Blog : Acupuncture
Over the last few months we've been talking about the treatment process – how we diagnose, how issues are treated and your pathway back to health. One of the most frequent and most important questions every new patient wants to know is “how long will it take for me to be well (or pain free or feeling normal)?” While the answer is always “it depends”, we understand how frustrating an answer this can be. Here we want to give you more information this month that hopefully will help to answer your question.
As we mentioned before, when we take on a new patient we have a high degree of confidence that we can treat that patient to “resolution.” “Resolution” is a bit subjective here because we not only look to resolve the primary reason you come to us for treatment, but we also look for other related issues to resolve as well, regardless whether or not the patient indicated that as an area of concern. If you go back to our December blog post about the Root and Branch, you'll see this allows us to treat the source of the imbalance as well as the primary symptoms. Symptoms are addressed in the context of the high-level imbalance and as the high level imbalances are corrected, symptoms resolve and cease to be an issue.
We divided the treatment process into 3 phases – I. Stabilization, II. As Little Treatment as Possible, with Improvement, and III. Maintaining Balance.
Phase I: Stabilization
In the Stabilization Phase, we expect to see some significant improvement in symptoms and schedule treatments frequently – usually once or twice weekly. During the early part of this phase we are determining the “dosage” for your treatments. The correct dosage restarts the healing process in your body so that the symptoms that brought you into the clinic are mostly not there between visits. This is why we say “it depends”. Everyone responds to treatment a little differently so some cases may require more frequent treatments and for some the number of treatments may be more or less than others. If you've been dealing with the issue for a long time (years), you can expect this phase to take longer. A rule of thumb is one month of treatments for every year that you've experienced the problem. However, we very often get significantly better results than this rule, as we expect to see noticeable changes within four – six treatments, though it may take longer for you to be symptom free between treatments if you have a chronic issue. Sometimes the primary symptom takes longer to resolve, but you may see other changes in secondary symptoms like sleeping better or less anxiety sooner. We will reassess after the first few treatments once we see how your body responds and can then give you a better idea of how long this phase may take.
A growing number of Physical Therapists and other medical professionals are beginning to offer a treatment they call Dry Needling or Intramuscular Stimulation (IMS). You may have noticed that Dry Needling bears a striking resemblance to Acupuncture, and you may have been wondering what it is, how it is different from Acupuncture and which therapy is right for you.
Dry needling is a term coined by Janet Travell, M.D. in the mid 20th century. She used empty hypodermic needles to diffuse trigger points (the term “dry” refers to the fact that the needles were empty). Physical Therapists have continued to refer to this therapy as dry needling even though they now use acupuncture needles.
So what's the difference?
There's no difference in that both use acupuncture needles and both treat trigger points (painful areas), but there is a big difference in the scope of what can be treated and the training required to do so. The World Health Organization, the American Medical Association(AMA), the American Academy of Physical Medicine and Rehabilitation(AAPMR) and our own Georgia Composite Medical Board have recognized that dry needling is a sub-type of acupuncture and is indistinguishable from acupuncture. However, the training required to perform dry needling is only 50 hours where the requirement to practice acupuncture is much more significant.
Acupuncturists obtain a Masters degree which includes, in addition to biomedical (western medical) training, at least 1365 hours of acupuncture-specific training, including 705 hours of acupuncture specific didactic material and 660 hours of supervised clinical training, and in most states, including Georgia, are required to pass a national competency exam. Further, in Georgia, acupuncturists without at least one year of post graduate practice must have one year of supervised practice under a licensed acupuncturist before becoming fully licensed to practice. Continuing education is also a requirement to continue practicing acupuncture. Contrast that with 50 hours of training required for physical therapists with no national standardized competency examinations, training standards, supervised practice requirements nor continuing education requirements for the safe practice of Dry Needling. There is indeed a big difference!
As we discussed last month, there are three phases of the treatment process. This month we look at the progression that patients take along the path back to health.
Human physiology – all physiology for that matter --follows the principle of Yin and Yang.
