ACC Acupuncture for Pain Management 2 — Questions and Answers
Question 1: Which acupuncture point is known as the 'command point' for the back and is frequently used for acute low back pain?
- BL 40 (Weizhong) (Correct answer)
- GB 34 (Yanglingquan)
- ST 36 (Zusanli)
- SP 6 (Sanyinjiao)
Correct answer: BL 40 (Weizhong)
BL 40 (Weizhong) is the command point for the back and is a primary point for acute and chronic low back pain.
Question 2: In neurophysiological terms, acupuncture analgesia is primarily attributed to which mechanism?
- Stimulation of endogenous opioid release (Correct answer)
- Inhibition of prostaglandin synthesis
- Blockade of sodium channels
- Activation of GABA receptors only
Correct answer: Stimulation of endogenous opioid release
Acupuncture stimulates the release of endogenous opioids including enkephalins and beta-endorphins, which are central to its analgesic effect.
Question 3: A patient with fibromyalgia presents with widespread pain and fatigue. Which acupuncture treatment strategy is most appropriate?
- Aggressive needling of all tender points in one session
- Gentle needling with few needles targeting systemic points (Correct answer)
- High-frequency electroacupuncture on local painful areas only
- Avoiding acupuncture and referring elsewhere
Correct answer: Gentle needling with few needles targeting systemic points
Fibromyalgia patients are often hypersensitive; gentle needling with fewer needles and systemic regulatory points is safer and more effective.
Question 4: Which dermatome-based approach in acupuncture involves needling points along the spinal segments corresponding to the patient's pain area?
- Trigger point acupuncture
- Segmental acupuncture (Correct answer)
- Auricular acupuncture
- Scalp acupuncture
Correct answer: Segmental acupuncture
Segmental acupuncture targets spinal cord segments innervating the painful region to modulate afferent pain signals at that level.
Question 5: For a patient with chronic knee pain due to osteoarthritis, which local acupuncture points are classically indicated?
- ST 35, SP 9, EX-LE 4 (Neixiyan) (Correct answer)
- BL 40, GB 34, ST 36
- KD 3, SP 6, LV 3
- GB 41, BL 60, KD 7
Correct answer: ST 35, SP 9, EX-LE 4 (Neixiyan)
ST 35, SP 9, and Neixiyan (EX-LE 4) are local points surrounding the knee joint directly targeting osteoarthritic knee pain.
Question 6: What is the gate control theory's relevance to acupuncture analgesia?
- Large-diameter A-beta fibers activated by needling can inhibit pain signals from small C fibers (Correct answer)
- Acupuncture closes ion channels at the synapse permanently
- Needling destroys nociceptive nerve endings in the skin
- Gate control applies only to transcutaneous electrical stimulation, not acupuncture
Correct answer: Large-diameter A-beta fibers activated by needling can inhibit pain signals from small C fibers
Acupuncture needle stimulation activates large-diameter A-beta fibers that can inhibit incoming pain signals from A-delta and C fibers at the dorsal horn, consistent with gate control theory.
Question 7: Which acupuncture point located on the dorsum of the hand between the 4th and 5th metacarpals is used for neck and shoulder pain?
- TE 3 (Zhongzhu) (Correct answer)
- LI 4 (Hegu)
- SI 3 (Houxi)
- PC 6 (Neiguan)
Correct answer: TE 3 (Zhongzhu)
TE 3 (Zhongzhu) on the dorsum of the hand between the 4th and 5th metacarpals is a key point for neck, shoulder, and upper back pain.
ACC Acupuncture for Pain Management 2
Which acupuncture point is known as the 'command point' for the back and is frequently used for acute low back pain?