biopuncture and antihomotoxic treatment

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    © IAH 2008

    Biopuncture and AntihomotoxicTreatment

    The Extra Dimension of Local Injections

    IAH Presentations Library

    Biopuncture describes the use of biotherapeutics for injection in specific

    spots or areas. These biotherapeutics stimulate natural healing in a direct

    and efficient way because they are injected directly into the target area.This technique offers medical professionals new possibilities in their goal

    to help their patients where other measures have failed or have produced

    too many side effects.

    These slides will inform physicians about the extra power of giving local

    injections with antihomotoxic remedies.

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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)

    The use of injections of biotherapeutics was introduced in Germany more

    than 50 years ago. Millions of ampules are injected worldwide every year.

    Meanwhile, the use of biotherapeutic injections did not acquire a specificname in medicine until 1991, when the term “biopuncture” was introduced

    during a medical congress in Belgium, organized by Bruno Van Brandt.

    Kersschot J, Biopunctuur, Oostende (Belgium): Biomedical Therapy

    Congress, November 17,1991.

     As a result, Dr. Jan Kersschot is worldwide considered as the “father” of

    biopuncture. Over the years, he further developed the use of

    antihomotoxic remedies in injection form, by blending ideas and

    techniques from for example neuraltherapy, mesotherapy, prolotherapy

    and trigger point therapy.

    Having a specific name to describe this technique gives it more exposure,

    both for medical professionals as well as for patients. The books, lectures

    and workshops worldwide have further promoted the use of antihomotoxic

    injections.

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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.

    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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    Extra dimension of injection

    INJECTION = TURBO EFFECT:

    • A. Direct effect on the tissues:

    • Local effect of the medication

    • B. Indirect reactions at a distance

    • Segment therapy

    • Trigger point injections

    Why should we give injections?

     A. Direct effect on the tissues: Traumeel injected in a muscle injury

    influences the local muscle fibers immediately.We have direct influence on the matrix.

    We have also a deeper tissue penetration than with an ointment (=

    max 2cm).

    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.

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    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

    The majority of products used in biopuncture are microdoses : we don’t

    use ampules which only contain dilutions beyond Avogadro’s number.

    The majority are antihomotoxic remedies.

    Sodium chloride and dextrose may be added.

    Other products may be added at the physicians own responsibility (e.g.,

    local anesthetics), but are not considered as biopuncture in the strict

    sense, but as supplementary tools which can improve the efficacy of

    biopuncture.

    In biopuncture, a lot of physicians add low concentrations of lidocaine or

    procaine to make the injection less painful and to evoke an additional

    effect on the neural system (as in neuraltherapy).In some cases, conventional medication such as tramadol or piroxicam

    are added to avoid injections of corticosteroids or to avoid an operation.

    This again is not biopuncture in the strict sense. Corticosteroids and

    phenol are not used.

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    Differences between biopuncture and other

    injection techniques (see also table next s lide)

    • Difference with mesotherapy (MS):

    • MS only injects superficially

    • MS only injects locally

    • Difference with homeosiniatry (HS):

    • HS only injects in acupuncture points

    • HS uses a Chinese diagnosis

    • Difference with neuraltherapy (NT):

    • NT uses only local anesthetics

    • NT also injects into autonomic ganglia

    Biopuncture describes the use of biotherapeutics for injection in specific

    spots or areas.

    These biotherapeutics are mainly injected in muscles, tendons and

    ligaments as well as subcutaneously. Some techniques described in

    biopuncture books, such as injections into joints and near peripheral

    nerves are becoming less popular. They are not regarded as standard

    treatment protocols any more.

    In the beginning, biopuncture also allowed the use of acupuncture

    injections, but since 2004 we leave the injections into acupuncture points

    to “homeosiniatry”.

    The next slide gives an overview.

