I would like to share with you today why "palpation-based diagnosis" is so important and unique, and why touching is so necessary in our treatments at Nekudat Maga.
As a practitioner of Acupuncture – Japanese Style, it seems so odd to treat and diagnose patients without touching and palpating them. Here is a story that happened just a few weeks ago in my clinic that emphasizes the importance of palpation.
A patient in her late 20s came into my clinic complaining of “drop foot”. Drop foot is the inability to dorsiflex the ankle or big toe due to damage of the fibular nerve. Usually a sign of a bigger problem. She has been suffering from this for quite so time, and when I asked about her diagnosis, and what her orthopedic doctor diagnosed, she said that they don't know. She said they did some CT’s MRI’s and didn't see any problem in the back and therefore ruled out back pathology.
As a practitioner of Acupuncture – Japanese Style, palpation diagnosis is of most importance, so when she lay on the treatment table and I started palpating reflexes, trigger points, Mu points, Shu points, joints, tendons, muscular structures etc.
When I palpated her back I found extremely tender spots especially on her QL muscles, and the whole lower back was hard like a brick wall.
Turns out I was the first one to actually palpated and touched her lower back. Her diagnosis from her MD was based only on her CT\MRI results, without ever actually palpating what was going on in her lower back and hip muscles. Orthopedic diagnosis CANNOT be based upon just looking on a piece of paper or computer image – it doesn’t work this way – we, as practitioners MUST palpate in order to gain accurate diagnosis!
Need less to say, after diagnosing her extreme tightness in her lower back muscles and especially her QL muscles, 4 treatments later there was movement of her big toe, and though not yet a full recovery I am very optimistic about her gaining full movement of her leg.
Palpation diagnosis is an inseparable part of Chinese medicine, and early texts, such as the Nan Ching (Ch.16), speak of 5 elements diagnosis through palpating pressure pain in the abdomen.
For some reason, palpation was not a mainstream diagnosis method in traditional Chinese medicine, maybe because of cultural reasons, where palpating was not cultural excepted at the time.
Yet, in Japan palpation became throughout the years a MAJOR diagnostic tool. With the help of many classical texts using palpation as an accurate diagnosis tool (such as; Nan Ching, Shang Han lun, Zhen Ju Da Cheng etc.), the Japanese made palpation a true art of diagnosis. This is also true due to Japanese government policy in the 16th century that encouraged the blind to practice acupuncture. So palpation and touch became inseparable part of Acupuncture- Japanese Style.
Zhen Ju Da Cheng – an acupuncture classic text from the 16th century says about acupuncture and palpation:
"… One has to examine the right and left, upper and lower part of the body… feel and palpate the body to find something in your hands… this is the rule”!!!
This is why I find palpation diagnosis so crucial in my clinic, and so characteristic of this style of acupuncture.