Hidden Rhythm Acupuncture in Tempe

Craig Amrine L.Ac.

1250 E. Baseline Rd., Suite 104 Tempe, AZ 85283 phone: (602) 430-5812

The Treatment of Back Pain with Acupuncture

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Thursday, November 05, 2009

“Oh, my aching back”- The Treatment of Back-Pain with Acupuncture
by: Craig Amrine, L.Ac.
11/4/09

Back pain is one of the most common medical complaints that the U.S. population has and seeks for medical attention. According to the National Institute of Health, approximately $50 billion was spent in 2007 on disability and medical care towards the treatment of back-pain. Why is this such an expensive problem? Why are neck and back problems so common? The answer lies in the joints.

A lesson in spine anatomy:

The human spine is made up of 33 individual vertebrae. 24 of these are movable. They include 7 cervical vertebrae in the neck, 12 vertebrae in the thoracic or mid-back, and 5 vertebrae in the lumbar or low-back. These 24 bones may have limited individual movement, but when used collectively, give us a surprising range of movement and flexibility. A complex interplay between ligaments, tendons, and muscles can allow us to ( when working properly) move as the most graceful dancer or (when not working properly) cause us to lay stuck on the living room floor after trying to lift the new TV. These vast network of ligaments, tendons and muscles not only give us the strength and coordination to move our bodies in innumerable directions, they also serve to limit or restrict our backs from too much flexion (bending). Limiting excessive flexion protects the spinal cord and prevents extreme loading on any one point of the vertebral bodies.

Each of the vertebra is separated by cartilage called the intervertebral disc. The disc acts as both a shock-absorber and as a central pivot when the spine needs to rotate or flex. Intervertebral discs are comprised of a core of a soft gelatinous material called the nucleous pulposus(3). Surrounding this material is a ring of more firm material called the annulus fibrosus. This combination of a soft deformable material contained by a more firm structure is often compared to a jelly donut.

Along with the discs, the vertebrae are also connected at a set of overlapping structures called the facets. Ligaments between the facets serve to additionally support the spine and limit the amount of movement occurring between adjacent facets. Collectively, these facets and the associated ligaments are called apophyseal joints.

So Why Does My Back Hurt?

All of these ligaments, muscles, tendons that we’ve discussed, and even the outer-most sections of the annulus fibrosus have high concentrations of nerves throughout, and consequently, can be a source of back pain when something goes wrong.   With such a large number of ligaments and moving parts (joints), its no surprise that back pain is so common.

The source of pain that is most often discussed is damage to a nerve root. The nerve root is the primary branch of a nerve that exits the spinal cord through openings in the vertebrae.   This opening can be limited or interrupted through either a bulge or rupture of the annulus fibrosus (disc herniation), narrowing of the spinal canal (spinal stenosis), or even a compression of the disc itself. In other words, something is pressing on the nerve root. When a back specialist is deciding if surgery is appropriate for back pain, he/she is most often looking for this type of situation. Specifically, they are looking for a place were either cartilage or bone is pressing or “pinching” on a nerve root.   If they do indeed find this situation, they may elect to surgically remove part of the offending bone or cartilage.

We can’t complete a summary of back pain without discussing sciatica. Sciatica is a specific form of back pain that can begin in the low-back and continue down into the buttocks, legs, and the groin. It is the result of impingement to the sciatic nerve; a relatively large bundle of nerves that begin at the nerve roots of the three lowest vertebrae. Sciatica is incredibly common and is often caused by one of three things; a disc bulge or herniation of one of the three lowest intervertebral discs, impingement of the nerve by the piriformus muscle, or pain in the a sacro-iliac (S.I.) joint. The S.I. joint refers to the interface between the sacrum (lower most fused part of the spine and the illium (hip). I include S.I. joint pain in with scatica, because the symptoms of S.I. joint pain often mimic sciatica. Without medical imaging techniques like MRI or a thorough medical assessment, it is difficult to differentiate between the two.

So, what happened? Why did you get a disc herniation at 32 years old when you just watched a TV program highlighting a 78 year old who just finished the Boston Marathon? There are lots of reasons. Causes can include diet, exercise (or the lack thereof), smoking cigarettes, inadequate stretching, occupation, genetic predisposition to certain back injuries, and yes....aging.

As we get older, we dry out. In other words, new cells aren’t made as quickly as old one’s die out. Disc cartilage will typically contain less water and will get more rigid and brittle. Another interesting fact is that the specific cells designed to hold water and stay spongy thrive at a very specific compressive pressure(1). If the pressure on the cells is either too low or too high, they will not produce the material that holds water (proteoglycan) to keep the cartilage soft. This scenario often occurs after a back injury due to trauma. An uneven load occurs on the discs due to damage, misalignment, etc. As a result,regions in the disc may be under excessively high pressure and other areas under excessively low pressure. Both circumstances will contribute to disc de-hydration and thus accelerate the degradation of the discs.

Great! Now I Know Why I Hurt. What Can I Do?

