Clinical anatomy, kinesiology, and the jing-jin ("sinew meridians" or myofascial tracts)
- Bones, muscles, discs and facet joints, and neurology
- Postural and motion dysfunctions
- The arthritic progression: strain/sprain, derangement, degeneration, from qi stagnation to bone bi/phlegm and blood stasis knotted together
History-taking: key diagnostic questions
- "Red flag" symptoms of urgent/serious medical conditions potentially warranting referral to physician care: stenosis, tumors, infection, fractures, and radiculopathies
- Differentiating symptoms of muscles, joint, disc, and spinal cord, and nerve root injuries
- Neural hypersensitization and psycho-social factors
- Functional capacity questionnaires for reporting to managed care insurance
Physical exam of the low back, core and pelvic girdle: how findings can guide acupuncture treatment
- Observation, inspection and palpation
- Joint exam: active range-of-motion and passive stress testing sacroiliac joint and pubic symphysis
- Neurologic exam: upper motor neuron; leg reflex, sensory, and motor function; sciatic neuropathy
- Manual strength testing and referred pain pattern charts for 10 key muscles of the low back, core and pelvic girdle
- Special orthopedic tests for the lumbosacral spine
- Documentation of physical exam findings
- Measuring and reporting functional capacity baselines and treatment outcomes
- Clinical flow charts to facilitate efficiency and accuracy in examination
Diagnosis and Pattern Identification
- Lumbosacral sprains/strains, postural and motion dysfunctions, and myofascial pain of the iliopsoas, quadratus lumborum, paraspinals, abdominals and gluteals
- True sciatica vs. radiculitis vs. piriformis myofascial pain
- Radiculopathies and stenosis
- Post-partum pain, insufficiency of the iliolumbar and sacrotuberous ligaments, and dysfunctions of the sacroiliac and pubic symphysis joints
- Chronic lumbosacral pain, spondylosis, arthritis, degenerative disc disease, scoliosis
- Spondylolisthesis and compression fractures
- Failed low back surgery syndromes
Treatment
- Myofasicial trigger point needling: quadratus lumborum, iliopsoas, gluteals, hip external rotators, and abdominals
- Joint stabilization/mobilization aka prolo-acupuncture: iliolumbar, posterior sacroiliac, and sacrotuberous ligaments; lumbar facet and pubic symphysis joints, and spondylolisthesis
- Active cupping: suction + thoraco-lumbar AROM
- Gua sha and tui na to restore lumbo-sacroliac joint mechanics
- Electro-acupuncture for radiculopathies, cord compression and sciatica
- 3-edged, lancet and 7-star needle therapies
- Exercise therapy, sport and work ergonomics
