Biopuncture (EN)

BP_LOGO'''What is Biopuncture?

Biopuncture is a therapy whereby specific locations are injected with biological products. The majority of the products are derived from plants. Most of these injections are given into the skin or into muscles.

What kinds of products are injected?

Products commonly used in Biopuncture are arnica, echinacea, nux vomica and chamomile. Arnica is used for muscle pain, nux vomica is injected for digestive problems, echinacea is used to increase the natural defense system of the body. Biopuncturists always inject cocktails of natural products. These ampoules are made by European companies, such as Heel, Guna, Pluger, OTI, Steigerwald, Hevert, Wala and Weleda. In Belgium, only Heel ampoules are registered. Lymphomyosot® is used for lymphatic drainage, Traumeel® for inflammations and sports injuries, Spascupreel® for muscular cramps, Zeel® for joint degrneration.

Are these products safe?

Yes, because the ampoules do not contain high concentrations of active substances. They usually contain diluted botanical products. As a result, toxic side effects are very unlikely. Additionally, the ampoules used in Biopuncture are manufactured by companies that guarantee the production quality of their products. Most of the ampoules used for injection are made in Germany and are held to very strict quality control regulations. Clinical studies on thousands of patients have confirmed the safety of ampoules such as Traumeel®.

How can these dilutions actually have an effect on the body?

The fact that most ampoules contain low concentrations of plant extracts is often a reason for conventional physicians to criticize the effects of these products. But it is important to know that the products used in Biopuncture are not diluted as much as in “real” homeopathy. That’s why we call them ultra-low doses. But how can such a small dose influence your body and stimulate healing? Scientists don’t have the final proof yet, but they postulate that these injections work through the stimulation of the immune system (which is in fact your defense system). Let’s compare it with a vaccination. When you receive a tetanus vaccination, only small amounts of a particular product are necessary to stimulate the immune system against lockjaw. In other words, just a few injections can protect your body for years. Biopuncture injections are not real vaccinations of course, but the idea of the mechanism of action is similar: small doses of the right product can have an important effect on the defense systems of your body. And that effect can last for months or years. And Biopuncture produces its clinical effects because it stimulates your immune system to restart its innate healing capacities.

Has it been proven that Biopuncture works by regulating the immune system?

Biopuncturists have observed the effects of these injections for decades. But the problem has been to convince other doctors how it really works. Recent research on Biopuncture has given new insight on how these products seem to do the job. For example, scientific investigation has illustrated that Traumeel® indeed works via the immune system. In June 2004, an article was published in an important medical journal, Clinical & Developmental Immunology, which is a highly respected journal in conventional medicine. Your physician will be surprised to hear that the mechanisms of action of Traumeel® include inhibition of IL-1ß and IL8 as well as inhibition of TNF-alpha secretion. Another study was published in 2014, also illustrating the effect on the immunesystem by Traumeel® on athletes (Scand J Med Sci Sports). If your doctor really wants to know more about these studies or is interested in other such studies on Biopuncture, he or she can find more information in the textbooks on Biopuncture.

But how does Biopuncture work to help me with my pain or inflammations?

In conventional medicine, the drug you take suppresses your symptoms immediately (anti-inflammatories, cortisone injections). That is why you need to take high doses of chemical substances in order to suppress pain or inflammation. And usually it works immediately. But as soon as the medication stops working, you have to take another pill to reduce the pain or to suppress the inflammation again. However, in Biopuncture small doses of products are injected in order to stimulate the natural healing processes. These ultra-low doses regulate mechanisms which are available anyway. So, the healing effect comes from your body — not from the products themselves. It’s the reaction of your immune system which will produce the proper reactions to regain natural healing. The reaction of your body may produce better local blood circulation, tissue repair, relaxation of muscles or local detoxification.

Will Biopuncture help me as quickly as conventional therapies?

It’s obvious that injections of such tiny doses are less powerful than, for example, cortisone injections. as pointed out earlier, the dose is too small to suppress the inflammation immediately. But that’s not the goal of Biopuncture. We consider inflammation to be an important element of true and lasting healing. The goal of Biopuncture is to support the natural inflammatory processes in order to achieve a complete and natural healing of the injured tissues. So, the primal effect is sometimes the opposite of conventional drugs. The pain may get worse the next day (“reaction phase”). Sometimes the pain may shift to other areas because the body is adapting to the new situation. Biopuncturists regard these phases as positive signs. As a result, the symptomatic relief may take a while, especially when the problem has been there for months or years. However, when dealing with fresh injuries, like sports injuries, these injections can give results very quickly, especially when dealing with healthy patients.

