| ELECTROACUPUNCTURE
Introduction
Electrical stimulation of parts of the body using a variety of methods
has long been known to be beneficial in producing hypoalgesia or in inducing
segmental stimulation at both the visceral and skeletal levels.
Electroacupuncture, or EAP,
is a method of stimulating acupuncture points using low voltage electric
current.
In ancient times, the Chinese used acupuncture to induce surgical analgesia.
In today's human surgery, it is used in combination with opioids to produce
local analgesia before certain operations. Studies and applications also
exist in veterinary medicine, where they have focused in particular on
cattle.
In clinical practice, EAP plays an important role in the treatment of
osteomuscular pathologies (chronic pain), myositis (myofascial pain) and
central or peripheral myopathies such as paresis and paralysis.
It is also used to act on smooth muscle by stimulating paravertebral segmental
points.
Application
EAP relies on the passage of alternating current produced by a generator
with multiple outputs whose frequency and intensity can be modulated.
This generator is
equipped with electrical cables whose free end features a small clip which
is connected to the handles of normal "Chinese" needles after the latter
have been inserted in the acupoints and trigger points. Depending on the
problem being treated, application time can vary from 10 to 45 minutes,
using several points simultaneously.
Direct current can also be used in a variety of ways, though greater caution
is required.
Technical Notes
EAP differs from Transcutaneous Electrical Nerve Stimulation, or TENS,
in its basic electrophysiology (biphasic wave, activation of Aa/ß fibers,
gate theory), transcutaneous action, and use of high frequencies and low
intensity.
The distinguishing features of EAP are thus:
- The output wave,
which is a biphasic square wave (i.e., a positive wave with a negative
peak, and pulse width between 0.2 and 0.4 msec)
- The use of low
frequencies and high intensity ('pain' component).
Application methods
differ according to the pathology to be treated.
Current can be applied continuously or intermittently, and with frequencies
from 2 or 3Hz to 100-150Hz.
The mediators liberated during EAP application will depend on the frequency
used:
- Low frequencies:
ß-endorphins and met-enkephalins from the brain
- High frequencies
(over i 100Hz): dynorphins from the spinal cord.
The treatment's aim
is to stimulate one of the following:
- Root of the nerve or dermatome
- Distal and proximal points of the meridian concerned
- Trigger points.
Consequently, the
needles are placed at local or distal points (antique Shu points) according
to the symptomatology to be treated, using special action or master points.
These points have a specific anatomical location:
- Adjacent to the
passage of a peripheral nerve
- Near the tendinomuscular
junctions
- In the periostal
area
- In the venter musculi.
Advantages
The main advantages
of EAP are as follows:
- Points that are
difficult to treat, especially in certain species of animal, can be
stimulated continuously in controlled fashion.
- Treatments can
be performed at intervals ranging from 7 to 15 days.
- It achieves greater
lymphatic drainage and more intense local antiedemigenic action, thanks
in part to the greater vasodilation it produces.
- Greater electroconductivity
of muscles and nerves, which means that EAP can make a significant contribution
to assisting recovery after spinal surgery and in cases of chronic paresis.
- It is beneficial
in physical rehabilitation after trauma or surgery.
Contraindications
Particular care must be taken with pregnant patients, as EAP stimulation
can induce miscarriage. Caution must also be exercised when using high
frequencies in areas affected by dermatological problems.
(V. Rovani: "Electroacupuncture";
in Veterinary Acupuncture Notes, Volume I, S.I.A.V., Torino 1999).
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