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Painful Conditions: Contents

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Headaches

Nearly everyone gets a headache from time to time, but for some people headaches can be so frequent and/or intense that they become incapacitating. Headaches account for nearly 2% of all GP consultations, and about 4,000 hospital admissions and 10,000 outpatient attendances per year. The conventional medical treatment of headaches usually involves drugs, but these are not always effective and often involve unwanted side-effects. This is why a considerable and increasing number of headache sufferers turn to alternative medicine in general, and Traditional Chinese Medicine (TCM) in particular, for help with their condition.

The two most common types of headache are Migraine headaches and tension type headaches. Migraines are sudden, violent headaches with recurrent attacks, and can last for several days. They are sometimes  preceded by a visual aura and can involve nausea and vomiting. The headache is usually on one side of the head, perhaps around the temple.

Tension type headaches can be one sided but are more usually felt on both sides of the head, perhaps like a tightness or pressure around the forehead and temples, possibly spreading down the neck. Most such headaches last a few hours, but sometimes they can take several days to clear. There are usually no other symptoms, except perhaps an aversion to bright light or loss of appetite.

Headaches and TCM

Pain in TCM arises when our Qi is not free flowing; for some reason it is stuck or stagnant. Headaches arise, then, when this is happening in our head, and TCM treatment of headache usually includes acupuncture to encourage the Qi to move more freely. Needles may be inserted near the pain itself, but quite often acupuncture points in the hands, feet, arms or legs may be used. These are points which are connected to the head by the meridian system and which are known to be able to regulate the Qi of the head.

TCM, however, is a holistic form of medicine, which means that it sees the person as a whole; the TCM practitioner will see the headache as part of a bigger picture which is the overall health of the patient. This will give him or her an understanding of why the headaches are happening, and treatment will thus be geared not only to symptomatic relief of the headache, but to improving the general health of the patient so that headaches will, in time, stop happening.

Is Acupuncture Helpful in the treatment of Headaches?

There have been plenty of studies done in the UK as to the effectiveness of acupuncture in treating headache and Migraine. One of the most recent was a very large scale trial involving 400 patients in GP practices (Vickers et al (2004)) which found that acupuncture was more than twice as effective as the standard (western medical) treatment, and resulted in better improvement in quality of life; this trial recommended that acupuncture should be more widely available for headache patients on the NHS and concluded that: "Acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine".

The British Acupuncture Council have published a briefing paper on the effectiveness of treating Migraine with Acupuncture, which can be accessed at www.acupuncture.org.uk by clicking Research, followed by Documents. This paper is also available from our clinic on request.

Migraine

Migraines are headaches with recurrent attacks, and can last for several days. They are sometimes  preceded by a visual aura and can involve nausea and vomiting. The headache is usually on one side of the head, perhaps around the temple, and is often severe and maybe pounding. Migraines affect around 15% of adults, and for many of these people the symptoms are incapacitating; sufferers may have to lie down in a dark and quiet room and wait for the headache to subside.

Sometimes migraines may be triggered by such things as certain foods, stress, bright lights or loud noise. Some women are more likely to get a migraine just before or during their period. More often than not, however, there is no obvious trigger to a migraine attack.

Migraine andTCM

Migraines in TCM most commonly arise because of a relative excess of Yang energy. It is in the nature of Yang to rise, and if this rising is unchecked by insufficient Yin, this is what happens—Yang energy rises up along one or more meridians until it gets to the head, where it has nowhere else to go, and where it therefore, as it were, bangs against the head, causing the typical throb of a migraine headache. 

So in the first instance treatment needs to root the Yang, hold it down, and stop it rising up ‘rebelliously’. Acupuncture is usually an effective means to this end.

Moreover, treatment also needs to address the imbalance which is causing the Yang to rise. This often means that the Yin energy needs to be nourished, and for this acupuncture as well as perhaps herbal therapy will be used, but we will also need to support this treatment by eating Yin nourishing foods and perhaps by appropriate rest and relaxation, for whereas Yang is the active and dynamic side of our nature, Yin is the quiet, reflective side. Modern life can therefore mean that our Yin gets a raw deal!

Another factor causing the Yang to rise is what we call Qi Stagnation. Here the Qi is not flowing freely, often due to stress and tension, and this makes it more likely that the Yang Qi will rush upwards. Acupuncture and appropriate exercise and self-expression will free up the Qi and help stop the migraines.

Is Acupuncture Helpful in the treatment of Migraine?

A recent large scale trial involving 400 patients in GP practices1 found that acupuncture was more than twice as effective as the standard (western medical) treatment for chronic headaches (of all kinds), and resulted in better improvement in quality of life; this trial recommended that acupuncture should be more widely available for headache patients on the NHS and concluded that: "Acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine"

A more recent and very large scale trial in Germany2, with almost 800 migraine sufferers participating, also found acupuncture to be more effective than pharmacological treatment in the prevention of chronic headache and migraine.

References:

1. Vickers A et al (2004) Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial BMJ  2004;328:744

2. Endres et al (2007) Acupuncture for the Treatment of Chronic Headaches Dtsch Arztebl 2007; 104(3): A 114–22

 

Muscle & Joint Pain

Probably everybody experiences numerous aches and pains during the course of their lives. Sometimes such pain is short lived and manageable, but for many people it is either so severe, or so lasting, that normal life becomes impossible. Such pain can deprive us of sleep, stop us working and cause depression and anxiety if we start to fear that the pain will never stop.

Sometimes such pain is part of a recognised condition such as rheumatoid or osteo-arthritis, or may be due to an injury or repetitive strain. Sometimes there is no obvious cause. Conventional treatment often involves strong pain-killing or anti-inflammatory medication which sometimes is ineffective and often brings unwanted side-effects. Furthermore, such treatment only masks the pain and does not address the underlying problem, so that the pain returns if the drugs are discontinued.

Muscle & Joint Pain and TCM

Pain in a particular area of the body arises when our Qi is not flowing freely through that area, either because it is stuck or stagnant, or because it is deficient. Since one of the principal functions of Qi is to bring nourishment to every area of our body, this impairment in the local Qi flow impairs our body’s natural healing process and prolongs the pain. Acupuncture can be extremely effective in alleviating pain because it regulates and frees up the flow of Qi; at the Clinic of Traditional Chinese Medicine we spend quite a lot of our time treating pain of various kinds.

Usually there will be two aspects to this treatment. The first priority, of course, is to stop, or at least alleviate, the pain itself. Acupuncture needles may be inserted near the area of pain, and also at other points on the meridians involved. These needles stimulate the Qi to flow more freely through the affected area, and thus reduce the level of pain. Usually a topical herbal remedy will also be prescribed which will enhance the effect of the acupuncture. How effective this treatment is will depend on the longevity of the pain; if it is of recent origin, then there may be very significant improvement very quickly. Chronic pain which has been ongoing for several years will usually need a course of treatments to make a significant difference.

