depth of needling should not exceed two fen, and the retention should not exceed one breath.” The deepest is no more than six fen, and the shallowest is one fen; the depth of needling is evidently shallow.
The Nanjing mentions the method of “lying needle.” The Nanjing: 71st Difficulty states: “Needle the Yang by lying down and needling it.” “Lying needle” means needling along the skin. The Bian Que Shen Ying Needle and Moxibustion Jade Dragon Classic clearly records the method of needling along the skin to penetrate the acupoints. It also clearly states that for pain, the lying needle method is particularly important. Importantly, after researching the historical relationships of ancient acupuncture literature, I chose the Acupuncture Classics, Su Wen with Wang Bing’s annotations, Taiping Shenghui Fang: Needle Classics, Bronze Man Acupoint Acupuncture Atlas, and Classical Acupuncture Atlas to investigate the needling depth of all ancient acupoints, confirming that the conventional needling depth in ancient times was relatively shallow, with acupoints needled below three fen accounting for about half of all acupoints.
How do I use superficial needling in clinical practice? For example, for common acne, I generally use a No. 7 sterile injection needle for treatment.
Method: The patient lies face down, taking a No. 7 sterile injection needle, holding it at an angle, quickly inserting it into the skin of the back, flipping the wrist, exiting the skin, and piercing the fibrous tissue within the superficial fascia of the skin and subcutaneous layer, inserting three to five needles, applying cupping, stopping the bleeding, cleaning the blood with a sterile cotton swab, and disinfecting the skin. It can be combined with acupuncture around the acne or subcutaneous puncture. The back points are conventionally selected in the inner scapular area. However, there is no need to be overly concerned; just randomly needling a few points will suffice. Once a week or twice is sufficient. It can also be done with a sharp surgical knife.
Some patients who have not healed for a long time have had very good results. There are patients who have seen results after one treatment and have been cured after three treatments. However, some patients are still not satisfied with the results, and the reasons are still unclear. The duration of the patient’s illness does not matter.
Needling is a relatively heavy superficial fascia therapy, requiring the breaking of some fibrous tissue within the superficial fascia, while also having a significant impact on the meridians. In folk medicine, it is often referred to as root cutting therapy, often used to treat relatively long-term diseases. I have also used it to treat hemorrhoids, and it has worked, but I have not treated many. There was a patient with insomnia for 20 years who was cured using this method, and afterwards, when coming for other ailments, their sleep remained very good.
Speaking of shingles, shingles have a tendency to self-heal, and there are many TCM treatment methods, including internal medicine, external applications, acupuncture, and bloodletting, all of which have good efficacy. Here, I will introduce a Western superficial fascia treatment. The book “Myofascial Release” has a Taiwanese translation. The main method is to hold the skin and stretch the fascia. I applied this to treat the pain of shingles.
Method: Use both hands to hold the skin in the painful area and pull it in various directions; both hands can pull inward or outward, in the same direction or opposite directions, and repeat the operation. Single-handed operation is also acceptable. This is not the original version; the original is mostly double-handed opposite stretching. Sometimes the pain stops immediately after the procedure. This is related to the depth of the disease; for shallow diseases, it can be effective immediately. To maintain the effect, “muscle inner effect taping” can also be used. What is muscle inner effect taping? It is the tape that Li Na uses on her knee during tennis. Taping means bringing the practitioner’s hand home.
Speaking of taping, let me insert a taping case. A patient with facial paralysis, accompanied by ear pain for two weeks. The ear pain was unbearable, and they had been treated elsewhere for two weeks. The ear had intermittent stabbing pain, occurring once every second, causing great suffering. After inquiring about the condition, I performed myofascial release, which I call “Dou Dou Fei”; friends who have played “Dou Dou Fei” with children will know this action. After treatment, the pain was significantly reduced. Therefore, I applied taping. After taping, I observed for 30 minutes, and the pain did not return. Upon re-examination, there was also no pain. The patient reported that it was the first time in two weeks that they could sleep peacefully, waking up at 2 AM due to needing to go to the bathroom, and was very excited, chatting with their husband for two hours. Taping therapy is safe and simple; among athletes, there is a saying: “No taping, no exercise.” It is widely used in the prevention and treatment of sports injuries.
Continuing with “Dou Dou Fei” treatment for shingles, there was a case of a bladder cancer patient who developed shingles in the waist and lower abdomen after surgery and radiotherapy. After undergoing various treatments, the skin lesions had healed. When seeking treatment, the patient had been suffering for a month, with unbearable pain and unable to sleep. I performed acupuncture, randomly needling in the affected area, followed by myofascial release, and they were able to sleep after one treatment, with pain disappearing after two treatments. This was not applied solely to shingles, but when applied to other superficial fascia pain, it can be effective immediately for shallow cases.