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    x(x)Joint injections

    x Autonomic ganglia (e.g., stellatum)

    xxMuscle, ligament

    xxxxSubcutaneous

    x Acupuncture points

    xxTrigger points

    xxxLocal injections

    xUndiluted medication, e.g., minerals and vitamins

    xx(x)Local anesthetics

    (x)(x)x Antihomotoxic medication

    (x)(x)xMicrodose (>D23), complex homeopathicmedication

    xHomeopathic single remedy (>D23)

    NTHSMSBP

    In mesotherapy (MT), they only inject superficially. Usually thesetechniques are used for esthetic medicine. Originally, mesotherapy usedconventional medication (Dr. Pistor) and not homeopathic products. Lateron, also natural products were used for subcutaneous injections. Thelatter is also described as homeo-mesotherapy or bio-mesotherapy.

    In homeosiniatry (HS) according to Dr. de La Fuye, they usehomeopathics (originally only single remedies) on acupuncture points.Both homeopathy and Chinese Medicine (Siniatry) are used for diagnosisand treatment protocols. Later on, the description “homeosiniatry” has alsobeen used for injection of antihomotoxic remedies in acupuncture points.

    Neuraltherapy (NT) only injects local anesthetics. They also inject intoorgans (e.g., prostate, thyroid) and into autonomic ganglia – the lattertechniques are never applied in biopuncture.

    Prolotherapy injects mainly into ligaments and bands, not subcutaneouslyor in muscles. They also use phenol, a product which is not allowed inbiopuncture for safety reasons.

    Trigger point injections (according to Travell) only describe injections oflocal anesthetics into myofascial trigger points (not subcutaneously, not inmuscle gellings or in ligament pain points).

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    Frequency and needles

    • Frequency:

    • Injections are usually given once a week

    • Needles:

    • 0.3 x 13 mm 30G x ½"

    • 0.4 x 20 mm 27G x 3/4"

    • 0.4 x 40 mm 27G x 1 ½"

    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 ½"

    0.4 x 20 mm 27G x 3/4"

    0.4 x 40 mm 27G x 1 ½"

    0.5 x 40 mm 25G x 1 ½"

    0.6 x 80 mm 23G x 3 1/8"

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    Reaction after injection

    • Sometimes there is an immediate improvement within a few

    seconds (or minutes) after injection. But usually this doesn’t last.

    That’s why we have to repeat the treatment (sometimes “layer

    by layer”) until complete cure is established.

    • When chronic or more complicated situations occur, the pain

    may get worse the next day. Such a “reaction phase” usually

    occurs within the first 24 hours after the injection and subsides

    by itself. It’s important to warn the patient about such a reaction

    phase.

    • Sometimes there can also be complications or side effects (next

    slide).

    Sometimes there is an exacerbation of symptoms. The latter means that

    the patient may actually have more pain, especially the day after the

    injection. This is not a side effect or a complication, but a sign that thebody is responding. In biopuncture, this is known as the reaction phase.

    Sometimes the pain shifts to another area during a reaction phase, and

    such reactions are also considered as positive reactions. Usually it means

    that the body is responding through changes in the posture due to

    alterations in the muscular tensions in the area. These issues should be

    discussed with the patient after each session.

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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)

    Temporary discomfort at the point of the injection is quite common.

    Prolonged reactions with stiffness and soreness are observed in some

    cases, as well as painful hematomas under the skin or in the injectedmuscle - especially when using thick needles. This is particularly liable to

    occur in those on steroids/anticoagulants and in the elderly.

    Local complications include allergic reactions, skin rash, hematomas,

    swelling of the injected area, or local stiffness.

    Infections after injection are avoided by using sterile injection techniques.

    Damage to organs can occur after accidental injections in the pleura,

    kidney, liver, etc. These complications can occur when dealing with

    enlarged organs (spleen, liver), anatomical variations or when dealing with

    patients that make unexpected movements during injection.

     Accidental injections into blood vessels, peripheral nerves or the 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 doesn’t 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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    Sharing information on biopuncture

    • Sharing information between doctor and patient:

    Every patient should receive a biopuncture pamphlet.

    • Sharing information between doctors:

    Biopuncture forum, biopuncture training, biopuncture books,

    biopuncture lectures

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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

    We will now discuss three subjects:

    Part 1. Local strategy for musculoskeletal complaints: here we will discusshow we treat musculoskeletal problems by giving local injections into for

    example muscles, tendons and ligaments.