In Chinese medicine we have different models to describe what is happening in the body. Just like in nature we all know if it is winter or summer. We also know if we are having a “normal” winter, or like this year, if we are experiencing weather that is unusual. From a certain point of view, when a person has a health problem is it a very similar phenomenon in that the body is not able to create the right physiological condition (or internal weather pattern, if you will) in the body at the right time. Think about menopausal hot flashes, for instance, one of the many conditions that we see frequently with so many women. Now assume the Chinese Medicine model where in each 24 hour period the nighttime is similar to the winter in nature and the daytime is similar to summer. We are supposed to be warmer in the day and cooler at night. Many cases of hot flashes are simply a matter of helping the body do what it naturally wants to do at night, which is return the warmth and nutrients deep inside. If the body can’t do this with the normal mechanisms available to it, then it will do the next best thing and vent its heat outward, which we recognize as a hot flash.
One of the most interesting parts of practicing this medicine is learning to recognize where in the cycle a patient’s imbalance is and treating effectively. It’s a little like playing a game of chess, but we have to start in the middle of the game with whatever chess pieces are still on the board. Once we identify where in the chess game the patient is, we then can determine in what direction the condition is likely to progress once have begun treating and resolving the symptoms and imbalance.
Depending on the imbalances in the body, we expect to see different pathways or progressions toward health. In Chinese medicine, there are 3 yang phases or “conformations” and 3 yin phases in the progression. Typically, more acute illnesses appear as yang disease attacking the surface of the body (via the nose, mouth, eyes, ears or wind gates). These include the common cold, flu, chills/fever, body aches, sore throat, stomach bugs, dizziness, etc.. If the person’s constitution is weak, the illness lingers, or if the pathogen is not treated properly (as is sometimes the case with the over use of antibiotics), the illness can become more chronic which means it has moved deeper into the body and has gone into a yin phase. The deeper the illness has moved into the body, the longer it takes to push it back out.
Last month, we shared with you the differences between Western and Chinese medicine and the causes of disease. If you missed Part 1 of this discussion in last month's newsletter, you can read it here. This month we continue that discussion with the treatment process.
When we take on a new patient we have a high degree of confidence that we can treat that patient to “resolution.” In order to understand what we mean by this, let's go back to last month's article to review a little bit about how we approach our work in the clinic and how Chinese Medicine views the body.
All systems operating in a cyclical pattern, including the human body.
One observation we have made over the years is how hopeless people often feel when they come into the clinic. They may feel broken and beyond repair. For some reason we have convinced ourselves, or rather allowed ourselves be convinced, that we, as humans are somehow different from all other natural organisms or systems in the world. As amazing, beautiful, wonderful and exceptional we are as humans, one of the central principles of Chinese Medicine is that we still operate under the same laws as any other system or organism. All systems have a built-in or innate healing mechanism.
As we mentioned last month, our system is designed to self-maintain a level of health and vitality throughout our entire life. Ecologists call a system’s ability to self-regulate “homeostasis”. Another term we borrow from ecology that mirrors the Chinese Medicine paradigm is that of the tipping point. A tipping point is the threshold that, when crossed, an ecosystem is unable to maintain its own integrity or homeostasis. Most of the patients that come into the clinic have a system that has fallen below the "tipping point" which means that their body is unable maintain it's equilibrium without "help."
Western Medicine attempts to "help" by using a surgical or pharmaceutical method, while Chinese medicine seeks to strengthen the body's ability to handle the problem unassisted.
Western medicine will often see the cause of a disease as a specific item, while Chinese Medicine will not see a specific cause or thing that failed, but will rather look at a large area of the body’s physiology that is not working optimally, or see one system that is not supporting another. As many people have observed as they have been referred form one specialist to another, to another, to another, addressing one symptom at the time. It appears that looking so granularly at a problem can lead to missing the issue (not seeing for forest through the trees). In contrast, Chinese medicine starts small and works big through an associative process by looking at all the individual pieces and finding the relationships between them. Symptoms are addressed in the context of the high-level imbalance and as the high level imbalances are corrected, symptoms resolve and cease to be an issue.
