Acupressure for Wholistic Pelvic Health: Focus on Sanyinjiao (SP6) Acupoint

Rachna Mehta, PT, DPT, CIMT, OCS, PRPC is the author and instructor of the Acupressure for Optimal Pelvic Health course. Rachna brings a wealth of experience to her physical therapy practice and has a personal interest in various eastern holistic healing traditions. Her course Acupressure for Optimal Pelvic Health brings a unique evidence-based approach and explores complementary medicine as a powerful tool for holistic management of the individual as a whole focusing on the physical, emotional, and energy body.

What is Acupressure

According to the National Center for Complementary and Integrative Health (NCCIH), a branch of the National Institute of Health (NIH), a recent study by Feldman et al¹ in the Journal of Pain showed that patients with newly diagnosed chronic musculoskeletal pain are prescribed opioids more often than physical therapy, counseling, and other nonpharmacologic approaches. A study² by Elizabeth Monson and colleagues noted that the use of effective nonpharmacologic options is now mandated by Joint Commission Guidelines³ per updated pain management recommendations. The study also noted that there has been a growing clinical interest in Acupressure as a therapeutic modality for symptom management in Western health care.

The scientific literature presents robust evidence supporting Acupressure as an effective non-pharmacological therapy for the management of a host of conditions such as anxiety, insomnia, chronic pelvic pain, dysmenorrhea, infertility, constipation, digestive disturbances, and urinary dysfunctions to name a few.  

Acupressure has roots in acupuncture and is based on more than 3000 years of Traditional Chinese Medicine (TCM). TCM supports Meridian theory and meridians are believed to be energy channels that are connected to the function of the visceral organs. Acupoints located along these meridians transmit Qi or the bio-electric energy through a vast network of interstitial connective tissue connecting the peripheral nervous system to the central viscera.

Acupressure has demonstrated the ability to improve heart rate variability, and thus decrease sympathetic nervous system activity. By decreasing sympathetic nervous system stimulation, the release of stress hormones such as epinephrine and cortisol is decreased, and the relaxation response can be augmented, which may correlate with decreasing levels of pain, stress, and anxiety².

The Sanyinjiao (SP6) Acupoint

Sanyinjiao (SP6) acupoint is one of the most extensively researched points in the literature. It is located four finger-widths above the tip of the medial malleolus. Studies have found Sp 6 to be effective in relieving pain associated with primary dysmenorrhea, premenstrual syndrome (PMS), labor pain as well as symptoms of menopause. Ancient and modern acupuncture charts map the Spleen meridian as part of the principal 12 meridians which are connected to the physiological functions of key organs.

A recent systematic review published by Abarogu et al⁴ reviewed the available evidence for SP6 (Sanyinjiao) acupressure for the relief of primary dysmenorrhea symptoms, as well as patients' experiences of this intervention. The review included six studies with a total of 461 participants. The primary outcome was pain intensity. They found that:

• SP6 acupressure delivered by trained personnel significantly decreased pain intensity immediately after the intervention (effect size = -0.718; CI = -0.951 to -0.585; p = 0.000)
• Pain relief remained up to 3 h after the intervention (effect size = -0.979; CI = -1.296 to 0.662; p = 0.000)

The review concluded that SP6 acupressure appears to be effective when delivered by trained personnel for Primary Dysmenorrhea symptoms.

Acupressure has also been used with various types of mindfulness and breathing practices including Qigong and Yoga. Yin Yoga, a derivative of Hath Yoga is a wonderful complimentary practice to Acupressure. Yin Yoga is a calm meditative practice that uses seated and supine poses, held for three to five minutes with deep breathing. Yin poses supportively align the body to stress connective tissues along specific meridian lines thereby activating potent acupressure points that lie along those meridians. Mindfulness-based holistic interventions are the key to empowering our patients by giving them the tools and self-care regimens to lead healthier pain-free lives.

The course Acupressure for Optimal Pelvic Health brings a unique evidence-based perspective by integrating Acupressure and Yin Yoga into traditional rehabilitation interventions. It is curated and taught by Rachna Mehta. To learn how to integrate Acupressure into your practice, join the next scheduled remote course on March 19-20, 2022.

 References

1. Feldman DE, Carlesso LC, Nahin RL. Management of Patients with a Musculoskeletal Pain Condition that is Likely Chronic: Results from a National Cross-Sectional Survey. J Pain. 2020;21(7-8):869-880.
2. Monson E, Arney D, Benham B, et al. Beyond Pills: Acupressure Impact on Self-Rated Pain and Anxiety Scores. J Altern Complement Med. 2019;25(5):517-521.
3. Pain assessment and management standards for hospitals. Online document at: https://www.jointcommission.org/standards/r3-report/r3-report-issue-11-pain-assessment-and-management-standards-for-hospitals/
4. Abaraogu UO, Igwe SE, Tabansi-Ochiogu CS. Effectiveness of SP6 (Sanyinjiao) acupressure for relief of primary dysmenorrhea symptoms: A systematic review with meta- and sensitivity analyses. Complement Ther Clin Pract. 2016;25:92-105.
5. Chen MN, Chien LW, Liu CF. Acupuncture or Acupressure at the Sanyinjiao (SP6) Acupoint for the Treatment of Primary Dysmenorrhea: A Meta-Analysis. Evid Based Complement Alternat Med. 2013;2013:493038.
6. Mehta P, Dhapte V, Kadam S, Dhapte V. Contemporary acupressure therapy: Adroit cure for painless recovery of therapeutic ailments. J Tradit Complement Med. 2016;7(2):251-263.