Superficial needling has two examples. One elderly female patient had heart failure after bone cancer, experiencing chest tightness at night. I saw that the previous doctor had given nitroglycerin, but the effect did not last long, and the doctor had to get up several times at night to handle it. So I performed superficial needling near the Lingtai (PC8) point, leaving one needle in place, resulting in a peaceful night’s sleep. Another patient with dilated cardiomyopathy also showed signs of heart failure and had been unable to sleep lying flat for 20 days, requiring special attention from the on-duty doctor every night. I also performed superficial needling at the Lingtai point, leaving one needle in place, and they were able to sleep lying flat.
Superficial needling can also have another application. Sometimes patients come to the clinic with sudden minor ailments, mainly pain-related. Sometimes I estimate that the problem is not serious and will insert a needle into a distal limb, then have the patient move. If it is indeed a minor issue, the patient will immediately feel pain relief. Of course, serious issues will not resolve so quickly. Young doctors in the clinic find it very miraculous and ask me where to needle and how to select points. I reply: “Randomly needle.” At this point, the young doctors seem to have doubts. One day, a young patient with shoulder pain came in, having only been in pain for one day. I called over a young doctor and said, “You point to a place, and I will needle.” The young doctor pointed to a spot on the patient’s forearm. Other young doctors gathered around to watch. I then inserted the needle into the spot they pointed to, gently twisting it, and instructed the patient to move the affected area. As a result, the patient immediately felt pain relief. The next day, they reported that they had recovered. Another patient had discomfort in the neck. I asked the young doctor to point again, and he said, “Zusanli (ST36).” Since the patient’s clothing was tight, I could not roll it up to Zusanli. After the young doctor agreed, I changed to a point above the ankle, inserted the needle under the skin, and had the patient move, resulting in immediate pain relief. In another case, although there was no obvious relief at first, after a few minutes of twisting, the pain significantly improved. Another patient with an ankle sprain for a month had significant walking limitations. I randomly needled at any point on the wrist, inserted the needle slightly, and they were able to walk on the ground. The next day, upon re-examination, they walked significantly better. There were still minor symptoms, and treatment continued. Originally, I used to use small section points, but now I no longer do. I have experimented multiple times, and light symptoms have repeatedly responded well. The young doctors no longer have doubts in their eyes. This is because superficial needling directly connects to the meridians. In fact, my explanation may not be entirely correct.
Superficial fascia treatment also has another method. Western orthopedic rehabilitation has introduced yoga breathing techniques; during breathing exercises, the superficial fascia also moves, so correct breathing has a pain-relieving effect.
Qi Baishi once said: “Those who learn from me live, while those who imitate me die.” Martial artist Zhao Daoxin said: “Look at what those martial arts masters practice behind closed doors.” Many methods have commonalities behind them.
Cupping, spine kneading, and scraping can also be seen as superficial needling methods. You can refer to the research results of Teacher Fu Zhonghua.
In the Sinews, Guarding the Sinews
In the sinews, guarding the sinews mainly treats muscle lesions. In clinical practice, the most commonly used tender points are located at muscle or skeletal muscle attachment points.
Everyone knows about tender points, but when it comes to in-depth research, the systematic and regular study of tender points that can effectively guide clinical practice belongs to Director Xuan Zheren of the Central Hospital of Jing’an District, Shanghai, and his “Xuan Zheren Soft Tissue Surgery” (hereinafter referred to as Soft Surgery).
How does pain arise? Soft Surgery believes that the soft tissues of the human movement system, such as skeletal muscles, fascia, ligaments, joint capsules, synovial membranes, and fat pads attached to the surface of the vertebral canal, or the fat connective tissues attached to the dura mater and nerve root sheath membranes within the vertebral canal, can produce aseptic inflammatory lesions due to chronic strain or acute injury, which chemically stimulate the nerve endings and cause pain. Soft Surgery diagnoses this as soft tissue damage pain. Traditional concepts believe that “ossification of the vertebral canal,” “herniated discs,” and “spinal stenosis” are the main causes of chronic pain due to nerve root compression. Teacher Xuan Zheren completely denies the theory of mechanical compression of nerve tissues causing pain. Clinical verification shows that normal nerve tissues subjected to acute mechanical compression only produce nerve compression symptoms, which vary from numbness to paralysis depending on the degree of compression, but not pain; chronic mechanical compression does not cause pain. The effectiveness of surgery is due to the cutting and detachment of the diseased soft tissues during the surgical process. There are also cases where patients undergoing disc surgery have had their symptoms disappear after only skin incision without completing the surgery.
