Analogies, N°1, between Mesopuncture (1) and Wet Needling (2).

Analogies, N°1, between Mesopuncture (1) and Wet Needling (2).

 (1) Fluid stimulus of the Acupuncture Point_ AP
(2) Injection in Trigger Point_ TP
Two administration modes of liquid drug: Either in the AP or in the TP.           
Publication in THREE parts. First part

Generalities
Trigger Points_ TPs
They are the most common cause, about 75%, of chronic musculoskeletal pain. TRAVELL and SIMONS, two doctors who described the TPs, define a TP as a tender nodule, a muscle knot in a palpable taut band of skeletal muscle.

·         The data for identifying the TPs are now considered to be:
Reproduction or aggravation of the pain usually experienced by the Patient.
Location of a taut muscle band.
Spot tenderness.

The TP is an irritable spot either spontaneously (active TP) or on digital compression (latent TP) able to generate either local or referred pain to other musculature, motor dysfunction and even autonomic phenomenon such as sweating, swelling, and ‘goose bumps’.

 Note. It is difficult to find ASHI Points with such properties.

These TPs may become activated by a variety of factors such as, poor posture, overuse or muscle imbalance.
TPs exhibit a local twitch response (muscle fasciculation) or a more global response, jump sign (flexion response) in reaction to digital pressure or Dry Needling (DN) or Wet Needling (WN).

Wet Needling_ WN
WN is the original method, proposed by two physicians, Drs. TRAVELL and SIMONS, to deactivate the TP by injection of a liquid drug into.

Acupuncture Point
It is described as a path starting in the epidermis and ending in the connective tissue.

Mesopuncture
Fluid stimulus of the Acupuncture Point_ AP or Mesopuncture is another stimulus mode of the AP proposed by the Chinese medicine, in addition to the metal needle stimulus or classical acupuncture

The fundamentals

In the book, ‘Précis d’ acupuncture Chinoise’ edited in 1977 by the Academy of traditional Chinese medicine from Beijing and intended for French-language students, one can read on page 292,Therapy by injection into acupuncture points,  a detailed description  of the treatment technique  by a liquid drug stimulus of the APs or Mesopuncture. 

In the books published in 1983 and 1999,Myofascial Pain and Dysfunction, the Trigger Point Manual, describing the fundamentals of TRAVELL and SIMONS work, can be found, in the chapter 'Methods to deactivate a trigger point’, among other methods to deactivate a TP, the original description of the WN.

The description of Wet needling treatment on Trigger Points_ TPs is identical to description of Mesopuncture or fluid stimulus on Acupuncture Points_ APs.

Whether it be to stimulate the AP in Mesopuncture or deactivate the TP in WN, we use liquid drugs and a vector of administration.

Liquid drugs used in Mesopuncture and WN.

      The liquid drug used depends on the medical expertise of the Therapist, his qualification in injecting liquid drugs and perfect knowledge of the pharmacology of each liquid drug used.

A variety of fluids have been injected into the TPs, including distilled water, normal saline, local anesthetics (procaine, lidocaine, bupivacaine), vitamin B solutions, long-acting corticosteroids, acetylsalicylate, and botulinum toxin.

It is possible to distinguish, liquid drugs

·         Without therapeutic effect, such as distilled water, saline…

·         With therapeutic effect of very long duration before reaching an efficient level: Trace elements, homeopathic remedies.

·         Whose physicochemical structure makes it possible to extend the duration of effectiveness as with some anti-inflammatory of the Western Pharmacopoeia used in the treatment of chronic TPs, for example or with hyaluronic acid

      The administration mode of liquid drug in Mesopuncture and WN

It should be noted that in Mesopuncture like in WN these are micro doses of liquid drug that are injected locally either directly in the AP or TP or indirectly around the AP or TP.

From the injection point in the skin, the liquid drug has the becoming of local injections:

·         At first, the liquid drug injected into a skin point, near the body area being treated, headed directly to this altered zone.

Analogies, N°2, between Mesopuncture (1) and Wet Needling (2).

Analogies, N°2, between Mesopuncture (1) and Wet Needling (2).

 (1) Fluid stimulus of the Acupuncture Point_ AP
(2) Injection in Trigger Point_ TP
Two administration modes of liquid drug: Either in the AP or in the TP.           
Publication in THREE parts. Second part.