Where are these injections given?

Most people — especially those who are apprehensive about injections because they may have had bad experiences with injections in childhood — are surprised at how easily and quickly these injections are given. In fact, these injections cannot be compared to the ‘usual’ injections given in conventional medicine. They are not as painful as an injection in, for example, a hospital because the needle used is very fine and the quantity injected is very small. Most of them are given under the skin, others are given into specific muscle points or into your ligaments (= bands that hold your bones together). Your doctor doesn’t give the injections arbitrarily, but they are administered in the zone you experience as painful. Sometimes he needs to inject in carefully chosen spots in other areas, such as in trigger points. The place where your doctor injects the product is as important as the product itself. It’s different for each patient. You may have joint degeneration of the hip, and yet the biopuncturist may inject into your muscles in the thigh. You may suffer from headaches after a whiplash, and the biopuncturist might decide to inject into your neck ligaments.You may have a hernia in the neck, and yet the biopuncturist may inject into your muscles in the neck and shoulder to treat your arm pain. If after a series of weekly sessions the pain in the arm disappears, the biopuncturist will conclude that the hernia on the MRI scan was not the real cause of the pain in your arm.

How many injections will I receive each session?

Usually you will receive several injections each session. For example, if your doctor wants to work on your liver, he or she will give about seven little injections under the skin on your belly. When you have pain in your elbow, your physician will look for several painful spots in your arm muscles or elbow ligaments, and inject each of them in one session. In such a case, you may receive anything from three to ten small injections in your elbow, neck and arm. So in most cases, several little injections are given in a specific zone (or in several areas) of the body at each session.

How many sessions of Biopuncture will be necessary?

The fact that your doctor uses small doses of natural products instead of cortisone injections means that you have to be more patient. If you have had problems for several months or even years, your doctor must work on different layers. If it is a complicated case, your doctor must also look for deeper causes of your complaints and work on these. This may be the case when treating, for example, eczema, allergies, headaches or migraine with Biopuncture. Sometimes your hormonal system has to be regulated. Or you need a detoxification (“cleaning” of the body) first. As a result, you may need several sessions to feel the results of the treatment. Because these products do not cause any major side effects, you may be motivated to be more patient than usual. In the long run, however, the results of Biopuncture are longer-lasting because the healing comes from within and does not depend on the pills you take every day to take away the symptoms.

What is a “detox” treatment?

An important issue in Biopuncture is the detoxification of the body. It literally means “cleaning the body” from all the toxins that have accumulated: for example from the environment (air pollution, smoking), from bad nutrition, or from medication. These toxins can block your defense system. Some injections work specifically on the liver and others on the kidneys. Cleaning up the lymphatic system with Lymphomyosot® is considered very important in Biopuncture (“lymphatic drainage”). It is like taking the leaves out of the gutter. The down side of such an approach is that old symptoms (which have been suppressed earlier on) may come to the surface again. But that is sometimes part of the healing strategy of the body.

Is there an element of risk with such injections?

It is clear that the doctor who decides to use Biopuncture, first will perform a conventional diagnosis. Then, the injections will always be given according to the latest technical standards, which is his or her duty as a medical professional. This includes a correct injection technique, and of course the use of sterile disposable material. The latter means that the needle has never been in contact with the body of any other patient and that any transmission of disease (e.g., hepatitis, AIDS) is impossible. This should give you confidence in the safety of the technique. But you may end up with a blue spot or some pain at the site of injection the next day. You may also feel a bit tired the first 24 hours after a treatment because your body uses a lot of energy in order to repair tissue or to drain toxins.

When should my physician suggest Biopuncture?

Biopuncture can’t solve all your medical problems. It is not a miracle therapy. It is up to your physician to decide what can be treated, and what can’t. Many patients choose to be treated with Biopuncture because they have experienced unwanted side effects of conventional painkillers. However, it is important to realize that Biopuncture isn’t designed to ‘take away’ the pain as with conventional medication. Pain is seen as an important ‘signal’ from your body that something is going wrong. It is similar to a red light on the dashboard of your car: the aim is not to just remove it but to look for the deeper cause. This means that if pain can be alleviated with Biopuncture — without prescribing painkillers — there is good reason to conclude that the deeper cause of that particular pain has been eliminated. The treatment for inflammation is similar. Inflammation goes with pain and swelling and that is uncomfortable, but the inflammation can also be a crucial part of tissue repair and long-term healing. Instead of blocking the inflammation with medication (taking anti-inflammatories or receiving a series of local steroid injections), biopuncturists try to regulate the inflammation (if possible) in order to support the natural healing mechanisms.