The goal of self treatment is two-fold, encourage proper alignment in the spine to ensure that any compressive load is even and make sure that the disc cartilage is fed with adequate nutrition to grow and repair itself properly. Simple steps can include exercises and stretching such as yoga that help strengthen the abdominal muscles and low back, proper nutrition that includes lots of proteins and fats, supplements such as glucosamine sulfate, and the proper use of inversion tables or other traction devices to relieve pressure and improve circulation. These “home remedies” can make a tremendous impact on making your back more durable, less prone to injury, and help decrease or eliminate several kinds of back pain including disc problems

Of course, there’s always surgery as an option. Regardless of the procedure, the goal is either to remove the offending bone or cartilage that may be pressing on a nerve root, or completely replace the cartilage with bone and fuse the vertebrae together to eliminate any movement that could cause further damage. Surgery is definitely not the “silver bullet”, however. Back surgeons will admit there is no guarantee that the surgery will actually get rid of your back pain. It comes down to comparing the risk of complications and scarring involved in surgery versus the pain and possible nerve damage in NOT having surgery. In fact, a survey was reported in the Journal of American Medical Association(7)interviewing a set of people who reported pain due to a disc herniation; half of which “fixed” it with surgery and the other half did not. Two years after surgery, there was statistically no difference in amount of pain between the two groups. This also supported the idea that many disc bulges and herniations can eventually heal themselves(5)

Thinking outside the box: Back Pain and Chinese Medicine

Thus far, you’ve read the standard information on spine anatomy and back pain that can be found on any number of text books,websites or journal articles. Is that it? If I have a bulging or herniated disc, I’m destined to suffer a lifetime of pain? Not exactly. A very common misconception is that the presence of such structural problems is guaranteed to cause pain. This is NOT true. A classic study sited by Newsweek(2) involved sending 98 people with no back pain through an MRI to image the structure of their spine. Almost two/thirds of those showed spine or disc problems. The article also mentions other studies that reinforce this mysterious disconnect between what we see on medical imaging versus what type of pain we actually feel. This brings into question our entire relationship between physical damage to the body and our perception of pain. A small handful of prominent physicians have observed that a strong connection exists between back pain and depression or stress(2). How is this possible? While this may be a revolutionary discovery in Western Medicine, the connection between emotions, pain, and disease has been long recognized in Traditional Chinese Medicine (TCM).

Instead of trying to identify the structural source for back pain, TCM tends to differentiate between the character of the pain. For example, is the pain worse in the morning when you first wake, or is it worse after a day of working and exercise? Is it more of a localized sharp stabbing pain, or is it more of a dull ache that comes and goes and moves around in the back. Does it feel better with applied heat or after you ice it?

Health and Disease According to Traditional Chinese Medicine

One of the more common systems used in TCM to identify disease is the 8 Principal Theory. We look at diseases in terms of either side of 4 distinct components. Rather than going into a detailed treatise on Chinese Medical Theory, we will summarize the 8 Principal Theory below:

External vs. Internal: Is the problem the result of external cause such as a flu virus, skin conditions due to some environmental irritant, or physical injury due to trauma? Or is it due to an internal problem or imbalance within the body.

Hot vs. Cold: Does the problem have a hot component or cold component? Cold problems will often feel cold, feel better with warmth, have a dull and achey feel, have a gradual onset, slow movement, and produce copious amount of clear fluids such as frequent urination. Problems with a hot component however, feel hot, tender to the touch, feverish, have a rapid onset, may be red or inflamed, produce dark or scanty fluids, and can lead to rapid outbursts of anger.

Yin vs.Yang: A Yin based problem is one that pertains to the (for lack of a better word) “goo” of the body. Yin is considered the substantive material within the body that circulates including blood, water, lymph, urine, sweat, semen, mucous. Yin has a cooling nature and is strongly associated to the female. Yang, on the other hand, is considered to be the energy needed to drive the “goo”. Yang has a warming nature and is strongly associated with the male. Yin and Yang function best when they are in complete balance. A simple metaphor is a candle where the wax represents the Yin and the flame represents the Yang. Too much of either will result in a candle that will either burn too brightly and consume it self (too much Yang or not enough Yin), or it will have the wax drown out the flame and extinguish it. (too much Yin or not enough Yang).

Excess or Deficiency:   Is the problem due to our bodies simply running low on certain things? This could include water, nutritional deficiencies, blood, and even Qi (energy). Or is the problem due to an excess or a localized buildup of something within the body. A common example is term we call “Qi stagnation” where energy within the body gets “clogged” at a certain area leading to localized pain or tenderness.

Within Chinese Medicine, these principals will pertain to both the internal organs such as the kidneys and liver as well as some of the substances such as blood and Qi. Most diseases, including back pain, can involve numerous combinations on these principals(6).

Chronic Low-Back Pain

From a TCM perspective, most back-pain that has a gradual onset, can be described as dull, weak, and achey and feels worse at the end of the day or after prolonged work is due to a Kidney Qi deficiency.   This could have been initiated by several factors that have weakened the Kidney area over time including lack of exercise, overwork such as repeated heavy lifting, excessive sexual activity, or childbirth. Tonifying local acupuncture points corresponding to the Kidneys is essential for this type of problem

Acute Mid-Back Pain

A very common area where people will feel back pain is just medial (inside) of the shoulder blade. This can also be an extension of the tender or tight type of pain that can be felt at the upper parts of the trapezius muscles. Typically, this type of pain is due to a Liver Qi Stagnation. Factors such as stressed work environment, anger, depression, or even prolonged sitting at desk can obstruct the Liver’s function of ensuring proper flow of Qi. This will often manifest as as Qi stagnation in the Urinary Bladder Channel.

