In 1935, a Chinese medical doctor named Huang Xuelong first introduced the concept of a relationship between the scalp and the cerebral cortex. Initial clinical studies showed that scalp acupuncture was particularly effective at treating neurological problems, especially those experienced by stroke victims, such as paralysis, tremors, aphasia (trouble speaking) and ataxia (lack of muscle coordination).
Over the years, its use has expanded. In the 1970s, three Chinese medical doctors, Jiao Shunfa, Fang Yunpeng and Tang Songyan, brought scalp acupuncture to greater prominence, creating a diverse system with different needling techniques (varying angles of insertion, depth, the number of needles, manipulation, twirling, etc.) Each doctor also focused on different areas of the scalp. Jiao specialized in motor and sensory areas, Fang focused on memory and speech centers, while Tang zeroed in on something called the "triple burner" (three energetic "organs" that have no corresponding physical organ known to Western medicine).
Today, these techniques have been refined, and one of the most recent developments in traditional Chinese medicine (TCM) is needling the shu points of the scalp for specific health problems. (Shu refers to points where the life force, or qi, of the internal organs can be energetically influenced on the scalp.) Modern scalp acupuncture combines the best of acupuncture with the best of Western medicine. It is heavily based on Western physiology as it pertains to circulation within the central nervous system, especially that involving the cerebral cortex, the circle of Willis (the cerebral arteries supplying blood to the brain) and the cranial nerves. The technique also incorporates a good deal of Western diagnostics. As Roisin Golding, an acupuncturist and founder of Acupuncture Works in London, UK, says, "Western medicine is incredible when it comes to neurological diagnostics. Unfortunately, Western medicine treatments themselves are so very broad-based, they're not that effective. Acupuncture and scalp acupuncture, on the other hand, are much broader in their diagnoses, but the treatments themselves are incredibly tailored to the individual."
Multiple scalp acupuncture methodologies are still in development, but a standard nomenclature for acupuncture points has been developed, and various "zones" mapped out. In general, the front zone of the scalp toward the face is used to treat the upper body, while the rear portion of the scalp is used to treat the lower body. Zones relating to functions, such as sensation, memory and motor skills, are usually found at the back and sides of the scalp.
Upon inserting the needles, manual stimulation is usually applied for one to two minutes, and then the needles are twirled again at intervals of about 10 to 15 minutes throughout the patient's visit.Unlike traditional body acupuncture, where the practitioner has a wide array of choices concerning the points and techniques to use for different issues, scalp acupuncture has more of a Western medical approach, with patients given the same diagnosis usually receiving the same or very similar treatment.
Scalp acupuncture for tinnitus and hearing loss
A puzzling ringing in the ears, a tone, a low buzzing or a whirring sound—that's how people describe tinnitus. It's a sound you can't get away from, and it can drive some people to distraction. Often accompanied by some sort of hearing loss, the US Centers for Disease Control and Prevention estimates that nearly 15 percent of the general public—over 45 million Americans and 360 million people worldwide—experience some form of tinnitus.
The most common cause of tinnitus is damage or loss of the tiny sensory hair cells that line the cochlea of the inner ear, which typically occurs as people age. It can also occur when a person is exposed to damaging sound levels—especially for long periods. Unfortunately, traditional medical treatments for treating tinnitus and the related condition of sudden sensorineural hearing loss (SSHL) are mostly hit-or-miss.
However, two studies on the use of scalp acupuncture have shown that it is effective for immediately and significantly reducing the effects of tinnitus.1 In addition, scalp acupuncture, in combination with traditional acupuncture, was found to be effective for treating SSHL.2
A new solution for stroke and neurological disease
Stroke, which affects approximately 800,000 people in the US and 100,000 in the UK every year, is the third leading cause of death and a major cause of long-term disability in adults. Strokes are most often caused by a blood clot or the rupture of a blood vessel in the brain that interrupts the blood supply, depriving brain tissue of nutrients and oxygen and resulting in a sudden die-off of brain cells.
Sensory perception, speech, movement and memory are often affected, resulting in such problems as difficulty seeing, walking, talking, and using one's arms and hands (usually on just one side of the body). Headaches, loss of consciousness, numbness and paralysis are also common symptoms.
Currently, there is only one approved approach to treating ischemic stroke (strokes that result from an obstruction within a blood vessel supplying the brain), and that is tissue plasminogen activator (tPA), a drug approved by the US Food and Drug Administration in 1996. Although tPA is able to dissolve blood clots, it is only useful if applied within a three- to six-hour window after a stroke has occurred. Any later than that, and its use can cause further hemorrhages in the brain.3
In 1997, the US National Institutes of Health (NIH) began recommending general acupuncture as a complementary rehabilitation therapy to restore movement, sensation, speech and other neurological functions after stroke. In 2002, the World Health Organization (WHO) followed suit. Since then, acupuncture has become a widely accepted treatment, showing better clinical curative results than conventional Western treatments for stroke-related disabilities.4
Scalp acupuncture takes stroke treatment to an entirely new level. Remarkably effective for treating acute and chronic central nervous system problems including stroke symptoms, it often produces immediate improvement within several seconds to a minute using just a few needles.5
Dr Philip Trigiani, orthopedic acupuncturist and founder of Physical Medicine Acupuncture and Dr Phil Wellness NYC in New York City, says he has many stroke patients referred to him from neurologists. "A couple months ago a man came in who was in his early 60s, with total paralysis in most of his upper body and part of his lower body on the right," he says. A smoker with cardiovascular disease, the man had had a stroke some months beforehand. "We got motion back right away after the very first session," says Trigiani. "He came in about two times a week for about a month and half and is now about 80 percent recovered."