Soft Surgery points out several clinical phenomena that cannot be explained by the mechanical compression theory. Recently, there has been a similar understanding of low back pain internationally. Low back pain is a subjective symptom that rarely has a necessary connection with objective signs. The British occupational health guidelines state: “The correlation between lumbar anterior displacement, herniated discs, and low back pain, sciatica, or neck pain is very small. Disc degeneration is related to age but not to pain.
Soft Surgery believes that the pathogenesis of this type of pain is: “Pain leads to tightness, and tightness leads to pain.”
The pathological process is: “Pain increases spasm, and spasm increases pain.”
The treatment principle is: “Eliminate pain to achieve relaxation, and use relaxation to treat pain.”
Teacher Xuan has studied TCM, and his silver needle therapy is to apply the long silver needles passed down from the old TCM practitioner Lu Yunxiang in “using needles instead of knives” for extravertebral soft tissue release surgery, called extravertebral dense pressure point silver needle acupuncture. Note that it is dense needling; it is said to be pressure points, but in fact, it is a pressure area that can be large or small. Extravertebral soft tissue damage is limited to the outside of the vertebral canal, which Teacher Xuan believes can be resolved with non-surgical treatment. Intravertebral soft tissue damage, as the name suggests, is the aseptic inflammation of soft tissues inside the vertebral canal, which Teacher Xuan believes requires surgery, but the incidence is very low.
Soft Surgery believes that soft tissue damage around the pelvis is the primary lesion, which compensates and adjusts through corresponding compensatory adjustments in all directions, developing a series of compensatory adjustments upwards and downwards, leading to various symptoms. It emphasizes that treatment should first address the primary lesion, then the secondary lesions. Soft Surgery applies the principles of treating upper diseases with lower treatments, lower diseases with upper treatments, front diseases with back treatments, back diseases with front treatments, left diseases with right treatments, and right diseases with left treatments, which originated from the holistic view of traditional Chinese medicine. However, community outpatient patients mostly have minor ailments, and directly treating secondary lesions can also yield acceptable results.
Extravertebral soft tissue damage can produce many symptoms. Soft Surgery divides soft tissue damage into three stages: muscle tension, muscle spasm, and muscle contracture. The first two stages respond well to acupuncture, while the last stage has poor results, but most patients are in the first two stages.
Let’s discuss chronic pain caused by extravertebral soft tissue damage in the cervical or lumbar region, which can lead to head, neck, back, shoulder, arm, waist, sacrum, buttocks, and leg pain. Here, I specifically point out chronic pain because many acute pains have self-limiting tendencies.
(1) Head and facial pain: Headaches are common clinical symptoms, most of which are due to extravertebral soft tissue damage. Commonly seen headache patients may experience pain on one side of the head or a line that jumps, feeling irritable, with various imaging tests showing no issues. However, after several weeks or months of treatment, they do not improve; this is a typical case of soft tissue damage. Needling in the area behind the neck and skull junction based on pain as a guide generally leads to recovery in about a week. Of course, many of these issues will self-resolve; those that do not can be treated effectively once the method is found. Some patients with chronic headaches have also shown good results after a period of treatment, but overall, those with longer disease durations do not fare as well as those with shorter durations.
A 17-year-old girl has suffered from headaches since she was three years old, spending half of her time in pain, which caused her to drop out of school for two years, during which she underwent continuous treatment and medication. After needling in the neck for a period, she now experiences headaches about once every half month, with mild symptoms and rapid relief. Another woman in her 40s has had headaches for over 20 years, mostly experiencing pain more often than not. After four needling sessions, her headaches have become infrequent and can self-resolve. Some facial pain is sometimes diagnosed as trigeminal neuralgia, but it is actually a similar issue; needling in the tender area can resolve it. Some symptoms may be diagnosed as neuralgia, but many are not; the real cause is soft tissue damage in the corresponding area, such as sciatica, occipital neuralgia, and some pseudo-trigeminal neuralgia or post-herpetic neuralgia. True neuralgia is not easy to treat, such as true trigeminal neuralgia or true post-herpetic neuralgia.
Teacher Fu Zhonghua pointed out that neural tissue lesions are difficult to treat, tendon lesions are hard to treat, while muscle fascia lesions are easier to treat. In general, the redder the tissue, the easier it is to treat; the whiter the tissue, the poorer the blood supply, making it harder to treat. However, if it is not true neuralgia, treatment is relatively simple, and following the principles of soft surgery yields good results. Facial numbness can also be treated this way.
(2) Neck and back pain: Neck pain needs no further explanation; patients often self-diagnose it as a herniated disc or bone hyperplasia, but it is actually unrelated, and needling can cure it. Back pain is generally related to the neck and back; finding the tender points and needling is sufficient. Safety in needling for back pain must be emphasized.