In a second step, the liquid drug passes into the blood, reaches the liver where it is conjugated. It returns into the blood to reach the injured area a second time.

Conclusion

The injured area receives twice the liquid drug, as well if the liquid is injected directly in the point or in the immediate vicinity of the point: what might explain equal efficienc, it seems, between indirect and direct liquid drug injections.

      Action Mode of the liquid drug in Mesopuncture and WN

The liquid drug has a dual action dependent on its physicochemical structure:

·         A physical or mechanical action due to the injected volume allows:
- facilitating the treatment of the trigger point in WN.
- obtaining the Acupuncture effect by stimulation of the AP.

·         A therapeutic action, due to the pharmacological properties of the liquid drug injected and described in the pharmacopeia. 

The injection vectors

Once the liquid drug selected it must be injected either in an AP or in a TP, by a hypodermic needle: It allows the selected liquid drug to cross the skin and reach either the TP to deactivate it or the AP to stimulate it. The main problem is the pain associated with the hypodermic needle use.

Compared to the acupuncture needle, the hypodermic needle is supposed to produce a ‘searing pain’, by numerous Patients.

·         It is necessary to ease the inserting pain of the conventional hypodermic needle in a TP already painful, pain accentuated by the various manipulations performed in the TP to deactivate it:

It is necessary, for this, to reduce the diameter of the hypodermic needle to be similar to the diameter of the acupuncture needle whose insertion is much less painful.

·         It is uncomfortable to insert the hypodermic needle into in an AP where a compact acupuncture needle comes to be inserted.

It is judicious, in this case, to use the hypodermic needle inserted into the AP for injecting the liquid drug for the Wet Needling treatment, as an acupuncture needle for the Dry Needling.

**-* The BMN fulfills this dual function.

The BMN is both a hypodermic needle and according to the FDA, an acupuncture needle: Its diameter of 0.30 mm is identical to the classical acupuncture needle. This hollow needle is surmounted by a resilient polymer reservoir with no silicone, no glue and no syringe body.

This deformable reservoir of the liquid drug selected is also used as a handle, essential for gripping the BMN during the acupuncture session, essential feature for the FDA, to qualify the BMN as acupuncture needle.  

Using the BMN needle both hypodermic and acupuncture, optimizes the insertion pain, during the Acupuncture or TP treatment.

 In this first version, the useful needle length is 13 mm allowing, thanks to the resilience of the polymer reservoir, to any medication, whatever its viscosity, to be sucked through the needle for filling the reservoir, by pressing the reservoir with two fingers.

The reservoir may be filled, by the Therapist, with any one of the drugs mentioned above.

The BMN device and Wet needling

Wet needling realized with the BMN, allows performing, according to the depth of the TP into the skin, in the same TP, a mechanical deactivation, by the BMN needle itself, supplemented by a liquid deactivation with the same device, by the volume of liquid drug from the reservoir, injected into the TP, adding by this way, the anesthetic or therapeutic properties of this liquid drug to the double mechanic deactivation, from the needle and the volume injected. 

Analogies, N°3, between Mesopuncture (1) and Wet Needling (2).

Analogies, N°3, between Mesopuncture (1) and Wet Needling (2).

 (1) Fluid stimulus of the Acupuncture Point_ AP
(2) Injection in Trigger Point_ TP
Two administration modes of liquid drug: Either in the AP or in the TP.           
Publication in THREE parts. Third part.

Two Wet Needling versions

Both versions of liquid drug injection are described according to the depth at which the liquid drug is injected.

-      The Wet Needling Trigger point injection, or direct wet needling, involves fluid injection directly into the TP located in the taut muscle band.

-      The indirect wet needling in which fluid is injected into the skin or subcutaneous tissue over the TP.

.It is the most commonly used option for the treatment of TPs by WN performed with the BMN, especially if the TP is deep because,  in the current version, the needle of the BMN is of 13mm long.

The BMN allows performing Wet Needling according to two ways:

If the TP is superficial, the BMN will complement the treatment by performing Dry Needling also.

 If the TP is deep, the Wet Needling, performed with an anesthetic by the BMN, will be followed by a mechanical treatment by the Therapist.