I’ve heard that things can get worse immediately after my first treatment.

Yes, that’s right. Especially the day after the injection, you may feel worse, experiencing more pain or discomfort. This is exactly the opposite of the so-called placebo effect! This temporary worsening of complaints usually means that the healing processes are being activated. In Biopuncture this is called the “reaction phase” and it means that real healing is on its way. It is also important to give the body the opportunity to heal itself. Especially if it is an old or complicated injury, it may take a while before the tissues or functions get repaired. For most tissues, it takes 3 to 6 weeks to heal, but for some injuries it takes longer. While the body repairs itself, the zone in repair may be extra fragile. During this “reparation phase” you should not overuse that zone.  In other words, don’t go working in the garden the day after you received injections in your low back muscles.

Can there also be a temporary worsening before final complete healing?

Sometimes you improve immediately after the first injection. Critics might describe such a phenomenon as the “placebo effect” by saying that you feel better because you believe you’re going to feel better. Such an immediate improvement is more likely to occur when dealing with a fresh sports injury, and when your immune system is working properly. But when dealing with complaints that have persisted for months or years, the injured tissues need time to heal. Then you may need several sessions before you notice any improvement. You may notice improvement in the begin phases of treatment and then a sudden worsening, because your doctor is now working at a deeper level. Sometimes the doctor has to change the product or the place of injection before you start feeling better.

When should I consider Biopuncture?

Neck pain and back pain respond well to Biopuncture, but one can also treat pain in the shoulder, knee or Achilles tendon using these natural vaccinations.  Biopuncture is also very successful in treating tennis elbow and golf elbow. However, Biopuncture is not just used for pain problems, osteoarthritis or sports injuries. An area of treatment worth noting is that of allergies and inflammations. For example, one can treat asthma, eczema and hay fever. And even patients with bronchitis, gastritis, cystitis and sinusitis can be treated with this technique. When a physician is experienced in the technique, he or she can also treat you for migraine, tension headache, pseudosciatica, and so on. In case of doubt, contact your family physician.

Who may benefit from Biopuncture?

The use of biological injections can benefit those patients who have tried conventional medicine but have had no success, or those who have had to stop taking conventional medication because of side effects. It is an interesting healing technique for those patients who want to avoid surgery (for example, for sciatica or sinusitis). In some patients it may be advantageous to combine the conventional approach with Biopuncture. Each case should be taken into account individually, of course. Unfortunately, we do not have large clinical studies which confirm the effectiveness of this method. This is unlikely to happen in the near future as conventional companies will not invest in expensive scientific research and clinical studies because natural compounds can not be patented. Additionally, it is very hard to design a double blind study on this injection trchnisue because each patient received an individualized injection protocol (e.g., trigger points, pain points).

When is Biopuncture not appropriate?

Let us be clear: Biopuncture cannot heal you from cancer, diabetes, a heart attack or AIDS. Nor is it an appropriate treatment for high blood pressure, fibromyalgia, varicose veins, Parkinson, depression or epilepsy. In cases where the disease is too serious or too aggressive, it can only be treated through conventional medication or surgery. When serious damage has already occurred, Biopuncture will be simply too late to reverse the damage and bring the body back into balance again. For example, a patient with a viral hepatitis can be treated with Biopuncture in order to support the healing mechanism of the body, but liver cirrhosis is a phase where cells are damaged beyond repair and healing is impossible. The same goes for chronic airways problems. Biopuncture can help patients as long as there is no emphysema or lung cancer involved. That is why it is important to first have a conventional diagnosis before starting Biopuncture treatment.


Biopuncture is a safe and standardized injection technique in complementary medicine. It uses biological injections to stimulate the natural self-healing capacities of your body. Consult your medical professional for more information about Biopuncture.

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Biopuncture Textbooks for Physicians:

The Clinical Guide to Biopuncture : available in English: 2010, Russian: 2012, Spanish: 2016

Biopuncture, The Management of Common Orthopedic and Sports Injuries; Thieme 2014:

Kersschot final front covere Book Biopuncture

– Kersschot J, Rotator Cuff Case Report: Diagnosis and Treatment Using the Biopuncture Protocol, J Complement Med Alt Healthcare J1(2): JCMAH.MS.ID.555559 (2017)


Martin Martin LS, Massafra U, Bizzi E, Migliore A. A double blind randomized active-controlled clinical trial on the intra-articular use of “Md-Knee” versus sodium hyaluronate in patients with knee osteoarthritis.