(3) Shoulder and arm pain: There are many types of shoulder pain, some easy to treat and some difficult. Adhesive capsulitis is relatively difficult; this disease is originally called shoulder periarthritis or frozen shoulder, but is now referred to as adhesive capsulitis, which is an inappropriate name. There is no good remedy for this; it takes time to treat. However, patients or non-specialist doctors often misdiagnose shoulder periarthritis; it is essential to personally examine them, as many are not true cases. If it is not true adhesive capsulitis, there is no problem; needling based on pain as a guide can treat it. Many patients seeking treatment for “shoulder periarthritis” are not actually suffering from it. Arm pain has many causes, often transmitted from soft tissue damage in the neck and back; primary and secondary lesions can be treated separately or together.
(4) Low back and sacral pain: There are many patients with low back pain; needling at the lesion site is sufficient. A patient from another region and a local patient both experienced low back pain simultaneously. The local patient had previously undergone surgery for a herniated disc and was in pain again. The local orthopedic department stated that he must undergo surgery again. After being introduced to me, he improved significantly after several needling sessions, and after intermittent treatments, he can now go to the gym. The patient from another region has been to many places and has also undergone needling but has not recovered. Although there are many experts there, they are not familiar with the case, so he flew to Zibo for treatment four times and showed significant improvement.
Recently, a patient with low back and leg pain reported that a bone expert from a provincial hospital suggested he undergo surgery again. He replied that he had been treated with continuous and then intermittent acupuncture for over a month and had improved, but the orthopedic expert expressed disbelief. Sacral pain can also be treated by needling the relevant tender points. If it is an issue with the sacroiliac joint, needling can also be effective, but there are cases where it does not work. Some believe there may be a subluxation of the sacroiliac joint, but Professor Li Yikai’s view is that if a car hits a person, the sacroiliac joint will not dislocate. This can be tried with the dynamic joint mobilization technique mentioned later.
(5) Hip and leg pain: Hip and leg pain generally arises from soft tissue damage in the lumbar and sacral regions; the primary lesion must be treated. Some have been diagnosed with avascular necrosis of the femoral head. Avascular necrosis of the femoral head and hip pain is also related to soft tissue damage, not the necrotic bone. Resolving the soft tissue damage will eliminate the symptoms. Moreover, many other issues have been misdiagnosed. There was a patient diagnosed with avascular necrosis of the femoral head who, after two months of treatment with Chinese medicine, physiotherapy, and shockwave therapy, still experienced hip pain. Upon examination, it was found to be soft tissue damage in the middle gluteal area, and after two warm needle treatments, the symptoms disappeared.
(6) Knee and ankle pain: The same patient who had improved low back pain also mentioned knee pain when going up and down stairs. He flew back to treat the infrapatellar fat pad, receiving treatment three times over the weekend, and was able to bear weight when going up and down stairs. He still experienced pain when squatting, so he returned for another treatment. Another elderly patient had knee pain for over ten years when going up and down stairs; after needling a few times at the tender points, he was fine. However, due to his age, he sometimes experiences pain again; acupuncture is ultimately not as effective as silver needles. The standard for healing with silver needles is five years without recurrence, allowing for any heavy physical labor, and no sensitivity to weather changes. This is my understanding; the standard definition should refer to “Xuan Zheren Soft Tissue Surgery.” Recently, a 50-year-old woman with knee pain for over ten years received acupuncture treatment over a dozen times and no longer felt pain. Another middle-aged male patient, who was thought to need surgery for knee pain when going up and down stairs, was treated according to soft tissue damage principles and quickly improved; after over 20 treatments, he had no symptoms.
(7) Heel pain: Heel pain is unrelated to bone spurs; attention should be paid to the infrapatellar fat pad, surrounding the inner and outer ankles, and the soft tissues of the calves. Other areas of the foot that hurt should also be examined to see if they are transmitted pain. Treat them using pain as a guide.
Traditional Chinese medicine emphasizes observation, listening, questioning, and palpation. Textbooks clearly state that palpation includes pulse diagnosis and palpation of acupoints, which is the physical examination of the body. In my clinical practice, physical examination is applied far more than pulse diagnosis. The various pain-related tender points have detailed explanations in Teacher Xuan’s book.
Now let’s discuss the signs related to soft tissue damage.
