The sequence of acupuncture and massage

There is no absolute "standard answer" to this matter, but judging from the actual effects of most clinical treatments, acupuncture first and massage second are the more general choices. Only in a few special scenarios will the order be adjusted, or even the two may not be operated at the same time.

Last week, I met a young man who works in Internet operations at the outpatient clinic. He suffered from stiff neck and shoulder and neck strain for almost a week. When he came in, his neck was so crooked that it felt as if a fixed button had been pressed. When he turned around, he had to move his entire upper body at the same time. I first pierced his cervical splenius, Fengchi and stiff neck points on his hand. I left the needle in place and twisted it twice for 20 minutes. At that time, he shouted, "My neck is much looser and I can turn more than half a circle." After the needle was removed, the trapezius muscle was released. When the muscle that was as hard as a rope was rubbed, he did not complain of any pain. He bowed his head and typed on the keyboard normally the same day after the treatment. If he had been rubbed first before pricking, he would often hide in pain during the kneading, and the acupuncture would also weaken his sense of energy, so the effect would be doubled.

After talking about practical cases, you have to talk about the rationale behind it, otherwise some people will always think it is empiricism. Acupuncture works directly on the muscle layer, fascia layer and even deeper. It is equivalent to opening up the deep blocked meridians first and mobilizing the sleeping Qi and blood to circulate. Then massage is performed. Whether it is the relaxation of the superficial muscles or the grooming of the middle fascia, it can follow the direction of the Qi and blood circulation. The effect is equivalent to 1+1>2. To use an inappropriate analogy, it is like opening a sewer pipe. First, use a pipe to loosen the deep blockage, and then use high-pressure water to flush it. It is definitely much more efficient than flushing first and then flushing. On the other hand, if you do a massage first, the qi and blood will be mobilized into the skin and superficial muscles, and the qi feeling will be much weaker when the acupuncture is inserted. Many people report that the muscles are a bit sore after the massage, and the pain of the acupuncture will be greatly amplified.

However, this rule does not apply to all situations. I have met many colleagues who have a background in bone setting, and they are accustomed to doing relaxing massage first and then acupuncture, which is completely justified. For example, when encountering a patient with acute lumbar sprain, the waist is as hard as a slate, and you can't touch the acupuncture points directly. If the patient is forced to prick, the patient's whole body will be tight, and the needle will not only be prone to stagnation and bending, but also the pain will cause him to break into a cold sweat. The experience is also very bad. They usually use rolling and kneading methods to relax the waist and Weizhong points for three to five minutes. Once the muscles are softened, they can then find the right acupoints and prick them accurately. The patient will feel less pain and gain Qi faster.

There are also several types of people for whom we will deliberately adjust the order in clinical practice. For example, when a little girl came for acupuncture for the first time, her palms were so nervous that she could not sit still. I would massage her shoulder, neck and Neiguan points for about ten minutes, and wait until her breathing stabilized before injecting her. This would basically prevent needle fainting. There are also elderly people with particularly weak Qi and blood. Their hands and feet are cold all year round, and their pulse is as thin as a thread. First, do a gentle massage on the limbs to guide the Qi and blood to the ends. When you insert the acupuncture, the needle will feel obvious and the recovery will be faster. There are also children under the age of five who have a strong fear of needles. First, massage the spine and rub the belly for a while, and then quickly insert the needles after they are familiar with it. Basically, they will be over after crying twice, so as not to struggle and sweat while holding down the needles.

Don't just talk about the order, there is a pitfall that many people have stepped on. At the site where the needle has just been inserted, especially where the needle has been left for a long time, or where the needle hole is bleeding, press firmly as you pin it up. Avoid needle hole operations for at least 4 hours. If you have performed invasive acupuncture procedures such as bloodletting or fire acupuncture, do not touch or press the operation site on the same day, otherwise it will easily cause infection or large-scale bruises.

To be honest, no matter who comes first, the core is to achieve better results and a more comfortable experience. There is no need to stick to a certain standard to argue. If you have strong tolerance and have no special circumstances, the fastest effect will be achieved by acupuncture first and then massage. ； If you are afraid of needles or have severe muscle spasms, it is absolutely fine to press first and then acupuncture. The best order is the one that suits you.