THE ORIGINS OF ACUPUNCTURE CHANNEL IMBALANCE IN PAIN OF THE EQUINE HINDLIMB

Objective: A study was conducted to define the relationship between or iental channel imbalance and pain of the equine hindlimb. Methods: One hundred eighty-five lame and muscle sore horses from a general equine practice in Virginia were examined by a single observer using traditi onal manual palpation of the acupuncture channels. The six hindlimb ch annels were evaluated and graded with particular emphasis on the react ivity of three transpositional acupoints, BL 18, BL 19, BL 20, and fiv e traditional veterinary acupoints Yao Zhong, Shen Shu, Xie Qi, Feng M en, and Fu Tu. All lame patients were evaluated with western methods t o establish an anatomical diagnosis. All nonlame horses with channel i mbalance were treated with either an intra-articular anesthetic, an in tra-articular cortisone, methylprednisolone acetate, or a hyaluronate and triamcinalone combination. The medications were Injected into eith er the three compartments of the stifle joint, tarso-metatarsal and di stal inter-tarsal joints, metatarsophalangeal joint, or the distal int erphalangeal joint The joint injections were conducted in sequence, di stal to proximal, until a definitive change in channel imbalance had o ccurred. Chi Square analysis was used to assess different frequencies of channel imbalance and the sites responsible fur that imbalance, wit h P < 0.05. Results: Channel imbalance was only indirectly associated with extra-articular pathology. Intra-articular structures of three jo ints of the distal hindlimb, the distal tarsus, metatarsophalangeal, a nd distal interphalangeal, accounted for all the observed abnormal, re ferred diagnostic acupoints. In the examined population, channel imbal ance was significantly more frequently related to the distal tarsus th an the hind fetlock, and both of these were significantly more frequen tly involved than the distal interphalangeal joint. Channel imbalance relating to the dorsal aspect of the digit was significantly more freq uent in metatarsophalangeal lameness than in distal tarsal lameness. N either the stifle nor midback pain was directly associated with projec ted, as opposed to local, channel imbalance. Lf projected channel imba lance could be defined as the presence of reactive acupoints not in th e immediate vicinity of the local site of pain, then the projected acu points detected in stifle lameness or back pain were associated with t he tarsus or the hind fetlock. Conclusions: The sites of hindlimb path ology resulting in channel imbalance were intra-articular, and they we re located within the distal tarsal, the metatarsophalangeal and the d istal interphalangeal joints. Channel diagnosis reflected intra-articu lar inflammation of only these three joints, and further diagnostic pr ocedures were required to establish a definitive western diagnosis. Th e presence of channel imbalance should be used to determine pattern di fferentiation In Traditional Chinese Medicine.