ACUPRESSURE
INTRODUCTION :
Acupressure was originated in ancient China. It showed superior therapeutic
potential against numerous disease conditions. Acupressure is a type of
acupuncture. Both acupressure and acupuncture are based on same fundamental
principle of acupoints activation across the meridians. In acupressure, muscular
tension is released by applying pressure with hand at specific acupoints or pressure
of the thumbs on specific points or the application of pressure to acupoints is used
to balance the flow of the physiological energy. Acupressure also resembles
reflexology; however in reflexology therapeutic response was obtained by work on
predetermined reflux zone. Acupressure demand application of physical pressure
on trigger points/acupoints/specific pressure points which are positioned along the
meridians. Meridians are the channels within human body which helps to
maintain Qi and thus, steadiness of health condition. Each meridian is connected to
various organs and tissues of human body. Activation of specific point on meridian
by pressure facilitates pain reduction at the local site and also reduces the pain
from other parts of the body. It is a pressure point, hand-mediated energy healing
technique which is considered as useful strategy for the management of multiple
symptoms, along with beneficial physical comforts, satisfaction and economy. As
a whole, acupressure is a manually operated, needle-free, non-invasive, cost-
effective and non-pharmacological healing intervention to promote patients' well-
being.
DEFINITION:
Acupressure is a form of alternative medicine. It involves applying pressure to
different parts of the body. Acupressure can help reduce muscle tension, relieve
pain, and more.
USES
Pain management
Individuals experiencing chronic back pain may benefit from acupressure.
Acupressure can improve blood flow and relax muscles.
Researchers have also shown that acupressure can reduce cancer pain.
In addition to reducing labor pain, acupressure may help induce labor for some
individuals. This treatment can help prepare the cervix to enter labor.
Researchers have also found that acupressure can improve sleep quality. This
treatment may offer an alternative treatment for people living with insomnia.
ACUPOINTS
Entire human body is a cluster of pressure points. 8 Acupoint is the point closest to
the surface of the skin and activation of acupoint is the prime step in
acupressure.9 Stimulation of specified acupoints is known to elicit functional
responses that can be used to treat diseases. 10 Acupoints are any specific points for
needle insertion in acupressure; mostly these are area of high electrical
conductance on the body surface.4 Each acupoint possess a different sensation
based on the body part which suffers from the pain or a specific problem. Simply,
application of pressure at different points cause different effects. 11, 12 Acupuncture
points per se have different physical effects according to location. 13 Location of
each acupoint on specified meridian is determined in terms of body inch (BI) or
Cun. One BI/Cun equals one thumb width at the base of the finger nail. 14 BI/Cun
are known as acupressure units of measurement (AUM).
Local Points (LP) and Distal Points (DP) are the two important acupoints,
employed by acupressurists to treat the patients in routine clinical practice.
Acupuncture and acupressure show different physiological effects on these points.
Application of acupressure on only LP exhibits the therapeutic response on
autonomic nervous system. Tender points (TP) are the third type of acupoints
present on nociceptors and polymodal receptors. Activation of such TP sensitized
polymodal receptors result in better effects on pain relief. 15 In acupressure,
acupoints can be activated by elbows, fingers, feet, knuckles, palms, thumb or
specific tools. In ancient China, acupoints were activated with the help of stones,
known as Bian Stones.5 Currently, numerous acupressure or elastic bands with a
protruding plastic button are available.16
MECHANISM OF ACTION
Qi permeates everything and it is vital energy of life. It is the quality attribute that
determines the state of one's health. Yin and Yang are customary medicinal traits
conflicting as well as in equilibrium with each [Link] accordance to traditional
Chinese medicine (TCM), acupressure uses pressure to stimulate specific acupoints
for therapeutic purposes and stimulating these points can correct imbalance
between Qi through channels and subsequently treat the diseases. Re-equilibrium
of Qi achieve therapeutic benefits by improving the physiological functions of
body systems or Zang-fu in the process. Zang-fu is a combined term for human
internal organs; five zang organs are the heart, liver, spleen, lungs and kidneys,
along with the six fu organs involve gallbladder, stomach, small intestine, large
intestine, urinary bladder and sanjiao (the triple energizer).It is simply a non-
pharmacological intervention on the body to treat a wide range of conditions by
applied pressure to specific acupoints. It is the massage of acupoints performed
with the fingertips, knuckles, thumbs, elbows or suitable devices to achieve
effective treatment that would last from several minutes to hours post a single
treat-ment. Acupressure is a multi-modal therapy whose working mechanism can
be elucidated by miscellaneous theories.