Disc Herniation and Sciatica

The underlying cause of disc herniations is often a deficiency or weakness, but will then result in the sharp stabbing pain when a disc rupture or sprain occurs as described as Qi or Blood Stasis. Both reducing the blood and Qi stagnation along with tonifying the underlying deficiency is required to resolve these types of problems.

Keep in mind, these are by no means the only causes of back pain. Our purpose here is to show some examples of the more common types of back pain and how they are viewed from a Traditional Chinese Medical perspective.

Seriously, how do needles help fix my back?

As stated earlier, there is a mysteriously large disconnect between structure problems seen in the spine and the amount of pain that is felt.   We’ve already mentioned that common sources of back pain include degeneration of the spine, muscle spasms, irritation of nerves around local damage, and even emotional disturbances such as depression.   Acupuncture has been found to be effective in stimulating circulation, decrease muscle spasms, reduce pain through stimulating B-endorphin release (4), and reducing stress. The beauty with acupuncture is that the risks and side-effects of treatment are nearly non-existent.

No one specific healing modality is perfect for all types of back pain, but many people have found relief with acupuncture. It is a safe, powerful, and relatively inexpensive option to drugs and/or surgery. So, before you resign yourself to a lifetime of pain, discomfort, drugs, degenerative treatments like cortisone, or risky surgery, give traditional chinese acupuncture a try. You’ll be surprised how something so simple can help such a complex problem.

End Notes:

(1) Adams, Michael A., Biomechanics of Back Pain, Acupuncture In Medicine 2004;22(4), pp178-188

(2)    Kalb, Claudia, The Great Pain Debate, Newsweek Magazine, May 10, 2004

(3) Gillard, Douglas, Disc Anatomy, www.chirogeek.com

(4) Pomerance, Bruce, Acupuncture and the Raison D'Etre for Alternative Medicine, Interview by Bonnie Horrigan in Alternative Therapies in Health and Medicine, Nov. 1996, Vol.2, No.6, p.85-91

(5)    BenEliyahu, David, Studies:Can Herniated Discs Reduce in Size or Resorb? www.sosherniateddisc.com/modules/news/article.php?storyid=5

(6)    Maciocia Giovani, The Practice of Chinese Medicine, 2nd Edition. Churchill Livingstone, Oxford 2008, pp 1058-1060

(7)    Springen, Karen, To Cut or Not to Cut, Newsweek Magazine, Nov 21, 2006
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Craig Amrine is a licensed acupuncturist in the state of Arizona (L.Ac.) and has received his Masters of Science degree in acupuncture from the accredited Phoenix Institute of Herbal Medicine and Acupuncture (PIHMA) in Phoenix, Arizona. He is also a nationally board certified Diplomate in Acupuncture with the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), and operates a successful clinic in Tempe, Arizona. His clinic, Hidden Rhythm Acupuncture, uses a combination of both traditional methods including the use of acupuncture, cupping, moxabustion, tui-na (body-work) as well as modern techniques using electrical stimulation and cold-laser therapy to treat a host of afflictions ranging from physical pain to respiratory, digestive, sleep, or neurological disorders. For questions or comments, he can be reached through his website at http://www.hiddenrhythmacupuncture.com

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Asthma Relief with Acupuncture

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Tuesday, September 29, 2009

Acupuncture for the Treatment of Asthma

Background of Asthma

According to the CDC (Center for Disease Control), nearly 6.7 million or 9.1 % of children were being treated for asthma in the United States in 2007. In that same year, 16.2 million or 7.3 % of adults were being treated for asthma. Among those, over 3,500 died. What if this disease was not only treatable, but treatable in a way that could lower or even eliminate the need for inhalers and drugs? These drugs and inhalers are not only costly and inconvenient, they have several serious health-risks and side-effects. The solution lies in acupuncture and Traditional Chinese Medicine (TCM).

What is Asthma?

What exactly is Asthma? A simple explanation is that asthma is a partial and temporary obstruction of the airways in the lungs. This obstruction is due to inflammation of the airways, contraction or spasms of the muscles around the bronchi, and excessive mucous in the bronchi of the lungs. This combination leads to wheezing and shortness of breath (dyspnea) that is commonly referred to an “asthma-attack”. These attacks can range from being annoying to life-threatening. What causes this?

Asthma can be divided into two types: Atopic or allergic asthma and non-allergic asthma.

Atopic asthma, as the name implies, is due to a hypersensitivity to airborne particles or allergens. An immunoglobulin E (IgE) immune reaction occurs where mast cells that line the bronchi surface release a series of enzymes including serotonin, histamine, bradykinin, and prostaglandins. These substances trigger early-stage bronco-spasms in the lungs. After this initial phase, other chemicals including eosinophils and leukotrienes are released that lead to both inflammation of the bronchial lining and the release of mucous. This triple threat of spasms, inflammation, and mucous causes the feeling of suffocation that is so common with severe asthma attacks. To put it simply, asthma sufferers exhibit an immune response that is not self-limiting and is disproportionate to the airborne irritant.