In the case of acute pain caused by an accident or sports injury for example, this may be all the treatment necessary. However, in many cases of pain it is important to look at any underlying patterns of disharmony of the patient’s Qi as well. This will make the treatment more effective and help to stop the pain recurring in the future. This holistic approach to treatment may involve acupuncture, herbal therapy or Chi Kung.

The smooth flow of Qi through the body is easily affected by emotional frustration, anger and stress; this means that our pain may well be exacerbated by, or even caused by, such emotional factors, and in this case treatment also aims to restore and maintain the smooth flow of Qi, and support the patient in their attempts to lead a more balanced and happy life. To take another example, sometimes the problem may be less to do with the flow of Qi in the local area and more to do with the quality of nourishment that the Qi is bringing. If one of our organ systems is not working effectively, this nourishment may be of poor quality; for example, if the digestive system is impaired then it will not be effective in turning the food we eat into nourishment. Acupuncture can help again by regulating the systems involved, and we may also benefit from some herbal medicine to strengthen digestion.

Arthritis

The term arthritis refers to a group of conditions that involve damage to the joints. These conditions are painful and are the most common cause of disability in people over the age of 50. The most common forms are:

  • Osteoarthritis – degeneration of the joint due to injury, infection or lifestyle issues. In the developed world Osteoarthritis can account for up to 25% of all visits to primary healthcare practitioners.
  • Rheumatoid arthritis – a chronic autoimmune disease in which the body’s immune system attacks the joints.

Acupuncture is generally well known for its effectiveness in treating arthritis, and most acupuncturists spend a good deal of their clinical time treating this condition.

Arthritis and TCM

Acupuncture works by regulating and harmonising the flow of Qi.  If this flow is obstructed or blocked, pain occurs. The disease factors involved in Arthritis inhibit this free flow, leading to pain and stiffness. These disease factors may be cold (in which case the joint may feel cold to the touch, and the pain may get worse in cold weather but be alleviated by warmth), or hot (the joint feels hot and inflamed); there may also be an accumulation of body fluids in the area, leading to swelling (and often an exacerbation of the condition in damp weather).

Treatment will usually involve the insertion of acupuncture needles around the area of the problem, as well as further down the affected limb. In the case of the cold and damp variants of the disease, a pleasant-smelling Chinese herb called moxa may be smouldered on the end of the needles to help clear the cold and damp. Sometimes a treatment called cupping will be used in conjunction with acupuncture to help speed up the recovery process by further encouraging the Qi to flow freely, and herbal therapy (either taken in the form of pills or tablets, or applied to the skin as a cream or ointment) may be employed to help expel the disease factors from the body.

Treatment will also aim to address and redress any underlying disharmonies in the patient’s overall health which may have contributed to the problem arising.

Osteoarthritis often responds quite quickly to acupuncture. Whilst the speed of improvement will depend on factors such as how severe the condition is, how long ago it started, and the overall health of the patient, treatments should begin to show improvement after four or five treatments, if not sooner.

Rheumatoid arthritis also responds well. Sometimes if the condition is flaring up and the joints are hot and swollen, it may be best to have treatments 3 or 4 days apart until the acute symptoms have settled down,  to avoid too much harm being done to the joint by allowing the flare up to continue un-treated.

Is Acupuncture Helpful in the treatment of Arthritis?

There is a growing body of evidence supporting the use of acupuncture in the treatment of arthritis. For example, a large scale study conducted in the USA in 2004 concluded that acupuncture both relieved pain and improved function in osteoarthritis of the knee.1 For details of other studies you can access the British Acupuncture Council’s briefing paper on Arthritis at www.acupuncture.org.uk by clicking on Research, followed by Documents. These documents are also available on request from our clinic.

The World Health Organisation 2 report on the efficacy of acupuncture concludes that acupuncture has been proven, through controlled trials, to be an effective treatment for rheumatoid arthritis.

References:

1 Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AMK, Hochberg MC. Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee: A Randomized, Controlled Trial. Annals of Internal Medicine. 2004; 141(12):901-910.

2 WHO (2002): Review and Analysis of Reports of Controlled Clinical Trials

Back Pain

In May 2009, the National Institute for Clinical Excellence (NICE) included a course of acupuncture treatment as one of the recommended ways of treating persistent, non-specific low back pain within the NHS. In China, acupuncture has been used as an effective treatment for back pain for thousands of years, and a growing number of people in the west are also able to testify to its effectiveness for easing their back pain; the decision by NICE to recommend acupuncture stems from the confirmation of acupuncture’s effectiveness by modern scientific research, some of which is referred to later in this leaflet.

However, effective treatment of back pain involves far more than just sticking a few needles in someone’s sore back. This leaflet tells you about Traditional Chinese Medicine (TCM), of which acupuncture is a part, and how it is used to bring relief to back pain sufferers.

Back Pain and TCM

Pain and restriction of movement arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of back pain, the obstruction is in one or more of the meridians (channels through which Qi flows around the body) on  the back.  So treatment will involve freeing up that flow of Qi, this will usually involve acupuncture treatment on the back and probably further down the meridians on the leg or foot; massage and cupping therapy may also help, as may a topical herbal application.

However, it is also important to understand why the Qi is getting stuck, and from the perspective of TCM there are several possible causes of this, including the following:.

i) Sometimes the Qi is blocked in the back due to what TCM calls a ‘pathogenic factor’ obstructing the flow; this is a form of external Qi which blocks the body’s own Qi. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels of the back and, as it were, ‘frozen’ the Qi there. The low back is particularly vulnerable to Cold pathogens, which leads to fairly severe pain which is worse in cold weather and better for a hot bath or hot water bottle. In this case as well as moving the Qi with acupuncture, we will want to expel the Cold, perhaps using moxibustion and warming topical applications. We will also, of course, advise you to keep yourself warm! Other common pathogenic factors are Damp and Heat; in the former case the back may feel heavy and perhaps be a little swollen, perhaps getting worse in wet weather; in the latter it may be warm and slightly red.

ii) Back pain may also point to underlying systemic disharmony. Our careful questioning at the initial consultation will give us a clear idea of any such disharmony, and in this case local treatment of the back will be supplemented by treatment to rebalance your Qi overall, using acupuncture and perhaps herbal therapy.

iii) Back pain which comes on suddenly, usually (but not always) as a result of  an accident or trauma, should respond quickly to prompt treatment, but may suggest an underlying weakness in the back which needs longer term attention—this is especially the case if the injury occurs during normal activity.

Is Acupuncture Helpful in the treatment of Back Pain?

One of the trials on which the NICE recommendation mentioned above was based was a UK project 1 involving 241 patients with non-specific back pain, which showed that acupuncture was significantly more effective at reducing back pain than conventional NHS treatments.

