Case Study: Acute Back Pain Resolved in 2 Acupuncture Treatments

A gentleman (43y) came in to my office a couple of weeks ago complaining of acute lower back (lumbar) pain which radiated down the lateral side (outside) of the left leg (I/T band). He described stabbing pain, level 8 (1-10 scale). This had happened a year ago. After an acupuncture treatment from a colleague the pain resolved until this recent episode. 

Discussion of Back Pain Acupuncture Treatment

I used balance method acupuncture points in his right hand. The pain reduced immediately upon insertion of the needles. While he rested with the needles in place, I made up a custom herbal formula to circulate blood. In TCM (Traditional Chinese Medicine) theory, stabbing pain is due to blood stagnation, or poor blood circulation in the area. In western medicine, the radiating pain indicates possible nerve impingement, likely caused by a disc protruding and pressing on the nerve root. He had not had any imaging of the area.

Results of Acute Back Pain Acupuncture Treatment

He returned 3 days later for follow up treatment. The pain had much improved. It was no longer a stabbing nature. Now he experienced mild stiffness in the morning with no radiating pain. I repeated the acupuncture treatment in the hand and changed the herbal formula. As the stabbing pain had resolved, i gave him a formula improve qi circulation in the area. The stiffness indicated the qi was not moving in the acupuncture channels of the lumbar region.

He presented the following week for acupuncture treatment with no pain. I gave him one more acupuncture treatment to consolidate the effects. I advised him to call me if the pain returned. He left my office a happy camper.

Update: Long-term Results of Back Pain Treatment

A year or more later I received a referral from this satisfied patient. When I thanked him for the referral I asked about the back pain. He told me he's been fine ever since. 

This is what I hear from my pain patients. "Believe me, if I had pain, I would have called you". So like the Maytag repairman in the old ad, once patients finish treatment, I rarely hear from them.

KB

Duke Univ Study Says Acupuncture Beats Pills for Headache

At last! When acupuncture first publicly arrived on the scene in the US in the 70's, the medical establishment's first concern was to be certain that the 'new' therapy was safe and wouldn't harm the public. After the millennium the safety concerns began to be put aside following a landmark NIH study in 1997 that confirmed acupuncture is safe & effective and encouraged researchers to turn to efficacy.

Most of the researchers seem reluctant to verify that acupuncture is highly efficacious, consequently the studies' highest accolades seem to be acknowledging that acupuncture can match western medicine in terms of effectiveness.

Duke University has a integrative medical department that is in the forefront of the field. It has recently released a study showing acupuncture is more effective than drugs for headaches. This is the first of its kind that i have seen. the study documented 62% relief in acupuncture patients compared to 45% effectiveness for those using drug therapy. Here's a 3min video from Duke University talking about the findings and interviewing an acupuncture migraine headache patient.

This is an article I have written discussing how acupuncture treats headaches. A few older studies are included. KB

Photo: RambergMediaImages , Flickr Creative Commons 2.0

Study Shows Acupuncture More Effective for TMJ Than Physical Therapy or Drugs

The spring, 2010, issue of the Journal of Orofacial Pain included a review of studies on the effectiveness of acupuncture for treating TMJ. The study concluded that acupuncture is more effective than physical therapy and medication in treating this disorder, and recommends more larger trials. The review also noted the absence of serious side effects in the acupuncture patients.

Here's a video showing a normal temporomandibular joint (hence TMJ)

Here's a video of a displaced TMJ that is clicking when it's opening.

This video shows a TMJ disc with a thin attatchment.

I seen pleasing results with acupuncture in treating TMJ and other facial pain. I've used both standard TCM (Traditional Chinese Medicine) style of acupuncture, which is most commonly taught in the colleges and being used today, and Dr. Tan's Balance Method of acupuncture. I've had satisfying results with both methods, but I see more immediate results using the Balance Method, with a more dramatic reduction in symptoms. Using the Balance Method, I expect to reduce pain on the first treatment.

For example, I recently treated a 25y woman (let's call her Michelle) with TMJ pain for 3-4 yrs. Pain was in her jaw, radiating to the temples, neck & spine, causing lockjaw and ear-ringing. Pain could be excruciating in the evenings, and was worse with stress. At the time of treatment her pain level was a 4-5 (1-10 scale) i inserted 3 needles in Michelle's wrist. Pain immediately disappeared in all areas. She no longer had ear congestion or ringing.

Acupuncture is a therapy, and a series of treatments is required. The number of treatments needed to eliminate the pain and symptoms varies, depending on the individual, and whether the condition is acute or chronic. For chronic pain a course of treatment (10-12) visits is usually required, acute pain responds faster and usually fewer treatments are needed to resolve the condition. I generally recommend weekly treatments. If pain is severe, or to see quicker results, twice a week is optimal in the beginning, for 2-3 weeks, until the pain level decreases and symptoms appear less frequently. When symptoms become intermittent, no longer on a daily basis I begin reducing the frequency to 10 days and later 2 weeks, then 3 week intervals to consolidate the treatment before discontinuing acupuncture when the condition is resolved. KB

Duke University Says Acupuncture Better than Asprin for Headaches

Duke University reviewed 31 studies to access the effects of acupuncture compared to drugs for the treatment of headache. The researchers found acupuncture is more effective (62%) than medications (45%). Findings were published in Anesthesia & Analgesia.