(1) Dizziness, eye pressure, eye pain, and vision loss. This is very common clinically, and the effect is good. In the upper cervical region, using pain as a guide, random needling can lead to improvement. A few days ago, a patient came for arm pain and mentioned that last time they had blurred vision and needed to wear glasses to cook. After needling, the blurriness disappeared, and they no longer needed glasses to cook. A patient with headache and eye pressure had elevated eye pressure, and the ophthalmologist initially diagnosed it as glaucoma. The patient trusted me and came for treatment; after needling, the symptoms disappeared, and the eye pressure returned to normal. Tinnitus can also be caused by soft tissue damage; short-term effects are good, while long-term effects may vary. Patients with facial spasms have shown some effectiveness, while others have not. A patient with over ten years of history had complete cessation of spasms after one month of needling, but over time, it may recur, albeit mildly; needling a few days later will still help. Facial paralysis is considered to be secondary to soft tissue lesions causing nerve edema; can sciatica be treated without needling the leg, and can facial nerve paralysis be treated without needling the face? Teacher Li Jiandong believes that the face is merely a proxy for the person, and the face itself is not the issue. However, there have been cases where needling the face led to increased movement. Incomplete facial paralysis can self-resolve; Western statistics show an 80% self-resolution rate, while complete facial paralysis is more challenging. How much effect can a practitioner have in this situation? This remains questionable. However, in clinical practice, there are often cases where patients have not shown active movement after several days of treatment, but after one or two days of needling, active movement appears. Is it because the time has come, or is it because needling is effective? Without double-blind control, it is hard to determine. I feel that needling using pain as a guide is effective.
(2) Nasal congestion, runny nose, difficulty swallowing, and limited mouth opening. This is similar to the above; if it is determined to be caused by soft tissue, needling is effective. Mei He Qi can be treated this way; difficulty opening the mouth can also be treated with the methods discussed later. Conditions such as rhinitis and pharyngitis can also be applied. A young male patient with rhinitis sought treatment; after needling the soft tissues around the neck and nose, the effect was good. He also mentioned having pharyngitis, and after treating the soft tissue damage, he saw improvement after one treatment, and his snoring also improved. After a month, he returned for a follow-up, and the snoring had not reoccurred. There have been multiple patients with sinusitis who have not improved after prolonged treatment; applying this method has also led to quick recovery. A young patient, 10 years old, with rhinitis and sinusitis for two months, with a sore nose and yellow discharge, had been treated with medication without improvement. After needling for two weeks, he was cured.
(3) Chest tightness, chest pain, palpitations, and premature beats. I have treated many of these. A young female patient came in with palpitations, and upon hearing her description, it was clear that it was due to soft tissue damage in the back; after one needling session, she improved and was cured in a few days. Another example is my father, who was hospitalized due to a cough after a cold. After a month of treatment with medication and IV fluids, he had not improved and could not lie flat, only able to sit passively. An ultrasound showed a small amount of pericardial effusion. He was discharged to stay at home for three nights, planning to transfer to another hospital on Monday. After three nights at home, I needled him once, and he could sleep half-sitting; after two needling sessions, he could sleep normally, and after three sessions, an ultrasound showed no pericardial effusion. Of course, at that time, I had just graduated and was not very skilled; I had not yet learned soft surgery, and treated him according to the principles of guarding the spine.
Another elderly female patient had not been able to lie on her left side for over ten years and had seen many doctors. Upon examination, it was found that there was soft tissue damage at both ends of the ribs; needling in that area led to immediate improvement, and she was cured in a few days. At the same time, her ten-year asthma also improved; at least when she first came, I could hear wheezing without a stethoscope during needling, but after a few treatments, I could no longer hear it with the naked ear. The patient also felt much better. However, asthma is a complex issue that is not solely related to soft tissue; it is difficult to treat, but issues caused by soft tissue can be alleviated. Breast tenderness can also be considered for soft tissue damage; if this is the case, it can be resolved.
(4) Abdominal bloating, diarrhea, and abdominal pain. These symptoms are more common; various conditions such as gastritis, cholecystitis, enteritis, and pelvic inflammatory disease that have not improved should consider soft tissue damage in the lumbar and back areas. This is very common; let me share a few examples. A patient with a 20-year history of stomach issues, taking a lot of medication every night, still experienced unbearable stomach bloating and pain. After needling the back for a month, he was able to stop most of the medication and had no discomfort, sleeping peacefully. After that, if any minor symptoms appeared, he would come for a few days of needling. Another patient with stomach issues had an endoscopy showing reflux and bleeding, with symptoms mainly of heartburn and discomfort behind the sternum. After intermittent needling for about two months, he had not undergone many treatments, and a follow-up endoscopy showed only superficial gastritis, with all symptoms resolved.
A patient with lower abdominal pain was diagnosed with pelvic inflammatory disease and had not improved after medication and IV fluids. Upon examination, there was significant tenderness at the transverse process of the lumbar vertebrae, and needling led to immediate recovery. Years later, he experienced palpitations, feeling anxious when crossing the street, with weak legs. After needling in the lumbar and abdominal areas, he was cured. Another young female patient reported discomfort at the cervix; I did not ask what the discomfort was, but she had been diagnosed with a chlamydia infection. After one needling session, she also improved, but it took several months of intermittent needling for complete recovery. Follow-up tests showed that the chlamydia was also gone, and this has been several years without recurrence. Abdominal issues are diverse, but chronic conditions are often related to soft tissue damage in the lumbar and back areas. Another elderly patient who had undergone appendectomy experienced pain around the incision four months post-surgery and was unable to live normally; upon examination, there was also tenderness at the transverse process, and needling led to immediate recovery.