A recent (2006) very large scale trial in Germany 2 involving over 1100 patients has found that acupuncture is much more effective at treating chronic low back pain than conventional therapies (drugs, physical therapy and exercise).

References:

1 Thomas K. et al (2005) Longer Term Clinical and Economic Benefits of Offering Acupuncture Care to Patients with Chronic Low Back Pain Health Technol Assess 9(32) 1-128  

2 Haake M. et al (2007) German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007 Sep 24;167(17):1892-8

Tennis Elbow and Golfer’s Elbow

Tennis elbow refers to pain on or around the outside of the elbow joint, usually due to damage of the tendon which connects the extensor muscles of the forearm to the humerus (upper arm bone). This can be caused by a single traumatic event, but is more usually due to repetitive over-use of the muscles. Playing tennis a lot if you are not used to it can lead to tennis elbow, but it may also arise from other causes such as using a computer mouse a lot.

Conventional treatment for tennis elbow may involve anti-inflammatory medications, physiotherapy, and steroid injections. Resting the arm from the activity which has given rise to the problem is an important part of the recovery process.

Golfer’s elbow is a similar condition, except that the pain is on the inside of the elbow and the muscles/tendons involved are the flexors.

 

Elbow Pain and TCM

Pain arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of elbow pain, the obstruction is in one or more of the meridians which flow down the arm from the shoulder through the elbow joint to the hand. Different meridians are involved for tennis elbow and golfer’s elbow. Treatment involves freeing up that flow, usually involving acupuncture treatment on the elbow and further down the meridians on the forearm or hand. However, it is also important to understand why the Qi is getting stuck at the elbow, and from the perspective of TCM there are several possible causes of this.

i) A single traumatic injury to the area will have temporarily damaged the meridians and blocked the flow of Qi. This is the most straightforward case and unless the injury is particularly severe a few treatments will usually be enough to substantially reduce the pain if not eradicate it completely.

ii) Sometimes the Qi is blocked at the elbow due to what in TCM is called a pathogenic factor obstructing the flow. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels at the elbow and as it were ‘frozen’ the Qi there. In this case as well as moving the Qi with acupuncture, we will want to warm the meridians, perhaps using moxibustion and warming topical applications such as Tiger Balm. 

iii) If the problem is due to repetitive strain, this may have weakened the Qi locally. Treatment here will involve a balance between strengthening the Qi and getting it to move.

iv) The problem at the elbow may arise partly because of problems further up the meridians in the neck and shoulder. When you first come to treatment, we will check these areas as well as the elbow, and if necessary treat any problems in the meridians in these areas as well as the elbow.

v) We will also check for any underlying or systemic weakness which may have made you more susceptible to injury or slower to heal. This is especially relevant for repeated or chronic injury. For example, recurring elbow problems may suggest that the muscles and tendons are not getting the nourishment they need to sustain the level of activity required, and this in turn might reflect (to take one possibility among many) an impairment of the digestive system. TCM practitioners are quick to recognise such a weakness and will use acupuncture, herbal medicine, or other modalities to help to restore the affected system to optimum functionality.

Is Acupuncture Helpful in the treatment of Elbow Pain?

A survey of Randomised Control Trials for acupuncture treatment of tennis elbow 1 concluded that there is strong evidence for acupuncture’s effectiveness, and the World Health Organisation 2 considers that the efficacy of acupuncture for this condition is proven.

References:

1 Trinh el al (2004) Acupuncture for the Alleviation of Lateral Epicondyle Pain: a Systematic Review  Rheumatology 43 (9)                                                

2 WHO (2002): Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials

Foot and Ankle Pain

Our feet support our body weight and need to be strong to cushion the repeated stress of striking the ground as we walk or run; they also need to be flexible to allow us to walk or run over uneven ground. There are many possible causes of foot pain such as a single injury, repetitive trauma, arthritis or wearing inappropriate footwear. Furthermore, most of us spend most of our lives these days walking on completely flat floors with our feet effectively bound in thick or hard soled shoes. This is not what our feet evolved to do, and is the source of many of the problems which afflict our feet and ankles.

A common type of foot pain is plantar fasciitis, in which there is pain on or near the heel, usually made worse by walking or running, and often affecting runners and athletes. It involves inflammation of the thick band of tissue that runs from the heel to the front of the foot, supporting the arch. Achilles tendinopathy (formerly called Achilles tendonitis) involves degenerated tissue in the tendon which connects the calf muscles to the heel, and is also a common problem among runners and other athletes. Overloading the calf muscles or the Achilles tendon may also lead to heel spur, a small bony projection on the heel.

Foot and Ankle Pain and TCM

Pain in TCM arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of foot or ankle pain, the obstruction is in one or more of the meridians which flow down the leg into the foot, so treatment will involve freeing up that flow of Qi, which will usually involve acupuncture treatment on the foot, perhaps combined with invigorating massage and the use of topical herbal applications. The patient can also do some simple daily exercises at home to help to restore flexibility and encourage the free flow of Qi to their feet, thus speeding up and maintaining the effects of treatment when away from the clinic.

It is also important to understand more deeply why the Qi is getting stuck at the foot though, and there are several possible causes of this.

i) A single traumatic injury to the area having temporarily damaged the meridians and blocked the flow of Qi. This is the most straightforward case and unless the injury is particularly severe a few treatments will usually be enough to substantially reduce the pain if not eradicate it completely.

ii) Repeated small stresses on the foot or ankle may have eventually weakened them, causing a local deficiency of Qi which in turn leads to the Qi failing to flow freely. Treatment here will need to not only restore the smooth flow but gradually strengthen the area concerned by encouraging the local nourishing circulation of Qi and Blood. This is often the case with, for example, chronic Achilles problems.

iii) Whilst the pain is felt in the foot, there may also be blockage of the meridians further up the leg; in this case treatment will also need to be focused in this area to ensure the foot has an adequate supply of flowing Qi.

iv) Sometimes the Qi is blocked due to what in TCM is called a pathogenic factor obstructing the flow. For example exposure to a wet environment, as for example in walking in the rain without proper footwear, may cause a Damp pathogen to lodge in the foot, typically leading to swelling, pain and a heavy feeling (Damp pathogens also have a tendency to sink down the body, so the feet are particularly prone to their presence). In this case as well as moving the Qi, the practitioner will seek to expel the pathogen, using acupuncture, topical and/or oral herbal medicine, and perhaps moxibustion.

v) Foot and ankle problems, especially if in both feet, may also point to underlying disharmony of our body’s Qi; for example, perhaps it has a general tendency to not flow freely, and the foot pain is only the most obvious manifestation of this. The TCM practitioner’s careful questioning at the initial consultation gives them a clear picture of any such disharmony, and in this case local treatment of the foot will be supplemented by treatment to rebalance your Qi overall, using acupuncture and perhaps herbal therapy.