BMC Musculoskeletal Disorders. 2016;17:94.


– Clin Dev Immunol. 2004 Jun;11(2):143-9. Inhibition of IL-1beta and TNF-alpha secretion from resting and activated human immunocytes by Tr14.

Porozov S, Cahalon L, Weiser M, Branski D, Lider O, Oberbaum M.


Tr14, a mixture of highly diluted (10(-1)-10(-9)) extracts from medicinal plants and minerals, is widely used in humans to relieve trauma, inflammation and degenerative processes. However, little is known about its possible effects on the behavior of immune cells. The effects of Tr14 were examined in vitro on the ability of resting and PHA-, PMA- or TNF-alpha-activated human T cells, monocytes, and gut epithelial cells to secrete the prototypic pro-inflammatory mediators IL-1beta, TNF-alpha and IL-8 over a period of 24-72 h. Tr14 inhibited the secretion of all three agents in resting, as well as activated immune cells. IL-beta secretion was reduced by up to 70% in both resting and activated cells; TNF-alpha secretion was reduced by up to 65 and 54%, respectively, and IL-8 secretion was reduced by 50% in both resting and activated cells (P < 0.01 for all cells). Interestingly, the effect appeared to be inversely dose-related; maximal inhibition (usually 30-60% inhibition; P < 0.01) was seen with dilutions of 10(-3)-10(-6) of the Tr14 stock material. This finding suggests that Tr14 does not inhibit immune cells functions by exerting a toxic effect. Indeed, Tr14 did not affect T cell and monocyte proliferation. Although additional studies are needed to clarify the mode of action of Tr14 and to demonstrate causative relationship between the inhibition of cytokine/chemokine secretion in cell culture and the reported clinical effects of the preparation, our in vitro results offer a mechanism for the anti-inflammatory effects of  Tr14 observed in clinical use.


– Scand J Med Sci Sports. 2015 Aug;25(4):534-42. doi: 10.1111/sms.12265. Epub 2014 Jun 12.

Exploring effects of a natural combination medicine on exercise-induced inflammatory immune response: A double-blind RCT.


Pilat C, Frech T, Wagner A, Krüger K, Hillebrecht A, Pons-Kühnemann J, Scheibelhut C, Bödeker RH, Mooren FC.


Tr14 is a natural, combination drug, which has been shown to modulate inflammation at the cytokine level. This study aimed to investigate potential effects of Tr14 on the exercise-induced immune response. In a double-blind, randomized, controlled trial, healthy, untrained male subjects received either Tr14 (n = 40) or placebo (n = 40) for 24 h after a strenuous experimental exercise trial on a bicycle (60 min at 80%VO2 max). A range of antigen-stimulated cytokines (in vitro), white blood cell count, lymphocyte activation and apoptosis markers, and indicators of muscle damage were assessed up to 24 h following exercise. The area under the curve with respect to the increase (AUCI ) was compared between both groups. The Tr14 group showed a reduced exercise-induced leukocytosis and neutrocytosis (P < 0.01 for both), a higher AUCI score of antigen-stimulated IL-1β and IL-1α (absolute and per monocyte, all P < 0.05), a lower AUCI score of antigen-stimulated GM-CSF (P < 0.05) and by trend a lower AUCI score of antigen-stimulated IL-2 and IL-4 as well as a higher AUCI score of antigen-stimulated IL-6 (all P < 0.1). Tr14 might promote differentiated effects on the exercise-induced immune response by (a) decreasing the inflammatory response of the innate immune system; and (b) augmenting the pro-inflammatory cytokine response.