    Part 2. Local strategy for functional complaints: here we will discuss how

    we treat functional complaints (e.g., asthma, gastritis, bronchitis) by giving

    local injections into the segment of the organ; these injections are usually

    given subcutaneously.

    Part 3. General approach of the patient: this means that in some cases wedon’t attack the symptoms (as in part 1 and 2) but we have to treat the

    general condition of the patient (terrain treatment). This may include a

    detox program with injections, a drainage with injections and a regulation

    of the hormonal system with injections. The general treatment is especially

    important in chronic and complicated situations.

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    Part 1. Strategy for musculoskeletal complaints

    • Four phases

    • Four injection techniques

     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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    Strategy for musculoskeletal complaints: 4 phases

    • Phase 1: Lymphomyosot

    • Phase 2: Traumeel

    • Phase 3: Spascupreel, Colocynthis-Homaccord,

    Ferrum-Homaccord, Gelsemium-Homaccord,..

    • Phase 4: Zeel, Discus compositum,

    Coenzyme compositum

    There are four phases when we approach the patient. Theoretically, theseshould be followed step by step, but in some cases we can skip the firstphase 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 andto support local lymphatic drainage. This phase is especially importantwhen dealing with sensitive patients. It is also a good preparation beforegiving more specific remedies.

    Phase 2: Traumeel injections to regulate local inflammation throughimmunomodulation.

    Phase 3: Here we will inject more specific remedies, which match thesymptomatology 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 ororgan support. These are e.g., Zeel and all the compositae like e.g.,Discus compositum and Coenzyme compositum.

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    Strategy for musculoskeletal complaints:

    4 techniques

    • A. SC (segment therapy)

    • B. IM (myofascial therapy)

    • C. Tendon/tendon sheath/bursa

    • D. Ligament/enthesopathy/periost

    There are four major techniques when we approach the patient.

    Theoretically, these should be followed step by step, but in some

    cases we can skip the first phases and go to the target tissueimmediately. We can also combine one or two different techniques in

    one session if necessary.

     A. The subcutaneous injection is the easiest one, and works through the

    local reflexes, as in mesotherapy (segmental therapy). It’s interesting

    for physicians who don’t have much experience with injections yet.

    B. Intramuscular injections are given when the muscles are involved.

    C. Injections around tendons, into tendon sheaths or into bursae are given

    when these soft tissues are related to the clinical picture.

    D. Injections into ligaments, into enthesopathies or to the bone (into the

    periost) are given when these tissues are related to the clinical picture.

    These injections are more aggressive and more painful, but can be

    interesting in difficult and chronic cases. We usually add hypertonic

    sugar to the antihomotoxic remedies for these injections.

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    Overview:

    16 ways to approach the patient

    D4D3D2D1D.Ligament

    C4C3C2C1C.Tendon

    B4B3B2B1B.IM

     A4 A3 A2 A1 A.SC

    4. Cellular 

    Compositae

    3. Symptomatic

    e.g., Homaccords

    2. Modulation

    Traumeel

    1. Drainage

    Lymphomyosot

    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 can’t 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.

    Subcutaneous injections are given when we want to influence deeper

    layers underneath, for example:

    the cutaneo-muscular reflexes to influence deeper muscular layersunderneath without giving injections in those muscles themselves

    the cutaneo-articular reflexes to influence joints underneath without giving

    injections in those joints themselves

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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

    • Less painful during injection

    • Safer (no injection in deep

    organs)

    Volume: about 0,1 – 0,5 ml at each spot

    -Injections depth: subcutaneously

    Keep your fingers away from the needle to prevent injecting your own

    fingers.

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    SC injections shoulder 

    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 theseinjections 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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    Local subcutaneous injections for tennis elbow

    This is an example of four subcutaneous injections in the elbow area for a

    patient who was afraid of deep injections. By giving these superficial

    injections we can evoke a natural healing through the segmentalreactions.

    Sometimes a few sessions on a weekly basis can be enough to have

    complete healing. Sometimes we will have to give deeper injections (eg in

    the ligaments of the elbow or the muscles of the arm) in order to have

    complete healing.

