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I hated treating conditions like plantar fasciitis! Problems on the soles of the feet gave me so much trouble. It seemed that no matter what I did in the way of treatment, the moment the patient applied weight to the foot again the injury would become irritated and the pain would return. As an acupuncturist it was very unsatisfying spending great periods of time applying treatment only to be told by the patient at the end of the session that pain levels are the same. Sometimes I’d sit for days following an unsuccessful treatment of plantar fasciitis gnashing my teeth and beating myself up for not being able to fix the underlying inflammation and resolve the problem. I saw no reason why the condition couldn’t be resolved using acupuncture, I just felt I hadn’t found the key yet and that was frustrating. In most cases I was forced to accept defeat after a few treatments and have to suggest to patients that they visit their podiatrist for some professionally fitted arch supports or some such thing. At one point I stopped accepting patients with problems like plantar fasciitis because I felt I was unlikely to be able to help. That was until I was introduced to a funny sounding acupuncture extra point combination called Mu Guan and Gu Guan. Now I look forward to each new case of planter fasciitis and foot pain that knocks on my door.
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Found on the heel of the palm and used for bone swelling, rheumatoid arthritis and swelling of the joints (McCann & Ross 2014, 59), Mu Guan and Gu Guan have become my go too move for all sorts of heel pain. Just last week a big, strong fella came to my clinic complaining of recent onset pain in the sole of the foot that his doctor had diagnosed as plantar fasciitis. The fact that it had only been bugging him for a couple of weeks made this fellow quite unusual because most of the time I only see cases of plantar fasciitis that have been ongoing for many months.
After a few questions and a preliminary investigation, I decided to needle Mu Guan and Gu Guan on the opposite palm. I then asked the patient to get off the table and walk around the clinic. To the patient’s surprise and my deep satisfaction, the pain in the heel was gone. All that remained was a little discomfort on the ball of the foot (at the metatarsal-phalangeal joints), which was dealt with by needling the image of this pain at the metacarpal-phalangeal joints on the opposite hand.
What is really pleasing about the treatment of foot problems like plantar fasciitis with Mu Guan and Gu Guan is that when patients present for follow up (normally several days after the first) they routinely report that the pain in the feet is either non-existent or significantly reduced. This fellow was no exception. Despite his impressive size (all of which was bearing down on his poor inflamed fasciae) and the fact that he had been on his feet for the usual periods of time at work since I last saw him and had even gone for a walk with his wife over the weekend, he reported significantly improved pain levels in the foot. To me this outcome meant that the process of healing the fasciae and resolving the underlying inflammation was well underway. Treatment was going to plan one might say. I was quick to explain, however, that the job was not done and that a number of follow up treatments would be necessary to ensure that symptoms were permanently controlled. I didn’t want this fella stopping treatment too soon and suffering a relapse; that’s not good for him, for me or for the profession! That said, I expect that with a couple more sessions we will have passed the acute phase of the condition and be well on the way to resolution.
If you have never used Mu Guan and Gu Guan before check out the location note and illustration below. They are easy to find, easy to use and just might become your go to move for problems of the heel too. Because of the sensitivity of the palmer surface of the hand the best idea is to perform a quick needle insertion. Fiddling about on the surface of the skin with slow or shallow insertion only results in pain because of the concentration of free nerve endings in the skin of the palm. The Koreans have a neat little tool they use for their hand acupuncture techniques called an acupuncture needle inserter that makes needling quick and painless. I’d also recommend taking the time to read a case study I found about heel pain that combines herbal medicine with acupuncture to Mu Guan Gu Guan.
Location note: Mu Guan is located at the base of the palm of the hand, 0.5 cun distal to the prominence of the pisiform bone between the Pericardium and Heart Channels. Gu Guan is located at the base of the palm of the hand, 0.5 cun distal to the prominence of scaphoid bone between the Pericardium and Lung channels.
Illustration: McCann & Ross 2014, 51
McCann, H. & Ross H-G, 2014 Practical Atlas of Tung’s Acupuncture 3rd Ed., Verlag Muller & Steinicke, Germany