Why do some people suffer with this allergic reaction while others do not? More importantly, why are the reported cases of allergic asthma on the rise? For reasons not fully understood, healthy individuals exhibit a series of self-limiting factors that prevent excessive immune response that asthmatics lack. One of the possible explanations is due to the Hygiene Theory(1). This theory suggests that atopic asthma is due to a lack of infections in infancy and the overuse of antibiotics and immunizations. Other theories suggest that IgG (immunoglobulin G) antibodies, which are known to help control IgE based allergic reactions, are lacking in infants pre-disposed to allergic asthma. Since IgG antibodies are the only immunoglobulins that can cross from the mother to the fetus, it’s thought that premature separation of the umbilical cord during child-birth can lead to an IgG deficiency in newborns, and consequently a higher chance of IgE mediated allergic reactions.

Regardless of the initial cause, atopic asthma is usually first seen in early childhood and is most often triggered by allergens including animal dander, pollen, and waste products of dust mites. The allergic response will reach its full reaction within 20 minutes of exposure to the allergens.

Non-allergic asthma, in contrast, is not triggered by allergens. Instead, it may be brought on by exercise or infections and often occurs later in life. While it also may be triggered by airborne irritants and cause bronco-constriction and inflammation, they do not induce an unregulated immune response.

Drugs: The Dangerous Solution

The common protocol for asthma is through medication. These medications can be delivered either through an inhaler or in a pill form and include corticosteroids, beta2-agonists, and leukotriene modifiers. Standard treatment is a two-step process. First, you’ll need to take a long-term drug that reduces inflammation and makes the bronchi less sensitive to airborne triggers. Secondly, you’ll have to take quick-relief drugs for acute attacks in the form of fast-acting inhalers. These will be bronchodilators or short acting beta-agonists.

Like all Western drugs, asthma medications include a list of health-risks and side-effects. How serious are they? It depends largely who you ask. Doctors and asthma clinics who’s treatment protocol involves drugs will emphasize that as long you follow the directions, health-risks are minimal and the benefits far outweigh the side-effects.

A very complete list of side-effects for these drugs can be found at www.rxlist.com. One of the most alarming effects of the beta2-agonists is, ironically, an increased number of asthma-related deaths! This side-effect is common enough that the FDA has required that these drugs include a “BLACK-BOX WARNING”. This label is the most serious warning that drug companies can carry.

The other commonly listed side-effects of asthma medication include: Upper respiratory fungal infections (Thrush), headaches, dizziness, anxiety/nervousness, sinusitis, loss of appetite, liver disfunction, skin rashes, and hypertension.

Prolonged use of the cortisone-based anti-inflammatory drugs include a host of systemic effects including impaired immune response and would healing, adrenal suppression, truncal obesity, sleep and emotional disorders, nausea, osteoporosis, acne, gastrointestinal disorders, and growth suppression in children.

So the question is, would you use these drugs if you had an alternative? More importantly, would you feed these drugs to your children?

Traditional Chinese Medicine and Acupuncture: A Safer Alternative

A more effective and dramatically healthier solution can be found through acupuncture and Traditional Chinese Medicine (TCM).

Ironically, the Chinese have no historical experience with early-onset allergic asthma. Even in modern times, the incidence of atopic asthma in China is almost non-existent. The closest equivalent is “breathlessness” or “wheezing”. The cause of these diseases were either invasion of some external pathogen, diet, emotions, or some combination of strenuous or excessive lifestyle. None of these can really be attributed to young children and explain the high incidence of child-hood allergic asthma. This again suggests that some aspect of the Western lifestyle is a major factor in the cause.

Modern Chinese medical theory suggests that atopic asthma is originally caused by the deficiency in Kidney and Lung Qi as well as internal Wind in the lungs. Specifically, it is in the deficiency of the defensive aspects of Kidney and Lung Qi. Along with the classic filtering functions, the Kidneys are responsible for growth and development, sexual function, and overall vitality and health of the body. Kidney Qi is also largely influenced by the overall health of the parents, which explains the possible familial connection of atopic asthma. The Lungs are important not only in air-exchange, but also play a large role in the body’s resistance to external disease. The strength of the immune system is largely determined by the health of the Lungs. In combination, both the Lungs and Kidneys are vitally important in both the cause and the eventual treatment of atopic asthma. When as asthma attack occurs, we see this as an attack of internal “Wind”. In TCM, the term “internal Wind” suggests some kind of spasm or contraction; in this case referring to the broncho-spasms common in asthma attacks.

In treating asthma with acupuncture, our goal is to both strengthen the defensive aspects of the Lungs and Kidneys as well as dispelling internal Wind. While this may seem like a monumental task, it is actually very simple using acupuncture. Acupuncture has a very powerful “regulatory” effect on the body and has been found to lower excessive levels of IgE and eosinophils that are responsible for the hyper-activity of the immune system during an asthma attack. Acupuncture is also very effective in controlling spasms (Wind) in the body whether they be in the form of tics, tremors, or even spasms. As a result, acupuncture can both address both the inflammatory as well as the broncho-spasm aspects of asthma.

Regardless of the type of asthma, acupuncture has proven incredibly effective in lowering the symptoms of even completely eliminating asthma in our patients. We get repeated updates from patients telling us they don’t have to use their medication anymore; how they can leave their inhaler at home during their morning run, or that their son or daughter can now play with other kids without fearing an asthma attack. Why is this asthma solution not more common? With it’s overwhelming evidence and virtually zero side-effects, it is a wonder why more asthma clinics and physicians do not offer this option to their patients. As the population of asthma suffers continues to rise, we will continue to be flooded with TV commercials for the latest asthma drugs. Instead of resigning yourself to a collection of medications, turn towards your local acupuncturist. Both your body and your pocketbook will be much healthier (and happier).

