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07-Feb-2014 08:24 AM
I am sometimes surprised when I learn that many acupuncturists did not get much training in auricular acupuncture in their formal schooling. Then I remember that I didn’t get much training in it either and it was what happened to me in my first 6 months of practice that helped me learn about finding and treating ear points.
At that time in California, our licensing exams consisted of both a written and what was called a “practical” exam. In the practical exam, you had to identify the location of 20 points, do an exam on a volunteer and identify some herbs. Everyone I talked to said the practical exam was easy and if you passed the written you would have no trouble with the practical exam. When I took the practical exam I found it was easy, knew I aced it, and went ahead and signed a lease for my office while awaiting official word that my license to practice had come through. I then got word that I failed the practical and would have to wait nearly 6 months before I could take it again.
I was in a bind. I had a wife and 2 children to support and I had signed a year’s lease. I did not want to risk doing acupuncture without a license but needed to start my practice as I knew it would take some time to build momentum. I asked an acupuncturist friend to make herself available to me part-time in case we got some patients whose insurance covered acupuncture but then I began doing acupressure/massage and especially auricular acupressure as that was the closest thing to doing acupuncture I could legally do. It was during those first months when I was not able to practice any acupuncture that I learned how to apply auricular techniques and here is what I learned:
The best way to find the most effective auricular points is by palpation. Those of you who follow my posts know I promote finding acupoints by feel but may not know the same is true for auricular points. Because auricular points are so small, the techniques for finding them by feel is a bit different than for body points but the same basic principal applies and that is you look for “inconsistencies” in the tissues. The good news is that it is easier to find inconsistencies in the ear than virtually any other part of the body and that is probably why auricular acupuncture is the best known and most widely practiced of all the “microsystems”.
The texture of the ear cartilage is smoother (more consistent) than the muscle most acupoints are found in but the inconsistencies that arise there will also be quite small and not easily found with one’s fingers. This being the case, you will want to use a probe of just the right size and shape to help you find them. One of my most prized pieces of equipment is a probe given to me by that friend who helped me out in my office those first months. She had brought it with her from China. It has a smooth, small, round tip that is just the right size for probing the ear cartilage. Too small or pointed a tip and you can actually break the skin, too large and it will not be able to find the inconsistencies with enough precision. I have found that some ball point pens work well (once the ink runs out) and even a slightly dulled pencil point will do in a pinch.
Run the probe along the cartilage in the area that corresponds to the patient’s problem such as the anthelix for spinal problems. You are trying to feel for slight inconsistencies that will often present as a tiny grain of sand lodged in the cartilage especially in relation to painful conditions. These spots will also be quite tender in acute conditions but may go the other direction and be less sensitive than normal in chronic conditions. You need to use an even pressure as you do this but on the light side. You also need to not confuse the occasional blood vessel you can run over as this will be more firm than the cartilage. Other than those blood vessels, when you run over something firmer than the cartilage in an area that corresponds to the patient’s problem, you have found a prime point. The nice thing about the right sized probe is that once you find the grain of sand spot you can press the probe into that with enough pressure to leave a tiny indentation that marks the spot. You can then stick a needle in that or, as I was limited to doing my first months in practice; tape on a small pressure sphere the patient can then wear for days at a time. I like to use the gold plated Magrain spheres (Sakamura brand) I get from Llasha OMS. The small metal spheres in those devices are similar in size to the grain of sand spots that can form in the cartilage I have been referring to.
Even without a probe, you should inspect the cartilage for areas of discoloration or lumpiness. This tends to be more the norm in elderly patients but in younger patients breaks in the normal coloration or texture, especially in areas that correspond to known problems, are signs that something is amiss. You can also try rubbing the cartilage with a bit of friction causing some redness to form and then look for breaks in that redness. Of course, you can use a “point locating” type of device as they measure inconsistencies in electric resistance. While such devices are helpful, I always encourage acupuncturists to refine their ability to find inconsistencies by feel or sight (all of the senses, really).
Acupuncture and acupressure is all about helping to restore normalcy. Our canvas is the skin and what lies just beneath. Get to know your canvas. Inconsistencies in that canvas are a sign of a loss of normalcy. Working-out those inconsistencies helps to restore normalcy and that is our art. Good healing, everybody!