What is the difference between acupuncture and massage?

The core difference is actually the path and depth of action. Acupuncture is an invasive external treatment method, while massage is a completely non-invasive physical release. There is no absolute distinction between the two, but the applicable scenarios are very different.

Last week, a programmer who had been working on a project for three nights came to see a doctor. He started to gasp in pain when his right shoulder was raised to 30 degrees, and his trapezius muscles were all covered with lumps and knots. I first performed a shoulder and neck massage for twenty minutes, using rolling and gentle kneading to loosen the tense muscles on the surface. He was able to raise his arm to 80 degrees on the spot, but he still complained of pain in the gap between his shoulder blades. The pain was so deep that when I pressed my hand, I could only touch the bony surface of the scapula, but could not touch the deep strain point at all. At this time, I took a 0.25*40 filiform needle and inserted it along the direction of the infraspinatus muscle to about 2 inches. He gently twisted it until he was breathed out. He hissed and said that the pulling soreness followed the needle. After removing the needle and lifting his arm, there was basically no pain at all.

That’s not to say that massage is useless. If you had a stiff neck after using the air conditioner the day before, and it’s just the superficial muscles on one side of your neck that are twisting and spasming, find a reliable massage therapist and massage for ten minutes or so. Most of the time it will be cured on the spot, so there is no need to get this shot. You can compare the muscle layer to a freshly steamed layer cake. The top two or three layers of wrinkled dough are massaged and kneaded. Once soft and loose, you will feel comfortable. However, if several layers at the bottom are stuck together, no matter how hard your hands are, they can't penetrate that deep. You have to use a fine needle to gently penetrate it and lift out the adhesions.

Nowadays, the industry has different views on the boundary between the two. Many senior practitioners of traditional Chinese medicine believe that the essence of both is to dredge the meridians and blood. There are even acupuncture schools that directly use fingertips instead of filiform needles and press the deep acupuncture points hard. Many mild cases can achieve similar effects to acupuncture.； Some scholars who do rehabilitation research have suggested that the role of acupuncture is not limited to local relaxation. Stimulating specific acupuncture points will trigger the body's neuromodulatory pathways and promote the secretion of endogenous analgesic substances such as endorphins, which can play a systemic regulatory effect. This is an effect that is difficult to achieve with massage that relies solely on external force relaxation.

I usually don't force patients to choose one in the outpatient clinic. If they are afraid of pain, and the problem is only superficial soreness caused by short-term exertion, I would recommend massage first. You can chat a few words during the massage, and the effect of relaxing your mood will be more prominent.； If it is an old injury that has been painful for several months, or a problem involving whole-body regulation such as migraine or primary dysmenorrhea, which cannot be relieved after several treatments, then acupuncture will be recommended. After all, it is a skin-breaking operation, and it must be made worthwhile to the patient.