Randomized controlled trials using scalp acupuncture show significant effects and improvement in neurological deficits following ischemic stroke.6 In a rat model of stroke, scalp acupuncture was reported to have a "rapid and strong effect" on neurological symptoms by reducing fluid buildup around the brain (cerebral edema).7 It's also effective for treating stroke-related paralysis, acute intracerebral hemorrhage and spastic hemiplegia (a condition where the muscles on one side of the body are in a constant state of contraction).5,8
After an ischemic stroke, it is important to use scalp acupuncture as soon as possible to achieve optimum clinical results. For hemorrhagic stroke—when a blood vessel in the brain bursts open, as opposed to being clogged up—it's advisable to perform scalp acupuncture as soon as the bleeding is controlled. Researchers from Heilongjiang University of Chinese Medicine in China also note that superior clinical outcomes are achieved when scalp acupuncture is combined with other methods of what is termed regular "body acupuncture."
Furthermore, scalp acupuncture has proven effective for the treatment of multiple sclerosis (MS) and other central nervous system disorders. One study, for example, cited how scalp acupuncture restored mobility and energy and eliminated incontinence, dizziness, numbness and tingling in the limbs in a 65-year-old man who had suffered from MS for 20 years. After 16 treatments, he was able to return to work.9 Scalp acupuncture is also a promising treatment for Parkinson's disease.10 Golding says she's treated many patients with Parkinson's over the years, such as a woman who suffered from ataxia and aphasia, such that her ability to speak was severely impeded. "I found her very hard to understand," says Golding.
"Her husband had to serve as an interpreter. She was also unable to walk because of her lack of balance, and her vision was badly disturbed."
Within a few scalp acupuncture sessions, Golding's patient was able to walk to the park unaided, and her speech was much clearer. Although her vision hasn't yet responded, says Golding, "she's doing much better, and it is easy for her to speak on the phone and have conversations with people."
Another patient, aged 68, with Parkinson's, "would shuffle in the door, and I'd do scalp acupuncture, and she would sometimes run for a cab outside my office afterwards!" says Golding. The woman did remarkably well for about 10 or 12 years on very reduced medications, carrying on an active social life, until eventually she deteriorated. "She said it was the only thing that ever really helped her," says Golding.
Golding combines electro-acupuncture (where a very low electrical current is passed between pairs of acupuncture needles) with scalp acupuncture in order to avoid some of the rapid needle twirling techniques that characterize most scalp acupuncture treatments, which she found both laborious for her and often uncomfortable for her patients. Since switching to electroacupuncture, "I find that it makes scalp acupuncture much more comfortable and completely tolerable for people," she says. "The patients can quite comfortably sit there and chat, and you can also increase and decrease the sensitivity of it so you can get the current strong enough."
Scalp acupuncture has even shown promise for facilitating the recovery of acute traumatic injuries, such as restoring some nerve communication in a patient suffering from acute spinal cord injury.11 Up to 80 percent of amputees develop phantom limb pain (where pain is felt in the missing limb area), and conventional medicine has few answers for alleviating their pain. Scalp acupuncture has been shown to provide pain relief for amputees suffering from pain in the amputated limbs.12
How scalp acupuncture works
According to Trigiani, scalp acupuncture is highly detailed in terms of how it affects certain cranial nerves and the microsystem that governs reflex changes in the rest of the body. For one thing, acupuncture on the scalp has an immediate effect, especially when dealing with neurological symptoms such as numbness, pain and paralysis from stroke. It works through something called proprioception, he says.
Proprioception is our unconscious perception of where our body is located in space—for example, reaching for a glass without needing to look for it. The sense of proprioception comes from nervous system signals generated throughout the body, like muscle tension and the balance mechanisms within the inner ear. "Touch any part of your body, and your brain immediately receives information as to what's being contacted and where you're at in terms of your physical being," says Trigiani. "The most dynamic points of contact in the body are the distal points: fingertips, toes, earlobes, inner ear and, of course, your cranium. In the case of scalp acupuncture, it's sending a signal to the central nervous system to cue that particular part of the organ. In this case, we're talking about the brain."
Trigiani says that scalp acupuncture is about 'waking up' the nerve cells in a particular complex of nerves and raising awareness at a certain level within the body that in turn allows it to self-correct and self-heal. "And because we're dealing more with proprioception, rather than trying to stimulate tissue and nerves directly, it's generally painless," he says. "I also use very fine needles—about the width of one human strand of hair—that go into the scalp almost effortlessly."
