Professional Documents
Culture Documents
Treatment
The Extra Dimension of Local Injections
IAH Presentations Library
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History of Biopuncture
1991:
First use of the word biopuncture by Dr. Jan Kersschot on a
medical congress on sports medicine in Belgium to describe
injections with biotherapeutics
1995:
First book on biopuncture (Dutch)
1998:
First English book on biopuncture
(later available in Spanish and Russian)
2004:
Biopuncture in General Practice
2008:
Biopuncture and Sports Injuries (USA)
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Definition of biopuncture
Biopuncture is a bioregulatory therapy method in which specific
biotherapeutics are injected in indication or tissue related bodily
zones or points on the basis of clinical and functional diagnosis.
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Specific biotherapeutics
Each patient and each condition may need a specific product for healing.
For example: Gelsemium-Homaccord for neck pain radiating into the arm,
Zeel for joint degeneration, Hepeel for liver drainage.
Indication or tissue related bodily zones or points
We inject into pain zones, reflex zones
We inject into pain points, trigger points
Clinical and functional diagnosis
-We use a Western diagnosis and conventional terminology
(not based on Chinese medicine nor a homeopathic diagnosis).
-We add specific questioning, clinical and functional testing to guide our
decision making.
--Questioning: e.g., what makes your pain worse? How did it start?
--Clinical and functional testing: e.g., testing the strength of a particular
muscle, looking for pain points or trigger points, testing the range of
motion in a joint.
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B. -Jnjections under the skin in the stomach area will influence the
function of the stomach (= segmental reaction).
-Injections under the skin in the thorax will influence the function of the
bronchi (= segmental reaction).
-Injections in a trigger point in the quadriceps muscle can take away
pain in the knee.
-Injections in a trigger point in the gluteus minimus muscle can take
away pain in the lateral side of the leg.
What to inject?
Biotherapeutics are medical products that
stimulate natural healing
do not suppress the immunological response of the body
do not interfere with the neural reflexes
do not suppress pain
do not suppress the local inflammatory response
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BP
MS
HS
x
(x)
(x)
Antihomotoxic medication
(x)
(x)
(x)
Local anesthetics
NT
Local injections
Trigger points
x
x
Acupuncture points
Subcutaneous
Muscle, ligament
x
x
x
(x)
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30G x "
27G x 3/4"
27G x 1 "
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Frequency:
-When dealing with an acute situation (e.g., an acute sports injury),
we can inject two or even three times a week (In most acute cases,
we need only between 1 and 3 sessions to have complete healing).
-When dealing with chronic problems, we start with weekly
sessions and can lower the frequency as soon as the patient gets
better (once every two weeks, once every four weeks). After about
six weekly sessions, we sometimes wait for about six weeks to see
how the clinical picture evolves before continuing the injections (the
6-6 rule)
Needles: as thin as possible
0.3 x 13 mm
30G x "
0.4 x 20 mm
27G x 3/4"
0.4 x 40 mm
27G x 1 "
0.5 x 40 mm
25G x 1 "
0.6 x 80 mm
23G x 3 1/8"
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Technical complications
Local complications include
allergic reactions, itching or skin rash
hematomas (superficial or deep)
swelling of the injected area or local stiffness
infections after injection
Damage to organs can occur after accidental injections in the
pleura, kidney, liver, etc.
Accidental injections into important blood vessels, peripheral
nerves or into central nervous system (epidural space)
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Prevention of complications
By competent clinical examination
By detailed knowledge of local anatomy
By injecting with respect to anatomic limits and/or by using
radiological control (before or during injection)
By taking the thinnest needle possible
By using safe injection techniques (by starting with the safest
techniques first)
By using sterile injection techniques
By using safe products
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Contraindications
An uncooperative patient/psychiatric patient
A patient who doesnt understand the strategy
Fear of the procedure or needle phobia
Patient is in a very bad (unstable) medical condition
Neoplastic lesions in the area
Anatomic deformations in the area
Acute non-reduced subluxations, dislocations, or fractures
Bleeding diathesis secondary to disease or anticoagulants
Allergy to injectable solutions or their ingredients
Allergy/hypersensitivity to botanicals like arnica (e.g., Traumeel, Zeel)
Allergy/hypersensitivity to botanicals like echinacea (e.g., Traumeel)
Allergy to local anesthetics (e.g. procaine, lidocaine)
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Biopuncture strategy
Part 1. Local strategy for musculoskeletal complaints
Part 2. Local strategy for functional complaints
Part 3. General approach of the patient
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As an overview, we can say that there are four different phases and four
different injection techniques available in biopuncture to treat orthopedic
complaints.