End Notes: Maciocia Giovani, The Practice of Chinese Medicine, 2nd Edition. Churchill Livingstone, Oxford 2008, pp 120-133

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Stress Management with Acupuncture: How does it really work?

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Monday, August 17, 2009

Taming the Lion: Acupuncture to Lower Stress

Being chased by a lion, public speaking, divorce, global warming, job-layoffs, the economy, raising teenagers...all of these things can cause us stress. Your heart races, your palms sweat, and you have difficulty swallowing, eating, sleeping. Overall, we see these as experiences we’d rather avoid. This stress response, however, is a natural reaction of the body, and was originally developed to increase our chance of survival.

In today’s world, the threat of being eaten by a predator SHOULD be awfully low for most of us. Nevertheless, most of us will experience high levels of stress during some time in our life. Is stress bad? How much is too much? Should it be avoided at all costs?

How we normally handle stress: The acute stress response

Stress shouldn’t be feared. The stress-response is a natural process that the body undergoes to help it cope with change. When we encounter an immediate threat, a series of chemical reactions are triggered by the autonomic nervous system (ANS) commonly known as the “flight-or-flight” response. These reactions are designed to be a self-limiting process involving the hypothalmus, pituitary gland, and the adrenal glands. Grouped together, this system is called the HPA-axis. The ultimate result is the release of excess amounts of two hormones: Epinephrine (Adrenaline), and glucocorticoids (Cortisol).

Adrenaline:

Adrenaline is a fast-acting hormone that:

- increases heart rate

dilates the pupils

increases breathing volume

- raises our alertness and clarity of thinking

reduces blood to our skin and digestive system

increases blood to our skeletal muscles

- makes us less sensitive to pain

All of these reactions were designed to enable us to fight harder or run faster...thus increasing our chance for survival.

Cortisol:

Cortisol acts a bit different. Cortisol stimulates an increase of glucose (sugar) in the blood to provide a source of extra energy. Glucose is the main source of energy used by both the brain and muscles. Instead of getting this sugar from carbohydrates (food), cortisol triggers a breakdown of muscle and fat. Cortisol also temporarily redirects certain immune cells and processes from the blood out into the surface tissue where they are needed in anticipation of an immediate attack or threat. This results in lower immune and inflammation functions in the blood and joints.

Like adrenaline, these are all designed to increase our chance of survival during an immediate threat.

What happens when the lion goes away? Our response to chronic stress

Normally, when the threat is removed, our bodies can revert back to their normal and “unstressed” state. Our adrenaline and cortisol levels lower back to their normal levels. Our blood pressure lowers, we get hungry again, our immune and inflammation responses come back to normal, and the hyper-alertness will fade and let us sleep easily.

Unfortunately, many of us have jobs or lifestyles that expose us to high-levels of stress on a daily basis and are unable or unwilling to find ways to relieve this stress. How do our bodies deal with this chronic state? While excess levels of adrenaline and cortisol are wonderful for coping with an immediate attack, they can cause some serious health problems if left unchecked.

Prolonged release of adrenaline, for example, can lead to:

- tremors

- insomnia

- digestive disorders

- excess sweating leading to dehydration and neuroendocrine disorders

heart palpitations

high blood pressure

Since adrenaline breaks down very quickly (half-life @ 2 minutes) however, these health risks are not usually a long-term problem.

Chronic stress is much more likely to lead to prolonged release of high-levels of cortisol. High cortisol levels are now being shown to cause a large number of health problems and has been shown to:

depress cartilage and bone formation

inhibit inflammation, prevent vasodilation

alter digestive function

It is also linked to heart disease, type 2 diabetes, weight gain, damage to the hippocampus (part of the brain responsible for short-term memory), secondary infections resulting from a suppressed immune system, and an increased rate of miscarriage.

In time, of course, the body can become insensitive to these elevated levels or even reach a state where it exhausts it’s supply of stress hormones. By this time, the stress response is now completely unregulated and confused. It is suspected that this condition plays a large part in modern auto-immune diseases such as chronic fatigue syndrome and fibromyalgia.

Turning the lion into a pussycat: How we lower stress.

Can’t we simply “think” these treats away? If it were only that simple! In an ideal world where we have all mastered transcendental meditation, I would suppose that chanting this mantra is all we would need. Unfortunately, few of us are so skilled. As a result, many turn to drugs, both recreational drugs and prescription anti-depressants and anti-anxiety medication. The dangerous side-effects and high-cost are leading many to look elsewhere, however.

There is hope! Safe and effective alternatives to drugs.

There are several ways to lower the effects of stress that are both safe and inexpensive. Probably the two most simple are through diet and exercise. Regulating the amount of simple carbohydrates (sugar), eating more fruits and vegetables, cutting back on the caffeine and alcohol, and eating several small meals rather than feasting on a few huge ones can help reduce high blood sugar levels...the primary effect of excess cortisol. Exercise is also a wonderful means to also help lower both cortisol and blood sugar levels. Meditation, interacting with pets, yoga, and even listening to music can all help to lower stress.

When simple solutions are not enough, however, acupuncture is an incredibly powerful tool to regulate the stress response.

