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| (1) Identify the affected meridian in the region of pain and ask the patient to characterize the pain on a visual analog scale (VAS) from 1 to 10. | |
| (2) Decide which unaffected extremity you want to treat first. | |
(3) (a) In the case that the chosen unaffected extremity is the contralateral arm of the painful arm or the contralateral leg of the painful leg, if the pain is on a yang meridian, the treatment has to applied to a yin meridian (or the other way around).
(b) If the pain is on the upper extremities, but the chosen unaffected extremity is a lower extremity (or the other way around), you can decide whether you treat yin or yang meridians first. | |
| (4) After the decision on which extremity should be treated and whether yin or yang meridians have to be used, look up in Table 4 which meridians are the balancing meridians to the affected meridian. | |
(5) (a) Palpate the balancing meridians in a corresponding body region by image or mirror (according to Figure 4) for Ashi points, decide which balancing meridian (according to Table 4) has the most painful Ashi points. Repeat this with other corresponding body regions (according to Figure 4) and decide which is the most painful area.
(b) If you have followed variant (3b) you have to repeat the examination on the contralateral side of arm or leg. Treatment has to be applied to the more painful side. | |
| (6) Treat the most painful balancing meridian in the most painful corresponding area. Treat this Ashi area. Insert a needle into the most painful Ashi point. Apply further needles in acupuncture or Ashi points, usually 1-2 proximal the first needle and 1-2 distal the first point on the acupuncture meridian. The number of needles is dependent on the extension of the painful area on the affected meridian. | |
| (7) Move the affected joint or palpate the original region for pain and ask the patient about a change of symptoms using VAS. In case of 100% pain reduction, don’t apply further needles. | |
| (8) Palpate another non affected extremity on balancing meridians (according to Table 4) in a corresponding body region by image or mirror (according to Figure 4) for Ashi points. But you have to stay in a balance of yin and yang between the legs or the arms. Repeat this with other corresponding body regions and decide on the most painful area. | |
| (9) See 6. | |
| (10) See 7. | |
| (11) Palpate the remaining non affected extremity on balancing meridians (according to Table 4) while staying in the yin-yang-balance of the extremities in a corresponding body region by image or mirroring (according to Figure 4) for Ashi points. Repeat this with other corresponding body regions and decide on the most painful area. | |
| (12) See 6. | |
| (13) See 7. | |
| (14) If the pain relief is still not sufficient, treatment can also applied to the affected meridian itself. But local treatment of the affected area can often produce discomfort to the patient, so the best choices are points by imaging or mirroring of corresponding areas (according to Figure 4) along the affected meridian itself. Repeat this with other corresponding body regions and decide on the most painful area. | |
| (15) See 6. | |
| (16) See 7. | |
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