According to Gate Control Theory by Melzack and Wall, acupressure at specific
point passes pleasurable impulses to the brain at a rate four times faster than
painful stimuli. Continuous impulses shut the neural ‘GATES’ and slower
messages of pain are blocked from reaching the brain and helps to improve or
strengthen the pain perception threshold of body. Based on the location of
stimulation, pressure-generation activates the small myelin nerves in the muscles
and pass stimulations to the higher nerve centres including spinal cord, midbrain,
hypothalamus and pituitary axis. Magnetoencephalography (MEG) studies
demonstrated conditioning of primary somatosensory response during the
acupressure. In addition to sub-cortical effects on endogenous pain regulation
acupressure also exhibits potential for affecting primary somatosensory processing
and possibly altering maladaptive [Link] acupressure (AA), a
micro-acupuncture is a non-invasive technique similar to reflexology in which
endocrine functions are improved effectively. It is known to exert its effects via
stimulating the central nervous system through the cranial/spinal nerves on the
auricle of the ear.
Biochemical mechanism (Fig. 1) of acupressure involves the stimulation of
acupoints that leads to complex neuro-hormonal responses. It involves the
counteraction among hypothalamic-pituitary-adrenocortical axis that leads to
overproduction of cortisol and cause a relaxation response. Also, it modulates the
physiological response by increasing endorphin and serotonin transmittance to the
brain and specific organs through nerves and meridians. After exercise, restorative
meridian acupressure helps to change the concentration of stress hormones and
lactic acid. Specifically in case of the respiratory function, acupressure plays a
moderating role. Activation of acupoint activates myelinated neural fibres that
stimulate the hypothalamus and pituitary gland, leading to the release of β-
endorphins from the hypothalamus into the spinal fluid and pituitary into the blood
stream, respectively. Thus, the analgesic and sedative effect of β-endorphins
facilitates the normal respiratory function of patient.
Fig. 1 showing Biochemical mechanism of acupressure
As per the Meridian theory, on stimulation of acupoints, the area along the
meridian will be affected whereas stimulating proximate acupoints would affect
the functioning of local tissues. Acupressure mediates nitric oxide (NO) signal,
known to improve local microcirculation via cyclic guanosine monophosphate
(cGMP). It helps in enhancing the physical performance by suppressing fatigue-
inducing molecules in the blood. The specific relationship between acupressure
and microcirculation can be enumerated by various spectroscopic methods. Near-
infrared spectroscopy (NIRS) assists in determining the regional oxygen saturation
whereas Laser Doppler measurement (LDM) is used to examine the
microcirculatory efficacy and underlying mechanisms of acupressure therapy. In
comparison to LDM, NIRS is more sensitive in detecting the tissue in-flow
changes as it can penetrate much deeper in the sample.
Applying a continuous pressure for approximately 1 min at specific hyperalgesic
points helps to reduce both local as well as propagating [Link] results in
acute reduction in pain sensitivity and pressure pain sensitivity (PPS).In most of
the surgical process, acupressure aids in preventing surgical haemorrhage and
accelerating the healing process. In summary, acupressure helps to decrease tissue
adhesion, promote relaxation and regional blood circulation, increase
parasympathetic nerves activity and intramuscular temperature along with
reduction in neuromuscular excitability.
BENEFITS
Acupressure offers a number of benefits over conventional treatments.
This alternative treatment is noninvasive.
In addition to the health benefits, acupressure can be fairly cost-effective.
With the proper training, individuals can learn to perform acupressure on
themselves.
This makes it an inexpensive and accessible option for treating certain
conditions.
Other benefits of acupressure may include:
improving vision
boosting hair and skin health
promoting relaxation
enhancing sleep
decreasing stress
SIDE EFFECTS
Most people who have acupressure done do not experience any serious side effects.
Mild side effects of acupressure may include:
tiredness
nausea
dizziness
