Acupuncture is a technique of inserting and manipulating fine filiform needles into specific points on the body with the aim of relieving pain and for therapeutic purposes. According to traditional Chinese acupuncture theory, these acupuncture points lie along meridians along which qi, the vital energy, flows. There is no physically verifiable anatomical or histological basis for the existence of acupuncture points or meridians. Modern acupuncturists tend to view them in functional rather than structural terms. Acupuncture originated in China and is most commonly associated with traditional Chinese medicine (TCM). Different types of acupuncture (Classical Chinese, Japanese, Tibetan, Vietnamese and Korean acupuncture) are practiced and taught throughout the world.

While acupuncture has been a subject of active scientific research since the late 20th century, its effects are not well-understood, and it remains controversial among researchers and clinicians. The body of evidence remains inconclusive but is active and growing, and a 2007 review by Edzard Ernst and colleagues finds that the “emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions.”

The WHO, the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), the American Medical Association (AMA) and various government reports have all studied and commented on the efficacy (or lack thereof) of acupuncture. There is general agreement that chinese medicine and acupuncture is safe when administered by well-trained practitioners using sterile needles, and that further research is appropriate.

Cupping refers to an ancient Chinese practice in which a cup is applied to the skin and the pressure in the cup is reduced (by using change in heat or by suctioning out air), so that the skin and superficial muscle layer is drawn into and held in the cup. In some cases, the cup may be moved while the suction of skin is active, causing a regional pulling of the skin and muscle (the technique is called gliding cupping).

This treatment has some relation to certain massage techniques, such as the rapid skin pinching along the back that is an important aspect of tuina (12). In that practice, the skin is pinched, sometimes at specific points (e.g., bladder meridian points), until a redness is generated. Cupping is applied by acupuncturists to certain acupuncture points, as well as to regions of the body that are affected by pain (where the pain is deeper than the tissues to be pulled). When the cups are moved along the surface of the skin, the treatment is somewhat like guasha (literally, sand scraping), a folk remedy of southeast Asia which is often carried out by scraping the skin with a coin or other object with the intention of breaking up stagnation. Movement of the cups is a gentler technique than guasha, as a lubricant allows the cup to slide without causing as much of the subcutaneous bruising that is an objective of guasha. Still, a certain amount of bruising is expected both from fixed position cupping (especially at the site of the cup rim) and with movement of the cups.

Traditional cupping, with use of heated cups, also has some similarity to moxibustion therapy. Heating of the cups was the method used to obtain suction: the hot air in the cups has a low density and, as the cups cool with the opening sealed by the skin, the pressure within the cups declines, sucking the skin into it. In this case, the cups are hot and have a stimulating effect something like that of burning moxa wool.

In some cases, a small amount of blood letting (luoci; vein pricking) is done first, using a pricking needle, and then the cup is applied over the site. The pricking is usually done with a three-edged needle, applied to a vein, and it typically draws 3–4 drops of blood (sometimes the skin on either side is squeezed to aid release of blood). A standard thick-gauge acupuncture needle or plum blossom needle may be used instead. This technique is said to promote blood circulation, remove stasis, and alleviate swelling and pain. It is employed especially when there is a toxic heat syndrome and for a variety of acute ailments.

Moxibustion is an oriental medicine therapy utilizing moxa, or mugwort herb. It plays an important role in the traditional medicine. Suppliers usually age the mugwort and grind it up to a fluff; practitioners burn the fluff or process it further into a stick that resembles a (non-smokable) cigar. They can use it indirectly, with acupuncture needles, or sometimes burn it on a patient’s skin.

Tuina (Tui Na) is an Oriental Bodywork Therapy that has been used in China for 2,000 years. Tuina (Tui Na) uses the traditional Chinese medical theory of the flow of Qi through the meridians as its basic therapeutic orientation. Through the application of massage and manipulation techniques Tuina (Tui Na) seeks to establish a more harmonious flow of Qi through the system of channels and collaterals, allowing the body the naturally heal itself.

Tuina (Tui Na) methods include the use of hand techniques to massage the soft tissue (muscles and tendons) of the body, acupressure techniques to directly affect the flow of Qi , and manipulation techniques to realign the musculoskeletal and ligamentous relationships (bone-setting). External herbal poultices, compresses, liniments, and salves are also used to enhance the other therapeutic methods.

