Q I am currently receiving acupuncture treatment for intercostal neuralgia, and I have heard that there is also a treatment called "Dochim." In what cases is Dochim treatment added?
A Dochim is a treatment added when improvement is slow with acupuncture alone, when adhesions in the chest wall fascia or intercostal tissues are suspected, or for chronic recurrent pain. It utilizes a small needle to dissect adhered tissues and secure space around the nerves. It is safely performed by a skilled practitioner, and faster structural changes can be expected compared to standard acupuncture.
Detailed Answer
These are the clinical indications for the addition of Dochim (knife needle). ① Stagnation of improvement after 5 or more sessions of standard acupuncture ② Identification of chest wall fascial nodules (trigger points) or intercostal line tenderness upon palpation ③ Chronic (3 months or longer) intercostal neuralgia ④ Suspicion of adhesions at the thoracic vertebrae joint/costochondral junction. The Dochim procedure uses a small needle with a diameter of 0.5–1 mm to incise and dissect the adhered tissues. Safety and accuracy are enhanced when performed under ultrasound guidance while verifying nerves and blood vessels.
Korean Medicine Clinic Perspective
In Korean medicine, Dochim is a treatment that directly opens structural adhesions—where clotted blood has physically adhered to tissues and cannot be resolved by the circulation of Qi and blood alone. By detaching an adhered nodule in the flank area using Dochim, followed by pharmacopuncture to reduce inflammation and support regeneration, the barrier to Qi and blood flow is removed, significantly increasing the efficiency of the acupuncture treatment. At Dongjedang, Dochim is performed only after thorough explanation and informed consent, and microbleeding and pain responses are minimized through ice packs and rest after the procedure.
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