Root and Branch
This process of treating both globally and specifically is sometimes referred to treating both the root and the branch. There is an old axiom that states “nourish one root many branches are nourished.” In the treatment process, as the patient’s primary symptoms resolve, the practitioner is also looking for other related branches to resolve and improve as a result of treatment, regardless whether or not the patient indicated that as an area of concern. As we examine the symptoms, the patient's pulses and other diagnostic information like the tongue or the abdomen, we are identifying these branches as well as the underlying or “root” cause. This allows us to treat the source of the imbalance as well as the primary symptoms. The better the assessment and treatment of the root, the more effective the branch treatment will be. Our method of determining how to treat is rarely, if ever, based on a Western Medicine diagnostic, whether it be a lab report, imaging or a Western Medicine diagnosis of this disease or that syndrome.
With each treatment there is a portion of each treatment that is devoted to treating both the root and the branch of the imbalance.
The root treatment is tied to identifying the cause or source of the deregulation of the system that caused the patient to seek help and is tied to the Chinese Medicine Diagnosis, not a Western Medicine disease designation. For instance, in Chinese medicine there are three different ways that a system may be imbalanced that would lead to a diagnosis by a Western Medical Doctor of Diabetes. Strictly speaking Chinese Medicine does not treat diabetes, but the causes and conditions that lead to it.
Differences between Western and Chinese Medicine
Chinese medicine is a science and medicine in its own right, with its own stringency and strictness of diagnosis and treatment similar to Western medicine, with procedures and protocols based on centuries of observation of how the universe works The ways of understanding the body's relationship to health and disease are very different between Western Medicine and Chinese Medicine. Chinese medicine focuses on increasing health to unseat disease, and supporting the body's inherent qualities to regain health.
Much of Western science is the direct product of the reductionism of Grecian origin. The scientific approach assumes that one must break a thing down into its smallest component parts or behaviors in order to understand it. This way of looking a problem involves a deductive reasoning process. Western science attempts to assess its cause and effect relationships in a linear or sequential fashion in order to measure, quantify, describe and hopefully predict phenomena. The process of Western science looks something like this:Hypothesis/theory (guess) -> experiment (experience) -> Laws. (Quantitative). Whereas the process of Eastern science looks like this: Natural phenomena (laws) -> experience (experiment) -> Thesis. (Qualitative). Both yield highly accurate information about totally different aspects of reality.
Chinese medicine uses the method of inductive reasoning that is associative and synthesizes, recognizing the inter-relatedness of simultaneous events, to interpret and treat disease. The question in Chinese medicine is not, “what bug is causing this disease?” so much as “what weakness or interrelated conditions are causing this person to be susceptible to it?”.
To use an analogy, let’s suppose that we walk into a room in our house only to find lots of flies in that room. Western Medicine might apply some bug spray to control the flies. A solution in classical Chinese Medicine would be to examine what the flies are attracted to. Upon observation we notice that someone left a ham sandwich in the room, which the flies are feeding on. Treatment would focus on removing the ham sandwich, so the flies have nothing to eat. Then we would ask the question, how did the flies get into the room in the first place. We look around and see that there is a crack in the window, so we fix the crack.
The goal of Chinese medicine is simply to restore balance. Chinese medicine does not treat disease, it treats individuals whose imbalances manifest in certain symptoms as the body attempts to regain balance. Illness is seen as an imbalance between internal influences such as diet, exercise, rest, and emotions; and external factors such as weather, trauma, microbes or poisons. Health is not just the absence of symptoms, it is a state of being in balance.
The preferred ways of restoring balance and staying healthy are the simplest ones. A balanced healthy, nourishing diet, lots of clean fresh air, adequate rest and regular sensible exercise are all a healthy body needs to stay healthy. When we get further out of balance than our normal internal mechanisms can restore, outside means may need to be employed to restore that equilibrium. That's where acupuncture and herbal medicine come into play.
Causes of disease
Your body is designed, like any other living system, to stay healthy and in balance. All of its mechanisms are programmed for survival. This is called homeostasis. Although your body has many elegant mechanisms by which to maintain balance, it constantly encounters things in the environment which can upset that balance. Extremes of temperature, physical or emotional stresses, microbes and toxins, can throw the body out of balance. A healthy body is in balance and is able to resist disease.
Before looking at the causes of disease, it's important to understand the relationship between ones inherited constitution, immune system and harmonious functioning of the body and mind (ie, health), and pathogenic factors that can unseat health.
