Scalp acupuncture is a specialized form of acupuncture that has helped many people with spinal cord injury (SCI) and dysfunction (see introductory article). 

Dr. Ming Qing Zhu

A leading scalp-acupuncturist is Dr. Ming Qing Zhu. In 1964, Zhu graduated from the prestigious Shanghai University of Chinese Medicine after studying with internationally recognized acupuncturists. Zhu acquired experience in multiple disciplines, including internal medicine, gynecology, pediatrics, traumatology, ophthalmology, neurology, and anesthesiology; and a reputation as a preeminent Chinese physician, especially in classical acupuncture.

After becoming dissatisfied with the limited results obtained from traditional body acupuncture on stroke patients, Zhu developed his scalp-acupuncture system. Since then, he has treated thousands of stroke patients with remarkable results. Building upon these experiences, he applied his techniques to other neurological disorders, including SCI.

Zhu’s Scalp Acupuncture (ZSA)

With ZSA, very short and fine needles are inserted obliquely into the scalp’s subaponeurotic layer. Rather than using points along linear meridians, Zhu defined 19 two-dimensional areas, mapped to various body parts. There is no risk of damaging brain tissue or bleeding. Manipulation is characterized by forceful, small-amplitude needle lifting and thrusting.

An essential ZSA element is Daoyin, physical and mental activities simultaneously carried out to direct the qi energy to affected body areas. Daoyin activities include chest and abdominal breathing, mental relaxation, massage, joint movements, pushing, pulling, rolling, standing, etc. Daoyin activities are customized to individual patient needs at the time of the treatment.

Critical Treatment Factors

All ZSA-treated SCI cases have shown marked improvement. Effectiveness is correlated with three factors:

1) Time: The best therapeutic window is within three months of injury. Immediately after injury, the spinal cord goes through a shock period in which a cascade of events occur, including bleeding or ischemia, edema, and spontaneous lysis. The damage will gradually spread up and down the cord. Early intervention of ZSA (even day one) helps to control bleeding and edema, shorten the spinal shock period, and, consequently, minimize neurological damage.

If ZSA is initiated after three months, functional recovery accrues more slowly and at a lesser magnitude.  It requires many times the effort to produce a fraction of the same result as in the first month.

2) Daoyin: A vigorous, persistent, six-to-eight hour/day exercise regimen is recommended, including passive and active movements, breathing, and relaxation. Even when active motion is not visible, the patient’s intention or mental visualization is crucial. There is nothing mystical about using the mind. Basically, the brain initiates nerve signals to travel down the spinal cord, making attempts to find new neuronal pathways through the injury site.

Once a visible movement is detected, the patient is asked to repeat the same pattern over and over to establish nervous-system memory. Our neural circuits turn off when they are not used, and, therefore, must be re-learned. By repetition, muscle strength increases and atrophy reverses.

Zhu encourages patients to use a standing frame early on, believing that standing has many benefits, including keeping the spine straight, preventing scoliosis, pressure sores, and bone loss; and improving pulmonary and cardiac functions.

3) Scalp acupuncture: Many patients are discouraged by the slow progress they make following standard rehabilitation programs. The addition of ZSA to such programs accelerates progress. Zhu expresses this recovery process through an analogy: “patients with SCI are like people trapped inside a dark room. Those who stay motionless will remain in the room forever. Those who exercise are probing for an exit, but the door is closed. Scalp acupuncture acts like a key. It opens the door and allows light to shine through. However, the person still needs to move towards the door, and lift his legs over the threshold in order to step out into the sun. Otherwise, he is still confined in the room no matter how wide the door is opened.”

Scalp acupuncture has advantages over traditional body acupuncture. First, it is much more effective in treating neurological conditions. Second, scalp needles do not interfere with bodily movements, whereas body needles must be withdrawn to avoid bending or breaking. Overall, ZSA is not a mechanical procedure that can be quickly learned; results depend heavily on the practitioner’s skill level acquired from much training and practice.

Other ZSA Benefits

In addition to functional recovery, other benefits accrue from ZSA, including:

Relieving pain:  ZSA is especially effective in relieving SCI-associated pain, without the adverse side effects of pharmaceuticals.

Reducing infections: ZSA and herbal medicine can help control SCI-associated urinary-tract and other infections.

Promoting bladder & bowel control:  Zhu believes that restored bladder and bowel control is a realistic outcome after ZSA, even for patients with clinically classified complete injuries. Again, earlier training enhances recovery.

Managing spasticity:  Zhu views spasticity as part of a normal recovery process that can increase muscle tone. However, if spasms become excessive, he can use ZSA and herbal medicine to control them, again avoiding adverse drug side effects.