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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

    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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    Muscle tissue infiltration

     Always use “Pincer palpation”:

    • Less painful during injection (gate control)

    • Safer (no injection deeper than our own finger tips to avoid

    injection in e.g., underlying organs)

    We always useWe always use “ Pincer palpationPincer palpation”:

    This means that we take the muscle between our thumb and secondfinger and grasp it while lifting it

     As a result, the injection is

    1.1. less painful (gate control: the thick nerveless painful (gate control: the thick nerve fibersfibers inhibit the thin nerveinhibit the thin nerve

    fibersfibers))

    2. safer (no injection deeper than our own finger tips to avoid2. safer (no injection deeper than our own finger tips to avoid injection ininjection in

    e.g. underlying organs)e.g. underlying organs)

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    Muscle tissue infil tration technique

    • Volume: about 0,5 - 2 ml at each spot

    (about 5 to 10 ml can be injected during each session)

    • Injections: at a depth of about 1 to 4 cm

    (up to 8 cm for the gluteus/piriformis)

    • We inject several layers in one injection (retrograde infiltration

    technique)

    • Frequency: usually once a week

    You can give several injections at several depths in the area

    You penetrate until the deepest point in the muscle

    Then you continue to inject while withdrawing the needle

    So you inject different layers with one needle penetration

    You also avoid to give all the liquid into a vessel

    In BP we call this the “retrograde infiltration technique ”

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    Reaction after IM injections

    • Reaction phase

    • Pain is worse the day after (usually within first 24 hrs)

    • Muscular shift

    • Pain shifts to another area because the muscle chains are

    adapting

    • Organ regulation

    • IM injections also have a segmental effect (see later)

    • Change in posture

    • Adaptation of the agonists and antagonists also leads to

    change in posture

    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 placewhile in fact healing is on its way, but the pain shifts to another areabecause the muscle chains are adapting after the biopuncturetreatment.

    Organ regulation

    IM injections also have a segmental effect (see later). For example,

    injections in the dorsal paravertebral muscle may influence healingof 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 haveto adapt to the new situation. Sometimes the treatment of chronicmuscle tensions leads to change in posture.

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    Four types of IM injections:

    • MPZ injections: intramuscular (IM) injections in the pain zone

    • MPP injections: intramuscular (IM) injections in myofascial pain

    points

    • MG injections: intramuscular (IM) injections in muscle gellings

    (myogeloses)

    • MTP injections: intramuscular (IM) injections in myofascial

    trigger points

    MPZ injections: intramuscular (IM) injections in the pain zone

    You inject IM in the area where the patient says he or she experiences the

    pain (PZ = pain zone) or you inject in those muscles who show weaknessor higher muscular tension.

    MPP injections: intramuscular (IM) injections in myofascial pain points

    You inject IM in the points you find are painful in those muscles who are

    painful, show weakness or show a higher muscular tension.

    MG injections: intramuscular (IM) injections in muscle gellings

    (myogeloses)

    You inject IM in the muscle gellings you find during clinical examination.

    MTP injections: intramuscular (IM) injections in myofascial trigger points

    You inject IM in the myofascial trigger points (at a distance from the pain

    zone) you find during clinical examination.

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    B1. MPZ injections:

    intramuscular in the pain zone

    • MPZ = Intramuscular injections in the pain zone (PZ)

    • The physician simply injects the muscles in the area that the

    patient has indicated as being the painful zone

    • Needling technique: at random (as in mesotherapy), but deeper

    (into the muscle tissues instead of SC)

    MPZ injections: intramuscular (IM) injections in the pain zone

    You inject IM in the area where the patient says he or she experiences the

    pain (PZ = pain zone) or you inject in those muscles who show weaknessor higher muscular tension.

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    6 MPZ injections low back

    in: Musculus Erector Spinae, left and right

    fig 33 p. 91 in “Biopuncture in General Practice”

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    B2. MPP injections: intramuscular injections in

    myofascial pain points

    • MPP:

    • Spots YOU FIND in the pain zone

    • show an extra sensitivity on compression

    • The patient indicates that particular muscle area as unpleasant

    when you put pressure on it (see next slide)

    MPP injections: intramuscular (IM) injections in myofascial pain points

    You inject IM in the points you find to be painful in those muscles who are

    painful, show weakness or show a higher muscular tension.

