I was first introduced (probably in 2005 or so) to a very different acupuncture technique: Pachi Pachi. I was introduced to it by my classmate, Dr. Don Snow, but it was originally written about and taught by Kiiko Matsumoto.
Pachi Pachi and Disk Herniations
In disk herniations (also known as a slipped disk), I will apply three needles at the vertebrae affected by the herniation, on either side of the spine and one central. I will do the same either at the level below or both the levels above and below. I will then spark the central needle every five minutes four times. A few body points, that change on the location of the herniation, round out the treatment.
Currently, I am using it on two patients. One has had a disk herniation in the low back. She has had debilitating pain affecting most of her activities for about a year. After 5 visits, she was completely pain free. We are currently extending out the visits to make sure the pain is truly gone.
My second patient, I have only seen twice as I am writing this. She was in a car accident and was diagnosed with a disk herniation in the lower neck. She has had severe headaches since the accident and her medical doctor wanted to do cortisone injections to help the pain. She was uncomfortable with that prospect and sought out acupuncture. After her first visit she had one headache (a great improvement in frequency) and it went away quickly (again, much better than before). She said she is very happy with the treatment and knows she chose the right path. I am really happy with her progress and expect her to be completely pain free in a few more visits.
What is Pachi Pachi?
It involves three things: acupuncture needles, triple bypass cords, and a pachi pachi sparker. There are variations of this that may eliminate either the cords or needles. Basically the sparker uses similar electrical aspects as TENS (transcutaneous electroneuro stimulation) or PENS (percutaneous electroneuro stimulation), but has higher voltage and is used intermittently rather than continuously for a set period of time. Basically, my protocol involves inserting at least three needles, applying the triple bypass cords, and sparking the middle needle every five minutes four times. Patients have described the sensation as "surprising" but not painful.
Triple bypass cords are specially made cords, from what I am told, that include a diode. What this does is allow for electricity to flow in a very specific direction around its three clips. This sets up a unidirectional circulation of electricity.
Does Pachi Pachi work?
I have tried to find research on this technique for over a decade. Without luck. It is a very niche acupuncture technique and I have had no luck in finding any literature on it. But I have been using it for all that time and have seen amazing results. I first started using it because it was almost miraculous on a patient with a lower back disk herniation. I was working with Dr. Don Snow and he applied the technique and this patient with debilitating back pain was uttterly pain free in four visits. Disk herniations are just not that easy to work with using any technique including acupuncture, surgery, or cortisone injections. That patient never came back. I have now used Pachi Pachi scores of times in disk herniations and other troubling situations and have seen this "miracle" in most of them. Not all of them. I do believe, and research on acupuncture supports this belief, that about 10% of the population does not respond to acupuncture. But way more often than not, my patients become pain free.
How does Pachi Pachi Work?
As I said earlier, there is no research on this technique, so there are no definitive answers to this question. I have thought about it a lot and have a theory as to it effectiveness. But first, here is a discussion of it.
I was revisiting Australia many years after I graduated medical school there. I was sitting around having beers (a very common occasion in Australia) with a couple of old classmates. One was on his way to becoming a maxillofacial surgeon, the other was almost finished with his orthopedic surgical training. I told them about this technique and asked their opinion on what could be the mechanism of action. In other words, how does it work? We thought about several possible mechanisms. The ortho surgeon thought that it ablats (destroys) the local nerves and therefore eliminates pain. I did not think this was the case because there would be local numbness and longer term side effects, neither of which I had seen in my patients. My other friend offered a few thoughts but nothing coherent.
I think what it does is electrochemically shuts down the inflammatory process. Without inflammation, pain will go away. It may also allow for some level of healing of the herniation. The flaw in this theory is that minor injuries to the area (even a "wrong" stretch) would reactivate the inflammation. And I just do not see patients coming back for treatment of their herniation very often. The support in this position is that I have used in many other conditions where there is inflammation and it works almost as well as with disk herniations.
The downside to this technique is that for many conditions (not usually disk herniations), it can be quite uncomfortable. I am currently effectively using it on a patient with carpal tunnel syndrome, but it is quite jarring. She endures it because she lost feeling in part of her hand years ago and this is the only thing bringing it back.
Bottom line is we do not know how it works. My experience clearly shows that it does work and it is very odd for me to employ something that I do not fully understand. But the results speak for themselves...
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