Stress, Anxiety, and Traditional Chinese Medicine

A strong link exists between the emotions and the internal organs in Traditional Chinese Medicine (TCM). Emotions such as fear, joy, anger, and worry all have a specific organs they are associated with. For example, extended bouts of anger, irritation, resentment, or bitterness can lead to problems with the liver. While these organ-emotion connections may at first seem odd, it is clear that TCM has always known that emotional health is strongly connected to physical health.

In TCM, acute stress would be seen as fear and would directly affect the kidneys. It is interesting to note that the adrenal glands lie directly on top of the kidneys. In TCM, fear exhibits symptoms including palpitations, insomnia, and dry-mouth. These symptoms look very much like our recognized symptoms of excessive adrenaline release.

Chronic stress, and the release of excess cortisol, would be associated with both worry and pensiveness in TCM. This would also include over-thinking, brooding, obsession and excessive nostalgic thoughts. We see these emotions as directly affecting the spleen and possibly the lungs and heart. Symptoms include tiredness, poor appetite, stomach pain, possible heart palpitations, and weight gain.

Aside from these primary symptoms, the patient will simply feel “stressed”, “burned-out”, have panic-attacks, or can’t sleep.

You’ve come to the right place. Acupuncture for Stress Reduction

I repeatedly tell new patients who come to me for stress relief that I cannot remove stress in their life. I can, however, change how their bodies react to stress. To put it simply, we work on convincing the patient that these stressors aren’t really that much of a threat. In other words, we can convince the body to simply ”Don’t worry and be happy.”

Acupuncture is a incredibly effective tool to reduce stress. Patients will often fall asleep on my table during a treatment....and leave the clinic feeling deeply relaxed. How is this possible? It is well documented that acupuncture can stimulate the release of endorphins; hormones that are responsible for relieving pain. It also has been clinically proven to lower stress-related cortisol levels. The theory behind this is that it modifies the autonomic nervous system to lower the release of cortisol levels during prolonged stress. The general sense of well-being may also be attributed to increased levels of mood altering neuropeptides including melatonin, serotonin, and dopamine. From a Chinese Medicine perspective, we do two things: Calm the mind and treat the underlying organ system that may be affected. This results in both an immediate feeling of relaxation or calm as well as increasing the patients resilience to future episodes.

Interestingly, studies show that acupuncture can also raise cortisol levels! How can it do both? The current research suggests that this largely depends on the acupuncture points used as well as the underlying condition of the patient. Overall, it appears that acupuncture has a “self-regulatory” effect that can blunt excess cortisol levels during high stress, but also boost cortisol and nor-epinephrine levels during times of exhaustion.

Taking it a step further: Acupuncture for Emotional Disorders

As we’ve already discussed, Traditional Chinese Medicine has a well established connection between physical and emotional health. As a result, acupuncture is not simply a means to relieve stress, it can also be a powerful tool for more serious emotional problems including depression, anxiety and panic disorders, and addiction. Many of these afflictions involve imbalances of other neurotransmitters including dopamine, melatonin, and serotonin. The inter-relationship between these neuropeptides and our emotions is incredibly complex. For example, a lack of dopamine is attributed to Parkinson’s Disease while too much dopamine can lead to psychosis. Simply altering these levels to “normal” amounts, however, has been found to be ineffective. Conventional Western medicine has only a rudimentary understanding of these mechanisms. This is why current drugs such as SSRI’s (selective serotonin re-uptake inhibitors) commonly used for depression carry a large list of side-effects. For example, a 2005 issue of the Harvard Mental Health Letter lists possible side-effects of SSRI’s as: insomnia, rashes, joint pain, digestive problems, decreased sexual desire, excessive bleeding/clotting disorders, and an increased rate of suicide behavior among teenagers.

As shown with it’s effect on cortisol, acupuncture has a “regulatory” effect on these substances. This can be demonstrated by the successful use of acupuncture for both Parkinson’s Disease and psychosis by “normalizing” the amount of measurable dopamine in the blood.

The real beauty of acupuncture for any mental disorders is this regulatory effect. Since our goal is to re-establish balance in the body, acupuncture lacks the common risks and toxic side-effects involved with conventional drugs.

The connection between acupuncture and these neurotransmitters is a convenient way to explain how acupuncture works. We shouldn’t fall into the assumption, however, that this is the ONLY reason for the success of acupuncture. Within TCM, we see the body as a circulation of Qi (vital energy), and we use the acupuncture needles to affect Qi in various parts of the body. While we don’t necessarily have to see Qi or quantify it from a modern medical perspective, we do understand the effect it has on our health. As a result, we are able to manipulate or correct it’s flow to ensure maximum health of our patients.

Acupuncture: A Powerful Option to Combat Stress

Let’s face it, we live in a stressful time. We can “endure” and hope that the stock-market will recover, we get our jobs back, global warming will end, our kids will avoid drugs, our relationships will improve......and in doing so, struggle with all the potential health risks associated with chronic stress. Or, we can find ways to rise above the chaos. Acupuncture is a great way to begin this process!

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Cold Laser Therapy : The Healing Power of Light

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Monday, August 17, 2009

Cold-Laser Therapy: The Healing Power of Light

Hear the word “laser”, and scenes from your favorite science-fiction or action movie may come to mind. This mysterious energy is shown cutting chains from a captured prisoner, knocking a missile out of the sky, or even blowing up an entire planet. In reality however, lasers have a much wider (and usually more benign) range of applications. They are used in all CD/DVD players, carry vast amounts of data in fiber optic networks, improve eye-sight with laser corrective surgery, and even remove unwanted body-hair or tattoos. Did you know, however, that lasers are now being used for healing?

