The purpose of this chapter is to present the Integrative Neuromuscular Acupoint System (INMAS) to healthcare professionals who have already used injection therapy for pain management.
In the late 1960s, traditional Chinese medicine (TCM) was experiencing an extraordinary period of development, and the leading direction of research in the field, sponsored by the Chinese government, was the integration of TCM with modern medicine. Many new methods were explored to improve the effectiveness of traditional needling and were referred to as “innovative needling-method therapy” (xin zhen liao fa). These new techniques included electrical acupuncture, scalp acupuncture, acupoint implant therapy (surgically implanting foreign material at the acupoints), acupoint tissue extraction therapy (surgically removing fatty tissue from the acupoints), and acupoint injection therapy. In addition, practitioners of Chinese folk medicine were using more than 80 types of needling methods such as eye, nose, wrist-and-ankle needling, and so on.
For injection therapy the Chinese doctors injected about 1cc of a vitamin solution (but not vitamin C, which creates a very painful reaction), and various Chinese herbal extracts at the location of acupoints, and they claimed very good therapeutic results. Like acupuncture anesthesia, this was developed as a move toward the integration of traditional Chinese and modern medicine.
In the United States, Dr. Janet Travell, without previous knowledge of Chinese acupuncture, discovered and published the patterns of pain trigger points in 32 skeletal muscles in 1952.1 The locations of these trigger points basically matched most acupoint locations in the ancient Chinese system. Dr. Travell injected anesthetics (0.5% procaine in physiologic saline) into these trigger points to treat myofascial pain symptoms such as lower back pain. Today the solutions used for injection may include isotonic saline, procaine, lidocaine, Botulinum toxin A (BTA), corticosteroids, and other longer-acting local anesthetics. Some of these injected solutions have some myotoxic effects.
Both the innovative Chinese acupoint injection method and Dr. Travell’s system have their merits. INMAS is a simple and comprehensive method that integrates the Chinese acupuncture channel (meridian) system with Western neuromuscular understanding. All the 20 (or 21) injectable homeostatic acupoints (HAs) that are specified in INMAS match the major acupoints of the ancient 10 channels (meridians) (large intestine, small intestine, stomach, gallbladder, urinary bladder, liver, kidney, lung, spleen, and governor) as well as the major trigger points of the modern neuromuscular system.