I practice Dr. Tan's Balance Method of acupuncture. Using this method, I expect to dramatically reduce pain on the first visit. Acupuncture is a therapy and a series of treatments is required. The number of treatments needed varies, depending on the individual, and whether the condition is acute or chronic. A course of treatment is 10-12 visits, and generally that is needed to treat a sub-acute condition. Chronic conditions take longer to treat.

All types of pain, including headache respond remarkably well to acupuncture. It is a shame more people are not using Chinese medicine for relief of their symptoms.

As an herbalist, i generally include an herbal formula to enhance treatment. Especially for chronic headaches, herbs give an extra edge to increase results of treatment. I compound individualized formulas for my patients which they drink as a tea.

Here's an article i wrote explaining how Chinese medicine treats headaches. KB

Dr. Oz: Why He Likes Acupuncture

Dr. Oz is an ardent supporter of acupuncture, and is frequently at the microphone touting the benefits of Chinese medicine and demystifying acupuncture. Here's a short piece Dr.Oz wrote for the Houston Chronicle citing studies that demonstrate acupuncture's benefits for insomnia, pain relief, and mitigating the side effects of chemo and radiation treatment for cancer patients.

Here Dr. Oz answers the question, "Does acupuncture really work?" He recommends it especially for pain and fibromyalgia. KB

Madonna Gets Acupuncture

The Material Girl gets acupuncture after shows to keep her dancing legs going.

Study Shows Acupuncture as Effective as Drugs for Carpel Tunnel Syndrome

A study published in May 2009 in The Clinical Journal of Pain compared acupuncture to the steroid drug prednisone for treatment of pain in carpal tunnel syndrome. The study concluded that:

"Short-term acupuncture treatment is as effective as short-term low-dose prednisolone for mild-to-moderate CTS. For those who do have an intolerance or contraindication for oral steroid or for those who do not opt for early surgery, acupuncture treatment provides an alternative choice."

This is big for a western medical study to recommend acupuncture as an effective alternative to drug therapy. For the symptoms of night time awakening due to pain and for motor function, the acupuncture group had better results. I've included an abstract of the article below.

Carpal Tunnel Syndrome is a repetitive use injury, commonly caused by excessive computer use (typing on the keyboard). The carpal tunnel is the hole that the (median) nerve travels through, located on the inside of the wrist where the wrist and hand meet. When the wrist is flexed, the carpal tunnel compresses, and the ligament on the roof of the tunnel presses on the median nerve, causing pain. The median nerve controls the thumb, index and middle fingers and the thumb (radial) side of the ring finger. Carpal tunnel patients experience pain in those fingers and palm area, not the pinkie finger as the median nerve which travels through the carpal tunnel does not affect the last finger or the pinky (ulna) side of the palm. Pain can also radiate into the arm. KB

Studies Show Acupuncture More Effective than Drugs for Headaches

In a December 2008 two doctors from the Department of Anesthesiology at Duke University Medical Center published the results of their systematic review of 25 studies on the use of acupuncture for treatment of headaches in Anesthesia and Analgesia. The authors concluded that acupuncture is more effective than drug therapy in relieving headaches. Here's a short NY Time's piece on their work. KB

Study Shows How Acupuncture Stops Pain

This article from the Medicine.net website discusses a western scientific study designed to explain acupuncture's pain relieving effect. It's a quick, interesting read. I would offer the caveat that no acupuncturist would recommend using morphine or other opiates after treatment, a conclusion a quoted researcher mistakenly draws from the study findings. It is validating to see western studies that scientifically verify acupuncture's results. KB

Imaging Sheds Light on How Acupuncture Works

SOURCE: University of Michigan Medical School, news release, August 2009

Castor Oil Packs

I've recently been researching Castor oil packs. Many holistic practitioners recommend them, and they have some intriguing uses. Castor oil comes from the Castor bean. It's use was popularized by early new-ager, psychic and medical intuitive, Edgar Cayce. You might find wikipedia's entry on him of interest: http://en.wikipedia.org/wiki/Edgar_Cayce .

From the point of view of Chinese Medicine, Castor oil seems to have the ability to move Qi, Blood and Phelgm (congealed fluids). This is seen by the claims to dissolve tumors and nodules and to improve Liver function, including treating cirrhosis.

Uses include bursitis/arthritis/joint pain, improving digestion/constipation, treating the liver/gallbladder, including cirrhosis and hepatitis, reducing menstrual cramping and dissolving tumours and nodules. I've seen claims of improving sleep/insomnia and relaxing facial wrinkles. You can find Castor oil in the health and body section of a natural food store. You might try a drug store, some may carry it. Do not ingest Castor oil as it is toxic. Do not use over open sores/wounds. Do not use with heavy bleeding (including menstrual).