Is Acupuncture Helpful in the treatment of Foot & Ankle Pain?

A US army study 1 has confirmed acupuncture as an effective treatment for plantar fasciitis. Another American study 2 of 67 cases of foot pain which had been unresponsive to conventional treatments found that almost half the patients had complete pain relief from acupuncture, and another third had better than 75% relief.

References:

1 Perez-Millan R & Foster L. (2001) Low-Frequency Electroacupuncture in the Management of Refractory Plantar Fasciitis: A Case Series. Medical Acupuncture 13(1)

2 Erickson R & Edwards B (1996) Medically Unresponsive Foot Pain Treated Successfully with Acupuncture Acupuncture in Medicine 14(2) 

Shoulder Pain

The shoulder is a very flexible structure that allows our arms a wide range of movement; to some extent this flexibility is gained at the expense of strength, and the shoulder is therefore prone to a variety of traumatic and degenerative problems. This tendency is perhaps often exacerbated by poor posture when our shoulders become rolled in and our chest collapses, and by a habitual hunching of our shoulders when we are stressed or anxious. All this means that shoulder problems are very common, ranging from mild occasional discomfort to severe pain and limitation of movement.

Conventional treatment of shoulder problems may involve physiotherapy, steroid injections, analgesic medications or surgery.

Shoulder Pain and TCM

Pain and restriction in movement in TCM arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of shoulder pain, the obstruction is in one or more of the meridians which flow around and through the shoulder, so treatment will involve freeing up the flow of Qi through the shoulder area, which will usually involve acupuncture treatment on the shoulder and quite possibly further down the meridians on the forearm or hand. Massage and cupping therapy may also help.

It is also important to understand why the Qi is getting stuck in the shoulder though, and from the perspective of TCM there are several possible causes of this, including the following:

i) Sometimes the Qi is blocked at the elbow due to what in TCM is called a pathogenic factor obstructing the flow; this is a form of external Qi which blocks the body’s own Qi. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels at the shoulder and, as it were, ‘frozen’ the Qi there. In this case as well as moving the Qi with acupuncture, we will want to warm the area, perhaps using moxibustion and warming topical applications. Other common pathogenic factors are Damp and Heat; in the former case the shoulder may feel heavy and perhaps be a little swollen; in the latter it may be warm and slightly red.

ii) Shoulder pain can often arise as part of an underlying disharmony involving inefficiency or poor functioning of internal organ systems. The careful questioning of a TCM practitioner at the initial consultation paints a clear picture of any such disharmony, and in this case local treatment of the shoulder will be supplemented by treatment to rebalance the patient’s Qi overall, using acupuncture and perhaps herbal therapy.

Is Acupuncture Helpful in the treatment of Shoulder Pain?

A recent Spanish study 1 of 201 patients with various forms of shoulder pain recorded complete resolution of symptoms in 59.7% of patients and ‘remarkable improvement’ in a further 33.8%. The authors concluded that acupuncture shows good results for shoulder problems, even when these are long standing.

References:

1 Guerra J. et al (2003) Acupuncture for soft tissue shoulder disorders: a series of 201 cases. Acupuncture in Medicine 21(1-2):18-22;

Neck and Shoulder Pain

Almost everyone these days suffers with neck and shoulder pain at some point in their life. This is in part because of the way we live; activities such as computer use and driving can over time put unnatural strains on the neck and shoulder joints. On top of that, a common response to stressful situations is to hunch the shoulders, and if the stress is ongoing, the muscles involved become increasingly tight and eventually painful. Other causes of neck and shoulder pain include trauma, whiplash, degenerative arthritis of the spine, cervical spondylosis, cervical spondylitis and, rarely, some abnormal conditions of the heart, lungs, spinal cord or abdominal organs.

Neck and Shoulder Pain and TCM

Diagnosis in TCM usually analyses a problem into what is the immediate cause of the problem (called the Branch) and what is the underlying disharmony which gives rise to the problem (the Root). Simplifying somewhat, with shoulder and neck pain the immediate cause will be either simply Qi Stagnation - the Qi is not flowing freely through the neck and shoulder area—or obstruction of the Qi by an external pathogen (an alien form of Qi which invades the body). Typically with neck pain a Cold pathogen of this type may be involved, especially if we have been exposed to cold draughts on the neck or been out in cold weather.

Treatment therefore begins with expelling any pathogen and promoting the smooth flow of Qi through the neck and shoulder area. Acupuncture is effective in this, but other forms of treatment such as moxibustion (in the case of a Cold pathogen for instance) and massage may also be helpful. In the case of an acute problem, such as waking up with a stiff neck, this may be all the treatment needful to resolve the problem, but in the case of chronic neck and shoulder problems we also need to treat the Root.

This is why we always look to give you a thorough and detailed consultation in which we ask you about all aspects of your health and well-being, including aspects which might not be obviously related to neck and shoulder pain. For instance, if your digestive system is not functioning optimally, causing symptoms such as bloating and tiredness after meals, a poor appetite and maybe loose stools, this will mean that all the muscles and other tissues in your body are not getting the nourishment they need. This nourishment obviously depends on food, and on our ability to digest food effectively. Thus an impaired digestive system may contribute to neck and shoulder pain. In this case we would want to regulate and strengthen the digestive system, using acupuncture and perhaps herbal therapy. Similarly, and this is often the case with neck and shoulder pain, your emotional life may be part of the Root. If for example there is a lot of frustration or anxiety in your life, this will tend to impair the smooth flow of Qi in your system generally, which becomes ‘uptight’ and tense. This may manifest in tight shoulder and neck muscles; acupuncture, as well as Chi Kung, is effective at restoring the smooth flow of Qi throughout the body, calming and relaxing the mind, and helping the neck and shoulders to soften and release.

Is Acupuncture Helpful in the treatment of Neck & Shoulder Pain?

A review of ten different trials has concluded that there is evidence that acupuncture is effective for chronic neck pain 1. Furthermore, according to a Norwegian trial, acupuncture can have significant long term effects in the treatment of shoulder and neck pain 2.  A recent Spanish study 3 of 201 patients with various forms of shoulder pain recorded complete resolution of symptoms in 59.7% of patients and remarkable improvement in a further 33.8%. The authors concluded that acupuncture shows good results for shoulder problems, even when these are long standing.  

References:

1 Trinh K.V. et al (2006) Acupuncture for Neck Disorders Cochrane Database of Systematic Reviews  Issue No 3.

2 Pain, July 2004; 109(3):299-307

3 Guerra J. et al (2003) Acupuncture for soft tissue shoulder disorders: a series of 201 cases. Acupuncture in Medicine 21(1-2):18-22.