This overview is a way to illustrate the possible approaches in
biopuncture. This table is not written in stone. Each physician will distillate
his or her own favorite approaches, adapted to the clinical situation.
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There are four phases when we approach the patient. Theoretically, these
should be followed step by step, but in some cases we can skip the first
phase and/or combine one or two phases (e.g., Phase 1+2 or phase 1+3).
Phase 1: Lymphomyosot is injected to stimulate local blood circulation and
to support local lymphatic drainage. This phase is especially important
when dealing with sensitive patients. It is also a good preparation before
giving more specific remedies.
Phase 2: Traumeel injections to regulate local inflammation through
immunomodulation.
Phase 3: Here we will inject more specific remedies, which match the
symptomatology of the patient. When there is muscle spasm we give e.g.,
Spascupreel. All the Homaccords belong to phase three (e.g.,
Colocynthis-Homaccord, Ferrum-Homaccord, Gelsemium-Homaccord).
Phase 4: Here we use products which are designed for cellular support or
organ support. These are e.g., Zeel and all the compositae like e.g.,
Discus compositum and Coenzyme compositum.
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Overview:
16 ways to approach the patient
1. Drainage
Lymphomyosot
2. Modulation
Traumeel
3. Symptomatic
4. Cellular
e.g., Homaccords Compositae
A.SC
A1
A2
A3
A4
B.IM
B1
B2
B3
B4
C.Tendon
C1
C2
C3
C4
D.Ligament
D1
D2
D3
D4
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When we combine the four phases (1,2,3,4) with the four techniques
(A,B,C,D), we have sixteen possibilities of approaching the patient.
The more we use an approach in the left higher corner (e.g., A1), the more
gentle the technique (less painful, less side effects, less reaction phase,
easy to perform). These are interesting for patients who are very sensitive
(they had previously serious reactions after other treatments or they show
a jump sign during examination).
The more our approach is in the right lower corner (e.g., D4), the more
aggressive the technique. The results will be quicker, but we see more
reaction phases after the treatment (e.g., pain worse the next day).
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A. SC (segment therapy)
Subcutaneous injections are given when deeper injections are
not possible.
Target tissue cant be reached.
Injection into the target would be too painful.
Injection into the target would be too dangerous.
They are easy and safe to give.
And can be very effective in acute and uncomplicated disorders.
They are also used to prepare the area for more advanced
techniques.
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Injection technique.
Pincer palpation
Always use
Pincer palpation:
you lift the skin with your left hand
while you inject with your right hand
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SC injections shoulder
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SC = subcutaneous
This is an example of four subcutaneous injections in the shoulder area for
a patient where the reason for the pain was not clear. By giving these
injections we can evoke a natural healing through the segmental reactions
of our subcutaneous injections.
Sometimes a few sessions on a weekly basis can be enough to have
complete healing. Sometimes we will have to give deeper injections (e.g.,
in the ligaments or the muscles of the shoulder) in order to have complete
healing. But even then, the local SC injections were a good preparation for
the deeper injections.
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B. IM (myofascial therapy)
Clinical picture muscle factor (M-factor):
Pain (not obligatory: only if active zone)
Local pain
Referred pain (= trigger point)
Weakness!
Restriction of movement
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M-factor = every patient where the main problem is muscular (even when
other doctors said it was related to osteoarthritis, a hernia, or
psychogenic)
Biopuncturists think about muscles when
there was an overuse before the symptoms came up
there is loss of power in the area
there is restriction of movement because some muscle fibers are
tighter and shorter (continuous contraction)
Patients with muscle-based symptoms often show relief while in
movement and when the area is heated
Muscular pain does not show on X-rays or scans, so:
Look for it during clinical examination
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Reaction phase
Pain may be worse the day after the injections (usually within first
24 hrs, more likely after the first injection).