Low back pain originating from the lumbar region is often misdiagnosed as gastrointestinal spasms, gastrointestinal dysfunction, acute or chronic appendicitis, pelvic inflammatory disease, etc. Reports indicate that among 94 cases of acute abdominal pain, 38 were misdiagnosed as appendicitis; after treating the soft tissue damage in the lumbar region, the abdominal pain disappeared. Elder Zhou Meisheng’s “Moxibustion Rope” mentions the Yao Yu point, located above the right large intestine point and below the right Zhi Shi point. Elder Zhou’s experience shows that in the vast majority of appendicitis cases, tenderness is present at this point. Elder Zhou believes it can treat appendicitis and is the first choice, with good efficacy. It is located near the transverse process of the third lumbar vertebra.
There was also a patient with abdominal bloating for over two years, a tall individual who could only eat half a steamed bun daily, losing weight and exhausting his family’s savings for treatment. When he found me, he brought a large stack of reports and images from various hospitals. I pressed on the transverse process and found significant tenderness, saying, “This is caused by soft tissue damage in the lumbar region.” After treatment, the patient gradually improved, not only increasing his food intake to two steamed buns but also regaining his energy and finding a job again. Left lower abdominal pain caused by transverse process issues has also been diagnosed as colitis. The aforementioned patient with rhinitis, pharyngitis, and snoring had been diagnosed with colitis for over ten years; he found that any slight dietary indiscretion would lead to diarrhea. Upon examination, there was tenderness at the transverse process, and after needling, he was fine; after a few days of treatment, he specifically drank beer to test it.
(5) Frequent urination, urgency, and difficulty urinating. This is also quite common and has good effects. Male patients with so-called prostate issues can be treated this way, as can females. An elderly female patient had recurrent urinary tract infections, experiencing frequent urination and urgency, with corresponding changes in her urinalysis, and had been on antibiotics for a long time. After needling, she was able to stop the antibiotics and did not have another episode. Another female patient experienced urgency and pain during urination for a week, diagnosed with a lower urinary tract infection, and received antibiotics via IV, with slight improvement. When she came in, she had urgency, pain during urination, and low back pain, with urinalysis showing red and white blood cells. Upon examination, there was tenderness at the transverse process of the third lumbar vertebra and the gluteus medius. Tenderness at the pubic symphysis was also noted. After needling multiple points in the tender area, she showed significant improvement after one treatment, and her symptoms basically disappeared after two treatments. Follow-up urinalysis showed normal results. Another elderly female patient presented with gross hematuria; after one needling session, the hematuria disappeared, and after two sessions, the frequency of urination stopped. Difficulty urinating or coughing leading to incontinence can also be effectively treated.
(6) Dysmenorrhea, menstrual irregularities, and difficulty menstruating. One case of prolonged menstrual bleeding did not improve after two months of treatment with both Western and Chinese medicine; examination revealed tenderness at the transverse process of the third lumbar vertebra, and needling led to recovery after two sessions. I have treated several cases with good results. Patients with menstrual flow that seems to come and go can also be treated with needling.
(7) Abnormal sensations such as numbness, tingling, coldness, and swelling in the limbs. This is also common; hemiplegia does not necessarily indicate cerebrovascular issues; many are related to soft tissue problems, and the effects are good. Some patients are so sensitive to cold in summer that they cannot wear skirts; after a few needling sessions, they can wear skirts and use fans. Another patient had to wear long underwear in summer, but after needling, they could take it off. There is also the issue of calf swelling and heaviness that occurs after prolonged standing or walking; this is often due to soft tissue damage in the popliteal fossa. A patient reported that their calves felt heavy as if filled with lead; a doctor suggested it was due to varicose veins and recommended surgery. Upon examination, there was significant tenderness behind the popliteal fossa, and after one needling session, the patient felt as if they had no legs; after a few more sessions, the issue was resolved. Soft tissue damage is not as thoroughly resolved with acupuncture as with silver needles; if it recurs, needling again can resolve it.
There is also a book that mentions shoulder soft tissue issues can lead to psychological symptoms. I have treated a patient with anxiety, and after needling the soft tissue in the neck and shoulder, they were cured.