Frozen Shoulder

Frozen shoulder, also called adhesive capsulitis, is a condition where the shoulder becomes very painful and stiff with an often drastic reduction in movement. Pain is usually worse at night, especially when lying on the affected side, and the restriction of movement can interfere with everyday tasks such as dressing or driving, meaning that this condition can often have repercussions for our working life.  Frozen shoulders usually resolve themselves, but as this can take several years, most sufferers will seek treatment to speed up the healing process, reduce pain and free up the joint.

Orthodox medicine considers that scar tissue forming on the shoulder capsule, which is a thin covering that protects the shoulder joint, is responsible for frozen shoulder. However, there is as yet no known reason why this scar tissue should form. Conventional treatments include painkilling drugs, physiotherapy, steroid injections and perhaps surgery.

Frozen Shoulder and TCM

Pain and restriction in movement in TCM arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of frozen shoulder, the obstruction is in one or more of the meridians which flow around and through the shoulder, so treatment will involve freeing up the flow of Qi through the shoulder area, usually involving acupuncture treatment on the shoulder and quite possibly further down the meridians on the forearm or hand. Massage and cupping therapy may also be beneficial.

It is also important to understand why the Qi is getting stuck in the shoulder. From a TCM perspective there are several possible causes of this, such as:

i) Sometimes the Qi is blocked at the elbow due to what in TCM is called a pathogenic factor obstructing the flow; this is a form of external Qi which blocks the body’s own Qi. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels at the shoulder and, as it were, ‘frozen’ the Qi there. In this case as well as moving the Qi with acupuncture, we will want to warm the area, perhaps using moxibustion and warming topical applications. Other common pathogenic factors are Damp and Heat; in the former case the shoulder may feel heavy and perhaps be a little swollen; in the latter it may be warm and slightly red.

ii) Frozen shoulder often arises as part of an underlying systemic disharmony involving inefficiency or poor functioning of internal organ systems. The careful questioning of a TCM practitioner at the initial consultation appointment gives them a clear picture of any such disharmony, and in this case local treatment of the shoulder will be supplemented by treatment to rebalance the patient’s Qi overall, using acupuncture and perhaps herbal therapy.

Is Acupuncture Helpful in the treatment of Frozen Shoulder?

A Hong Kong study 1 of 35 patients with frozen shoulder measured improvement in pain, strength and mobility after a six week course of treatment, and again 20 weeks after the treatment finished. Patients who had acupuncture treatment and appropriate exercise had improvement of 76.4% after the course of treatment, and this was maintained 20 weeks later. This compared with 39.8% for patients who had exercise but no acupuncture.

References:

1 Sun K. et al (2001) Acupuncture for Frozen Shoulder Hong Kong Medical Journal 7(4) 381-391

2 Guerra J. et al (2003) Acupuncture for soft tissue shoulder disorders: a series of 201 cases. Acupuncture in Medicine 21(1-2):18-22;

Hip Pain

The hip is where our leg connects to our pelvis, and is a ball and socket joint which in health moves freely in all directions, giving our leg a lot of flexibility. The weight of the upper body is transmitted through the hips when we are standing, walking or running, so along with the flexibility the hip joint also needs substantial strength.

From the point of view of conventional medicine, hip pain can arise from a number of different conditions such as

  • Arthritis
  • Bursitis
  • Tendonitis, especially in the iliotibial band
  • Muscle strains such as groin or hamstring strains
  • Osteoporosis

Conventional treatment depends on the cause of the pain and can include physical therapy, anti-inflammatory medication, and, in the case of arthritis, hip replacement surgery.

Hip Pain and TCM

Pain and restriction in movement in Chinese Medicine arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of hip pain, the obstruction is in one or more of the meridians which flow around and through the hip  So treatment will involve freeing up the flow of Qi through the hip area, and this will usually involve acupuncture treatment on the hip and quite possibly  further down the meridians on the leg or foot; massage and cupping therapy may also help, as may a topical herbal application.

However, it is also important to understand why the Qi is getting stuck in the hip, and from the perspective of Chinese Medicine there are several possible causes of this, including the following:.

i) Sometimes the Qi is blocked at the hip due to what Chinese Medicine calls a ‘pathogenic factor’ obstructing the flow; this is a form of external Qi which blocks the body’s own Qi. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels at the hip and, as it were, ‘frozen’ the Qi there. In this case as well as moving the Qi with acupuncture, we will want to warm the area, perhaps using moxibustion and warming topical applications. We will also, of course, advise you to keep yourself warm! Other common pathogenic factors are Damp and Heat; in the former case the hip may feel heavy and perhaps be a little swollen; in the latter it may be warm and slightly red.

Ii) Hip pain may also point to underlying systemic disharmony. Our careful questioning at the initial consultation will give us a clear idea of any such disharmony, and in this case local treatment of the hip will be supplemented by treatment to rebalance your Qi overall, using acupuncture and perhaps herbal therapy.

Is Acupuncture Helpful in the treatment of Hip Pain?

A recent (2006) very large scale trial in Germany has found that acupuncture is of significant benefit in controlling pain caused by osteoarthritis of the hip and knee. 1

References:

1 Witt C. et al (2006) Acupuncture in patients with osteoarthritis of the knee or hip: A randomized, controlled trial with an additional nonrandomized arm. Arthritis & Rheumatism, 54; 11: 3485 – 3493).

Knee Pain

Knee pain usually arises either due to injury or to degeneration of the joint. Injury can involve damage to one of the ligaments within the knee which hold the bones together, a tear of one of the menisci which provide stability and support to the joint, or an inflammation of one of the tendons which attach the leg muscles to the bones.

Degenerative problems which can affect the knee include osteoarthritis, rheumatoid arthritis and gout.

Conventional treatment for knee pain includes physiotherapy, anti-inflammatory medications and sometimes cortisone injections.

Knee Pain and TCM

Pain in TCM arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of pain in the knee, the obstruction is in one or more of the meridians which flow down the leg from the thighs, through the knee joint to the foot.  Treatment will involve freeing up that flow of Qi through the knee area. This will usually involve acupuncture treatment on the knee and further down the meridians on the lower leg or foot.

It is also important to understand why the Qi is getting stuck at the knee. From the perspective of TCM there are several possible causes of this.

i) A single traumatic injury to the area has temporarily damaged the meridians and blocked the flow of Qi. This is the most straightforward case and unless the injury is particularly severe a few treatments will usually be enough to substantially reduce the pain if not eradicate it completely.

ii) Sometimes the Qi is blocked at the knee due to what in TCM is called a pathogenic factor obstructing the flow. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels at the knee and, as it were, ‘frozen’ the Qi there. Similarly exposure to a wet environment (for example kneeling on a wet lawn when gardening) may cause a Damp pathogen to lodge in the knee, which typically leads to swelling, pain and perhaps a heavy feeling around the knee and in the leg. In this case as well as moving the Qi with acupuncture, the TCM practitioner will aim to expel the pathogen involved, which may involve, for example, warming the area by using moxibustion and warming topical applications, among other techniques.

iii) Knee problems, especially if on both knees, may also point to an underlying systemic disharmony. The careful questioning of a TCM practitioner during an initial consultation appointment will give them a clear idea of any such disharmony, and in this case local treatment of the knee would be supplemented by treatment to rebalance the patient’s Qi overall, using acupuncture and perhaps herbal therapy.