Lozada C, et al. A Multi-Center Double-Blind, Randomized, Controlled Trial (db-RCT) to Evaluate the Effectiveness and Safety of Co-Administered Tr14 and Ze14 Intra‑articular (IA) Injections Versus IA Placebo in Patients with Moderate-to-Severe Pain Associated with OA of the Knee. Arthritis Rheumatol 2014; 66 (suppl) S1266, ABSTRACT NUMBER: 2896

232 patients were randomized and treated (All Tr14 & Ze14, n=119, All Placebo, n=113; Intention-to-Treat (ITT) Tr14 & Ze14, n=117, Placebo, n= 111). Treatment arms were well balanced across demographic and baseline characteristics. Tr14 & Ze14 did not discriminate for WOMAC A Pain as expected after only 1 of 3 injections on Day 8 (p=0.3715), but subsequently was significantly different (p<0.05) on Days 15, 43, 57, 71, 85 and 99 (primary endpoint day), and approached significance on Day 29 (p=0.0686). Logistic regressions showed the proportion of MCID responders was not significant on Day 8. As this was an expected finding, it served as a no-effect internal-model-validation. Tr14 & Ze14 was significantly different (p<0.05) on all subsequent days except Day 29 (approached significance, p=0.0599, Figure 1). 50′ walk pain was similarly discriminating as was the physician global assessment. Total WOMAC and subscores B&C were directionally consistent with WOMAC A. There were no related SAEs. AEs were generally mild and unrelated to treatment. Local knee-related AEs, lab assessments, ECGs and vital signs were unremarkable and similar between treatments.

Tr14 & Ze14 provided statistically significant and clinically relevant pain relief on days 15 to 99 in comparison to placebo. In this double-blind, randomized, controlled trial, a biological/mineral multi-extract combination was shown to be a safe and effective treatment for pain in moderate-to-severe knee OA.

MOZArT Trial
Biopuncture: Definition and indications in pain management

European Journal of Integrative Medicine 2016 Volume 8, Supplement 1, Page 5


Biopuncture applies biotherapeutics for injection into specific zones or points to evoke and support bioregulation. By way of local injections, one provides a stimulus which evokes a physiological reaction followed by a clinical response. In this way, autoregulation is achieved, usually after several weekly sessions. The technique has been standardized internationally, and is described in several textbooks.

The products are described as ultra-low dose medications (ULDMs). These ampoules contain homeopathically diluted ingredients (mainly plants and minerals) – but these are not diluted beyond Avogadro’s number (D23). Several companies produce such ampoules for injection (Guna, Heel, Hevert, OTI, Pfluger, Steigerwald, Wala, Weleda).

The ampoules can be injected into pain zones, pain points, and trigger points. The products can be injected subcutaneously, in muscles, near tendons, in bursae, joint capsules, ligaments and periost. The clinical effect results from both the medication as well as from the needle penetrating tissues. Both the products as well as the injection techniques are standardized in order to maximize results and clinical safety. This injection technique is applied in several areas where other treatment modalities have failed. Biopuncture can be used for neck pain, back pain, ankle sprain, muscle tear, tennis elbow, golf elbow, whiplash, sciatic pain and Achilles tendinopathy. More research is necessary to confirm the efficacy and safety of this injection technique.

Copyright © 2016 Published by Elsevier GmbH


Mauders, K., Pilat, C., Deuster, V. et al. Effects of Tr14 on recovery and inflammatory immune response after repeated bouts of exercise: a double-blind RCT. Eur J Appl Physiol (2017) 117: 591


The purpose of this double-blind, randomized, placebo-controlled clinical trial was to investigate the effects of the natural combination medicine Tr14 consisting of 14 diluted biological and mineral components on the inflammatory immune response and recovery up to 72 h after repetitive bouts of bicycle tests.


Antigen-stimulated IL-1ra and IL-6 were defined as primary outcome measures. Moreover, various immunological and serum muscle damage markers were investigated. The evaluation was performed using the score of the area under the curve with respect to increase (AUCi) for 24 and 72 h after the second exercise test (EX2).


The Tr14 group indicated a lower decrease of lymphocytes by tendency (p = 0.06) and a lower activation of lymphocyte activation markers (CD62L absolute: p = 0.04; CD69: p = 0.01 and CD69 absolute: p = 0.05) in the period 24 h after EX2. In addition, the Tr14 group indicated a higher expression of antigen-stimulated CCL3 (p = 0.01), CCL4 (p = 0.07) and serum CCL2 (p = 0.05) in the period 24 h after EX2. There was a tendentially lower decrease of monocytes (p = 0.09) and a lower expression of antigen-stimulated MMP-3 (p = 0.01) in the Tr14 group in the period 72 h after EX2. However, antigen-stimulated IL-1ra and IL-6 showed no group differences.


In line with the previous results, it was shown that Tr14 attenuates the adaptive immune response partially. Furthermore, the results indicate that Tr14 is able to stimulate the innate immune system via an increased production of pro-inflammatory chemokines. It is speculated that the higher expression of chemokines might play a role in the regeneration and recovery after exercise.