Offering auriculotherapy as an adjunct service can increase patient satisfaction and referrals in your practice

Feeling stressed? Massaging a tiny point on your ear can keep you calm all day, says Zev Myerowitz, DC. And that is just one of the many conditions that responds well to auriculotherapy, or ear acupuncture, which has been finding increasing popularity as an adjunctive treatment modality among chiropractors. It is easy to see why many DCs find it both useful and advantageous.

John Amaro, DC, based in Arizona, is also president of the International Academy of Medical Acupuncture (IAMA). “Auriculotherapy is a vital part of our program,” he notes. Yet, it is not necessary to study the entire field of acupuncture to make effective use of auriculotherapy as an adjunct, he adds.

This ancient healing technique can support the treatment of everything from musculoskeletal complaints to pain caused by chronic or terminal illness, and even to support patients who are recovering from addictions to tobacco, drugs, or overeating.

Ear, There, Everywhere
Though auriculotherapy has been part of Asian healing techniques for hundreds or perhaps thousands of years, it also has a certain amount of history in the western world.

William Kneebone, a San Francisco DC, who has used both auriculotherapy and acupuncture in his practice for nearly 20 years, says auriculotherapy is a marriage of east and west.”

“Auriculotherapy was developed, in its present form, by a French physician named Paul Nogier in the 1950s,” he says. Kneebone explains that Nogier became curious about the ear’s potential to affect various ailments after several of his patients found relief from sciatica pain. All patients had been treated by an itinerant healer, who had merely made a small scratch or cauterization on the ear.

Through experimentation, Nogier created his own map of the ear and its relationships to the internal and external body. “If you look at an auriculotherapy chart, you’ll see a number of points that Nogier came up with,” Kneebone adds. “You’ll see ‘liver, Chinese point’ and ‘liver, French point.’”

The ancient Greeks, Romans, and Egyptians also used auriculotherapy, notes Amaro. The technique is also the subject of much current research. “Acupuncture deals with the electromagnetic fields of the body,” he explains, “but auriculotherapy has been shown to have a clear-cut embryonic relationship to the nervous system.”

The secret to the ear’s extremely sensitive relationship to the body and organs may have something to do with the fact that the external ear actually begins modest development within the first 9 days of human fetal development—right after the microscopic brain and spinal cord begin to form. “A little knob develops, as a projection of the mesoderm, and this knob ultimately becomes the external ear,” Amaro explains. Research is finding that “when you tap into a particular reflex, the shoulder for example, it literally taps into the brain and spinal cord as well.”

Perhaps because of auriculotherapy’s Western roots and the results of modern research, auriculotherapy won over members of the medical community even before acupuncture gained acceptance. North American medical professionals have sought training and used auriculotherapy for at least 30 years.

From Ear to Eternity
Myerowitz has used both acupuncture and auriculotherapy for the past 25 years in his Holden, Maine-based practice. “Basically anything that’s going on in the body can be treated through the ear,” he says. Although he treats “hundreds of conditions” with auriculotherapy, he has also studied and uses several forms of acupuncture, including the Japanese, Traditional Chinese Medicine (TCM), and Five Elements forms. Currently, he is studying Taoist acupuncture, which he describes as predating TCM “by a couple of thousand years.” Myerowitz is also a postgraduate instructor at the Parker College of Chiropractic (PCC).

Myerowitz says he uses auriculotherapy in about 80% of his treatments, generally in conjunction with acupuncture or chiropractic. His practice focuses mainly on patients with degenerative diseases, ranging from cancer to AIDS, multiple sclerosis, fibromyalgia, Parkinson’s, and diabetes. Both auriculotherapy and acupuncture are effective in treating the pain and fatigue many of his patients experience, he says.

The ear points have a core communication with the body’s innate ability to heal, he says. “An ear point is amphoteric, which means when you treat that point, it automatically either increases or decreases chi energy, depending on what that particular point needs. If the point needs to be tonified, it will draw energy in; if it needs to be dispersed, it will let energy out.”

Myerowitz also finds the ear useful for diagnosis. “The ear is the gateway to the body,” he says. “It can be used to diagnose a condition before symptoms actually appear,” and also offers valuable information as to whether or not a patient has completely recovered from a condition.