The BMN device and Mesopuncture

Mesopuncture is an acupuncture treatment version in which the AP is stimulated by a liquid drug chosen by the Therapist

Mesopuncture or stimulation by a liquid drug of the AP completes the historical AP stimulation by metallic needle.

Usually Mesopuncture accompanies the metal stimulation or classical Acupuncture, preceding or following it, becoming perfectly integrated in the conduct of the consultation without downtime and without preventing the decubitus, as with the BMN:
A specific disposable device, avoiding the double needle insertion, traditional stimulus by metal needle and fluid stimulus by a hypodermic needle, particularly uncomfortable when this double insertion is repeated with two needles inserted, although with a single BMN inserted into the AP, the Therapist can perform Acupuncture and Mesopuncture.

The fluid stimulus of the Acupuncture Point AP or Mesopuncture is another stimulus mode of the AP, in addition to the metal needle stimulus, proposed by the Chinese Medicine.

Inserted into the AP, the BMN needle performs a metal stimulus or classical acupuncture: The needle handling is soft and suave; it does not seek to deactivate a muscle knot but to stimulate, carefully, an AP: it is the metal Acupuncture effect.

A few drops of liquid drug from the reservoir are deposited into the AP, they stimulate the AP mechanically by their volume or physicochemical structure or both,  it is the fluid acupuncture effect or MESOPUNCTURE.

The pharmacological activity of the selected liquid drug is preserved: It is the pharmacological effect.

Conduct of the Mesopuncture

The BMN needle or an acupuncture needle is inserted into the AP to perform acupuncture.
A few drops of liquid drug from the BMN reservoir or few drops of a liquid drug contained in a syringe are injected into the AP: The liquid drug acts both by the volume injected and its pharmacological properties.

It will have been realized with the Mesopuncture performed by a metallic needle:

A metal stimulus due to the inserted metallic needle.
A fluid stimulus due to the volume injected.
A pharmacological effect by preservation of the therapeutic properties of the liquid drug injected.

·         We find the same classification as in WN

Direct Mesopuncture.
The liquid drug is injected directly into the PA localized in the connective tissue by the BMN needle.

Indirect Mesopuncture. 
The liquid drug is deposited on the skin to reach the PA by iontophoresis: indeed the PA starts at the epidermis and ends in the connective tissue…

It can be emphasized the role of massage in the AP stimulation and TP relaxation.

Conclusion

This article highlights the deep analogies in the treatment of trigger points and acupuncture points, between Wet Needling and Mesopuncture.

Course online. N ° 1. Overweight aesthetic pain. MAM & BMN.

Course online. N ° 1. Overweight aesthetic pain. MAM and BMN.

Obesity overweight cellulite addiction pain. Crania-facial, aesthetics neck and hands. Mesotherapy acupuncture Mesopuncture or MAM. With/without needles, the BMN. 

To help decrease with methods minimally invasive, certain health, cosmetic or body shape disorders, it is useful to gather several therapeutic modes such as the Association of two versions of Chinese medicine (Acupuncture and Mesopuncture) and an administration mode of Western drug (Mesotherapy) whose value depends on the effectiveness of the drug chosen and used by the therapist.

Literature learns us:

o   On the one hand that the Acupuncture Point _ AP begins in the dermis/epidermis.

o   On the other hand, that the Mesoterapia Point _ MP, can be created, in anywhere in the dermis and particularly around the AP, facing the painful or altered zone: This proximity between APs and the MPs allows the same needle to reach the AP and create the MPs.

That is why we have created a therapeutic set the Mesotherapy Acupuncture Mesopuncture or MAM, beneficial for the Patient: They are two versions of Chinese medicine, acupuncture Mesopuncture and a new Western way of injecting a drug, Mesotherapy. 
Acupuncture, Mesopuncture: Stimulus by needle, Stimulus by a liquid drug.

The Acupuncture Point _ AP, is a path starting in the epidermis to terminate in the subcutaneous tissue, in the connective tissue; It is a systematized localization point, known since thousands of years.

• The AP is stimulated with metal needle.

Since time is used, in the West, acupuncture, to relieve pain or other health or aesthetic disorders, but not only through APs located on specific areas of the human body at the skin surface. The location is systematized and taught in universities of China and certain countries of the world.