Muscular shift
The patient thinks that the pain is only moving to another place
while in fact healing is on its way, but the pain shifts to another area
because the muscle chains are adapting after the biopuncture
treatment.
Organ regulation
IM injections also have a segmental effect (see later). For example,
injections in the dorsal paravertebral muscle may influence healing
of stomach problems.
Change in posture
If one muscle relaxes (e.g, biceps), other muscles in the area (e.g.,
triceps) have to adapt as well. Even muscles in the neck may have
to adapt to the new situation. Sometimes the treatment of chronic
muscle tensions leads to change in posture.
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B3. MG injections:
intramuscular (IM) injections in muscle gellings
Muscle gellings
= Hardened parts in muscles = Myogeloses
Can be felt :
taken between 2 fingers
by snapping palpation
Sometimes painful by palpation
Unpleasant feeling when identified!
Sometimes rope-like bands
Need many treatments with BP (chronic: years)
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C. Tendon/tendon sheath/bursa
Tendons are bands of fibrous tissue that connect muscle to
bone
Tendonosis/tenosynovitis/bursitis
Repetitive strain on tendon/tendon sheath
Related to muscle overuse
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D. Ligament/enthesopathy/periost
Ligament injections
(also: bands, fascia, joint capsules)
Injections in the enthesopathy
Injections in the periost
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Ligament injuries
A. Sensory nerve endings irritated
B. Ligamentous tissue damage
Poor blood supply to ligaments
slow healing (may become chronic!)
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neck pain/headache
e.g., LTP in iliolumbar ligament
pseudo-sciatic pain
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Overview
1. Drainage
Lymphomyosot
2. Modulation
Traumeel
3. Symptomatic
4. Cellular/Organ
e.g., Homaccords Compositae
A.SC
A1
A2
A3
A4
B.IM
B1
B2
B3
B4
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Four phases
Phase 1: Lymphomyosot
Phase 2: Traumeel
Phase 3: Homaccords, Hepeel, Engystol
Phase 4: Coenzyme compositum or more specific compositae
Two techniques
A. Subcutaneous injections (= most common technique for segment
therapy)
B. Intramuscular injections (usually in the paravertebral muscles)
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Asthma/bronchitis
Phase 1: Lymphomyosot
Phase 2: Traumeel
Phase 3: Drosera-Homaccord, Engystol or Ignatia-Homaccord
Phase 4: Echinacea compositum or Coenzyme compositum
Where?
SC: Front (sternal side)/back (dorsal side)
IM: in the paravertebral back muscles (dorsal level)
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Tracheitis/Bronchitis
Day after: a lot of sputum
(expectoration)
= reaction phase
= good reaction
You have to tell your patient in
advance!
And always give a BP
pamphlet to each patient.
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Where?
SC: Front/back (dorsal
side: midline T2 - T9)
IM: in the paravertebral
back muscles (dorsal level)
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Where?
SC: Front + back (dorsolumbar side: midline)
IM: in the paravertebral back muscles (dorsolumbar level)
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Fig: RZ (reflexzone)
Ileum SC
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colon SC
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Sabal-Homaccord,
Hormeel
Phase 4: Solidago compositum,
Testis compositum,
Ovarium compositum or
Coenzyme compositum
Where?
SC: front/back (dorsal side:
sacral midline)
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2. Detoxification:
Hepeel (Hepar compositum) for liver
Berberis-Homaccord (Solidago compositum) for kidneys
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1. Drainage
Lymphomyosot for lymphatic detoxification
Where?
Submandibular area (Waldeyer)
Thoracic area (reflex zone of thymus/bronchi)
Epigastric area (liver/pancreas/gastric area)
Abdominal area (reflex zone ileum/colon)
Pelvic area (reflex zone bladder/genitals)
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2. Detoxification
2A. Hepeel (Hepar compositum) for liver
2B. Berberis-Homaccord (Solidago compositum) for kidneys
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Liver detoxification:
Reflex therapy by using SC injections in liver area
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