When the constitution is strong and pathogenic factors are relatively weak, we can more easily resist the harmful effects and not become ill. We are better able to remain unaffected by those around us who suffer from colds and can better handle emotional and physical stressors. Even if the pathogen is strong, a person with a strong constitution may be able to battle it vigorously with high fever, and rapid recovery. Note that a high fever indicates a the body is fighting the disease with vigor.
However, if our constitution is weak, exposure to even a mild pathogen may cause us to become ill. We may catch infectious disease more easily and may be more affected by emotional and physical stress. When we do become ill, the symptoms may be milder because we don't have the same strength to fight the disease. The illness may also last longer, and may be able to penetrate further into the body creating a more chronic condition.
Management and treatment of pain is one of the most important aspects of effective acupuncture. When David started Red Earth, he was doing some work in Google to understand what, related to Chinese Medicine, people are searching for. At the time, he plugged every possible search-term he could think of – probably a list of 30 or so criteria. The result: One term was exponentially and universally searched on way more than any other term, and it was pain. Everyone wanted to know how to get out of pain.
An estimated 76.5 million Americans experience pain, one-third of whom describe their pain as “severe” and "disabling." Acupuncture has long been recognized as an enormously effective, natural treatment for pain, which makes it an attractive alternative to opiate-based drug prescriptions, and in certain circumstances is even an alternative to conventional surgery, with no risk of addiction and other major adverse side effects.
An estimated 2 million people in the U.S. suffer from substance abuse related to prescription opioid pain relievers. In the US, this addiction to opioids has resulted in hundreds of thousands of people overdosing on prescription medication.1 Deaths from prescription opioids quadrupled since 1999, resulting in 78 American deaths due to opioid overdose a day.2 In a recent analysis published in the Archives of Internal Medicine, researchers concluded that acupuncture has a definite effect in reducing chronic pain, such as back pain and headaches – more so than standard pain treatment. This year, the CDC has revised its guidelines for prescribing opioid pain relief, seeking to improve patient safety and address opioid misuse by encouraging providers to recommend non-pharmacologic therapies like acupuncture for pain.3 The integration of acupuncture into treatment plans of those suffering from chronic or acute pain can significantly diminish the need for addictive medications, and ultimately promote a better quality of life.
Acupuncture for pain relief is so effective that the US military has explored the use of acupuncture in the battlefield, and several hospitals are incorporating it into their Emergency Departments. Research shows that acupuncture is as effective or sometimes more effective than conventional care for the most common chronic pain conditions. And acupuncture has a far better safety record than any of the conventional treatments for pain without the common side effects like dizziness, nausea, constipation, anxiety and chemical dependence that are associated with pain medications.
Repairing the Healing Mechanism:
Our goal at the clinic is to “Restore the Body’s Ability Heal”. The human body is a living system, just like any other living system. One thing that we observe about most people who come into the clinic in pain is that they want to have their body “fixed” and don't understand the self-repairing, self-healing aspect to their body. In reality the self-repairing mechanism is simply disabled, or impaired and that is the underlying cause of pain.
An important part of our job as a traditionally trained Acupuncturist, is to identify where the repair mechanism failed and how to correct this mechanism through the treatment process. When the repair mechanism begins to work, pain is reduced.
How it works
Acupuncture points are places where nerves, muscles and connective tissue can be stimulated. This stimulation increases blood flow while at the same time triggering the release of endorphins, our body's natural painkillers, and by affecting the part of the brain that governs serotonin, a brain chemical involved with mood. Because emotions are intimately connected to the sensory centers of the brain, what we feel emotionally may determine, in part, what we experience physically in our bodies.