For insomnia, put a drop on each eyelid before retiring, and then do my insomnia meditation described in an earlier post, 4/09.

For the face, put a few drops of Castor oil on the face at night to soften skin, relax wrinkles and reduce swelling and blemishes. Pay particular attention to problematic areas.

The following link gives a long list of personal testimonials of people's experiences with using Castor oil packs. There's a wide variety of intriguing uses presented here:

http://www.earthclinic.com/Remedies/castor_oil.html

Usually Castor oil is administered as a Castor oil pack. I've include the instructions for making a Castor oil pack below (taken from earthclinic.com). For most conditions, do Castor oil packs 4x/week for one hour duration.

Materials
* Three layers of undyed wool or cotton flannel large enough to cover the affected area
* Castor oil
* Plastic wrap cut 1-2" larger than the flannel (can be cut from a plastic bag)
* Hot water bottle
* Container with lid
* Old clothes and sheets. Castor oil will stain clothing and bedding.

Place the flannel in the container. Soak it in Castor oil so that it is saturated, but not dripping. Place the pack over the affected body part. Cover with plastic. Place the hot water bottle over the pack. Leave it on for 45-60 minutes. Rest while the pack is in place. After removing the pack, cleanse the area with a dilute solution of water and baking soda. Store the pack in the covered container in the refrigerator. Each pack may be reused up to 25-30 times.

I am interested in learning about your experience with Castor oil, positive or negative. Please send me your feedback about this. KB

The Spiritual Aspects of Pain

I was reviewing some notes this evening about the treatment of pain in Chinese medicine from a seminar taught by Jeffery Yuen. Jeffrey Yuen comes from two Daoist lineages – 88th generation of the Yu Qing Huang Lao Pai (Jade Purity School, Yellow Emperor/Lao Tzu Sect) and 26th generation of the Quan Zhen Long Men Pai (Complete Reality School, Dragon Gate Sect). As a Taoist priest, he has some interesting perspectives on healing and Chinese medicine.

With regards to treating pain, Jeffery discusses the spiritual implications of pain.

In Chinese medicine there is an oft repeated adage: tong zi bu tong, zi tong, bu tong. Tong means pain, and the adage translates thus: where there is pain there is stagnation [or lack of free flow - of qi and blood] where there is stagnation there is pain. In other words, when qi and blood do not move freely, pain results. (Qi broadly refers to life energy.) In Chinese medicine, the practitioner then must determine where the stagnation is located in the body (this would usually refer to the site of pain: one must determine which acupuncture meridians or channels are involved) and what has caused the qi and blood to stagnate. Generally we are looking for a physical cause of the stagnation, although emotions can also cause stagnation.

As a Daoist priest, Jeffery interprets pain as indicating that a person is emotionally, mentally or spiritually stuck. This mental/emotional/spiritual stoppage causes a physical stagnation in the body, manifesting as somatic pain. Here we are referring more to a long-term or chronic pain, rather than an acute injury. So those suffering from chronic pain might want to look at their inner life and well being to find blockages. This could be marital strife, job dissatisfaction, inability to reach one's life goals: any number of life issues where one is not moving forward in the desired direction.

Jeffery notes that the more one focuses on the pain, the more one enhances the illness: one focused on the terrible receives the terrible. This is the law of attraction: like attracts like. He further observes that it is painful to change our lives, and that it is painful to surrender.

He says pain likes to spread. Pain likes misery. Pain likes to refer (to other areas, such as sciatic pain that shoots down the leg or pain from a heart attack that presents as an achy sensation in the left arm). He says that pain does not like to be alone: it wants family to resolve the problem for you. He asks, " Can one resolve the pain [or the emotional/spiritual source of the pain] themselves?"

He discusses the significance of different qualities of pain:

1. Rigidity: Indicates withdrawal from life, moving away from life or the enthusiasm.
2. Cold (pain that is worse in cold weather, feels better with a hot pad, shower or bath): indicates retreat, apathy.

He goes on to say that healing requires hope and perseverance to bring meaning into one's life.

He says that it is not up to the practitioner to command change, but rather to be a catalyst to help the patient change.

You may have noticed the red Chinese character by my blog title: "Kath's Musings on Health, Chinese Medicine & Spirituality". This character is ying, which means guide. I chose it as a symbol of a couple of ideas that are relevant here:

1. In Chinese medicine we use the term guide, as in guide out stagnation, or guide out phlegm fluids. By this we mean that we are helping the stagnation or phlegm to move out, showing the way, in a physical sense.
2. In a more spiritual sense, the practitioner is guiding the patient on a course of healing, lighting the path out of the darkness.

These two ideas express how I see my role as a practitioner; both in treating the physical body and as an agent for emotional/spiritual growth, where ultimately all healing takes place. But it is not up to me to force it, my role is to point the way so that the body, mind and spirit can find it's course. KB