Auricular diagnosis can involve inspecting the ear for discoloration, swelling or change in texture; palpating points with a probe, which will reveal physiological abnormality through tenderness to touch; or by using electronic readings, where a higher-than-normal reading will indicate dysfunction. Like chiropractic, Myerowitz adds, acupuncture treats the body, not the symptoms.

Kneebone also uses auriculotherapy primarily for pain relief, though he also uses it to stimulate organs, to calm a person who is anxious, or to revitalize someone who is fatigued or depressed.

As an example, he mentions a female patient with Multiple Sclerosis. “Of all the things she’s had done to her, auriculotherapy gives her instant pain relief, takes her fatigue away, relaxes her muscles so they’re not so tight, and increases her flexibility.”

Patients like auriculotherapy because it’s painless and usually gives them a sense of increased well being. “There is no condition or type of person that I wouldn’t automatically consider for auriculotherapy,” he says. “Seventy-five percent to 80% of my practice is people with chronic illnesses. I do a lot of work with homeopathy, detoxification, nutrition, and we’ll use auriculotherapy to help us get the organs balanced out, as part of the picture. I learned a long time ago that no single approach works in totality, all of the time.”

Amaro, who has practiced acupuncture and auriculotherapy for 32 years, notes that each of the vertebrae can also be isolated and independently treated on the ear, as well as on the spinal column. “If a person has a fourth-lumbar subluxation or pinched nerve, you can literally go into the corresponding reflex area on the ear, and expect a positive response,” he says. “There are really no limitations on it. Musculoskeletal problems respond really well. I use auriculotherapy, in some form or other, on nearly every patient who comes through my door.”

Hear Ye, Ear Ye
Auriculotherapy can be an effective practice-builder, too. Since DCs are already well-versed in anatomy and physiology, a postgraduate program in auriculotherapy can set them well on their way, without a large investment in time or equipment.

Doug Briggs, a Delaware-based DC who has used auriculotherapy for the past 6 years, says, “Auriculotherapy is easy to incorporate into an existing practice. It just requires scheduling a few more minutes to treat a patient.”

“It’s a phenomenal referral source,” says Amaro. Because auriculotherapy can be done with microelectrical currents or with lasers, it appeals to people who would never consider acupuncture due to their fear of needles. And patients love it, “because it’s quick, it’s easy, and it’s very, very effective,” he adds. Acu-patches—tiny stainless-steel granules affixed to flesh-colored adhesive circles—allows the patient to self-stimulate an auriculotherapy point over the weekend, he adds. “They’ll come back and say, gosh, I was having headaches and I just stimulated that point you showed, me, and the headaches were under control.”

An average treatment time can take less than 2 minutes, Amaro notes. “You can insert a very slim needle and just let the person relax. Otherwise, you can use electronic or laser stimulation, and literally hold it for 12 to 15 seconds per ear. Generally you won’t use more than five to seven points per ear.”

Those who use electrical stimulation of auricular points can bill for the procedure as transcutaneous electrical nerve stimulation. “People charge various fees, depending on the part of the country and the level of expertise,” says Amaro. “I know people who charge as little as $15 to as much as $75 per auriculotherapy treatment.”

Offering a greater variety of services, such as auriculotherapy, will help expand the practice, says Kneebone. “You can help more kinds of people, and the ones you’ve helped before, you can help better. It’s something the practitioner can learn quickly, the treatments don’t take long, and you don’t have to invest a lot of money. There are point stimulators out there for less than $100, and up to several thousand dollars.”

Myerowitz adds, “By adding auriculotherapy to the practice, you’re going to get far better results than you’re getting right now.”

A 300-hour diplomate course on acupuncture, now being developed through PCC’s postgraduate department, will also include auriculotherapy. And the IAMA, in conjunction with New York Chiropractic College, conducts a Fellowship and Diplomate program in acupuncture that explores auriculotherapy in precise clinical detail.

Oh, and that point on the ear? It’s on the navicular fossa, Myerowitz says. “When you’re feeling all stressed out, massage that point and it will calm you right down.” CP

Grace Golightly is a contributing writer for Chiropractic Products.