Acupuncture and Nutrition Clinic – Houston

http://www.medpagetoday.com/PrimaryCare/AlternativeMedicine/34673

Of course this research comes as no surprise, but it’s nice to read that the authors of a meta-analysis concluded that “acupuncture provides more relief from various types of chronic pain than does usual care and should be considered a valid therapeutic option.” Research based on my patient base suggests the same results.

During my monthly call in radio show, people always have questions on pain. Whether it be neck, shoulder, back or migraine pain, many want to know if there are other options to hydrocodone, topomax, or even extra strength tylenol.

Part of the problem with acupuncture research is that results show benefits but the mechanism of action is very hard to define or measure. In Western style research, scientists like to be able to explain how and why the treatment works. The difficulty in part is trying to measure an abstract form of energy, we can Qi (chi). You can feel Qi, but cannot readily see it or measure it beyond feeling for it in the pulses. In spite of the mechanism of action not being completely understood, results of this study showed that acupuncture treatment for pain relief was statistically better when compared to sham acupuncture and even higher for no acupuncture.

Many researchers like to attribute the beneficial results of acupuncture due to placebo effect. To challenge that point, I often refer to veterinary acupuncture which started many years ago on race horses who were lame. More often than not, the horses and now dogs and cats, move better after being treated with acupuncture. No matter how lovable and smart our animals are, they do not have the capacity to fake it (to please their owners). Either they are limping or they are not after a treatment. The results speak for itself.

Because it is so difficult to define the mechanism of action, many researchers continue to report that treatments remain “highly controversial.” But to be fair, many results are inconclusive due to poor study parameters such as too few subjects and inconsistency of quality and reliability of studies. But it’s also worth considering whether positive results of studies should be disregarded solely due to uncertainty as to mechanisms of action.

This study however, included almost 18,000 subjects and “conducted an individual patient data meta-analysis based exclusively on high quality randomized trials that their findings should be considered “both clinically and scientifically important.” In addition, their finding of “true acupuncture having significantly greater effect than the sham procedure indicates that the effects of the procedure do extend beyond placebo.” They conclude that this is “of major importance for clinical practice,” meaning that acupuncture should be considered “a reasonable referral option for patients with chronic pain.”

Dr. Avins, one of the authors of the study wrote: “The ultimate question is: does this intervention work (or, more completely, do its benefits outweigh its risks and justify its cost)?” “For acupuncture, the current meta-analysis offers “some robust evidence” that acupuncture does provide greater chronic pain relief than usual care, mechanisms of effect aside.”

For many of my patients, this research will be consistent with their experience. But Chinese medicine will only be considered a valid form of medicine with medical doctors when clinically solid studies show clear benefit. More and more studies are being conducted that show thousands of years of medicine from China as being a consistently effective and safe option of treatment for many health concerns. If you are interested in reading more research on acupuncture, you can look at studies from the National Institutes of Health Complementary and Alternative Medicine Office.

Acupuncture cupping is an aspect of Chinese medicine that is frequently used to treat pain as well as internal medicine issues. Cupping traditionally consists of placing glass, plastic or bamboo cups on the skin to create a vacuum seal. A glass cupping seal is created when an alcohol soaked cotton ball is burned and placed inside a cup to remove the air. The cup is then quickly placed on the body which creates the vacuum. This is called fire cupping. Another type of cupping uses plastic cups with a pump to create a seal. I have attached a picture of me in China with a bamboo cup so you can see what it looks like to be “cupped” and a patient in China being treated with plastic cups.

Based on the principles of Chinese Medicine, cupping increases blood flow to the surface of the skin thereby moving pain caused by stuck energy and/or removing toxins causing disease. Cupping has been used for relieving colds, bronchitis and other lung conditions, menstrual pain, and all types of body pain. Chinese medical theory states that stagnation of blood is the cause of pain and many diseases. Cupping thereby moves the stagnation (stuck energy) and promotes the blood flow in the affected areas. When the blood flows there is less pain in the channels being treated.

Cups are applied on acupuncture points on the meridian or channel being affected by pain or disease. It is frequently used in conjunction with acupunture since cupping stimulates circulation and relieves pain and swelling. Cupping is not painful, but patients will feel a tug or pulling sensation under the cups as the vacuum seal is created. Successful cupping will usually leave a bruise on the skin. I remember the press going on about Gwyneth Paltrow attending the Oscars in a backless dress which showed the bruises left by cupping on her back. These bruises go away of course, but it is not uncommon to have them.

I like to do sliding cupping on patients with larger areas of pain. For example: sciatica down the side or back of the leg. Oil is used to moisturize the skin and then a number of cups are placed in the area to be treated. Once the suction cups are in place, I will slide the cups up and down or around the painful area, thereby promoting blood flow in a larger surface area. Usually after the sliding cupping, I will then place acupuncture needles for a complete treatment.

Chinese medicine has been around for thousands of years. The ancient art of Chinese healing is time tested. If you are dealing with hard to treat, stubborn pain that has not been helped with Western medicine practices, you might consider trying Chinese medicine. When we help patients that can only be given drugs by their doctors, it speaks loudly to the power of the needle. Give it a try.

This was a call from one of my monthly radio shows taking call in questions.