Specific signs, on the skin or on the thickness of the skin, help all therapists to locate the AP, in the same cutaneous site.

The AP chosen depends on the source of the pain or disorder to be treated.

The AP is stimulated by internal way with compact metal needle or by external way with massage, laser and waves. Is created an Acupuncture Effect noticed since millennia by Chinese Acupuncturists.

• To complete or extend the acupuncture effect, Chinese medicine began, at the end of the last century, the use of a liquid drug in the Acupuncture Point or Mesopuncture, at first, in ear points and then in APs of the whole body.

• Mesopuncture uses either a syringe and needle, or the principle of iontophoresis, without needles by passive drug deposit at the skin surface.

We prefer the use of BMN.

Western medicine, for its part, began several years ago to treat various health or aesthetic disorders by the deposit in the dermis or superficial hypodermis of the nearest area of the health or aesthetic disorder, of few drops of a drug, already active on these disturbances, thus creating the Mesotherapy Point- MP, specific of Mesotherapy.

Publication of Mesotherapy and publication of Mesopuntura were born, at the same time:

Is it a real coincidence?

·         The Mesotherapy Point MP does not exist unless it is created everywhere in the dermis, even around the AP: In fact, a MP can be created anywhere in the dermis  if it is injected (Classic Mesotherapy) at this point, some drops of drug _Allopathy, trace elements, phytotherapy, homeopathy, saline, distilled water, vitamins, anti-aging etc.  

Mesotherapy Point MP is created throughout the dermis even around the AP: The MPs are so close to the APs that they can be adjacent:

Therefore, the same needle, having already performed Mesopuncture, by injection of a drug in the AP can create several MPs, by injecting a few drops of the same drug used for Mesopuncture, around the AP, through the dermal part of the AP, throughout the dermis surrounding the AP, without removing the needle insertion into the AP.

The MPs and Mesotherapy are thus created.

Mesotherapy is not a new treatment: It is another way of administering a drug by input located in the dermis of a few drops of drug in front of or near the damaged region.

• PMs can also be created without needles, without injection, by iontophoresis.

This entanglement between the Acupuncture Points APs already labeled and the Mesotherapy Points MPs that can be created in the dermis of the whole area separating two neighboring APs is the basis of the therapeutic set, Mesotherapy Acupuncture Mesopuntura or MAM.

In addition as we have already indicated and as explained below, it is an easy opportunity offered to add the benefit of each of the three therapeutic modes, Acupuncture Mesopuncture, Mesotherapy, for which are used, in addition, the same device (BMN, for example), the same drug, the same needle insertion in a single therapeutic act.

But Acupuncture Points already exist on the skin.

Course on line. No 2. Aesthetic Overweight Pain. MAM and BMN.

Course on line. No 2. Aesthetic Overweight Pain. MAM and BMN.

Aesthetics: Face neck hands scalp. Obesity, overweight, cellulite, addiction, pain. Mesotherapy Acupuncture Mesopuncture or MAM. With/without needles, the BMN. 

The BMN, essential device for Mesotherapy Acupuncture Mesopuncture.

Since 1988, we have been producing the BMN, marked CE, for

MESOTHERAPY.

ACUPUNCTURE / MESOPUNCTURE.

Joining ACUPUNCTURE / MESOPUNTURE and MESOTHERAPY, in a single insertion into the skin.

• BMN is an acupuncture and Mesopuncture needle, as fine as for acupuncture, crowned by a deformable reservoir, filled and emptied as a count drops, with two fingers, disposable. (Distilled water, physiological serum, vitamins, homeopathy, allopathy, phytotherapy, trace elements ...).

The needle. Length, 13mm. External diameter 0.3mm.

The reservoir. Length 10-12mm. Volume 14 / 100ml.

 Each therapist chooses the drug, to deposit with iontophoresis or to inject with BMN, after having examined his Patient.

BMN allows the injection of a drug into the AP, or Mesopuntura, already stimulated by the metal of the needle or Acupuncture, of the BMN device.

Each Therapist chooses the insertion length of the needle, whether for Mesotherapy or Acupuncture.

In the dermis or superficial hypodermis, outside the AP, the BMN is a Mesotherapy device, complete, practical.