The healing power of light

The role of using light to improve health is not new. Natural sunlight is an essential component to produce vitamin D. UV-light is used to help treat skin conditions such as psoriasis. Lack of sufficient sunlight is known to cause a condition known as seasonal affect disorder (SAD) that is characterized by severe depression. The use of lasers in medicine, however, first became popular as precision cutting tools. A combination of small beam diameter and high power has allowed lasers to replace the scalpel for certain surgery procedures.

The healing power of lasers was first discovered soon after lasers were first invented. During an experiment to determine if laser-light caused cancer in 1967, Endre Mester exposed the shaved backs of several mice to low-powered red laser light. Not only did the laser treatments not cause cancer, he noted that the hair grew back much quicker on the treated mice than on the un-treated control group! Over the years, this discovery has led to a field of study called “photo-biomodulation”. Lasers, and in certain applications LED’s (light-emitting diodes), are being used to accelerate healing, reduce inflammation, and reduce pain.

A laser is defined as a device that produces intense radiation in the visible or near visible wavelengths. Laser light is unique in that it is close to one specific wavelength and propagates in-phase; meaning that all of the electro-magnetic waves oscillate together in an ordered and aligned way. Together, these conditions make up the term coherency. When the coherent light is columnated, it can travel vast distances with very little loss of power or scattering. How are lasers different than LED’s? While LED’s can produce light of single color (wavelength), the light is neither in-phase nor can it be easily columnated. Lasers are also capable of producing much higher power than LED’s.

Laser treatment used for healing is called “low-level laser” or “cold-laser” therapy. By definition, lasers used for cold-laser therapy range in power from 5 to 500 milliwatts (0.005 to 0.5 Watts). Lasers less than 5 milliwatts lack the power to induce a bio-stimulatory effect, while lasers greater than 500 milliwatts may cause excessive heating and burn the skin. To put this in perspective, laser pointers that can be purchased at your local drug-store range between 1 and 5 milliwatts. Lasers used for surgery, however, range from 5 to 50 Watts.

Lasers are now being made in virtually every color of the rainbow. Which colors heal?

Cold-laser therapy systems are available in several different wavelengths (colors). They range from green (532 nm) to red (650 nm) to near infra-red (750 to 950 nm). What color is best? A lot depends on what you are trying to heal. Each color reacts differently with the body. Green laser light, for example, is very quickly adsorbed by the skin and blood and can be used only to help heal surface wounds such as bed-sores or diabetic ulcers. Red lasers can penetrate more deeply, but are still generally used for surface conditions such as burns, acne, and hair restoration. IR (infra-red) lasers penetrate much deeper and are used to help heal muscle, ligament, and even bone. Some systems will combine lasers of different wavelengths into a cluster to increase their range of uses.

How do they work?

The health benefits of cold laser therapy can be roughly divided into three categories:

-Reduce inflammation

-Reduce pain

-Accelerate tissue repair

Reduce inflammation

Immediately after an acute injury, the body undergoes a complex series of reactions designed to stop bleeding and initiate the tissue repair process. This process normally includes edema, inflammation, and pain. These reactions are designed to protect the damaged area while the body repairs itself. Laser therapy has been shown to reduce inflammation by increasing the amount of vaso-dilating and anti-inflammatory compounds such as prostaglandin PGI2. It has also been shown to reduce Interleukin 1 (IL-1), a pro-inflammation component that is connected to inflammatory diseases like rheumatoid arthritis.

Reduce pain

Laser treatments have been shown to stimulate increased levels of beta-endorphins. B-endorphins are neuropeptides that serve as natural analgesics to reduce pain.

Accelerate tissue repair

To speed tissue repair, laser light affects the mitochondria. The mitochondria is the part of the cell responsible for producing ATP (adeno-triphosphate); the chemical energy of the cell. Laser light has been shown to greatly accelerate the production of ATP, thus speeding up the overall activity of the cell. In cells responsible for repairing tissue, including bone, muscle, ligament, skin, and even nerves, this results in an increase rate of repair.

These explanations are only a sample of a large list of mechanisms shown to be influenced by laser therapy.

What are the dangers? Risks?

One of the greatest risks of laser therapy is damage to the eyes. Cold-laser therapy treatments should always be conducted with proper safety glasses worn by both the patient and the practitioner. Other potential risks and contraindications include:

-No treatment over suspect tumors or cancer cells

-No treatment over the thyroid

-No treatment over the fontanelle of infants

-No treatment if the patient is using photo-sensitive or immunosuppressant drugs.

These potential risks are a conservative precaution and have not been completely proven. Special exceptions are already being discovered including the use of laser-therapy in the eyes to help with macular degeneration

The future of cold-laser therapy.

The body of evidence showing the benefits of laser therapy is growing at an exponential rate. Much of today’s research is directed towards understanding all the physiological mechanisms that are affected during laser exposure. As cold-lasers with high output power are becoming more popular, it has been discovered that the risk of over-dosing does exist. The result of over-dosing, however, seems to be simply a decrease in healing-rate. In response, optimizing treatment times and laser power are being vigorously investigated.

