In the past I would put lectures together about how acupuncture works. I came across an article about the local twitch response. These phenomena were objective findings that showed acupuncture did something therapeutic to the body. The local mechanism of acupuncture by Chu J. is an article that explains how emg needles create a local twitch response by hitting motor end-plate plate zones that could explain acupunctures therapeutic effect. Considering that this phenomenon is thousands of years old, and is mentioned in classic texts, it drew my interest and warranted further evaluation.
Within my office I share space with a colleague. He is a chiropractic neurologist and performs EMG/NCV testing. In New Jersey he is not allowed to do the needling portion, only the evaluation. There is a medical doctor that does the needling. They had both brought up anecdotal evidence of patients feeling better after the procedure. In the past the three of us joked that they were performing therapeutic EMG’s. I had mentioned that I would like to perform diagnostic acupuncture.
So at this point in my career I will put two and two together and dive deep into this possible eastern/western medical cross over. Historical reference to “when needling it should feel like a small fish biting a hook” we may quantify that local twitch response through modern neurological diagnostics.
For those of you who are unaware EMG stands for electromyography. A needle electrode is inserted into a muscle to measure electrical signals that cause muscles to contract. These signals are interpreted and are evaluated for muscle function. My particular interest in this procedure is that it is astoundingly similar to acupuncture, and thought that there could be a diagnostic application to acupuncture. If one were to go to: https://clinicalgate.com/anatomy-for-needle-electromyography/ one could see the overlap on the anatomy charts.
When the muscle being tested is at rest there should be no signal reading. When the muscle is activated the observation produces an action potential.
Action potential activity at rest may indicate pathology such as inflammation or muscle disease. Sometimes there are spontaneous muscle movements called fasciculations. Fasciculations a.k.a local twitch response (LTR) is a clinical objective sign that confirms the presence of a trigger point (Hong, 94). This indicates both a diagnostic and/or therapeutic effect of acupuncture and/or EMG testing, thus perpetuating our inside joke of therapeutic EMG or diagnostic acupuncture mentioned in previous journal entries. The main difference between acupuncture and EMG is that the EMG picks up the electric activity and is interpreted. We are trained as acupuncturists to elicit the LTR when needling and can indicate an objective finding of the effects of our procedure.
Hong, C Z. “Persistence of local twitch response with loss of conduction to and from the spinal cord.” Arch Phys. Med. Rehabilitation, vol. 75, no. 1, Jan. 1994, www.ncbi.nlm.nih.gov/pubmed/8291955. Accessed 3 Nov. 2018
About the author
Michael D. Beys L. Ac., D.A.C.M. is a Doctor of Acupuncture and Herbal Medicine. His training consisted of over 3000 hours in the study of acupuncture and herbal medicine and has over 20 years of clinical experience. He was supervising acupuncturist at RUMC’s substance abuse Detox Center, South Beach Psychiatric Rehab facility and treating acupuncture physician at Sunrise Detox.
He is also fluent in Greek, and Spanish, and proficient in Mandarin, Arabic, and Italian. Currently, his practice focuses on fertility and women’s health, pain management, and substance abuse mental health.