In acupuncture there are many different styles of needling, in a way of getting at the “point”. The different terrains of the body allow modifications of the regular way of needling so as obtaining a desired effect from the area. Usually first, one using differential diagnosis and palpation, one selects the points or areas to be needled and and determines what effect does is to be derived from the point. The diagnosis, leads the practitioner as to how to balance the point to best elicit the systemic effect that would be most beneficial to the patient. For example, someone with a Liver stagnation pattern, would t have points selected that would harmonize the Liver and course it. The overall pattern of the diagnosis and symptoms would point to the particular areas that would need to be palpated. One would then palpate the areas and choose the most “active” points or the “weakest” points on the necessary channels to needle. The needling would then be stimulated according to whether the point would need to be activated or reduced. This style of needling is typical of Oriental medicine and there are various ways of stimulating points according to the variety of styles. Chinese Acupuncture, the more rigorous of the Oriental styles, prefers aggressive needling with methods of needling depths, speeds, and directions. The clients breath is listened to so as the direction of the flow of qi may be altered, either facilitated or redirected with the stimulation. An inward breath directs qi inside and up, an outward breath directs it outside and down. Similarly with depth, active points are shallowly needled at first, then are needled deeper with time, and then are drawn up to guide excess qi out of the channel, and weak points are needled deeply to gather qi and then shallow to consolidate the flow. Japanese acupuncture, however, seems to disregard depth to an extent. Needling is only done shallowly, with a minimal amount of points used. In some particular styles, the needle sometimes doesn't even penetrate the skin, but is held over the point to create a connection like a conduit with the practitioner, the point, and the patient. The idea behind this is that less is more, and points are chosen for wide systemic effects, instead of the Chinese, that uses more direct points for symptoms and patterns. The pattern is more important to treat than the symptoms. Likewise, active points are stimulated toward dispersion, and weak points are stimulated toward tonification. These ways of balancing the channels of the body. Western needling has taken away the idea of active points, and weak points. Using muscular physiology, it chooses areas of expressed symptoms to relieve pain, and trigger biochemical effects. The areas are usually bone and muscle junctures, as well as nerve innervations, or simply areas of pain. There is no particular points since they are areas of expressed symptoms, whether it may be rashes, pain, strains, pinched nerves, etc. Muscular testing is done to choose where mobility is hindered, so as to pick the right areas that may free that mobility. Trigger point therapy come out of the pain referral areas that cause active points of pain in different synergistic/antagonistic muscle groups. Targeted muscle groups in the shoulder as well as in the back would be used to relieve neck pain for example. The active place to be needled would be the most tender areas to touch. Saline injections at the site used to be used but now simple “dry needling” is done to the area (dry- no injection of wet substance = acupuncture needle in point). Motor point needling is done in muscular innervations usually where the nerve and muscle are near meeting, the usual outcome of such needling is a muscle spasm or jump. The needle insertion causes a muscular contraction releasing the muscle. A muscle maybe in contraction due to nerve entrapment, lactic acid build up, or due to habit and posture. The release would reset the muscle to a more desirable length freeing up mobility, and releasing tension. In my practice, all styles are used depending on pattern and the need. However, as far as how the widespread medical profession sees needling will be discussed in.