In the dermis, hypodermis, connective tissue, BMN is an Acupuncture / Mesopuncture, disposable needle.

http://www.mesopuncture.com

We propose, on this triple therapy or MAM, courses on the Internet with treatment options using or not a specific device, BMN.

*** We propose this triple therapy or MAM, in the form of Internet courses with treatment options with / without the BMN we produce.

Our courses, on-line

& FACIAL AESTHETICS of hands, neck and hairy leather.

& PAINS, RHEUMATISM, SPORTS

& Aesthetics of the body: 1- OVERWEIGHT AND REGIME. 2- CELLULITIS.

& OBESITY and CELLULITE, very complete.

& NERVOUS DISORDERS OF DAILY LIFE.

& ADICTION (Alcohol, Tobacco, Sweets.).

Structure of the course

** - * The APs to be treated are determined, according to the health or aesthetic alteration described in the course.

Schemes and legends help to choose and locate, on the skin, the active APs, location accessible to any Therapist, beginner or professional, in Acupuncture.

There are three classes of APs that need to be determined to conduct treatment in Acupuncture: APs of general, regional and local action.

If the location of the PAs does not pose a problem it is the implication of the APs, in the treatment, that implies the professionalism of the Therapist.

• The identification and location of APs of regional or general action are the result of a thorough knowledge of acupuncture. In these APs are inserted the usual acupuncture needles.

• APs of local action are much easier to employ by practitioners, including beginners, because they do not need extensive knowledge in acupuncture:

The APs of local action are located in the neighboring skin area or in front of the 'diseased' region of the body.

It is in this area that the MPs are created.

It is in the APs of local action that most BMNs are inserted, the BMN use  in this skin area is necessary and judicious.

Indeed, the APs already exist in this area and the MPs that can be created around these APs will be nearby or adjacent what allows to create the MPs, with the same needle of the BMN already inserted in the AP: indeed, without completely removing the needle from its insertion, the needle already inserted in the PA is directed, from the dermal portion of the pathway of the AP in the skin, to the dermis-hypodermis of all the around of the pathway of the AP, according to a star schema, to deposit into this layer of skin, micro-doses of the drug contained in the BMN reservoir, thus creating the PMs. It has therefore been done, with the BMN, in each Acupuncture Point_ AP, THE triple treatment Mesopuncture Acupuncture Mesotherapy_ MAM with a single and same insertion into the skin

In summary,

Treatment begins by questioning and examination of the patient followed by the treatment.

Acupuncture needles are inserted in all parts of the body except in the neighboring area or in front of the 'diseased' body zone.

• In the course, are described mainly the localized APs, in front or neighbors of the altered zone. Schemes and legends help to choose and locate, in the skin, the AP, location accessible to any Therapist, beginner or professional, in Acupuncture.

• At any point of the dermis in front of the altered area, separating this PA from the neighbor, the MPs are created by injection, with needle (classic Mesotherapy), some drops of drug in the thickness of the dermis or without injection by iontophoresis or Virtual Mesotherapy.

*-* Treatment options 

They are also two modes of application of the MAM:

 *- Non- invasive option:

It is performed:

Acupuncture by external stimulation: Massage, pulsed light, laser, heat, and more...

Mesotherapy and Mesopuncture by iontophoresis produced by the appliance of virtual Mesotherapy apparatus.

*- Minimally invasive option: BMN performs this triple treatment with the same and unique insertion in the skin of the same BMN.

The Knee Osteoarthritis and Acupuncture Mesopuncture

The Knee Osteoarthritis and Acupuncture Mesopuncture                                                                                                                                                 

Mesopuncture is a supplementary means from the classical acupuncture treatment for osteoarthritis in general and especially in the knee osteoarthritis.
It complements the classical acupuncture session.
As with the laser, it is an association, Chinese medicine and modern pharmacopoeia.

The BMN allows performing Mesopuncture Acupuncture Mesotherapy or MAM, with the same device inserted in the same Acupuncture Point_ AP.
It is the injection (or the passive deposition), in the AP of few drops of a liquid drug.
Let us remember that there are three categories of Acupuncture Points _ APs:  APs of general, regional and local action.
The Mesopuncture is preferentially applied to APs of local action.

