The relationship between acupuncture and massage profession

Acupuncture and massage (tuina) are parallel clinical majors that coexist with each other under the external treatment system of traditional Chinese medicine and are highly complementary in technology. However, they have different emphasis on professional training goals, practice boundaries, and core technology logic. The two are neither subordinate nor completely mutually exclusive. In clinical applications, they are often used together according to the patient's condition.

If you go back to the source, the "Huangdi Neijing" has long listed "Bianstone, Pressure and Nine Needles" as the three major external treatment methods. They are all methods discovered by the ancients in daily practice to deal with trauma and joint pain. To put it bluntly, they are the earliest "physical therapy". In my hometown, there are barefoot doctors of the older generation who have never systematically studied the theory of traditional Chinese medicine. When they have a headache, they will prick their temples twice with a sterilized sewing needle. When their backs are sore, they will sit on the doorstep and rub their waist and eyes. The essence is the simplest combination of acupuncture and acupuncture. It is not an exaggeration to say that the two professions have the same roots.

Many people say that "needling and pushing do not differentiate between home and body", and this is true. If you go to a university of traditional Chinese medicine, you will know that most schools have a unified enrollment program for "acupuncture and massage" at the undergraduate level. The basics of traditional Chinese medicine, meridians and acupuncture points, and systematic anatomy courses are all taught together in the first three years. It is only in the fourth year of internship and graduate school that the courses are divided into different directions. When I was in school, students in the acupuncture class had to practice basic rolling and kneading techniques, and those in the massage class had to practice inserting filiform needles with cotton balls every day. No one could escape the practical assessment. It is even more common in grassroots clinics and community health service stations. A doctor will sit in for a consultation and massage patients with cervical spondylosis for 20 minutes to relax the tense trapezius muscles, then insert a few electro-acupuncture needles into the cervical spine, and finally pull out two cans. One set can be used smoothly. The patient also finds it convenient and does not have to go to two departments.

But having said that, there are also many people in the industry who don’t buy the idea that “all diseases should be treated with acupuncture and acupuncture”. This is not a deliberate argument, there are real practical considerations behind it. The first is the hard requirement for practice boundaries. According to the current practice standards for doctors, only practitioners who have obtained a traditional Chinese medicine practitioner certificate and whose scope of practice is registered as acupuncture can perform acupuncture operations. It is a complete violation for health massage therapists or doctors whose scope of practice is only massage to perform acupuncture without obtaining acupuncture qualifications. Furthermore, the technical focus of the two majors is really very different. I once took an intern who majored in massage. His hands were very strong and he could loosen and knead the deep muscle knots of the patient's waist accurately. However, after practicing for half a month to insert the needles, the patient still screamed and couldn't hold his fingers steady. On the other hand, I, a senior fellow in the acupuncture major, was very good at syndrome differentiation and acupoint matching, and was able to treat patients with facial paralysis and stroke sequelae. After a few pricks, there was obvious improvement. However, he asked him to do a lumbar oblique pull on the patient. After trying it twice, he did not dare to exert force, for fear that the angle was wrong and it would be broken. Think about it, massage requires several years of practice to exert force, from rolling and kneading to pulling to reset. The strength and angle of the hands are almost useless. Acupuncture majors practice finger strength and back point matching every day. How can they spend so much time on manual practice? Everyone eats their own food, it is really not something that can be crossed casually.

Last year I met a 40-year-old programmer who suffered from sympathetic cervical spondylosis. He had headaches and nausea every day, his neck was so stiff that he couldn’t move, and he was so painful that he even avoided the touch of a masseur. I first went to the acupuncture department for two weeks to perform pricking on Neck Jiaji, Baihui, and Neiguan. The symptoms of nausea basically disappeared and the edema also subsided. Then I transferred to the massage department for joint loosening and muscle relaxation, combined with shallow acupuncture twice a week for relaxation. It took almost a month to fully recover. At that time, doctors from the two departments even got together to talk and said that if they pressed hard when the pain was severe at the beginning, it would aggravate the inflammation. First, acupuncture was used to relieve pain and reduce edema, and then massage was used to loosen adhesions. This was the best solution.

Nowadays, the industry does not have to separate the two professions clearly. Instead, there are more and more integrated methods: for example, for patients with sports injuries, acupuncture analgesia is performed first and then joint reduction is performed immediately. The patient feels less pain and the reduction success rate is also high; there is also the now popular tendon acupuncture combined with massage to release myofascia, which is much better for chronic fasciitis that has not been cured for a long time than using one method alone. Of course, we have to admit that there are indeed many unscrupulous businessmen who are deceiving people under the banner of "combination of acupuncture and pushing". They have neither qualifications nor skills. News about pneumothorax caused by acupuncture and cervical spine damaged by massage can be seen from time to time. This is not a problem of the profession itself, but a problem of people.

To put it bluntly, whether it is acupuncture or massage, they are essentially methods to help people regulate qi and blood and unblock meridians. The roots of the two professions are rooted together, but the branches that grow out are different. Being able to help each other solve problems is much more meaningful than having to fight over who is superior and who is subordinate to whom.