When we learn about disturbing events and news that makes us cringe such as we have heard in the last few weeks, it can be extremely hard for us to process it. We may think that it’s something that just should not have happened, it goes against our sense of right and wrong, and we just can’t get our minds around why and how it happened. We may become obsessed with watching the same news reports over and over trying to grasp what happened. However, this just brings more sorrow and distress for the victims, and makes us feel like we are helpless to do anything. We may even fear for ourselves and our families. The more we watch, the more we feel despair, fear, anger, grief and discouragement. And when other traumatic life events such as the death of a loved one, or a car accident happen in the midst of this chaos, we can reach the tipping point and experience these emotions in a big way. If we have experienced trauma in the past, then current shocking events may trigger a resurgence of negative emotions and anxiety. One of the down-sides of our current media saturated culture is that it is easy to become “caught” in a negative media feedback loop. To help break this cycle, you can simply give yourself a “News Fast,” by turning off the TV and not checking Facebook, etc. for a period of time. Regarding stress, trauma and negative thoughts, we have seen many people helped through using acupuncture.
When emotions overwhelm us, there is a ripple effect to the physical body which may manifest as back pain, headaches, digestive issues, insomnia, high blood pressure or a number of other symptoms. Rawls tells of a recent case she experienced. “I had a patient who I’ll call Cindy (not her real name) who came in with upper back pain. When I had her point to the area of pain, it was in the area of the acupuncture point associated with the emotion of grief. I asked her if she had experienced an emotional upset and she related that her grandmother, to whom she was very close, had passed away the week before. Her emotion of grief and sorrow manifested as back pain.”
We’ve discussed the emotions before in our blog posts in February about the Heart, and last year in December with our 5 Tips for Relieving Stress and Anxiety. However we find that most folks don’t think about Acupuncture for help with grief, anxiety and despair associated with traumatic events.
Acupuncture supports the body’s ability to heal naturally by addressing the areas of the body where emotions have created physical symptoms, and also by regulating the nervous system which stimulates our “fight or flight” response when we are stressed, and our “rest and digest” response when we are not. It also regulates the hormones that are produced by the body in response to the nervous system such as endorphins, cortisol, thyroid hormones and others. Acupuncture restores balance by stimulating the body’s built-in healing mechanisms.
The #1 question we are asked at the clinic comes from those who are wondering if acupuncture can help with a problem that they or someone they know has? Red Earth Acupuncture employs centuries old traditions that have proven to be effective for a broad range of conditions.
Chinese Medicine views disease and pain as an imbalance in the body. Our bodies have a number of mechanisms that regulate balance in the body: these include the regulation of body temperature, pH, hormones, blood flow and concentrations of sodium, calcium and glucose. These mechanisms may get out of balance for a number of reasons such as long time poor dietary habits, traumatic events, medications, environmental toxins, or injuries. When the body gets out of balance, we begin to see it manifested physically as disease, intense pain, digestive problems, menstrual irregularities and other issues.
Chinese medicine works to restore balance of the various systems of the body. Rather than simply treating a symptom, this approach heals the body from the inside out, and allows the body to utilize its natural healing functions.
Some of the conditions that can be treated at Red Earth Acupuncture are:
- Pain of all kinds – back pain, knee pain, headaches/migraines, dental pain, arthritis, post-surgical pain, epigastric pain, injuries, TMJ, cancer related pain, tendonitis, sciatica
- Digestive Disorders – acid reflux, nausea, vomiting, diarrhea, constipation, gastritis, IBS/IBD, gallstones
- Circulatory Problems – blood pressure irregularities, hypertension, poor circulation
- Respiratory Issues – allergies, asthma, chronic bronchitis
- Women's Health – infertility, menstrual irregularities, menopause symptoms, pregnancy, childbirth and postpartum issues, urinary tract infections, incontinence
- Men's Health – too much or too little urination, sexual dysfunction, prostatitis
- Children's Health – digestive issues, bedwetting, colic, eczema, asthma, allergies, nosebleeds
- Emotional Health – anxiety, insomnia, stress, depression, PTSD
- Brain and Nervous System – dizziness, vertigo, shingles, MS, Bell's Palsy
- Eyes, Ears, Nose and Throat – common colds/sore throats, cough, sinus problems, earaches, Meniere's disease, eye disorders
- Hormone Imbalances – thyroid issues, diabetes, chronic fatigue, adrenal fatigue
- And more....
Spring is a time of rebirth, sudden growth, and rapid expansion; an awakening of the life process. With that in mind, we thought this month might be a good time to talk about Fertility and Pregnancy.
So you want to have a baby?
