Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

Clinical Application:
Facial Palsy (Bell's Palsy)

the bladder channel like BL2, gallbladder channel
GB6 and EX-HN5, small intestine SI18, stomach

Bell's palsy is a good indication for acupuncture
and moxibustion treatment. In this condition theseverity of the paralysis symptoms during the first few
days of the disease are an indicator of the prognosis.
Yet, in about 60% of the cases it heals without any
treatment, so that even if acupuncture and moxibustion
is effective, it would be difficult to express the degree towhich this treatment modality contributes to therecovery. Nevertheless many patients seek acupuncture
and moxibustion treatment, when western medical
therapy have been ineffective. Currently, in the absenceof therapies based on hard evidence, acupuncture andmoxibustion treatment has been proven worth a try
during all stages of the disease.
The earlier the treatment with acupuncture andmoxibustion starts, the better the prognosis. In
particular daily treatments should be administeredover several days following the onset. In many cases inwhich a certain degree of paralysis remains even after
a course of several months, complete recovery many
not be possible.
Bunshi Shirota recommended mainly adjusting
the general physical condition with moxibustion andthe use of acupuncture as a local treatment. Patientswere instructed to perform daily moxibustion at home.
Acupuncture:BL2, GB14, TE23, GB3, SI18, ST3, ST4, Ikoten, ST6,ST5, ST7, TE17, BL10, GB20, TE15, BL18, LI11.
Moxibustion:
CV12, GV12, BL12, BL18, BL20, LI10, GV34, GB2,TE22, GB2, GB16.
For the face thin No. 2-3 needles are used andinserted superficially (to a depth of up to 1 cm).
Occasionally,

threadlike

moxibustion

isalsoperformed1).
Sodo Okabe made the following statement"Considering that the face is the affected body partsuggests the occurrence of anomalies in the brighteryang channels of both foot and hand. For this reason,
essential points on these channels should be added forthe treatment of the roots. For the face, acupoints ofchannel ST1, ST4, ST5, ST7 and LI20, large intestine
channel Geiko, etc. are selected depending on thesymptoms. At the same time stiffness of the neck andshoulder on the affected side and tenderness should benoted. In particular, the region in front of and behindthe sternocleidomasteiod muscle should be checked forindurations and tenderness. Selecting points here isimportant in order to relieve increased tension andstiffness over the shoulders and back.
Needles should be inserted superficially to a depthof 1 to 2 mm and retained for a while. Hemorrhage isparticularly likely to occur on the face, so that shallow
needling should be a matter of course, while
indurations and tender areas on the neck allow
somewhat deeper needling. In general, if the limbs arecool, care should be taken to warm them. The face isparticularly related to both arms and legs, so thatwarming arms and legs can be considered an
important point for a successful treatment."2)
Isaburo Fukaya did not use any needles, but only
moxibustion for his treatment. He chose histherapeutic points not on the face, but mainly on theback, including GV14, GV12, SI14, BL18, BL15, BL14,
GB20, BL20 and similar points and applied threeextremely small moxa cones (half the size of a ricegrain) each on these points. Targeting tenderacupoints the disappearance of tenderness orindurations during the treatment decreased therelevance of those points for the treatment. The point
Saninko on the leg was always selected. Usuallymoxibustion is not done on the face, but when
palpation revealed a reaction, points like SI19 or GV20
were treated with moxibustion. Sometimes it isnecessary to apply moxibustion several dozen times
until its heat is felt3). He reported several cases inwhich he achieved a complete cure with this method.
Besides ordinary acupuncture and moxibustion
treatment, electroacupuncture is also frequently used
for this disease. Umeda reported that strong electric
stimulation in new cases within 2 weeks after onset
may lead to nerve degeneration and thus may
aggravate the condition, so that for the treatment
during this period only shallow needling should be

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

used4). Tsukayama also reported that during the earlyphase mostly needle retaining was used, whileReferences
12

sequelae of facial paralysis with asynchronoustransdermal low frequency electrization (AET)6).
Moreover, micropuncturing to let blood is also very

3

effective for this disease. In particular, if there are any
fine visible vessels micropuncturing in the buccal

4moxibustion treatment is effective, but compared toBell's palsy the effectiveness is insufficient.

AcupunctureandOkabe S.: The Essence of Acupuncture andMoxibustion Therapy p 96-97, Sekibundo 1983
Fukaya I.: Stories about Healing Diseases withMoxibustion, Collections No. 1 to 10, Shinkyu noSekai Publisher, 1972
Tsuta Y., Hosokawa Y., Umeda T., et al.: Treatmentof Facial Palsy; Shinkyu Osaka Vol.13, No.1 54-72
1997

5

Ordinary needles would be sufficient for this purpose,but there are only very few reports on this form ofthe herpes zoster virus, causing the Ramsay Hunt
syndrome marked by poor prognosis. Acupuncture andPractical

1, p. 292-296, Sogensha 1966

reported they achieved improvements in various
evaluation scores treating patients suffering frommicropuncturing.
Among the diseases causing facial palsy there isalso a viral infection of the geniculate ganglion withB.:

Moxibustion Therapy Based on Case Reports, Vol.

electroacupuncture was often used once the paralysis
had become fixed to a certain degree5). Arai et al.

region on the affected side should always be used to let
blood. Even a minimal amount will be effective.

ShirotaYoshida N., Tsukayama H., Okada A., et al.:Diagnosis and Treatment of Facial Pain and Palsy;
Ido no Nihon 59(10) 7-20, 2000

6Arai C., Yamaguchi S., Omata H., et al.: On theEffectivenessofAcupuncture

TreatmentofPatients with Sequelae of Facial Palsy, Summary
Collection of the 54th Conference of the Japan
Society of Acupuncture and Moxibustion, No. 201,
2005

Generally, needles need to be inserted to a depth of 3 toClinical Application:
Low Back Pain

5 cm, but when the patient has a fever like during a

Low back pain can have various causes, anddepending on the cause, requires the corresponding
specific treatment. Acupuncture and moxibustion
treatment is suitable for low back pain of any origin.
Shirota frequently used the following treatment
points for both acupuncture and moxibustion.
CV12, ST27, BL20, BL23, GB25 (Sawada style), BL25,GV3 (waist), BL32, Onodera's gluteal point, Kampu,
GV34, LR4.

cold or immediately thereafter, needling for low backpain to a depth of 1.5 to 2 cm will be sufficiently
effective. If in these cases the entire back musculature
is tender, scatter pricking targeting the muscles along
the second line of the bladder channel from top tobottom often elicits a needle sensation (Hibiki) andproduces an immediate, marked effect.
Among the forms of low back is also one thatoriginates from neurasthenia and requires the use of
the acupoints GV20, BL10, BL11, GV12, etc. Without

Occasionally BL18 may be required. GB26 orcalming the central nervous system in this way,

GB28 can also be required. In either case, spots ofimprovements are rather unlikely. Subdermal needles

marked tenderness or induration are needled. In casemay be unexpectedly effective for pain of the lumbarof a strained back (acute myofascular low back pain),myofasciae causing pain while lying in bed. In caseapplication of acupuncture and moxibustion close toblood network vessels are visible in the lumbar region,

the vertebra at the level of BL26 can be very effective.

blood letting from these can be markedly effective1).

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The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)