Key Highlights:

This presentation is Part V of a series focused on a neurofunctional approach to electroacupuncture for managing pain associated with movement disorders. The methodology integrates neurophysiology, neuroanatomy, biomechanics, and neuromechanics to optimize treatment outcomes.

Dr. Elorriaga Pain Amplification Articles 2019

1. Clinical Methodology – Neurofunctional Operating System
• Dr. Elorriaga emphasized the importance of selecting optimal needle insertion sites (“best neuroreactive sites”) for acupuncture based on a rigorous understanding of the peripheral nervous system, including sensory and motor innervation of muscles, ligaments, capsules, and tendons.
• Treatment inputs are categorized into:
• Local neurological inputs (directly related to the affected area)
• Axial inputs (posterior primary rami territories)
• Systemic regulatory inputs (head, neck, ears, hands, and feet stimulating neurohormonal and neuroendocrine responses).
• The approach involves detailed topographic and neurofunctional analysis, incorporating movement analysis and palpation to identify treatment targets.
2. Importance of Neuromotor, Neurosensory & Biomechanical Knowledge
• Understanding the kinetic energy involved in movement and how it is managed by biological systems is fundamental.
• Movement generates kinetic energy, which is indestructible and must be managed through either continuation of movement, energy transfer, tissue deformation (elasticity, tension, compression), or heat dissipation.
• The human body, like engineered structures (bridges, domes), relies on biomechanical principles such as compressive and tensional strategies to maintain shape and structural integrity and absorb and disperse mechanical forces.
3. Biotensegrity and Mechanical-Metabolic Interactions
• Tensegrity, a design principle involving continuous tension and discontinuous compression, was highlighted as the biological architecture underlying the musculoskeletal system, from macroscopic fascial networks down to cellular cytoskeletons.
• Dr. Elorriaga referenced NASA-related cellular research showing gravitational forces directly influence cellular behavior, with load or tension affecting gene expression, cell survival, and metabolism — via a cellular membrane mechanism termed mechanotransduction.
• This knowledge supports the clinical observation that gentle movement therapies (Qigong, Yoga) provide unique benefits beyond conventional exercise due to their influence on mechanometabolic cellular responses.
4. Clinical Applications in Force Management and Movement Disorders
• Dysfunction, pain, and injury often result from impaired force management within the kinetic chain rather than from isolated tissue failure. For example, low back pain may stem from an initial inadequate force absorption distally in the lower limb rather than from intrinsic back pathology.
• Effective treatment requires restoring force distribution and tissue adaptability through the use of neurofunctional mapping and movement analysis. Targeted interventions will address:
• Neuromotor deficiencies: restoring activation of prime movers, synergistics, and stabilizer muscles.
• Articular restrictions: improving accessory joint movements and pericapsular sliding.
• Tissue adaptations: relaxing tight muscles and supporting connective tissue remodeling.
• Example treatment strategies include stimulating specific nerves or muscles to restore eccentric control and enhance force absorption during movement.
5. Neurofunctional Mapping and Hypothesis-Driven Treatment
• Clinical assessments integrate history, movement observation, and neurological testing to identify the original injury (“Ground Zero”) and the current adaptive changes.
• Treatment targets are prioritized based on residual adaptability and the goal of restoring efficient movement and neuromuscular control.
• The presenter underscored the futility of symptomatic treatment alone without correcting the underlying biomechanical and neurological dysfunction.
6. Neurophysiological Basis of Pain and Neuromodulation via Acupuncture
• Pain is a central nervous system event, a brain-processed information phenomenon most often triggered by nociceptive input but always modulated by the activity of non-nociceptive sensory fibers as well as multiple CNS signals, generated independently from the activity of peripheral nerves.
• Effective neurofunctional acupuncture targets non-nociceptive afferent fibers to increase sensory traffic that inhibits processing of nociceptive signaling in the spinal cord, mimicking the natural “gate control” mechanism.
• This approach advocates focusing on encapsulated mechanoreceptors and other sensory nerves rather than targeting nociceptive fibers.
7. Handling Chronic Dysfunction with Multiple Compensatory Changes
• The starting point is always the oldest injury or event, understanding how it altered biomechanics and neuromotor control.
• A comprehensive inventory of the currently remaining adaptive mechanisms (neuromotor, metabolic, mechanical) guides treatment planning.
• Treatment involves restoring movement capabilities, neuromotor activation, eccentric muscle function, and lymphatic clearance.