In summary, damage to the soft tissues in the head, neck, back, shoulder, arm, waist, sacrum, buttocks, and legs can lead to pain, limited movement, and over 50 other symptoms, including headaches, dizziness, eye pressure, eye pain, vision loss, difficulty swallowing, limited mouth opening, chest tightness, chest pain, palpitations, premature beats, abdominal bloating, diarrhea, abdominal pain, frequent urination, urgency, incontinence, dysmenorrhea, menstrual irregularities, and sexual dysfunction. These symptoms are completely similar to those of diseases in internal medicine, neurology, neurosurgery, psychiatry, thoracic medicine, cardiology, orthopedics, abdominal surgery, pediatric surgery, urology, male medicine, gynecology, family planning, rehabilitation medicine, sports medicine, ophthalmology, otolaryngology, dermatology, and dentistry.
So when should we consider that these are caused by soft tissue damage? Soft Surgery points out that these symptoms should only be considered when ① they appear in the later stages of long-term extravertebral soft tissue damage-related low back or neck pain; ② relevant specialist examinations have completely ruled out their associated diseases; ③ the pain site must have a series of regular and highly sensitive tender points, and applying non-surgical or minimally invasive therapies, such as strong stimulation of tender points through massage, needling at tender points, or injecting liquid medication at tender points, can rapidly improve these symptoms. Furthermore, for severe and stubborn cases, performing extravertebral soft tissue release surgery targeting the tender points can lead to more significant improvement or complete disappearance of symptoms. At this point, the aforementioned symptoms can be regarded as caused by extravertebral soft tissue damage.
I believe that chronic non-systemic diseases can all be treated as soft tissue damage or soft tissue damage-related symptoms, and specialist opinions can be referenced. These soft tissue damage-related symptoms are often misdiagnosed as migraines, allergic rhinitis, Meniere’s disease, chronic gastritis, chronic cholecystitis, chronic colitis, coronary heart disease, breast hyperplasia, pelvic inflammatory disease, dysmenorrhea, prostatitis, and benign prostatic hyperplasia, post-herpetic neuralgia, costochondritis, trigeminal neuralgia, etc. Some say that Dr. Wu is a divine doctor, a divine needle, good at treating difficult and complicated diseases, which is certainly not true; I can only treat some minor ailments. However, some friends are not very familiar with soft tissue damage, and many minor issues caused by soft tissue damage have remained unresolved for a long time.
Research shows that the most common disease in humans is the common cold, followed by chronic pain caused by soft tissue damage. If we add various symptoms caused by soft tissue damage, the incidence of soft tissue damage will be even higher. If interested, please study “Xuan Zheren Soft Tissue Surgery”; there are many things that cannot be elaborated here, and it is best to read it personally more than twice. Using pain as a guide combined with burning needle techniques yields even better results; silver needle therapy is a vivid illustration of burning needle techniques.
In the Bones, Guarding the Bones
The Ling Shu: End and Beginning states: “If the hand bends and does not extend, the disease is in the sinews; if it extends and does not bend, the disease is in the bones; guarding the bones in the bones, guarding the sinews in the sinews.” Here, the distinction between sinews and bones does not depend on bending or extending, but rather on depth and treatment methods. The sinews and bones are actually difficult to separate.
I believe that lesions at the attachment points of skeletal muscles can be considered as “in the bones.” This treatment is similar to the “guarding the sinews” method mentioned above, except that the needling depth must be deeper, requiring higher accuracy. Another method is to treat diseases through adjusting the bones and joints, which can also be considered as “guarding the bones.”
This brings us to Western manual therapy; there is a technique called joint mobilization. Joint mobilization includes the Nordic approach, the Australian Maitland technique, and the New Zealand Mulligan’s dynamic joint mobilization technique. I learned joint mobilization from watching Professor Yan Tiebin’s videos. Later, there was a patient with pain in the distal joint of her little finger, who was familiar with all the top hospitals in her area but had not been cured. I applied joint mobilization and cured her in one session, and she has not had a recurrence for several years. She also had pain in the big toe joint, showing signs of hallux valgus, which was also resolved after several sessions of joint mobilization. After that, I looked for all the Chinese materials on joint mobilization, spinal manipulation, and manual therapy available on Amazon, Dangdang, and Taobao, and also browsed some foreign materials, discovering Mulligan’s dynamic joint mobilization technique.
During my studies, my statistics teacher gave an example. When someone goes to buy dates and randomly grabs a handful, if there are worms, although the seller says that only that handful has worms, this statement cannot be trusted. Because if there are worms in that handful, it is a small probability event, so the seller’s words cannot be trusted. The verification of acupuncture and manual techniques is relatively convenient; as long as safety is guaranteed, many methods can be used. If it does not work once or twice, just give up. Therefore, I have tried many methods, and the one that has impressed me the most is Mulligan’s dynamic joint mobilization technique. For suitable patients, it is truly effective, and I was quite excited when I discovered this method. Since then, there have often been astonishing results.
