By Michelle Gellis AP, DiplAc
The use of motor points in the acupuncture treatment of musculoskeletal pain has become very popular in recent years. Less familiar to most practitioners is the use of facial motor points in the treatment of both neuromuscular conditions, and for cosmetic purposes. The use of motor points to treat pain dates back to the work of A.H. Bennett, M.D. in 1882.1 More recently, the work of several researchers has built the foundation for the growing use of motor points by acupuncturists to restore muscle function.2
Motor points are located at the most electrically excitable part of the muscle where the motor nerve bundle is attached. More specifically, a motor point is defined as ‘the skin region where an innervated muscle is most accessible to percutaneous electrical excitation at the lowest intensity. This point, on the skin, generally lies over the neurovascular hilus of the muscle and the muscle’s band or zone of innervation.’3 When a muscle is in spasm, it has lost its ability to function properly. Correct needle insertion into the muscle’s motor point will cause it to ‘jump’, which resets the muscle to normal function. When a muscle is in flaccid state, it has also lost its ability to fire properly. By stimulating the motor point, the flaccid muscle can return to a functional state. Motor points are not the same as trigger points. Trigger points are tender points in the muscle that most people refer to as ‘knots’, which can refer pain to other parts of the body.4 Motor points tend to contain a larger concentration of nerve endings than other areas in the muscle and are more electrically excitable.5 They are neuromuscular junctions and are anatomically specific6
Facial motor points are unique in several ways: 1) Facial muscles are thinner than most of the muscles in our body therefore require a different needling technique. 2) Most muscles in our bodies attach to bones or other muscles, however facial muscles attach to our skin, giving us the ability to make facial expressions. Therefore, they can be used to rejuvenate the skin by relaxing tight muscle and wrinkles. 3) Unlike the motor points on the body, there are no huatuojiaji points that correspond to the motor points on the face.
Many facial motor points correspond with traditionally documented acupuncture points, such as Yangbai GB-14 for the frontalis muscle and Quanliao SI-18 for the zygomaticus major muscle.7 They are often located in the belly of the muscle. Motor points used in treating facial conditions are all innervated by the seventh cranial nerve, except those of the masseter and temporalis muscles. To determine which motor points to needle, one must identify which muscle(s) are affected. For example, if a patient cannot smile, there are four main muscles that may be affected. The zygomaticus major (which draws the angle of the mouth upward and outward), zygomaticus minor (elevates the upper lip), the levator labii superioris (elevates the upper corner of mouth) and the risorius (retracts the angle of the mouth laterally). Once the affected muscles have been identified, the corresponding motor points can be treated. Motor point needling is effective for many conditions involving paralysis. Needling a motor point helps a muscle to recover its length. Readers should note that learning to locate and needle facial motor points effectively typically requires special training, usually in a hands-on environment. Arnica gel is usually applied to the skin to prevent bruising, and a 0.16-millimeter gauge needle is inserted into the belly of the muscle and vigorously lifted and thrusted until the muscle jumps. If performed incorrectly, stimulation of a motor point can cause damage to the facial nerves. Proper screening for contraindications such as neuropathy or concurrent use of anticoagulants, or thrombocytopenia or lymphedema is essential. Recorded webinars on the use of facial motor points and live classes on cosmetic acupuncture can be accessed at https://www,facialacupunctureclasses.com.
Part of this article was taken from the Journal of Chinese Medicine • Number 110 • February 2016-A Multifaceted Approach to the Acupuncture Treatment of Neuromuscular Facial Conditions-Michelle Gellis
1 Bennet, A., (1882). A Practical Treatise on Electro-diagnosis in Diseases of the Nervous System. J.H. Vail & Company: New York
2 Gunn, C.C., Milbrandt, W.E, Little, A.S. & Mason, K.E. (2002). “Dry-Needling of Muscle Motor Points for Chronic Low-Back Pain: a randomized clinical trial with long-term follow-up” Spine, 5, 279-29
3 Callison, M., (2007). Motor Point Index: An Acupuncturist’s Guide to Locating and Treating Motor Points. AcuSport Seminar Series: San Diego
4 Hong, C.Z. (1994). “Lidocaine Injection Versus Dry Needling to Myofascial Trigger Point”, American Journal of Physical Medicine & Rehabilitation, 73, 256–263.
5Lomo, T. (1976) “The role of activity in the control of membrane and contractile properties of skeletal muscle” in Thesleff, S., (ed.). Motor Innervation of Muscle. Academic Press: London
6Walthard, K.M. & Tchicaloff, M. (1971). Motor points. Electrodiagnosis and electromyography. Licht, S., (ed.), Third Edition. Waverly Press: Baltimore, Chapter 6, p 153-170
7 Liu, Y.K., Varela, M. & Oswald, R., (1975). “The correspondence between some motor points and acupuncture loci”, American Journal of Chinese Medicine, 3, 347-358.
The following article, “The Importance of Clearing Blocks Prior to Facial Acupuncture Treatment”, was published in the Journal of Chinese Medicine. Below is the abstract and a link to the article.
Rooted in traditional acupuncture theory, the method of clearing blocks before initiating further treatment is essential to facial acupuncture. A block is defined as a break in, or impediment to, the smooth flow of qi through the body. Blocks can prevent facial acupuncture treatment from being effective, and unless cleared can mean treatment can aggravate patients’ symptoms. This article covers the theory, diagnosis and treatment of blocks as practised in the five element style of acupuncture, and discusses the importance of clearing these blocks in order for facial acupuncture to be safe and effective. Also included is a discussion of the feedback mechanism between our emotions, facial expressions and internal organs, and why clearing blocks is vital to this mutual exchange.