**- In osteoarthritis of the knee, the PAs chosen are active on the various components of osteoarthritis

Mesopuncture is the injection (or passive deposition), in the AP of few drops of a liquid drug. The daily active dose is divided in several micro-deposits created into the various APs.

• Due to its intrinsic pharmacological properties it treats the knee osteoarthritis.

• Due to its physicochemical volume, it stimulates the AP.

The choice of the liquid drug used depends

On the ‘Acupuncture effect’, therapeutic effect in Acupuncture, produced by the AP stimulation.

On the ‘pharmacologic effect’, therapeutic effect known in the western pharmacology of the liquid drug.

      The ability to create Mesotherapy Points and to associate them to APs in the dermis around the AP with the liquid drug depends on the presence or absence of ‘pharmacological effect’ of this liquid drug.

it depends on the association or not of Mesopuncture to Mesotherapy
The liquid drug into the AP.

It is injection (or passive deposition), in the AP of few drops of a liquid drug. 
**-* The liquid drug has two actions, in the AP, both dependents on its physicochemical structure: 

Due to its physicochemical structure or volume, the liquid drug is a fluid stimulus of the AP, adding an energy dimension to the pharmacological treatment. The liquid drug keeps its intrinsic therapeutic properties, active on osteoarthritis in general and especially of the knee :  Pharmacological effect.

       Stimulates the AP creating a therapeutic effect: Acupuncture effect.

The duration of both actions of this injection, in pharmacology and acupuncture, also are dependent on the rate of resorption of the liquid drug, of its physicochemical structure. It often exceeds the stimulus duration of the classic metal needle.

       Generally, the pharmacological properties (pharmacological effect) of the liquid drug selected and injected into the AP are synergistic of the therapeutic properties resulting from the stimulation of APs (Acupuncture effect): Pharmacological and Acupuncture effects are synergistic and of same duration.

Two therapeutic possibilities:

--- Either the Pharmacological effect, of the drug used, is synergistic of the Acupuncture effect produced by the drug when injected into the dedicated AP. Duration of the Acupuncture effect due to stimulation of the AP is the same as duration of the pharmacological effect.

This liquid drug of dual effect pharmacologic and Acupuncture can also be used for creating MPs.

There is no in the pharmacopoeia active liquid drug in osteoarthritis, by both pharmacological and acupuncture effect, beyond 2-3 weeks.

--- Or there is no synergy between the pharmacological effect of the drug and acupuncture effect, produced by stimulation of the AP, by this drug.

Is found in this group, liquid drugs whose pharmacological action, so-called comfort, is not synergistic of the acupuncture effect born from the AP stimulus by these liquid drugs.

This acupuncture effect is of long or even very long duration

This type of long-term stimulation is obtained with hyaluronic acid and its derivatives. The pharmacological effect although not valued is not to be neglected.

In conclusion: The knee osteo-arthritis of is managed by Mesopuncture Acupuncture Mesotherapy or MAM in a single therapeutic gesture with a single BMN inserted in each PA.

Around the AP, with the same needle and liquid drug, it is possible to create Mesotherapy points also of the same therapeutic action duration.
The liquid drug injected into the APs located in the skin, like in Mesotherapy, has an interesting therapeutic future: 

It reaches directly the weathered zone first, and then after passage into the blood and conjugation in the liver, it again reaches the altered zone: The liquid drug acts twice in the altered area.

Nota.
For the treatment of osteoarthritis, by Mesopuncture Acupuncture, we do not have, in our pharmacopoeia, active drugs for more than a few weeks. 
It is possible to use liquid drugs of long or even very long stimulus duration of the AP (Acupuncture effect) without synergistic pharmacological effect but with pharmacological effect, not harmful, rather dedicated to comfort or aesthetics, as hyaluronic acid, for example. This type of long stimulus of the AP is interesting because it is possible to space the Acupuncture sessions: Fear of needles, loss of time, financial concerns etc. or to use them for patients intolerant to anti-inflammatory drugs or wishing to avoid them....

Conclusion:  Osteoarthritis of the knee is treated by Mesopuncture Acupuncture Mesotherapy_ MAM. 
We can find, at the disposal of Therapists, the specific device to achieve, with a single needle insertion, Mesopuncture Acupuncture (and Mesotherapy eventually).