Trigiani particularly likes scalp acupuncture because it works within minutes, "sometimes even just seconds." He often asks patients to move a body part during a treatment, or he might use osteopathic methods (treating disorders by manipulation and/or massage of the bones, joints and muscles) or touch contact points on the body related to the problem area while performing the scalp treatment. All of this is designed to maximize the conversation between the brain and the body, waking the brain up to what's going on with various systems and organs.
Take Bell's palsy, for example, a sudden, temporary weakness in the facial muscles that makes part of the face droop. In addition to needling the appropriate scalp points for this condition, Trigiani also sometimes uses a fingertip to hold a contact point on the opposite side of the body along the appropriate nerve pathway. "A few minutes later, you can see the face start to go back into a more balanced position," he says. While dramatic results can be seen in one session, generally a number of treatments are necessary for permanent changes to occur. "If somebody comes in with allergies, and they're sneezing or if they have asthma, I can relieve it in about one second with scalp acupuncture. But the body may go back to that old anchor point because there's been damage to the neural pathways," Trigiani notes. "But it's just a matter of coming in a few times to stabilize and solidify the results."
In addition to all the other conditions he addresses with scalp acupuncture, Trigiani has about an 85 percent success rate with women coming in for fertility treatments. "There are very powerful points along the cerebral cortex for fertility and for the stomach," he says, "that strengthen the uterus and other reproductive organs, as well as the kidneys." One recent patient, Christy, 42, had been unable to get pregnant and was told she never would—even though her reproductive organs were in good shape, and she was healthy. She went to see Dr Phil for pain issues, going for sessions two to three times a week. In addition to resolving her pain, she soon discovered that she was pregnant. Says Christy: "It's definitely given me a broader perspective of what's possible."
Science catches up with ancient practices
Acupuncture is based in the ancient premise of Traditional Chinese Medicine that qi (energy) moves throughout the body along 12 main energy channels known as meridians, and that energy points along the meridians correspond to the major organs and functions of the body.
The first known historical reference to acupuncture and the practice of needling specific points on the body to release energetic blockages or stimulate energy to affect various disorders is The Yellow Emperor's Classic of Internal Medicine, dated somewhere around 100 BCE. But recently, scientists from New York University School of Medicine and Beth Israel Hospital discovered the 'interstitium,' a 'superhighway' of interconnected compartments throughout the body supported by a meshwork of strong, flexible proteins, which sits just below the top layer of skin.1
In addition to its roles as a shock absorber preventing tissues from tearing and as the source of lymph, the fluid involved in the immune system, the interstitium also generates an electrical current (via its protein bundles), which at last could offer a scientific explanation of exactly how acupuncture works (see Last Word, WDDTY, July 2018).
A needle in time
Michael L, 61, of New York City came in to see Dr Trigiani for severe tinnitus in the left ear. He'd also experienced an 85 percent loss of hearing. The onset was sudden and inexplicable, and he had not been able to find a successful treatment for almost a year. He also struggled with dizziness and lack of balance.
He went to at least eight different specialists, including ear, nose and throat doctors, and was tested for everything, including Lyme disease. He was given steroid and antiviral injections into the inner middle ear, but nothing helped. Eventually, he says, "Doctors shrugged their shoulders and said, 'We don't know what to do for you.'" He received immediate relief from the tinnitus and pressure resolution in the middle ear with scalp acupuncture. "During about the third session I had an emotional experience," he says. "I blew my nose and what appeared to be a fluorescent mucus came out. And that was when I knew I was on the right trajectory, and hope was born!"
After four to six months of twice-weekly treatments, which also included electrically stimulating the nerves around the ears themselves, 95 percent of his hearing had been restored. "It's been three years now, and the symptoms have not returned," he says.
Zoé S, 44, of London, was suffering from cerebellar ataxia, which is when the cerebellum—the area of the brain responsible for controlling gait and muscle coordination—is somehow damaged, causing a lack of fine control of voluntary movements. Medically diagnosed in November 2016, she tried physical therapy, occupational therapy, speech therapy and the Alexander Technique. Nothing provided anything more than partial and temporary relief. Then she found Roisin Golding. Then, she says, "I improved drastically within two weeks, especially in the areas of my speech and balance."
Joe M, 58, of New York City, had suffered from spasmodic torticollis—an extremely painful chronic neurological movement disorder—for 26 years. The condition, also called cervical dystonia, caused his neck to involuntarily turn left and right, upward and down, with little or no ability on his part to control the painful and embarrassing movements. For over two decades he sought relief through massage and physical therapy, exercise and even Botox injections. Nothing worked.During his very first appointment with Dr Philip Trigiani for a scalp acupuncture treatment, he says, he felt quick relief, a loosening of neck and back muscles and a lessening of neck spasms and pain. Now, he reports, "I feel more overall relaxation, more mobility, less pain and fewer neck spasms."
Dr Phil Wellness NYC: www.drphiliptrigiani.com
Neuro-Acupuncture Institute: www.neuro-acupuncture.org
Acupuncture Works: www.acupunctureworks.co.uk