Achilles Presentation Flashcards
Mechanotransduction
process in which cells sense and respond to stimuli
With DN, mechanotransduction occurs by
mechanical coupling of collagen fibers to the needle
> > direct pull on collagen fibers
Why do we need direct pull on collagen fibers from the needle?
- increases elongation, cell perimeter, and CSA
- better alignment of collagen bundles
- stimulates mechanotransductino of fibroblasts
Needle manipulation: able to transmit mechanical signal with pistoning?
yes, but only once needle grasp has been initiated
Needle manipulation: when the needle is inserted but not manipulated…
treatment outcome no better than sham
Needle manipulation: results in greater activation of
- C- fibers
- distal, superficial, and deep mechanoreceptors
- stretch receptors
C fiber excitation stimilulates
- glycine release from the SC
- attenuates pain transmission
In addition to glycine release from the SC and pain transmission, needle manipulation stimulates release of
endogenous opioids, which have both central and local effects
Needle manipulation at acupoints: Why?
Needle grasp is greater in acupoints than nonacupoints
Why is needle grasp greater at acupoints?
- acupoints and meridians are frequently located along connective tissue lines
- connective tissue can wind around the needle at these points
- NV bundles present
Needle manipulation at acupoints: neurovascular bundles - location
along connective tissue lines
Needle manipulation at acupoints: neurovascular bundles located along connective tissue lines
significance
same amt of needle grasp may have more powerful downstream effects at acupoints
DN and tendon healing: mechanisms
- increased blood flow via local vasodilation
- increased fibroblastic growth factor
- accelerated tissue healing rates
DN and tendon healing, there’s an impact of having more fibroblastic activity following rotational needle manipulation, in that it sets up the environment for
collagen remodeling and production
0.3 cun
pinky
0.5 cun
index
1 cun
thumb
1.5 cun
index/middle fingers
2 cun
index, middle, ring
3 cun
width of 4 fingers
4 cun
width of hand
EDN: why use?
RCTs within the acupuncture literature achieve better analgesia by adding estim than with intermittent manual stimulation (i.e. twisting) alone
Use of estim has what effects in pts with knee OA
- increases beta endorphins
- reduces cortisol
For acute pain, use this frequency estim:
2-4 Hz at 250µs
Why use 2-4 Hz at 250 µs for acute?
facilitat mm contraction
For chronic pain, use this frequency estim:
100 Hz at 150µs
Chronic pain: 100 Hz at 150µs is better for this type of pain
nerve, achy, or OA type pain
100Hz at 150µs is better for this type of pain control
C-fiber mediated pain control
