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Pressure Point

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Vol. 14 •Issue 11 • Page 51
Pressure Point

Acupressure is gaining momentum in the rehab realm.

The technique was developed over 5,000 years ago in a culture deeply rooted in the healing aspects of touch. Jin Shin Do, or "the way of compassionate spirit simultaneously,"1 is better known to Westerners as acupressure.

And it can be a powerful modality for patients in pain.

In the early 20th century, Japanese practitioners began to weave their time-tested theories and techniques with newer western knowledge of anatomy and physiology. This marriage resulted in a technique now called shiatsu. Shiatsu combines Asian forms of body work and western theories that are closely related to chiropractic and osteopathic medicine. As Japanese practitioners began perfecting shiatsu through the 20th century, the practice took the form of acupressure in the Western world.

Hands-on Treatment

Acupressure is just one of the many types of massage therapy. But it's unique in that it closely parallels acupuncture.2 Both operate on the hypothesis that releasing tension and stress at selected body points can free a body's energy flow, invigorate health and modulate pain.

Rather than using needles at these points, an acupressure practitioner applies deep finger pressure to combinations of specific points. Depending on the points (meridians) manipulated, proponents believe that this therapy can relieve pain and nausea, eliminate allergies and improve other health conditions.3

These approaches rest on the Oriental principle that energy force flows through a healthy body's 14 meridians, or channels. When stress, tension or other factors inhibit this flow, tension builds at selected points along the meridians. Applying pressure to these points, usually with the fingertips, restores energy flow and relieves symptoms.

Acupuncture and acupressure both concentrate on the same pressure points. The effects of acupressure may not be as dramatic or immediate, but acupressure is still effective, especially when the pressure is held for a long time and repeated over an extended period.4

Unlike its needle-bearing cousin, acupressure is used to treat more holistically and universally. But it's also beneficial in healing physical ailments and easing pain from injury or joint problems.5 For instance, in the sports medicine world, practitioners employ variations of digital compression, in which the thumb, fingertips or elbow manipulate underlying tissues.6

When points are stimulated, endorphins are released, which block pain and increase blood flow to the area. All points are referenced according to anatomical landmarks, which usually lie under major muscle groups and along bony indentations or protrusions.

Acupressure practitioners use charts to specify certain points that may be contributing to a patient's pain. These clinicians may use an ohmmeter, which sends an electrical impulse through the area, to locate an exact point of pressure. An easier and more popular method is to simply palpate the area for a small fibrous nodule or strip of tense muscle tissue that might be tender to touch.2

Each session depends on patient symptoms and a specific plan of sequence that's established by an acupressurist. To stimulate muscle points, practitioners apply pressure directly on the area of tension until the patient feels slight, but tolerable, pain. Hold the tension for 10 to 12 seconds, then rest one second, and repeat four times before moving on to the next point. Repeat this treatment for approximately two weeks and then re-evaluate pain levels.

Practitioners generally administer acupressure three times per day, with three hours between treatments, until pain dissipates. Signs of improvement usually appear within one or two days. If the patient shows no signs of improvement after two weeks, administer a new sequence or investigate other forms of treatment.

Applications and Cautions

Acupressure doesn't treat illness. However, there are many non-pathological indications that acupressure can relieve. For example, acupressure can release the stress, anxiety and tension that contribute to chronic headaches or insomnia.

Acupressure can also ease the swelling, muscle fatigue, soreness and pain associated with musculoskeletal conditions, poor circulation, stiffness and muscle tension.7 One experiment—called the physical response education system project—found that administering Jin Shin Do to children on a weekly basis improved learning and decreased allergies, seizures, bedwetting, constipation, night coughing, lung congestion, ear infections, runny noses, nosebleeds, skin conditions and weight problems.1

But even though acupressure appears to be a gentle intervention, it's still a form of medicine. There are appropriate applications and contraindications that practitioners should know.

Acupressure isn't suitable for people with heart conditions because the circulation of the massage treatment can overburden a failing heart. In addition, if the pressure point is under a mole, varicose vein, abrasion, bruise or cut, applying pressure can cause further damage to the skin.

Women shouldn't receive acupressure treatment during pregnancy, especially after three months. Also, avoid treating people 20 minutes before or after heavy exercise, a large meal or bathing. And acupressure shouldn't be used after a recent surgery.7 Other precautions are possible broken or brittle bones, bleeding disorders and fragile skin.

Finally, before administering acupressure, be sure that the patient discussed the modality with a physician, especially those who are taking medications for other conditions. Acupressure can lower blood pressure to a dangerous level in patients taking blood pressure medications.5

Today's stressful environments can scramble one's physical, emotional and spiritual states. Illness can exacerbate this imbalance. Reharmonizing these elements is a major component of recovery, and the skilled practice of acupressure can hold remarkable power for this purpose.


1. Tappan, F.M. (1988). Healing massage techniques: Holistic, classic, and emerging methods (2nd ed.). Norwalk, Conn.: Prentice-Hall.

2. Prentice, W.E. (2003). Arnheim's principles of athletic training (11th ed). Boston: Mcgraw-Hill.

3. Derrick, R.C. (2001). The rubdown lowdown. Essence, 31(11), 20-22.

4. Fritz, S. (1995). Mosby's fundamentals of therapeutic massage. St. Louis: Mosby.

5. Greeley, A. (2002). Acupressure: Hands on healing. Vegetarian times, 304, 35-40.

6. Benjamin, P.J., & Lamp, S.P. (1996). Understanding sports massage. Champaign, IL: Human Kinetics.

7. Salvo, S.G. (1999). Massage therapy: Principles and practice. Philadelphia: The Curtis Center.

Patrick Giovannoni is a senior in the athletic training program at Marshall University in Huntington, W.Va.

Through the Years

Acupressure is a healing art developed in Asia more than 5,000 years ago. At the time, most people knew how to perform acupressure to offer help through the power of touch.1 Acupressure descends from manipulative therapy, which has long been a part of traditional Chinese medicine.

This procedure was also called anqiao and anmo. The word anmo comes from the traditional Japanese form of manipulative techniques that use the meridian theory. During the Ming Dynasty (1368-1644), it was called tuina, which means push. Japanese therapy was at its peak of development during the Edo period (1603-1867). During this time, anmo was looked down on because it was thought to pleasure the rich. Western medicine arrived in Japan during the 19th century and rapidly became a part of Japanese medicine.2

In the early 20th century, the movement to combine Japanese theories and techniques with Western anatomy and physiology resulted in the development of shiatsu. Shiatsu combines Asian forms of body mechanics and Western forms of chiropractic and osteopathic medicine.

The version in the United States became acupressure, which was developed with influences from Asian manipulative therapy and Western anatomy. Acupressure and other forms of shiatsu are more adaptable because they don't require needle insertion and can be taught as a series of educational levels.2


1. Teeguarden, I. (1978). Acupressure Way of Health. Tokyo: Japan Publications.

2. Beal, M. (2000). Acupuncture and Oriental body work: Traditional and biomedical concepts in holistic care. Holistic Nursing Practice, 14(3), 69- 78.

–Patrick Giovannoni


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