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American College of Rheumatology (ACR) fibromyalgia tender point map with acupuncture point correlates (from Google Images). 

American College of Rheumatology (ACR) fibromyalgia tender point map with acupuncture point correlates (from Google Images). 

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A multidimensional model of chronic pain includes not only physiologic and psychological/emotional factors, but also the dimension of subtle energy. In this chapter, the subtle energy dynamics of chronic pain are explored by first outlining the subtle anatomy and energy physiology described in many healing traditions around the world. Then, specifi...

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... pre-scientific explanation of acupuncture. Acupuncture, as the most intensively studied of the energy modalities, has received the most theoretical attention as to possible mechanisms of action. Elsewhere in this text, a fascial mechanism, as well as a neuromodulation theory, for acupuncture are proposed; neither model requires nor negates the independent existence of subtle energy. I will briefly describe a highly speculative mechanism of action for acupuncture that proposes a direct interaction between qi and neurons. The key component to this model is the relatively neglected direct current, perineural system described by neurosurgeon Robert Becker (9) . In contrast to the familiar digital, on-off, synaptically based neurological communication system, this analog system involves slower inter- cellular interactions that occur via ion fluxes within the extracellular matrix of the glial cells in the central nervous system (CNS) and along nerve sheaths in the peripheral nervous system (PNS). Many physiologic processes, including wound healing and possibly oncogenesis, are regulated by this system. Some healers believe this network in the CNS and along the axon sheaths in the PNS is the physical carrier of healing energy (10) . It is possible that the electrically charged and highly ionized solution in this matrix can be influenced by qi flow itself to induce action potentials, much like fluxes in magnetic fields can induce electrical currents in a nearby conducting medium. Thus, the interface between qi and physiology, between electromagnetic charge and perineural conduction, may be where the neurological mechanism of acupuncture lies. Recent advances in the neuroanatomical model of pain include advanced imaging technology and an improved understanding of neuroplasicity, including the molecular biology (e.g., C-fos gene expression), and neurotransmitter-receptor activity (e.g., NMDA receptor linked wind-up of wide dynamic range neurons). However, a different model of pain etiology emerges when the energy perspective is adopted. This section will focus on the specific energy dynamics of four common pain diagnoses; myofascial pain syndrome (MPS), fibromyalgia syndrome (FMS), complex regional pain syndrome (CRPS), and phantom limb pain (PLP). The first two are characterized by specific point disturbances in local tissue, which will be related to acupuncture point (acupoint) imbalances, CRPS will be conceptualized as an imbalance with a particular deficiency of emotional energy, and PLP will be described as a disturbance in the underlying energetic matrix. The key clinical finding in MPS is localized pain in a taut band of muscle called a myofascial trigger point (MTrP) (see Chapter 5). MTrPs appear to be randomly dispersed, according to the map of Western medicine, because they are found in anatom- ically heterogeneous tissues and locations. However, from an energy medicine or TCM perspective, they function as key acupoints. They were first linked to acupuncture points 30 years ago by Ronald Melzack, the pioneering pain psychologist (11) , who found >70% correlation of MTrPs with acupuncture points. In addition, the Western medicine treatment of MPS via trigger point injections is remarkably similar to acupuncture. The trigger points are inactivated, through injection of a range of substances (whether steroids, anesthetics, or saline). A standard MPS treatment guide (12) shows just such an injection into a MTrP in the brachii triceps tendon (see Figure 1). However, if the practitioner were using a dry needling technique (without any injected liquid), the procedure would in fact be remarkably similar to acupuncture needling of the Large Intestine-10 (acupuncture point Shou San Li on the hand Yangming meridian). The electromagnetic activity in acupoints and in MTrPs has been investigated (13, 14) . The emerging consensus is that MTrPs are characterized by heightened sympathetic activity. Therefore, the energetics of MTrPs are described as having an excess of qi requiring dispersion, in contrast to the tender points of fibromyalgia which, as we’ll see are deficient in qi and require tonification. From this point of view, MTrPs are generated when a physical injury results in a local or regional energy blockage that is frequently accompanied by underlying emotional factors. Unless these emotional components are addressed the block may not be released despite treatment of the physical MTrP (6) . An upcoming patient vignette illustrates how the emotional root of MPS can be treated via energy therapy. Two key components of FMS are primarily energetic in nature: the profound fatigue and the pathognomonic tender points. As with MTrPs, the location of FMS tender points is somewhat mystifying from the anatomical perspective. The map of tender points put forward by the American College of Rheumatology (ACR) correlates exactly with key acupuncture points, including Bladder 10, Large Intestine 11, and Bladder 25 (see Figure 2). The life history that precedes the diagnosis of FMS is often striking in the degree of cumulative stress and attendant symptomatology that occurs before medical attention is sought. From an energetic perspective, it seems likely that this accumulated physical and emotional stress has totally depleted the FMS patient’s energy system. Western medicine refers to adrenal exhaustion (15) as an indicator of a breakdown in the “Fight or Flight” response to stress. The parallel energetic process would be a breakdown in the root center, the chakra center that regulates survival issues. One well-known experimental finding suggests that the energy drain of insomnia may create the early symptoms of FMS. Healthy volunteers who are deprived of the restorative phase of sleep known as slow wave sleep will reliably develop tender points, which then disappear when normal sleep cycles are restored (16) . In effect, this energetic exhaustion leads to a breakdown of the root center (the foundation of the chakra system’s house of cards), which snowballs into complete energetic and endocrine collapse. Comprehensive treatment of FMS must address all these issues. Classical homeopathy sometimes succeeds in finding the unique silver bullet known as the consti- tutional remedy that will specifically and directly resolve the underlying imbalance (17) . Dr. Jacob Teitelbaum’s comprehensive FMS treatment protocol addresses endocrine dysfunction at all levels. It is one of the few FMS treatments that have shown statistically significant benefit in double blind, controlled experiments (18) . His protocol involves supplementation or replacement of each endocrine gland’s hormonal product: DHEA supplementation restores adrenal/root chakra function, thyroxine restores thryoid/throat center function, melatonin restores crown/pineal function, and so on, as the chakra/endocrine axis is reconstructed. While his model does not use subtle energy terminology, it calls to mind the chakra/endocrine parallels outlined in Table 1. Complex regional pain syndrome (CRPS) is a pain syndrome occurring most often in an extremity that is associated with abnormal autonomic nervous system activity and trophic changes. The disorder has both nociceptive and neuropathic features and is characterized by persistent pain, allodynia or hyperalgesia, edema, alterations in skin blood flow, and sudomotor dysfunction (19) . The underlying pathophysiology of CRPS remains incompletely understood at this time. Until recently, the pain medicine literature has suggested that CRPS involves a significant psychosomatic component. Many now advocate that the psychological distress seen in CRPS is a late conse- quence of unrelenting severe pain that makes concomitant anxiety and depression a nearly universal finding in chronic CRPS. However, Ochoa and others have noted (20) the strong placebo responsiveness in CRPS as evidence for the psychophysio- logical reactivity of these patients. As of yet, the mind-body link in CRPS has been explored only via survey instruments (i.e., the incidence of childhood trauma is 30%) (21) . The role of physically insignificant trauma as a precipitant for the syndrome has been widely noted but not fully explored. In the course of in-depth psychodynamic interviews, these physically insignificant initial traumas (sprained ankle, stubbed toe, injection of medication) are, however, often revealed to be emotionally significant, and at times even devastating, to the patient. By adopting a specific psychodynamically cued interview technique with CRPS patients, a significant degree of unaddressed emotional pain is frequently uncovered (unreported findings by author). The intensity of these psychological symptoms does not approach that seen in post-traumatic stress disorder (PTSD) and the process can best be described as suppressed dysphoric emotion, typically anger. The energy model of CRPS proposes that the mildly injured body part becomes so identified (often consciously) with emotional conflict that the patient chooses to ignore or at least withdraw attention from that part of the body. In other words, the qi is withdrawn from a specific region as a psychological defense against experiencing the associated unpleasant emotions that are somatically embedded in that area of the body. In time, the familiar sequence of CRPS symptoms develops—initially manifested as disturbances of the autonomic nervous system (allodynia, vasomotor instability), but ultimately progressing to frank tissue damage (loss of hair, cornification of nails, and osteoporosis). Interestingly, these latter symptoms are all characterized by loss of tissue vitality and can be readily reconceptualized as signs of chronic energy depletion. This “qi withdrawal” model may explain why energizing therapies like exercise can be so effective, particularly in younger/adolescent patients (22) —the vigorous aerobic exercise re-establishes circulation into the affected area, not only of ...