Is Acupuncture Helpful in the treatment of Knee Pain?

A systematic review 1 of trials of acupuncture as a treatment for chronic knee pain concluded that both pain levels and knee function are significantly improved by treatment with acupuncture. The review concludes that “the amount of high quality, long-term evidence for acupuncture is impressive when compared with the evidence for many other interventions for chronic knee pain. For example, recent reviews could find no long-term data to support the use of oral or topical NSAIDs [anti-inflammatory medication which is often used in orthodox medicine to treat knee pain]”

References:

1 Acupuncture treatment for chronic knee pain: a systematic review White N.E. et al (2007) Rheumatology 2007 46(3):384-390

Pelvic Girdle Pain

Many pregnant women complain about pubic pain, yet doctors and midwives often dismiss this pain as either 'inconsequential', 'unfixable', or 'just one of those pregnancy discomforts that have to be endured'.  None of this is true:  research has shown that acupuncture can help. 

Symphysis pubic dysfunction (SPD), also known as pelvic girdle pain or pubic symphysis pain is caused by the pelvic girdle area not working as it should, probably because of hormones, misalignment of the pelvis, or an interaction of the two.   It may be caused by excessive physical work during pregnancy or fatigue with poor posture, whilst lack of exercise and weight gain may contribute to the condition. 

The symptoms vary, but almost all women who have SPD experience substantial pubic pain.  Tenderness and pain low down in the frontal pelvic area is common, but often this pain feels as if it is inside.  The pubic area is generally very tender to the touch; many mothers find it painful when the doctor or midwife pushes down on the pubic bone while measuring the uterus.  

Pelvic Girdle Pain and TCM

Any activity that involves lifting one leg at a time or parting the legs tends to be particularly painful. Lifting the leg to put on clothes, getting out of a car, bending over, sitting down or getting up, walking up stairs, standing on one leg, lifting heavy objects, and walking in general tend to be difficult at times. Other symptoms include sciatic pain, difficulty rolling over in bed, bladder dysfunction (temporary incontinence at change in position), waddling gait and even knee pain. 

Pain in TCM arises when our Qi is not free flowing; for some reason it is stuck, or ‘stagnant’. TCM treatment of Pelvic Girdle pain usually includes acupuncture to encourage the Qi to move more freely. Needles may be inserted near the site of the pain itself, but quite often acupuncture points in the hands, feet, arms or legs may be used. These ‘distal’ points are connected to the rest of the body by the meridian system and are known to be able to regulate Qi throughout the whole body.

TCM is an holistic form of medicine, which means that it treats the person as a whole. The TCM practitioner sees pain as part of the bigger picture of the patient’s overall health. This gives him or her an understanding of why the pain is happening, and treatment will be geared not only to symptomatic relief of the pelvic girdle pain, but also to improving the general health of the patient so that the relief of pain will be maintained after treatment.

Is Acupuncture Helpful in the treatment of Pelvic Girdle Pain?

Although a limited amount of research has been carried out, those studies which have been completed have shown that acupuncture is effective in treating pelvic girdle pain. A study involving 386 women across 27 hospitals in Sweden in 2005 1 found that acupuncture was more effective than standard treatment, including stabilising exercises, and resulted in better improvement in quality of life; this trial indicated that whilst no cure exists for pelvic girdle pain during pregnancy, acupuncture was the treatment of choice for patients with experiencing the types of pain in the lumbar region which are associated with SPD (for example one sided sacroiliac pain, one sided sacroiliac pain combined with symphysis pubis pain, and double sided sacroiliac pain).

References:

1 Elden, H, Ladfors, L, Fagevik Olsen, M Ostgaard, H-C,  Hagberg, H (2005) Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial, British Medical Journal

This trial is available to view online at:

http://www.bmj.com/ by searching for ‘pelvic girdle pain + acupuncture’.

Sciatica

Sciatica usually refers to pain which refers along the course of the sciatic nerve—deep in the buttocks, down the back of the thigh and possibly to the back of the knee, the back and lateral aspect of the calf and foot.  It is rarely an inflamed nerve (known as neuritis) but more often a symptom that is characteristic of several syndromes:

  • Lumbar disc herniation (most common)
  • Piriformis syndrome
  • Sacro-iliac strain
  • Intraspinal tumour

Acupuncture can be extremely effective in the treatment of both chronic and acute back ache, even when there are structural imbalances in the spine.  Many cases of chronic back ache have been cleared in a few sessions, although back ache accompanied by sciatica can take longer to treat. 

Probably the main underlying cause of back ache is a sedentary lifestyle with very little exercise.  Gentle exercise such as brisk walking, T’ai Chi and gentle stretching and twisting exercises can all help to prevent back ache.  In some cases excessive exercise can cause back problems, especially if such exercise includes excessive jogging or aerobic exercise for those in their late 30’s or 40’s.

Sciatica and TCM

Diagnosis and treatment of sciatica in orthodox medicine is based on the location and nature of the pain. Most often anti-inflammatory and pain relieving drugs will be prescribed. These may block the symptom but do not treat the underlying cause.  In TCM, diagnosis and treatment of sciatica and related conditions is based upon an in-depth consultation which involves identifying the causative factors of the pain. Treatment is based upon a number of factors including physical and emotional signs and symptoms. During a treatment, the practitioner will work with the patient to balance their body and mind. For example, much attention is given to the detail of the patient’s lifestyle, diet, exercise and previous history.  Other practices, such as Chi Kung and T’ai Chi, flowing forms of martial arts, may also be recommended to enable the patient to relieve their pain and enable them to manage their health in a constructive way.

Is Acupuncture Helpful in the treatment of Sciatica?

Research into the treatment of lower back pain, both chronic and acute, indicates that acupuncture can be helpful.  Duplan et al (1983) researched the use of acupuncture for sciatica in the acute phase and found that it could significantly improve the symptoms.  Zhi and Jing (1995) demonstrated that scalp acupuncture could also be effective. 