Combining ancient chinese medicine with modern technology: Laser Acupuncture

An increasing body of evidence suggests that laser treatments on specific acupuncture points can stimulate a similar effect as acupuncture needles. Successful studies include laser acupuncture as a means to successfully treat osteoarthritis of the knee and the use of laser acupuncture in the ears to help smoking addiction. This discovery provides a unique alternative to patients who are terrified of needles, but still seek the powerful healing benefits of acupuncture.

Cold-laser therapy: Inexpensive, effective, and safe

Laser therapy is an exciting and relatively new field that can offer people a very safe and effective option to help with speeding up injury repair and reducing pain. Next time you seek help from a physical therapist, chiropractor, orthopedist, or acupuncturist, ask them if they also use cold-laser therapy. It may end up being your best option!

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Allergy and Sinus Relief with Acupuncture

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Monday, August 17, 2009

Allergic Rhinitis

What is it?

Allergic rhinitis is the summary of symptoms including nasal

congestion, itching, and sneezing caused by exposure to

irritants including dust, animal dander, smoke, and pollen. When

a person is first exposed to specific irritants, certain Ig E

antibodies are created and bind onto the mast cells of the upper

respiratory tract. Subsequent exposure of these allergens

provoke an excessive release of histamine. Histamine causes an

increase in the permeability of the epithelial lining within the

sinus cavities, resulting in heavy bouts of sneezing due to

overstimulation of the nerve-endings. This is followed by high

amounts of nasal discharge and eventual blockage.

If sinus drainage is obstructed due to the swollen mucosa,

infection of the paranasal or sphenoidal sinus cavities can result,

commonly leading to sinusitis.

Symptoms

Allergic rhinitis will usually manifest with sneezing, profuse

runny nose with white or watery discharge, stuffy nose, slight

headache, and watery eyes.

Western Treatment

The classic Western medical treatment for treating allergies

involves taking allergy medication that typically fall under

categories including:

1)Oral antihistamines

2)Nasal antihistamines

3)Decongestants

4)Nasal Sprays

Side-Effects of Medication:

Many of these types of medication act as either histamine blockers , supressing the

immune response (steroids), or by constricting the blood vessels in the sinus cavities.

With their wide-ranging actions, the side-effects of these medications can greatly vary.

Adverse side-effects can include but are not limited to mild drowsiness and dry-mouth to

nausea, heart palpitations, insomnia, or even hypertension. Severity of symptoms will

largely depend on the dose, length of treatment, and overall health of the patient. Several

of the medications will require special precautions such as avoiding alcohol during

treatment or avoid during pregnancy.

The Traditional Chinese Medicine (TCM) Perspective

Allergic rhinitis is considered to be a “wind-cold” invasion characterized by sneezing, and

a white or watery discharge from the nose. Normally, both the defensive-Qi systems

governed by the Lung and Kidneys can successfully expel pathogens before they take root

in the body and cause serious harm. In cases of allergic rhinitis however, the immune

system is hyper-reactive due to a deficiency of both the Lung-Qi and Kidney-Qi defense

mechanisms. Normally, the Lungs aid in the defensive system to protect the body from

external pathogens. The kidneys help power the lungs and are responsible for overall

personal development including birth, growth, and sexual development.

Deficiency of the Lung and Kidney Qi defense systems can be due to a number of factors

including hereditary, problems during pregnancy or childbirth, or can be incurred later in

life due to factors such as over-work, excessive use of drugs or antibiotics, or excessive

sexual activity.

Treatment using Traditional Chinese Medicine:

During treatment, it is important to treat both the root of the disease (Kidney-Qi

deficiency) as well as manifestation (Lung-Qi deficiency and wind-cold invasion in the

nose). So, acupuncture treatments include both tonifying Lung and Kidney Qi to reduce

the hypersensitivity to irritants, expelling the wind-cold from the nose, and draining

phlegm to eliminate the congestion.

What is the difference between Allergic Rhinitis and Sinusitis?

To put it simply, sinusitis is usually defined by a sinus infection due to repeated attacks

of allergic rhinitis. While allergic rhinitis is characterized by itching, sneezing and

excessive white or runny discharge from the nose, sinusitis is more characterized by

stuffy nose, thick/yellow nasal discharge, feelings of heat, diminished sense of smell, and

a bitter taste.

While acupuncture treatments may be similar for both afflictions, allergic rhinitis

treatments will address the underlying Kidney deficiency while sinusitis treatments will

focus more on addressing the accompanying heat component of the disease.

Craig’s final word(s):

During the spring and summer months, a huge population around the country and within

Phoenix struggle with allergies. I’m amazed on how many TV commercials are shown

advertising the latest in allergy medication, but then only briefly mention the ridiculous

list of risks and side-effects of this latest “medical breakthrough”. New patients will tell

me stories how they are forced to sleep sitting upright in a chair because of the sinus

pain, and that they can’t stand the negative side-effects of sinus and allergy medication.

My personal experience treating rhinitis with acupuncture has been incredibly

encouraging. Most of my patients will experience dramatic improvements after just a few

treatments. I personally consider this affliction one of the easiest to treat. I must

emphasize however that while patients will experience huge changes after just a few

treatments that lead many to believe they are “cured”, treating the hypersensitivity

component of the the allergy does take a bit longer.

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