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... Some disorders, like chronic pain, show energy dynamics that align with this proposed energy/emotion linkage: 59 In myofascial pain, the characteristic trigger points are palpable, painful knots in the fascia and muscle that are often located at common acupoints. 9 They are over-energized because of unacknowledged emotional distress 95 and can be "sedated" (TCM for "relaxed") by acupuncture and acupressure massage, or by dry needling and trigger point injections of saline solution (Western analogues of acupuncture). ...
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The field of energy medicine (EM) is perhaps the most controversial branch of integrative medicine: its core concept - the existence of an invisible healing energy – has not yet been validated by Western medicine, and the mechanism(s) of action of its techniques have not been fully elucidated. In this paper, these problems are addressed by first outlining the organization of the human subtle energy system, and noting which components of that structure (meridians, energy centers and biofield) are impacted by various EM techniques. Evidence regarding the existence of this “subtle anatomy” is then presented from three realms: basic science research into electromagnetic fields (EMF), subjective experiences of EM, and clairvoyant perceptions of EM in action. Secondly, EM’s mechanisms of action are explored by describing how these techniques alter energy dynamics and affect biologic processes, a subject that could be termed “energy physiology”, to parallel conventional medicine’s foundation in anatomy and physiology. Finally, research into “energy physiology” is proposed, focusing on unusual experiences that are not fully explained by the current mechanistic biomedical model, but which do have plausible and verifiable energy-based explanation. These subjects include phantom limb pain, subtle energy-induced oxidative stress, emotional entrainment in groups, and the invisible templates that guide cell growth and differentiation. Keywords: biofield, subtle energy, energy medicine, phantom pain, energy psychology