Sunday, April 29, 2012

Shonishin Pediatric Acupuncture

sho=little    ni=children    shin=needle

One of my favorite modalities for treating children in the clinic is sho-ni-shin pediatric acupuncture. Shonishin is a gentle, non-invasive form of treatment for infants and children as young as one month up to about ten years.

Shonishin emerged in the Osaka region of Japan in the 1600s, and is based on Chinese acupuncture techniques dating back at least two thousand years. To this day, many Japanese parents bring their children to shonishin practitioners for regular treatment.  The use of shonishin is becoming more popular around the world today.

Shonishin uses a specialized set of small metal tools, none of which are actually inserted into the child's body as acupuncture needles are. The pediatric practitioner uses these tools to stroke, rub, tap and press the skin to give different kinds of gentle stimulation. These techniques harmonize and fortify the child's vital energy, help clear illness-causing pathogens, and strengthen the child's constitution.

Gentle and Fun:

Children typically find shonishin to be comfortable and even pleasurable. They have fun holding and playing with the different shonishin tools. In addition to the traditional Japanese metal tools, I like to use common household objects (spoons, combs, pretty seashells) to perform shonishin techniques. Indeed, the child being relaxed, comfortable and playfully engaged is an important aspect of shonishin therapy.

For infants a treatment may take less than five minutes, and for older children, treatment duration can be up to ten or twenty minutes. The key to successful shonishin treatment is “less is better.” The beauty of shonishin is its simplicity, gentleness, and its effectiveness.

Medically Effective:

Children are typically very responsive to shonishin treatment.  Significant, even dramatic, changes in symptoms are often seen during the course of a short treatment, and/or during the hours and days that follow a treatment.

Shonishin can be extremely effective in treating digestive and respiratory conditions in children. It helps calm the nervous system and enhances circulation and relaxation, thereby improving a child's general health.

Shonishin is best used preventatively and as a constitutional strengthener. In Japan, many parents take their children for regular monthly or bi-monthly therapy. Clinical studies in Japan have, in fact, shown that shonishin treatment improves the condition of the respiratory tract, causing children to miss less days of school. Regular shonishin treatments can help improve your child's resiliency, particularly during times of stress and transition (i.e. starting school) or during the cold and flu season.

Shonishin is used to treat a wide variety of pediatric problems, including:
  • failure to thrive
  • constitutional weakness or imbalances
  • colic
  • sleep difficulties
  • indigestion, GERD, constipation, and diarrhea
  • night terrors
  • attention deficit hyperactivity disorder (ADHD)
  • allergies, asthma
  • colds, fever
  • excema
  • ear infections
  • bedwetting
  • developmental concerns

Why is shonishin effective for children?

From a Chinese medicine perspective, children are not simply mini-versions of adults. Their bio-energetic systems are totally different from adults because they are in a constant state of growth development. Children, therefore, must be approached differently from adults in terms of medical diagnosis and treatment.

Children are at the most yang phase of the human life cycle. Their energy (Qi) moves extremely rapidly. Metabolic and physiological processes reflect this rapidity. At the same time, their bodily structures, including their vital organs, are still fragile and soft. The movement of Qi is not as rigidly confined to meridian pathways as it is in adults.

What does this mean in terms of pediatric illness and treatment? Children are extremely receptive to energetic influences, including environmental stimulation, microbial pathogens, etc. They get sick easily and illness progresses rapidly. The flip side of this coin is that children respond much more quickly than adults to gentle bio-energetic medical treatment such as shonishin.

Because children's meridian systems are not rigidly set, the treatment of individual points is less effective in children than in adults. Shonishin is effective because it targets body regions more than individual points.

According to Chinese medicine theory, children easily retain toxic pathogens from illness, fever, antibiotic treatment, vaccinations or from embryological development. These retained pathogens can be implicated in chronic infectious or inflammatory processes (i.e. recurrent ear infections, eczema, allergies, etc.) Shonishin, in combination with herbal therapy, is an excellent way of supporting the child's body to expel these pathogens and mount effective immune responses.

Parent Involvement:

When I work with families in the clinic, I like to send parents home with techniques they can use to continue to support and treat their children at home. This includes administering herbs, dietary changes, home remedies and simple massage techniques. I also love to share simple shonishin techniques because even a very small amount of shonishin (a minute or two) can have a significant impact. (The use of tools make the therapy quicker-acting than basic massage techniques.) Parents can perform shonishin with common household items (a spoon or fork, a seashell, the toes of rabbit's foot --- legend has it that shonishin was originally performed with the foot of a mole before the development of metal tools!)

Neighborhood-based medicine:

One of the original proponents and teachers of shonishin was a man by the name of Mr. Mori, who lived in the Osaka district of Japan in the 17th century. Mr. Mori was a pediatric specialist who typically treated eighty patients per day. His clinic was located in the downstairs portion of his house, and he treated patients primarily from the neighborhood where he lived. Whenever a neighborhood child got sick, the child's parents took him/her to Mr. Mori. Though he triaged patients who needed additional medical care, Mr. Mori treated all pediatric conditions.

This tradition has lasted until the present day in Japan. Before World War II, there were many shonishin specialists, or acupuncture practitioners who exclusively treated children with shonishin. Although the number of Japanese practitioners who specialize exclusively in shonishin has dropped since World War II, the traditions still exists. To this day, many practitioners who treat children using shonishin in Japan work from their home, living upstairs while working downstairs. If they don't do this, then their clinics are often in or very near residential areas. Many of their patients come from the local part of town where the practitioners live. Patients are able to walk to the clinic or get there with a very short ride, meaning that the practitioner is within easy reach when a child is sick and that regular shonishin treatments are a part of a families regular routine. In fact, many Japanese families bring their healthy children to receive shonishin as a balancing treatment once a month on or before the full moon. One of my teachers shares that in Japan, all the shonishin clinics have post a flag outside on full-moon days (each flag with a different animal on it) to let people know they can come for shonishin!

I like the stories of shonishin therapy in Japan because the images fit so well with the social mood of today, including efforts to reclaim health care from corporate giants; reliance on local, community-based wisdom and resources; emphasis on preventative health practices and lifestyle modifications over heroic medical procedures.


Birch, Stephen. Shonishin: Japanese Pediatric Acupuncture. Stuttgart, Germany: Thieme, 2011.

Glick, Soma. “Treating Children with Oriental Medicine.” Acupuncture Today, October, 2002, Vol. 03, Issue 10.

Tiberi, Alex. "Chinese Medical Pediatrics." Pacific Symposium on Oriental Medicine, 2002.

Lang, Raven. "Introduction to Chinese Medicine Pediatrics." Lectures in Oakland, CA, 2009.