Post Herpetic Neuralgia / Shingles – Micro-knifing Tender Areas (Acupotomy) Reduces Pain 60% and Persists over Course of 6 – 12 Months

Previously, there was a technique involved producing 2nd degree frost burns in tender post-herpetic neuralgia areas –  as a means to reduce pains.
Suzuki H, Ogawa S, Nakagawa H, et al. Cryocautery of sensitized skin areas for the relief of pain due to post-herpetic neuralgia.
Pain 1980;9:355–362

Now it looks like areas can undergo micro-knifing with an acupuncture needle with a knife on the end instead.

Efficacy of acupotomy therapy for the treatment of postherpetic neuralgia
Liu, C
Pain Clin J, October 2012, 8(5) 360- 363

  • 11 Cases
  • Slin lesions (I presume tender ones) and the corresponding paravertebral areas had “lysis” weekly 3-7 times
  • “pain was obviously relieved” – dropped VAS pain levels from 6.3/10 to 2.5 (60% improvement).
  • This improvement was stable over 6-12 months suggesting it was not placebo

Comment –  One of the most successful treatments for chronic low back pain was a gross technique involved cutting the back muscle tissue to the bone over the facet areas bilaterally – “myotomy” – the areas would badly bruise.  Ree (1971)  claimed 998/1000 were successful and 57% patients recovered while facet denervation, which overtook that, had only a 27% success rate.

Rees, W. E. S. (1971).
 Multiple bilateral subcutaneous rhizolysis of segmental nerves in the treatment of the intervertebral disc syndrome.
Ann Gen Pract, 26(126), 392.

Ress WES:
Multiple bilateral subcutaneous rhizolysis of segmental nerves in the treatment of intervertebral disk syndrome.
Australian Annals of General Practice 26:126-127, 1971

Sorry- so far back can’t get anything on it except a citation. Boy, was that buried…

Rees later felt all he needed to do to achieve the same recovery was denervate the facets. I think that was  a mistake as I think considerable pain comes from the other dorsal rami – which would be cut in a myotomy.

Acupotome needles have a cutting edge on the end. Apparently the are applied subcutaneously under scarred (?and painful) areas and undergo microcut.

Did come across a You-Tube video demonstrating its use:

Had trouble locating a supplier but found one in China:

I ordered some and will see where their use lies. I believe certain chronic pains contain an element of micro-entrapments (like cluneal nerves over iliac crests). I’ve used 5% lidocaine to turn them off (might need 3 to get a good take) but that, combined with microcuts would be better. Argument would be that that would be neurodestructive while 5%  subcutaneous dextrose shots might help repair… michael kors site officiel michael kors site officiel

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