by Zach Olesinski R.Ac

Differences between Traditional Chinese Medicine and Japanese style acupuncture.

My introduction and training in acupuncture began with Traditional Chinese Medicine (TCM), the most commonly known form of acupuncture practiced in North America. After my first year of acupuncture college I was introduced to a Japanese style acupuncturist. From diagnosis to treatment, it was a very different experience from what I had been learning in TCM school. The Japanese style of acupuncture instantly resonated with me and became a source of inspiration in my studies and practice. After completing my formal education in TCM I continued on my path to learning the Japanese style of acupuncture, studying with several Japanese teachers, both in North America and in Japan.

I would like to highlight some of the key differences between TCM and Japanese style acupuncture.

First, I would like to discuss the difference in diagnostic techniques. In TCM, diagnosis is made according to the main complaint as well as pulse and tongue diagnosis. Typically, diagnosis is primarily logically informed, putting the patient’s described symptoms into a diagnostic framework. If patient has “X” symptom then they have “X” disease pattern. Besides pulse diagnosis, there is often limited palpation (touch diagnosis) besides looking for ashi points (pain points).

In Japanese style acupuncture, however, pulse, acupuncture point, and abdomen palpation (known as hara diagnosis) are used to inform the diagnosis and treatment. The abdominal diagnosis used in Japanese style acupuncture provides specific and accurate points of reference for understanding the internal imbalance(s) which inform the acupuncture treatment. Different areas of the abdomen highlight organ imbalances which are corrected using specific acupuncture points.

Secondly, acupuncture techniques vary in regards to the level of stimulation given during the treatment. In TCM acupuncture, treatments often encourage stronger needle stimulation, which can be painful. The concept behind strong needle stimulation is that it increases qi (energy) flow to the point. It is believed that without a strong stimulation (which is called de qi), the treatment will not be as effective.

In Japanese style acupuncture, gentle and superficial acupuncture stimulation is practiced to ensure the patient feels comfortable at all times during the treatment. The concept of keeping the patient comfortable throughout the treatment allows for the patient to relax more into a healing state.

Furthermore, the mental state and physical strength of the patient dictates how much stimulation is applied throughout the treatment. This is determined by the patient’s condition(s)/symptom(s) as well as sensing how their body is responding to the acupuncture during the treatment. Sensing how the patient is responding during the treatment is done by having one hand on the body (known in Japanese as the oshide, or sensing hand) at all times during the treatment.

The oshide allows the practitioner to sense how much stimulus the patient can handle and how much the acupuncture needle is inserted, if inserted at all. Instead of assuming how much stimulation is needed, the body dictates the treatment. For example, if the person is tense and hyperactive then applying strong acupuncture stimulation could cause the body to become overstimulated. In this case, to ensure the patient’s body isn’t overstimulated the Japanese style acupuncturist may simply place the acupuncture needle on top of the acupuncture point (known as contact needling), without it entering the skin to achieve changes to the condition. In Japanese style acupuncture, it is believed that less is often more in regards to stimulation while still yielding effective results during the treatment.

Thirdly, unlike in TCM acupuncture, in Japanese style acupuncture the practitioner typically stays with the patient during the treatment to ensure they understand how in the moment the body is responding to the acupuncture and if the treatment is working. The acupuncture treatment is used as a form of real time diagnosis.

hara diagnosis

Going back to hara diagnosis where specific regions of the abdomen correspond to different internal systems, such as the organs. Palpating these different areas of the abdomen allows the practitioner to understand which specific organ(s) are imbalanced and narrows the treatments focus. Acupuncture points are then chosen in response to the hara findings. Typically, if the correct acupuncture point(s) are chosen then the body will respond, being reflected by the hara findings changing. For example, if the liver hara reflex is active, such as tightness and pain on palpation, liver points are then selected. After the liver acupuncture points are stimulated, the practitioner goes back and palpates the liver hara reflex. Typically if the correct points are selected, the hara reflex will become less tight and painful. This allows for real time feedback as to the patient changing internally (ie. organ function improving) and allows the practitioner to know they are treating the condition correctly.

Lastly, in Japanese style acupuncture, the use of the therapeutic herb mugwort is used in a therapy called moxibustion (known in Japanese as okyu). Though TCM does use moxibustion as a treatment modality as well, Japanese style acupuncture has refined different moxibustion techniques. Such Japanese techniques include cone moxibustion (chinetsukyu), where the mugwort is applied directly onto the skin and burned as well as warm needle moxibustion (kyutoshin), where the mugwort is placed at the end of an inserted needle and lit. Both of these techniques induce physiological changes to the body such as increased circulation.

These are the most common differences between the two styles of acupuncture. Each have their own merits and prove effective for treatment of a wide range of conditions. For me, the Japanese style has resonated most and is the style of acupuncture I enjoy and use in my current practice. Most people are familiar with TCM acupuncture and may not have experienced Japanese style acupuncture. If this is something that interests you and you want to try Japanese style acupuncture, please feel free to contact me. I currently practice acupuncture out of Lite Mind Body Clinic in Toronto, Ontario.