Couples planning to have a baby typically put a lot of thought into preparing for parenthood. There’s putting together the nursery, planning for a college fund, and picking names - all focused on preparing for the arrival of the baby. These things are definitely important, but perhaps even more important is to prepare for the pregnancy itself. The health of the parents is arguably the most important factor in determining the health of the baby.
It’s important to prepare your body well before (at least 4-6 months) you intend to become pregnant so that it is strong, ready to conceive and carry the child through to a healthy birth. Chinese Medicine says we need to “tend the garden”, preparing the soil for a healthy baby. We look at diet and lifestyle not only for the mother but for the father as well. It takes a lot to make healthy baby-producing sperm, and we will want to make sure that the father’s “garden” is properly tended too. Here's a great recipe that will help you tend the garden...
It takes the body about 120 days to mature the eggs that will come to ovulate and the health and quality of an egg can be greatly affected during that time. For men, it takes about 70-90 days for a man’s sperm to mature. (reference: “Making Babies: A 3 Month Proven Program for Maximum Fertility,” Jill Blakeway, LAc and Sami David, MD). If a woman goes into pregnancy depleted from stress, health issues or other imbalances, it may take some time to restore balance so that she can sustain a pregnancy for 9 months. We stress that couples should take the time to address any imbalances before they try to become pregnant.
Eating a well balanced diet high in dark leafy greens and good quality protein can help to ensure that your body is making strong healthy blood, ideal for creating and sustaining a healthy pregnancy. Equally important is finding ways to reduce stress. Sleep, meditation and moderate exercise are great ways to do this. Regular sleep patterns that maintain the normal circadian rhythms also support healthy menstrual cycles. Regular acupuncture treatments and, if necessary, herbal therapy can also help balance hormones, reduce stress and strengthen the body to prepare it for pregnancy.
We look at fertility treatment as more than just helping a couple become pregnant. We view pregnancy as a natural process that occurs when there is a healthy mother and father, and we want to help the parents have a healthy child. That is, after all, what the mother and father really want. Right?
We see many patients that have issues becoming pregnant, and there can be a number of reasons for this. Many times this is due to menstrual issues (irregular periods), but it can also be caused by stress, illness, ovarian cysts, or other seemingly unrelated factors, Since the uterus is the environment where the baby will live, we look at the menstrual cycle to indicate where there may be an imbalance creating the inability to conceive and hold a pregnancy. Our goal is to create a nourishing and sustaining environment for the fetus to thrive.
Acupuncture and herbal therapies can improve ovarian and follicular function and increase blood flow to the ovaries and uterus creating a strong environment for the egg to be nourished and carried to term. As mentioned above, they can also help reduce stress and balance hormones, both of which can be key factors in fertility issues with both women and men. Chinese medicine can stimulate the endocrine system to produce hormones that stimulate the reproductive system, including sperm production in men. Moxabustion can warm the uterus so that it is the right temperature to allow implantation.
Difficulty getting pregnant can be stressful both emotionally and financially. Our goal is to help reduce this stress and provide a safe, effective treatment with no drugs or side effects. If you have had many failed attempts at pregnancy and are using IVF or other western medical treatment for infertility, Acupuncture and Chinese Medicine can provide additional support.
Red Earth Acupuncturist, Rawls Whittlesey, has recently started volunteering with the Atlanta Veterans' Acupuncture Clinic in Atlanta. This is a FREE clinic for Veterans, Active Military and their families. Acupuncture is currently being investigated by the Walter Reed Medical Center in Washington, D.C. as a viable treatment for PTSD in returning veterans. The military has also started using acupuncture in the battlefield to help with pain. Acupuncture treatments are offered in a group setting, with participants sitting quietly together. Everyone receives the same treatment which consists of 5 points in the ears. Some of the benefits include:
Improved mental clarity, concentration and memory
Decreased nightmares, hyper-vigilance and flashbacks
Reduced anxiety and irritability
More restful sleep
If you or someone you know is a Veteran, Active Military or one of their family members, please share this information with them. Clinics are held each Monday night at 6:00 - 7:00 pm, and the 1st and 3rd Saturdays at 10:00 - 11:00 am at the Church of the Epiphany on Ponce de Leon in Decatur. For more information visit the website www.acupunctureforveterans.org.