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    You look for PPs with your hands in the patient’s

    PZ (pain zone)

    • While you examine:

    • You look for hard parts

    within the injured muscle.

    • You check when the

    patient has sensations of

    pain or discomfort.

    • A. Feel his body move

    away

    • B. by making grimaces

    • C. by screaming

    • D. by moving other body

    parts.

    PP = Pain point (you find with finger pressure)

    PZ = Pain zone: the zone or area where the patient has the pain

    PPs = Pain points you can find during clinical examination

    MPPs = Muscular Pain points

    The patient indicates MPPs as painful on digital compression:

     A. By trying to move away from the digital pressure = jump

    sign,

    B. by making grimaces (check facial expression!),

    C. by saying “au!” (listen to the patient’s sounds he makes!),

    D. by moving other body parts (sometimes very obvious,sometimes only subtle movements).

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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)

    Sometimes we find hardened areas in muscles. They are like strings or

    nodules and are referred to as "myogeloses" or muscle gellings (MGs).

    They are not always painful, but they are related to chronic muscletensions, for example in the calf muscles (e.g., runners) or in the piriformis

    muscle (car racers).

    MG injections: intramuscular (IM) injections in muscle gellings

    (myogeloses)

    You inject IM in the muscle gellings you find during clinical examination.

    Sometimes we can take them between two fingers (see next slide).

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    Rope-like bands (MGs)

    • MG in dorsal back

    • Disturbed muscle chains

    • Low(!) back pain

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    B4. MTP injections:

    IM injections in myofascial trigger points

    MTP injections =

    • Intramuscular injections in the trigger points that you find during

    clinical examination

    • But outside the actual pain zone!

    • The patient indicates MTPs as painful on digital compression

    and by pulling away (= jump sign)

    • Active MTPs also give referred pain

    The latter means the injection is given at a distance from the pain

    zone!

    MTP injections: intramuscular (IM) injections in myofascial trigger points.

    You inject IM in the myofascial trigger points (at a distance from the pain

    zone) you find during clinical examination.

    These MTPs are based on the books of Travell and Simons.

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    Headache from superficial MTPs in trapezius

    muscles

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    Referred pain from deep myofascial trigger points

    in the hip area

    • Pain in the leg: from MTP in Glut min

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    Looking for MTPs in thigh muscles (adductor

    magnus) for patient with pain in the groin

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    Looking for MTPs in quadriceps for patient with

    pain in the knee

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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

    We will mainly discuss the ligament injuries.

    Injections in the enthesopathy and in the periost will not be discussed.

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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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    Clinical picture of the ligament factor 

    (in biopuncture: “L-factor”)

     A. Pain

    • A1. Local pain (LPP)

    • A2. Referred pain (LTP)

    B. Joint instability

    • B1. Clicking sound

    • B2. Degenerative changes (if chronic)

    L-factor = every patient whose main problem is a ligament (even when

    other doctors said it was related to osteoarthristis, a hernia, or

    psychogenic)

    Biopuncturists think about ligaments when

    there was an accident or trauma

    there is nerve-like pain

    Patients with ligament based symptoms often show relief while in

    movement and when applying ice

    Ligamentous pain does not show on X-rays or scans, so:

    Look for them during clinical examination.

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    Two types: LPPs and LTPs

    • Ligament injections in LPPS

    • e.g., LPP in ankle ligament

    ankle swelling and local pain

    • e.g., LPP in acromio-clavicular ligament

    pain in shoulder 

    • Ligament injections in LTPS (also referred pain!)

    • e.g., LTP in nuchal ligament

    neck pain/headache

    •e.g., LTP in iliolumbar ligament pseudo-sciatic pain

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    Part 2. Strategy for functional complaints

    • Strategy for functional complaints

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    Reflex zone injections (RZ):

    • This is referrred to as SEGMENT THERAPY

    • These injections have no direct contact with the target organ

    These injections are given:

    • A. Subcutaneously (SC)

    • They work through the viscero-cutaneous reflexes

    • B. Intramuscularly (IM)

    • They work through somato-visceral reflexes

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    Overview

    B4B3B2B1B.IM

     A4 A3 A2 A1 A.SC

    4. Cellular/OrganCompositae

    3. Symptomatice.g., Homaccords

    2. Modulation

    Traumeel

    1. Drainage

    Lymphomyosot

    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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    Fig: asthma or bronchitis

    (anterior and posterior)

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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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    Functional disorders of stomach

    • Phase 1: Lymphomyosot

    • Phase 2: Traumeel

    • Phase 3: Nux vomica-

    Homaccord

    • Phase 4: Coenzyme

    compositum

    • Where?