“I would like to ask the Acupuncture & Nutrition Clinic if they can help my husband. He is 67 years old and has a lot of hip pain. He is still very active and very much works 40 or 60 hours a week. The pain radiates down the side of his leg into the knee area. Do they think that they might be able to help that?”

Our response: “We treat a lot of hip, low back and sciatic type pain. Pain down the side of the legs does sound like a type of sciatica that’s coming from the low back, maybe the hip. We do treat a lot of sciatica at our clinic. The usual location of needles would be on the opposite shoulder. We would actually needle various joints of the shoulder because that mirror-images the hip and then down the middle of the upper arm to the elbow which would mirror the knee. Once the needles are in we would ask him to move in a way that normally would elicit pain. If it’s better, then we’ve done our job well. If not, we need to go back and reassess our diagnois of the channel problem. Sciatica down the side of the leg is actually a very treatable condition.”

We frequently tell patients to remember that acupuncture is like a therapy: chemotherapy or psychotherapy. The treatments build on each other until the body is able to maintain the “re-routed” circuitry. If someone has had a condition for 20 years, it’ going to take more than a few treatments to make it better. It’s good to be realistic in those expectations.

Even if you think about one month of treatment per year. Obvioiusly that’s a lot of treatments and its doubtful that many treatments would be necessary. But the take home message is about being patient and recognizing that Chinese medicine is a gentle form of medicine that nudges the body to work in a way that it used to know how to do. There is memory. Once you really promote healing in the area that’s hurting or diseased, the body will respond in the majority of cases.

In the previous blog, I gave a brief description of what Yin and Yang represent. In short, it’s about warming and cooling energy. This blog is taking you to another level of understanding in Traditional Chinese Medicine (TCM). This post will explore the concepts of Qi (chee) and Blood and how and why they are fundamental components in TCM.

The concept of energy in TCM, is referred to as Qi (chee). The Qi energizes the body, moves and warms. Therefore Qi has Yang energy. (See Yin and Yang from previous blog). Blood and body fluids are sustenance for the body. They nourish and moisten the whole of the body and therefore are Yin in nature.

The strength of our Qi comes from our Prenatal or Congenital Qi (our parents) and Acquired Qi from our food and air. Qi is the source of movement in all directions. Qi protects the body like a shield against pathogens (i.e. viruses) and allows for bodily functions to work efficiently. Qi warms the body and ensures the appropriate flowing/movement of substances in the body, like blood and body fluids.

Qi can be deficient as in infirmity of old age, chronic illness or malnutrition. It can collapse as in prolapse of organs (bladder, uterus). Stuck Qi (stagnant Qi) results in feeling deep, achey pain, a sense of distention and/or emotional upset. Qi can also flow in the wrong direction (rebellious Qi) manifesting as cough, nausea, vomiting, hiccups, dizziness and diarrhea.

Blood as we know it is a thick liquid and therefore one of the most dense forms of Qi (Yin in nature). In TCM like in Western medicine, Blood functions to nourish the body. In TCM it is understood to flow and circulate in the meridians. Blood flow in the meridians includes the organs and tissues of the body as well as body hair, tendons, ligaments, bones and viscera. It moistens and nourishes the whole body, especially the eyes and tendons. Hair growth is related to quality and amount of blood.

In TCM the three most important organs related to Blood are the Liver, Heart and Spleen:
-“Liver stores and regulates the blood; when the body moves, the blood will flow through the channels. When the body rests, the blood returns to the Liver and is stored.”
-“The Heart governs the blood, which means the Heart pumps the blood.”
-“The Spleen contains the blood which means the Spleen manages the blood by preventing the
blood from spilling out into the vessels, i.e.: hemorrhaging, bruising.”

Qi (energy, life force) moves the blood and keeps it circulating. Without strong Qi to move the blood, the blood will gather and get stuck. The areas where blood stagnates will result in pain and disease as a result of inadequate blood moving and nourishing the body. The interaction between Qi and Blood is significant. If our Qi is weak, it won’t be able to sufficiently move the blood. If our blood is deficient it won’t nourish and moisten the body and will also result in disease and pain.

Disorders of the Blood include blood deficiency, blood stagnation and heat in the blood. The reasons for this could be from blood loss, reduced blood production or the blood nourishing qualities being reduced. General signs of blood deficiency include dizziness, palpitations, lusterless complexion, pale lips, insomnia, dry skin and hair. It may not show up as anemia in Western medicine but would still be considered blood deficiency in TCM. Other problems related to blood deficiency include amenorrhea or shortened menstrual cycle, and dry, itchy skin.

Some of the causes of blood stagnation come from Qi deficiency not moving the blood, heat in the blood and impact trauma causing hemorrhage or bruising. The generals signs of blood stagnation include purplish lips and tongue and/or papules on the tongue. Local areas of blood stagnation would manifest in painful swelling or knife-like stabbing pain. Bleeding can occur when the blood vessels can no longer hold the pressure caused by the stagnation and the blood will be a dark purple-black. Western diseases that relate to blood stagnation would include a heart attack or stroke.

Heat in the blood is a result of heat toxins entering the blood. It is characterized by rapid blood movement, hemorrhage and/or deep red rashes, eruptions on the skin or hives, and dry mouth. Heart-Blood heat will cause anxiety, mental illness and mouth ulcers. Blood heat in the uterus will cause excessive bleeding during the menstrual cycle.