References:

Duplan, B., Cabanel, G, Piton JL., Grauer, JL, Phelip, X. (1983) Acupuncture and sciatica in the acute phase.  Double blind study of 30 cases. La semaine des hopitaux; organe fonde par l’Axxociation d’enseignement medical des hopitaux de Paris. Vol 59, no 45 pp 3109-3114

Legge, D (1997) Close to the Bone, The Treatment of Musculo-Skeletal Disorder with Acupuncture and other Traditional Chinese Medicine: 2nd Ed. Woy Woy, Sydney College Press

Maciocia, G(2008) The Practice of Chinese Medicine Edinburgh, Churchill Livingstons

Zhi, L, Jing, S. (1995) Clinical comparison between scalp acupuncture combined with a single body acupoint and body acupuncture alone for the treatment of sciatica American Journal of Acupuncture, Vol 23, no 4 pp 305-307.

Sacroiliac Pain

The sacroiliac joint connects the bottom of the spine (the ‘sacrum’) with the pelvis (the ‘ilium’ ). Problems with this joint can arise from a traumatic injury such as a fall, from misalignment of the joint or from inflammatory joint disease (e.g. ankylosing spondylitis). Hormonal changes during pregnancy can also affect the sacroiliac joint.

Dysfunction of the joint typically causes a dull ache around the base of the spine, which can become a sharp pain during activities such as sitting down, bending, lifting etc. Pain may also be felt in the groin, buttock and at the back of the thigh.

Sacroiliac Pain and TCM

Pain  in TCM arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of sacroiliac pain, the obstruction is in one or more of the meridians which flow through the lower back  So treatment will involve freeing up that flow of Qi through this area, and this will usually involve acupuncture; massage and cupping therapy may also help, as may a topical herbal application.

However, it is also important to understand why the Qi is getting stuck, and from the perspective of TCM there are several possible causes of this, including the following:

i) A single traumatic injury to the area will have temporarily damaged the meridians and blocked the flow of Qi. This is the most straightforward case and unless the injury is particularly severe a few treatments will usually be enough to substantially reduce the pain if not eradicate it completely.

ii) If the problem is due to repetitive strain, this may have weakened the Qi locally. Treatment here will involve a balance between strengthening the Qi and getting it to move.

iii) Sometimes the Qi is blocked due to what TCM calls a ‘pathogenic factor’ obstructing the flow; this is a form of external Qi which blocks the body’s own Qi. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels in the low back and, as it were, ‘frozen’ the Qi there. The low back, in fact, is often particularly vulnerable to cold. In this case as well as moving the Qi with acupuncture, we will want to warm the area, perhaps using moxibustion and warming topical applications. We will also, of course, advise you to keep yourself warm! Other common pathogenic factors are Damp and Heat; in the former case the area may feel heavy and perhaps be a little swollen; in the latter it may be warm and slightly red.

iv) Sacroiliac pain may also point to underlying systemic disharmony. Our careful questioning at the initial consultation will give us a clear idea of any such disharmony, and in this case local treatment of the area will be supplemented by treatment to rebalance your Qi overall, using acupuncture and perhaps herbal therapy.

Is Acupuncture Helpful in the treatment of Sacroiliac Pain?

A recent (2007) large scale trial of acupuncture in the treatment of low back pain found acupuncture to be almost twice as effective as the conventional therapy of pain-killing drugs, physiotherapy and exercise.1

As one of the researchers commented, “acupuncture represents a highly promising and effective treatment option for chronic back pain. Patients experienced not only reduced pain intensity but also reported improvements in the disability that often results from back pain - and therefore in their quality of life.” 2

References:

1  Haake M. et al (2007)  German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007 Sep 24;167(17):1892-8

2  Boyles, S. (2007) Study: Acupuncture Eases Low Back Pain Available at  http://www.medicinenet.com/script/main/art.asp?articlekey=84091

Facial Pain

From the standpoint of conventional medicine, there are numerous possible causes of facial pain, including:

  • Sinusitis
  • Trigeminal neuralgia (nerve pain)
  • Toothache
  • Ear infection
  • Dysfunction of the jaw

Pain may be dull, throbbing, stabbing or cramping; for some people it is intermittent, for others constant. Facial pain can be extremely distressing and debilitating, and sometimes the cause is not clear.

Facial Pain and TCM

Pain  in Chinese Medicine arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of facial pain, the obstruction is in one or more of the meridians which flow through the face. So treatment will involve freeing up the flow of Qi through this area, this will usually involve acupuncture on the face itself and on other points on the relevant meridians, perhaps on the arms or legs. Facial acupuncture is not an unpleasant experience; the needles are so fine that the insertion is often not felt at all, and once the needle is in the right place the patient usually feels only a dull, slightly achy or tingling sensation.

However, it is also important to understand why the Qi is getting stuck, and from the perspective of Chinese Medicine there are several possible causes of this, including the following:.

i) Sometimes the Qi is blocked due to what Chinese Medicine calls a ‘pathogenic factor’ obstructing the flow; this is a form of external Qi which blocks the body’s own Qi. For example, a Cold pathogen may invade the channels resulting in severe, biting pain which is worse in a cold wind or in cold weather. In this case as well as moving the Qi with acupuncture, we will want to warm the area, perhaps using moxibustion. We will also, of course, advise you to keep your face out of the cold! Other common pathogenic factors are Damp and Heat; in the former case the area may feel heavy and perhaps be a little swollen; in the latter it may be warm and slightly red.

ii) If the meridians have been invaded in this way, there is also likely to be a deficiency in the ’defensive Qi’. This is a concept in some ways parallel to the western notion of the immune system; in a healthy person the ’defensive Qi’ fights off any invading pathogens, and if one is lodged in the face this may well mean that the defensive Qi needs strengthening, with acupuncture and perhaps herbal therapy. 

iii) Facial pain may also point to a more generalised underlying disharmony. Our careful questioning at the initial consultation will give us a clear idea of any such disharmony, and in this case local treatment of the area will be supplemented by treatment to rebalance your Qi overall, using acupuncture, herbal therapy and dietary modifications.

Iv) Emotional factors may also play a part in facial pain. For instance, the stresses and strains of modern life and the loss of the ability to relax fully and deeply tend to leave us ‘uptight’. In this state the Qi does not flow so well, and this can exacerbate facial pain. Similarly, excessive or constant anger leads to Qi rushing upwards into the head and face (‘blowing our top’). In these cases acupuncture can help to relax and calm the spirit, and we can advise on ways to modify lifestyle and help you deal more satisfyingly with what life throws at you.

Is Acupuncture Helpful in the treatment of Facial Pain?

A study of 201 patients treated with acupuncture for facial pain was carried out at a hospital in Scotland 1; the author, a consultant oral and maxillo-facial surgeon, concluded that acupuncture has a significant role to play in the management of facial pain, and in some cases it may be the only treatment required.