Dynamic joint mobilization (MWM) includes multiple techniques. The one I often use is the casual SNAGS. “SNAGS” is an abbreviation meaning to continuously provide the joint surface with a sliding motion that it should originally have. MWM requires many details, and I have not mastered it well; I only apply the corresponding force to the bone in the direction of the joint plane while the body is loaded, and the direction and magnitude of the force can vary, or it can be accompanied by the patient’s active movement, with symptom disappearance as the standard. It can be repeated several times, and for suitable patients, symptoms can disappear immediately.
Does this sound familiar? The Ling Shu: Five Evils states: “Pressing with the hand can relieve pain, and then needle it.” The Ling Shu: Back Acupoints records: “To obtain verification, press the area; if it responds in the middle and the pain resolves, that is the point.” This method can cure light symptoms in one session. I estimate that if it does not work once, I will not use this method.
Using SNAGS does not waste time; it only takes a few minutes to determine whether it is effective. For example, if a patient has pain when extending the neck backward or bending sideways, I can use SNAGS to treat it. If we treat the correct segment, the patient’s range of motion increases and pain decreases. If the treatment is ineffective, I can immediately switch to another segment of the neck for treatment. If it is still ineffective, then SNAGS is not suitable for this patient. Additionally, SNAGS is just one of the methods for treating musculoskeletal diseases; it can serve as both a diagnostic and therapeutic method. Acute low back pain, although movement is limited, can still be treated in patients who can move; it can be effective if suitable.
Let me share a few examples. A 9-year-old boy had neck pain upon waking; after 20 seconds of joint mobilization, the pain disappeared, and he was followed up as cured. A 22-year-old female patient experienced dizziness, nausea, and vomiting for a day; after a few minutes of joint mobilization, her dizziness disappeared, but she still felt nauseous. Another patient with posterior head pain was treated with joint mobilization, and after three rounds, the headache disappeared. Another female patient had pain in the left shoulder extending to the scapula; after treatment, the pain disappeared immediately. A patient with pain between the lateral epicondyle and the olecranon for two months underwent joint mobilization in the neck, and the pain disappeared. Upon re-examination, she reported no pain, although there was still some numbness. For a patient with low back pain, I used a homemade joint mobilization belt, which helped the patient assist the practitioner safely, and after treatment, the patient showed significant improvement and reduced pain; upon re-examination, they had greatly improved.
There was also a patient with acute low back injury who underwent standard joint mobilization, but the effect was not good. I then performed the technique on the abdomen, moving from the abdomen towards the back, and the patient showed significant improvement immediately. Another patient with medial collateral ligament inflammation of the knee underwent treatment with the assistance of a belt, and after treatment, there was also significant improvement; upon re-examination, the pain continued to decrease. A patient with bilateral temporomandibular joint pain underwent pressure on the temporomandibular joint, and after repeatedly opening and closing the mouth three times, they were immediately cured. Recently, a young female patient complained of stabbing pain on the ulnar side of the left forearm; I performed this technique at C7 and T1, and the pain disappeared immediately. Follow-up over several days showed no recurrence. Let’s discuss other cases.
The Wai Tai Mi Yao records that pressing the Da Zhui point can treat choking, which refers to the sensation of choking. I have also used this to treat patients with sore throats; this is my expanded application. Recently, I have been applying this method; pressing the cervical spinous process can immediately relieve throat pain, and pain from oral and tongue ulcers can also be relieved immediately. Teacher Huai Tang used the sharp hook needle to treat throat pain at the Tian Zhu point, and there is also the “Throat Holding” method to treat below the Ya Men point, which is also in this area. Gastric colic can also be treated with SNAGS; once, I saw a little girl in the clinic holding her stomach, looking in pain. I asked her, and she said the doctor suspected gastric spasm and had given her atropine. While her father went to get other medicine, I pressed on the spinous process around T6 or T7, applying continuous pressure repeatedly, and before the medicine arrived, the little girl was no longer in pain. I do not know if she was completely cured, but she was certainly much better compared to when she was in pain. Teacher Gao Shuzhong taught pressing the Zhi Yang point to treat gastric colic, and the location is similar. Another patient with difficulty breathing can be relieved by pressing the thoracic vertebrae.
Another patient with stomach pain was also treated with immediate pain relief, but soon after, it recurred. Further examination revealed pancreatitis, and they were transferred for hospitalization. If ineffective, we must consider whether it is an indication.
In summary, the treatment of soft tissue damage is a complex and multifaceted process that requires a thorough understanding of the underlying principles and techniques. The integration of traditional Chinese medicine with modern approaches can yield significant benefits for patients suffering from various conditions.