Tuina (Tui Na) has a variety of different systems that emphasize particular aspects of these therapeutic principles. The main schools in China include the rolling method school which emphasizes soft tissue techniques and specializes in joint injuries and muscle sprains, the one finger pushing method school which emphasizes techniques for acupressure and the treatment of internal diseases, and Nei Gung method school which emphasizes the use of Nei Gong Qi energy generation exercises and specific massage methods for revitalizing depleted energy systems, and the bone setting method school which emphasizes manipulation methods to realign the musculoskeletal and ligamentous relationships and specializes in joint injuries and nerve pain.

In a typical session, the client, wearing loose clothing and no shoes, lies on a table or floor mat. The practitioner examines the specific problems of the client and begins to apply a specific treatment protocol. The major focus of application is upon specific pain sites, acupressure points, energy meridians, and muscles and joints. Advanced Tuina (Tui Na) practitioners may also use Chinese herbs to facilitate quicker healing. Sessions last from 30 minutes to 1 hour. Depending on the specific problems of the client, they may return for additional treatments. The client usually feels relaxed but energized by the treatment.

Tuina (Tui Na) is now being popularized in this country as a powerful therapeutic extension of traditional western massage methods. Tuina’s (Tui Na) simplicity and focus on specific problems, rather than a more generalized treatment, make it both an excellent alternative and/or extension of the Swedish-style massage. By utilizing treatments of shorter duration, it can be used in a variety of settings, including home, office, clinic or hospital. It is well suited for both the professional massage therapist or the active, health conscious individual.

Tuina (Tui Na) practitioners can be found by calling Acupuncture Colleges of the American Oriental Bodywork Therapy Association.

Tuina (Tui Na) dates back to the Shang Dynasty of China, 1700 B.C.E. Oracle bones show that tuina (tui na) massage was used to treat children’s diseases and digestive complaints in adults. By 600 C.E. Tuina (tui na) was included in the Imperial Medical College as a separate department. Tuina (tui na) flourished throughout China until the Qing Dynasty where it was suppressed along with other Chinese cultural arts. Following the Communist revolution, Tuina (tui na) was restored along with other traditional medical arts and was included in the creation of the current system of Traditional Chinese Medicine Colleges.

Currently, Tuina (tui na) is taught as a separate but equal field of study in the major traditional Chinese medical colleges. Tuina (tui na) doctors receive the same demanding training as acupuncturists and herbalists and enjoy the same level of professional respect.

Benefits, Limitations, Contraindications

Tuina (tui na) is well suited for the treatment of specific musculoskeletal disorders and chronic stress-related disorders of the digestive, respiratory and reproductive systems. Effective treatment protocols have been tested in a practical setting. Tuina (tui na) is not especially useful for those seeking a mild, sedating and relaxing massage since it tends to be more task focused than other types of bodywork. Contraindications include conditions involving fractures, phlebitis, infectious conditions, open wounds, and lesions.

Herbology is the Chinese art of combining medicinal herbs.

Herbology is traditionally one of the more important modalities utilized in traditional Chinese medicine (TCM). Each herbal medicine prescription is a cocktail of many herbs tailored to the individual patient. One batch of herbs is typically decocted twice over the course of one hour. The practitioner usually designs a remedy using one or two main ingredients that target the illness. Then the practitioner adds many other ingredients to adjust the formula to the patient’s yin/yang conditions. Sometimes, ingredients are needed to cancel out toxicity or side-effects of the main ingredients. Some herbs require the use of other ingredients as catalyst or else the brew is ineffective. The latter steps require great experience and knowledge, and make the difference between a good Chinese herbal doctor and an amateur. Unlike western medications, the balance and interaction of all the ingredients are considered more important than the effect of individual ingredients. A key to success in TCM is the treatment of each patient as an individual.

Chinese herbology often incorporates ingredients from all parts of plants, the leaf, stem, flower, root, and also ingredients from animals and minerals. The use of parts of endangered species (such as seahorses, rhinoceros horns, and tiger bones) has created controversy and resulted in a black market of poachers who hunt restricted animals. Many herbal manufacturers have discontinued the use of any parts from endangered animals.