Are You Missing the Point of Auricular Acupuncture?

Auricular Acupuncture (AA) – its been around for a while but perhaps not as long as you might think.

 Some History

Most would assume that traditional Chinese medicine is the originator of this popular therapy but the auriculotherapy most of you are familiar with today was refined and formalized by a French neurologist –  Dr. Paul Nogier in the 1950’s and 60’s.

Although Nogier is known as the Father of modern auricular acupuncture, his interest in this therapy all started because he saw a number of people who had a specific spot cauterized on their ears done by a local healer (Mme Barrin) whose father learned of the technique from a TCM practitioner – specific to help people with their sciatic pain.

This traditional Chinese medicine technique of cauterizing a specific spot in the ear is what got Nogier interested in auricular acupuncture in the first place and he simply took this therapy to a new level.

Now, I’m not going to do a deep dive into the history of where auricular acupuncture came from – there are better people suited to do that than myself.  I’m much more interested in helping new acupuncturists and Naturopaths discover all the ways they can incorporate this treatment option into their clinical practises – expanding their treatment options and getting better patient outcomes.

Today, we are going to answer these questions:

What are your clinical options with auricular acupuncture and – what problems is auricular acupuncture helpful for?

There are a number of clinical options for us practitioners:  there are ears seeds, intradermal tacks and regular needles – even electro options.  All have their advantages and disadvantages.

What Can AA Treat?

As for what problems auricular acupuncture can be helpful for – this answer is pretty easy.  I feel confident saying that ANY treatment could incorporate auricular acupuncture.  Whether you are treating anxiety or sleep problems or menstrual concerns or even shoulder pain.  There’s an ear point for that…

So, knowing that basically every treatment could incorporate at least one or two auricular points. let’s check out our treatment options:

Treatment Options

Ear Seeds

Ear seeds are an extremely safe and simple way to stimulate points on the ear.  The best part is that clients can go home with these points in their ears and press them whenever they need them.

I typically tell clients to leave the ear seeds in their ears for around a week but I’ve seen them last even longer!  If you clean the area well with 70% alcohol, the seeds will stick to the skin very well – just make sure the area is dry before you apply.

Every time I’ve put ears seeds in for a client, they always want them inserted again at the next treatment.  Clients absolutely love them!

The one drawback is that they may not be strong enough to stimulate certain areas of the ear (the helix or lobe for example).  The whole point is to feel the stimulation when you press on these seeds so if your patient can’t feel anything when they press, they are likely not helping.

Intradermal Tacks

The tacks are a stimulation upgrade as they tend to provide more sensation than the ears seeds.  They actually pierce the skin.

However, I don’t like to leave the tacks in more than a couple of days – infection is rare but possible and the longer they stay in the ear, the more likely an infection could set in.

The tacks should also be disposed of in a sharps container.  Not many clients have these handy so they may need to be removed and disposed of by the practitioner.  This could be an issue if the client is coming in from a distance to see you.

Also, be sure you don’t press the tack with your finger on the other side of the ear!  This is an easy way to create a needle-stick injury.  Make sure the length of your tack is appropriate for the area you are working on.  Many different styles and types of tacks exist on the market these days.

Needles

Finally, regular acupuncture needles are the most common way to stimulate these ares of the ear.  With a steady hand, you can be incredibly accurate with your point location.  Stimulation is also easily noticeable for most clients.

The main thing is that you need to insert the needles enough so they are “rooted” – meaning that don’t have a wobble when you touch them.

The NADA Protocol

When I was doing my training with the NADA group at a local hospital in Toronto, it was discovered early on that if you don’t root your needles, they will easily fall out with any jaw movement from the client (talking laughing etc.).

In a NADA scenario, people are in a seated position so if a needle falls, it usually falls into the clothes of the person you are working on…not a fun thing to have to retrieve!  Lying down reduces this issue but rooting your needles is the best practise.

Needle choice is half cun or one cun.  Anything longer gets to be too heavy and is more likely to fall out.

Obviously, the needles come out before patients leave your office so the downside is that stimulation of the area stops when the treatment is over.  However, due to the strong nature of the stimulation, the treatment effects are long lasting – even when the needles come out.

It’s also worth mentioning that the ears bleed easily so keep a q-tip handy to catch any drops.

Electro Stimulation 

In addition to the above, you have the option of electrical stimulation with things like a pointer plus pen, an electro acupuncture machine or a TENS unit.

Electro therapy in the ear is becoming more common and if done correctly, can be very helpful clinically.  After all, many feel that the stimulation of these points has an effect on the vagus nerve – the longest nerve in the body – which reaches from the ear all the way down to the lower abdomen.  Many studies have been done on vagus nerve stimulation via the ear.   A lot of these studies are looking at treating things like dementia, depression, anxiety, insomnia and digestive concerns.

How to Choose Your Points

As mentioned before, if you know the functions of all the points in the ear, you can add one or two ear points for every treatment you provide – no matter your area of specialty.  Learn the functions of these points through one of the resources found below if interested in doing a deep dive into the actions and indications of these points.

However, even if you just have a TCM diagnosis to work with, you should easily be able to add one or two ear points for any treatment protocol.

For example:

Lets say someone comes in with menstrual pain due to Liver Qi stagnation – you can do the Liver point and the uterus point

Perhaps someone comes in with Kidney Yang def with back pain – do the Kid point and the lower back area of the ear

What about Heart Yin deficiency with insomnia?  Just do the Heart point and a calming point like Shen Men

The treatment options are amazing in the ear.  Combine the ear points with a solid point selection protocol for the body and you are well on your way to providing a top notch acupuncture treatment for your clients.  For those interested in knowing more about how to simplify their approach to acupuncture point selection, take my Acupuncture Point Selection Mastery course and stop struggling to find the best acupuncture points for your TCM diagnosis.

Four Steps to Better Auricular Treatments

1.  Know your ear anatomy – it just makes locating points easier when you have anatomical references to refer to.

2.  Start to learn the main organ points and the master points – know where they are and why you would use them.

3. Use the appropriate stimulation technique – when should you be using ears seeds and when you should be using stronger sensations like needles.  This depends on your patients’ anxiety and sensitivity levels.

 4.  Patient feedback – make sure the sensation is noticeable but comfortable.  Tell patients that if the ear seeds or tacks start to hurt, they should remove them and be sure to clean the area well.

Helpful Resources

There are loads of ear charts out there but my favourite chart is from Terry Oleson PhD.  He is another important name in the auricular therapy world and has written a few books definitely worth checking out.  This chart is in my clinic and I reference it often.

I like this chart as it differentiates the European points and the Chinese points (C and E), it refers to the anatomy of the ear to help with point location and is overall the most accurate chart I know of.

Books

Auriculotherapy Manual: Chinese and Western Systems of Ear Acupuncture  By Terry Oleson, PhD

Ear Acupuncture:  A Precise Pocketbook  By Beatte Strittmatter