Click on link below for the full article:
By Michelle Gellis LAc MAc DiplAc
Facial Gua Sha is a technique in which specially crafted hand held pieces of smooth jade are used to invigorate the skin, smooth out wrinkles and increase blood supply. Facial Gua Sha can be used to treat a variety of skin conditions such as Acne, Rosacea, Melasma and dark circles.
Facial Gua Sha is used as part of a compreh.
ensive acupuncture facial rejuvenation program for wrinkles, sagging and puffiness. Facial Gua Sha benefits areas such as the neck and jowls, which are prone to sagginess, the puffiness under the eyes, and the deep wrinkles on the forehead. The increased blood circulation which occurs during Gua Sha, helps to detoxify the face and move stagnant blood and inflammation, which can occur under the eyes. By providing increased blood flow to the face, the skin is better nourished and healthier.
Part of the benefit of the treatment is that acupuncture points on the face are massaged with the Gua Sha tool, which in turn benefits the Fu organs. Conditions such as TMJ, Bell’s Palsy, Rosacea, melasma and other inflammatory conditions can be effectively treated with facial Gua Sha.
Facial Gua Sha is typically done as the last step of a facial acupuncture treatment. When done properly, there should be no residual redness on the patients face. When I teach Facial Acupuncture Classes, I tell my students that the goal is to get the “gua” without the “sha”.
Specially designed facial Gua Sha tools are used during treatment. Jade is unique in that a static electromagnetic field originates during the contact of jade with the human body
Regular use of jade therapy:
- Strengthens internal organs and systems (liver, stomach, heart, bonds the entire circulatory system, vision, hearing) and spirit
- Softens blood vessels
- Smoothes out wrinkles
- Improves quality of blood
- Purifies and normalizes the nervous stream
- The vibration of the jade stimulates and helps the circulation in the brain and removes tiredness
Facial Gua Sha should be preformed by a trained, licensed acupuncturist in order to avoid complications. For more information on facial gua sha or facial gua sha training visit https://www.facialacupunctureclasses.com or http://www.gellisacupuncture.com
Acupuncture Treatment for Facial Pain and Paralysis
By Michelle Gellis LAcMAcDiplAc
This article addresses acupuncture treatment for facial pain and paralysis which are common conditions which can be difficult to treat with western medicine. As a practitioner and instructor of facial acupuncture I frequently get calls from individuals seeking help for various medical conditions affecting the face. Although conditions such as Bells Palsy, Stroke, TMJ, Trigeminal Neuralgia, and Ptosis are vastly different, they all affect the facial muscles, nerves, functionality and appearance of the face. Fortunately, there are many acupuncture techniques, which are extremely effective in bringing movement and normal sensory function to the face.
Facial and scalp acupuncture, facial cupping and motor points are uniquely suited to address facial pain and neuropathy. The same Acupuncture points which can be used to raise a saggy jowl or a furrowed brow can be used to treat a drooping eyelid such as with ptosis or bells palsy. The same scalp points which can help with nerve pain or motor issues can help with facial pain from trigeminal neuralgia or shingles on the face. Facial cupping, (when done with special facial cups and by a practitioner trained in facial cupping) brings blood and energy to the muscles of the face and has the potential to relieve TMJ and invigorate conditions affected by paralysis or weakness such as MS, brain injury, or stroke. https://facialacupunctureclasses.com/facial-cupping/. Lastly, intramuscular needling techniques (which are invaluable in acupuncture facial rejuvenation for relaxing taught muscles which cause deep wrinkles) can be used to relax an atrophied facial muscle as may happen with myasthenia gravis or stroke.
In Chinese medicine, not all individuals exhibiting particular symptoms of a disease will have the same treatment. Treatment is based on a thorough diagnosis of the patient’s medical history, diet, lifestyle and other factors. Once a diagnosis has been made by a licensed acupuncturist specially trained facial acupuncture, the facial concerns as well as the underlying condition, which may have caused them, are treated. I have been working with patients with these types of conditions for over a decade, and the results I have seen have been very positive. The benefit of acupuncture is that there are no side effects, downtime, or invasive procedures. Typically results can be seen after 6-8 treatments and many insurance companies cover the cost of acupuncture treatment (you would need to contact your provider for eligibility). Acupuncture needles are the diameter of a human hair and the treatment is virtually painless. Most of my patients fall into a deeply relaxed state during treatment and receive benefits reaching beyond their physical symptoms. For more information on treatments for Facial pain, paralysis and neuropathy. Contact Michelle Gellis https://facialacupunctureclasses.com
“When I contracted Bell’s palsy, I went to my doctor and was put on a 6 day regimen of cortisone to help to reduce the inflammation of the cranial nerve.
It was not until a week later, after I contacted Michelle Gellis, my acupuncturist, and had a treatment, that I experienced any improvement in my condition. The improvement was dramatic in lessening of the facial paralysis. Within a 3-week period, my facial paralysis was improved to a point, that people could not tell that I had been suffering with the condition. Originally, being told that my condition could last somewhere between 6 weeks, on the mild side, and 6 months, I was thrilled, when the regimen of treatments that Michelle performed, had helped my condition so dramatically”. -Linda B. D.
“I contacted Michelle for my ptosis condition (one eyelid sat lower than the other) because my wedding was approaching, I was desperate and even considering surgery, but after just a few sessions my eyelids were even. I was so grateful my eyelids were even for my special day-and so thankful that I did not have to go the invasive route, along with its expense and recovery time. Michelle is very skilled with her needles and definitely master of her craft.”-Steph J
Since I’ve started the treatments with Michelle for my TMJ and related migraines, I have felt great improvement. I actually have not had one migraine since I started and the overall pain in my jaw has decreased significantly. I have not been able to even chew anything on the right side of my mouth for the past few years and I am now starting to retrain myself to chew on both sides. The Improvement has been amazing, much better than I had hoped for. -Jackie M