Managing autonomic dysreflexia: Acupuncture has a bi-directional regulatory action on our system. For example, the same needle at a single acupuncture point can either increase or decrease blood pressure. It automatically adjusts to the body’s need to restore homeostasis.

Maintaining better overall health: Our patients with SCI believe that they enjoy better health; have more energy, motivation, and positive outlook; stronger immunity; and less muscle atrophy.

Perseverance

Zhu emphasizes hard work; patients know it means eight hours of serious work daily seven days a week. There is no short or easy way.

What defeats people is the lack of perseverance and long-term support. After the initial depression, most patients come to terms with their situation and live as their doctors have indicated. A small percentage are determined to fight the odds, but even these few may not be able to put up with the demands of the therapy, mundane routines, emotional cycles, and financial drain. As time goes by, they slow down on their rehabilitation efforts, or allow themselves to be distracted by other life activities.

SCI Cases

The following represent several example cases of individuals treated with ZSA (pseudonyms are used):

Tom, 21, sustained T-11-compression and T-12- burst fractures in June 2003. His MRI indicated a complete spinal-cord transection and severe spondylolisthesis. Classified as an ASIA-A injury (i.e., complete injury), Tom had neither motor or sensory function below the umbilicus nor bowel-and-bladder control.

Seven months after initiating ZSA, herbal medicine, and a vigorous exercise regimen, Tom started walking with the assistance of walker and regained considerable bowel-and-bladder function. Defying all medical expectations, he progressed from ASIA A to C (partial motor and sensory recovery) in less than a year.

Nancy, 23, sustained a C5-7 incomplete injury due to an April 2000 auto accident. Recovering in a Vancouver hospital, she solicited the Zhu’s assistance. A few weeks after injury, Zhu started treating her at bedside from morning to evening.

Daily treatment typically began with both scalp and body acupuncture. The body needles were removed after one hour, but the scalp needles were left in for more than 24 hours. The bulk of the days consisted of almost non-stop exercises, from passive to active, the chest to the feet, the internal organs to external limbs, and lying to sitting positions. A little over a month after injury, she attempted to stand.

As Nancy recovered further, Zhu continued treatments, his main goals being to alleviate pain and soreness, increase stamina, correct posture and gait, and initiate new movements. Every week saw a small recovery breakthrough, which cumulatively resulted in Nancy starting to walk with a walker by November.

Eight days after sustaining a C4–C6 SCI after a surfing accident, Jim started ZSA treatment. After 18 daily treatments while still in traction, Jim initiated some arm and toe movements, as well as torso muscle contractions. Unfortunately, he had an untimely fusion operation after which he became paralyzed again. It took more than four weeks for his upper extremities to get back to where they were before the surgery. The lower extremities lost all motor functions.

Need for Cooperation & Conclusion

Many state-of-the-art SCI research facilities believe that the nervous system is capable of considerable regeneration after injury. Many receive considerable grant funding for SCI animal research. Their research findings are highly regarded, in spite of their uncertain application to humans. Nevertheless, the merit of their approaches is never questioned, yet scalp acupuncture is routinely met with skepticism.

Even when scalp-acupuncture results are clearly evident, they are denied by the biomedical establishment. For example, a patient with an incomplete C-6 injury came for treatment six months after injury. He could only move his left lower extremity. During the first acupuncture treatment, everybody in the room witnessed his right leg started to move and his hand grip increased by 2.5 kg. On his second visit, he told us that he defecated on his own volition the night after the first treatment. Since then he did not need digital stimulation.

Surprisingly though, when he returned for his third visit, excitement had faded from his face. His neurologist told him that those functions would’ve recovered spontaneously anyway and had nothing to do with the acupuncture. Soon afterwards the patient stopped coming for treatments. We were told many months later that his condition remained at the same level. Was it a coincidence that the functions came back during and right after our treatment? Why did it not continue to improve on its own after the treatments stopped? How can we explain the many coincidences that we observe in our clinic? Although it is true that incomplete SCI may recover spontaneously, is it not also apparent that scalp acupuncture helps to speed up the recovery?

SCI is so complex that no single approach alone can fix it. It requires multi-disciplinary modalities working synergistically. We hope that Zhu’s Scalp Acupuncture can be accepted and valued as one of them. We strongly believe that in conjunction with other therapies, especially in the early stage of SCI, Zhu’s Scalp Acupuncture can significantly speed up and promote functional recovery.

For further information: see www.scalpacupuncture.org or call 408-885-1288.