References:

1 Merchant N. (1995) Facial pain: a review of 200 cases treated with acupuncture Acupuncture in Medicine, Nov 1995 VOL X111 No2, 67-70)

Gout

Gout, or gouty arthritis, is a painful inflammatory condition of one or more joints, usually the big toe but possibly other joints in the body. It usually comes in sudden attacks lasting from three to ten days; there will be severe pain, swelling and red shiny skin over the affected joint. It can make walking difficult and the pain can be exacerbated by even gentle contact with, for example, bed clothes. It is caused by the build up of uric acid in the blood stream, and for this reason is more common in men who have higher levels of uric acid.

Certain kinds of food and drink, including beer and spirits, can lead to raised levels of uric acid and so precipitate gout, as can various prescription drugs. Some medical conditions such as psoriasis, diabetes, high blood pressure, vascular disease and hyperlipidaemia (high fat and cholesterol levels in the blood) also increase the risk of gout, as does obesity.

Gout and TCM

Chinese herbal medicine and acupuncture have been used to treat gout for centuries. Gout is a form of what TCM calls ‘Painful Obstruction Syndrome’; something is blocking the natural flow of Qi through the affected joint. Treatment therefore aims to stimulate the Qi to flow more freely through the joint, and to remove whatever is causing the obstruction. This obstruction is usually an external form of Qi that has lodged in the joint, and in the case of gout this is usually a hot pathogen, possibly also complicated by the build up of ‘dampness’ - body fluids which are not being metabolised properly. Acupuncture in the vicinity of the affected area can stimulate the flow of Qi through the joint and expel the blocking pathogen, and other acupuncture points on the body can help to clear the heat and, if necessary, expel the dampness. Often a cooling topical herbal application applied to the area will speed up the healing process.

In TCM it is important not only to treat the immediate symptoms of gout, but also to look at the individual in their entirety and thus to be able to understand why they are susceptible to gout in the first place. Treatment can thus be aimed not only at curing the current attack, but preventing future attacks. How this is done will vary from person to person; treatment needs to be individualised to fit the needs of the patient. It may, to take one possible example, be the case that the person’s Qi is not as free-flowing as it could be; this is often a consequence of a busy stressful life, in which some emotions are not able to find proper expression, leading to a build up of frustration and manifesting as a generalised ‘uptightness’. If the Qi does not circulate freely, the extremities, in particular, are often affected, leading to their being susceptible to the kind of obstruction described above. Acupuncture treatment and perhaps some Chi Kung exercises can help to restore the free flow of the Qi and thus help prevent future attacks.

Is Acupuncture helpful in treating Gout?

The World Health Organisation1 lists gouty arthritis as one of the conditions for which the therapeutic effect of acupuncture has been shown. For example, a study of 60 patients2 suffering from gout showed that acupuncture was significantly more effective than conventional western pharmaceutical treatment, both in terms of reducing pain and reducing levels of serum uric acid.

References:

1  WHO (2002): Review and Analysis of Reports of Controlled Clinical Trials

2  Xie X et al ((2009) Observation on Therapeutic Effect  of Surrounded Needling Therapy on Acute Gouty Arthritis Department of Acupuncture, Affiliated Hospital of Jiangxi High Training School of TCM, Fuzou 344000

Carpal Tunnel Syndrome

Characterised by pain and numbness which affects the thumb, index finger, middle finger and ring finger, carpal tunnel syndrome frequently occurs in the later stages of pregnancy owing to oedema (swelling of soft tissue) in the hands.  The numbness, tingling or burning sensations occur because the median nerve is being restricted as it passes through the carpal tunnel in the wrist.   The symptoms will be worse for use, and may even spread to the forearm and palm of the affected arm.  In chronic cases, the muscles around the thumb may waste.

This syndrome can, if severe, interfere with daily activities such as being able to hold a cup or brush the hair. There may be loss of sleep due to being woken in the night by pain in the hands. In some cases “double entrapment” occurs; in which nerve roots at the cervical spine also need to be released by inserting needles into the Para spinal muscles.

Acupuncture can also help with other symptoms commonly found in patients suffering from Carpal Tunnel Syndrome such as neck pain, shoulder strain, headaches and eye strain.

Carpel Tunnel Syndrome and TCM

Pain in TCM arises when our Qi is not free flowing; for some reason it is stuck or stagnant. Wherever it is in our body, TCM treatment usually includes acupuncture to encourage the Qi to move more freely. Needles may be inserted near the pain itself, but quite often acupuncture points in the hands, feet, arms or legs may be used. Based on an individualised assessment of the signs and symptoms exhibited by the patient, acupuncture is used to treat the excesses or deficiencies of Qi located in various meridians. 

TCM, however, is a holistic form of medicine, which means that it sees the person as a whole; the TCM practitioner will see the pain as part of a bigger picture which is the overall health of the patient. This will give him, or her, an understanding of why the pain is happening, and treatment will thus be geared not only to symptomatic relief of the wrist pain, but to improving the general health of the patient so that the pain will, in time, be relieved.

Is Acupuncture Helpful in the treatment of Carpel Tunnel Syndrome?

A review of the research literature carried out by Leake and Broderic in 1999 indicated that acupuncture was effective for a wide range of conditions, including Carpal Tunnel Syndrome. Acupuncture helps to restore normal nerve function and can provide long term relief of pain associated with Carpal Tunnel Syndrome. There is limited research into the specific condition of carpal tunnel syndrome in pregnancy, but case histories indicate that treatment is successful although the number of treatments required to resolve the condition will depend upon the length of time it has been experienced.  Wolfe (undated) details three cases using various means to treat the condition which led to successful outcomes for the patients concerned.

In 1997, the US National Institute of Health Consensus panel, having reviewed the available clinical studies, acknowledged that acupuncture can help in the treatment of this condition.  Other studies have shown that acupuncture can help to stimulate the production of cortisol, a hormone which reduces pain and inflammation, as well as helping to reduce oedema.

References:

1 Leake, R., Broderic, J.E. (1999) Treatment Efficacy of Acupuncture: A review of the Research Literature, Integrative Medicine, Vol1, Iss. 3 pp107-115

2 Wolfe, H.L (undated) One Approach to Acumoxa Therapy for Pain due to Tendonitis of the Hand, Wrist, and Forearm.  Available from: http://acupuncture.com/conditions/tendonitis.htm

3 Endres et al (2007) Acupuncture for the Treatment of Chronic Headaches Dtsch Arztebl 2007; 104(3): A 114–22

Disclaimer
The Sean Barkes Clinic does not claim to cure any conventional medical disease states.  Traditional Chinese Medicine seeks to re-establish and maintain the harmonious function of the human body-mind using tried and tested principles that have been discovered and matured over millennia.  A Western medical diagnosis provides very little by way of insight in informing a Chinese Medical diagnoses.  Patients usually recognise their own condition in terms of the medical disease category that they have been given by their GP or other conventional medical practitioner.  The research presented here is merely an indication of the potential to draw parallels between Traditional Chinese Medicine and Modern Western Medicine.