    • SC: Front/back (dorsal

    side: midline T2 - T9)• IM: in the paravertebral

    back muscles (dorsal level)

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    Functional disorders of the intestinal tract

    (ileum/colon)

    • Phase 1: Lymphomyosot

    • Phase 2: Traumeel

    • Phase 3: Colocynthis-Homaccord, Spascupreel

    Nux vomica-Homaccord or Veratrum-Homaccord

    • Phase 4: Coenzyme compositum or Podophyllum compositum

    • Where?

    • SC: Front + back (dorsolumbar side: midline)

    • IM: in the paravertebral back muscles (dorsolumbar level)

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    Fig: RZ (reflexzone)

    Ileum SC colon SC

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    IM reflex injections for ileum/colon

    Segment therapy:

    • One can give injections with the same remedies (Spascupreel,

    Nux vomica-Homaccord)

    • into the paravertebral musculature

    e.g., on the lumbar level on both sides:

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    Functional disorders of pelvis

    • Phase 1: Lymphomyosot

    • Phase 2: Traumeel

    • Phase 3: Berberis-Homaccord,

    Sabal-Homaccord,

    Hormeel

    • Phase 4: Solidago compositum,Testis compositum,

    Ovarium compositum or 

    Coenzyme compositum

    • Where?

    • SC: front/back (dorsal side:

    sacral midline)

    • IM: in the buttock muscles

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    Part 3. General approach using biopuncture

    • 1. Drainage:

    Lymphomyosot for lymphatic detoxification

    • 2. Detoxification:

    Hepeel (Hepar compositum) for liver 

    Berberis-Homaccord (Solidago compositum) for kidneys

    • 3. Bioregulation of the hormonal system:

    Hormeel (Ovarium compositum or Testis compositum)

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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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    Drainage of lymphatic system

    Standard treatment with biopuncture:

    • Airways (BALT): reflex points thorax front/back side (air 

    pollution, smoking)

    • Liver/stomach/colon: reflex points front/back side (pollution of

    food and medication)

    • Ileum (GALT): reflex points front/back side also

    immunomodulation

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    Drainage of lymphatic system

    • After mononucleosis

    • Chronic intoxication

    • Air pollution (airways)

    • Food, medication (liver, intestinal tract)

    • As a major detoxification for any chronic disease, such as:

    • Migraine

    • Chronic fatigue

    • Allergy

    • Multiple pathology

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    2. Detoxification

    • 2A. Hepeel (Hepar compositum) for liver 

    • 2B. Berberis-Homaccord (Solidago compositum) for kidneys

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    Detoxification of the liver 

    • What?

    • Hepeel (first choice remedy)

    • Hepar compositum (chronic, tissue damage)

    • Where?

    • SC: Front + back

    • IM: in the paravertebral back muscles

    (dorsal level)

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    Liver detoxification:

    Reflex therapy by us ing SC injections in liver area

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    Detoxification of the kidneys/ureter/bladder 

    • What?

    • Berberis-Homaccord (first choice remedy)

    • Solidago compositum (chronic, tissue damage)

    • Where?

    • SC: Front + back

    • IM: in the paravertebral back muscles (dorsolumbar level)

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    Kidney detoxification: reflex therapy by using

    SC injections in kidney areas

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    3. Bioregulation hormonal system:

    • Hormeel or Ovarium compositum

    • To treat all symptoms which are related to the female

    cycle/hormonal system

    • E.g., Hormonal migraine injections into the reflex zone of the

    ovaries (next slide)

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    Reflex zone of ovaria: give two or three SC

    injections on each side in the fossa iliaca