Tuina Therapy for Intestinal Spasm
Intestinal spasm, also known as spasmodic intestinal colic, is the most common functional abdominal pain in children. Its main characteristics include sudden onset of abdominal pain, yet no abnormal physical signs are detectable during pain-free intervals.
Causes may include improper diet (such as consuming large amounts of raw/cold foods, binge eating, excessive breastfeeding, or high-sugar foods causing intestinal gas accumulation); climatic changes (like exposure to cold); or irritation from parasitic toxins. These factors may trigger temporary intestinal ischemia or overactivity of the parasympathetic nervous system, leading to smooth muscle spasm in the gastrointestinal tract and resulting in abdominal pain. When gastrointestinal smooth muscles go into spasm, they obstruct passage of contents, potentially causing vomiting. After sustained spasm, muscles gradually relax spontaneously, relieving pain and forming what is known as the "interictal period." If the underlying cause persists, pain may recur.
Clinical manifestations of intestinal spasm in children include:
Healthy children suddenly experiencing paroxysmal, intermittent abdominal pain, with no detectable abnormalities during symptom-free periods—the hallmark feature. The pain lasts several minutes to tens of minutes, occurring intermittently. After repeated episodes lasting tens of minutes to several hours, pain may cease entirely. In rare cases, pain recurs over days, varying in severity; severe cases may involve rolling on the ground. Typically, pain centers around the umbilical region, indicating small intestine involvement. When proximal colon spasms occur, pain appears in the right lower abdomen; distal colon spasms cause left lower abdominal pain. If pain occurs before defecation, it likely indicates spasm in the descending colon or sigmoid colon. In older children, pain may present in the flank, usually unilateral, due to spasm in the hepatic or splenic flexure of the colon. Younger children may experience epigastric pain, suggesting gastric spasm—though technically not intestinal spasm, but rather gastric spasm, the mechanism is similar, so Tuina therapy remains effective.
Tuina therapy for intestinal spasm:
1. Deficiency-Cold Type
Techniques: Pushing, massaging, kneading, pressing.
Points/areas: Wanyang (SI3), Sanguan (HT7), Liufu (SI3), Fuyang (CV12), umbilicus and surrounding abdomen, Pitu (SP6), Zusanli (ST36).
Procedure and requirements:
① Separate push Wanyang: 100 to 300 times.
② Push Sanguan: number of pushes should be at least three times that of Liufu. If Liufu is pushed 50 times, Sanguan must be pushed at least 200 times; specific number depends on the degree of deficiency-cold.
③ Retract Liufu: number of retractions should match Sanguan pushes.
④ Separate push Fuyang: child lies supine; practitioner uses both hands’ fingers to push simultaneously from the xiphoid process along the costal arch downward to the axillary midline, 200 times.
⑤ Massage and knead umbilical area: child lies supine; practitioner first applies palm rubbing to the abdomen for several minutes until warmth is felt.
During massage, some children pass gas frequently; younger infants may even defecate. Symptoms significantly improve after passing gas or defecation.
2. Excess-Heat Type
Techniques: Pushing, pressing, pinching, kneading.
Points/areas: Guanyuan (CV4), Liufu (SI3), Tianganhe (HT3), Yiwofeng (SI3), Wailaogong (SI3), Sihengwen (LI10).
Procedure and requirements:
① Separate push Wanyang: 100 to 300 times.
② Push Sanguan: approximately 300 times.
③ Push Liufu: approximately 900 times. Clear Tianganhe: 100 to 200 times.
④ Press and knead Yiwofeng: press and knead each side dozens of times.
⑤ Knead Wailaogong: use fingertip kneading, 10 to hundreds of times.
⑥ Push Sihengwen: child’s palm faces up; practitioner uses one finger to push sequentially across the transverse creases of the second, third, fourth, and fifth metacarpophalangeal joints—each joint receiving dozens of pushes.
⑦ Pinch spine: child lies prone, head slightly raised, or parent holds child’s forehead to elevate head. Back faces practitioner. Index and middle fingers joined, thumb opposite; both index fingers’ ulnar sides touch, grasp skin at Weiyan (GV1) with fingertips, thumbs push inward toward deeper tissue, index and middle fingers lightly squeeze outward like twisting something. Continuously move upward along the spine from Weiyan to Dazhui (GV14), repeating 6–10 times.