According to the American Heart Association, about 74.5 million people in the United States age 20 and older have high blood pressure. This is about one in three adults. High blood pressure is defined as systolic pressure that averages 140mm Hg or higher, and/or a diastolic pressure that averages 90 mm Hg or more. However, anything above 120/80 is considered pre-hypertensive.
In a study published by the Journal of the American Heart Association, results showed that acupuncture significantly lowered average 24-hour ambulatory blood pressure for a six-week treatment, a randomized trial reported. However, the effect disappeared in three months after a cessation of acupuncture treatment. This suggests that ongoing treatment is required to maintain the effects of treatment. Read the full article here.
Most patients included in the study were already on antihypertensive drug therapy, and these patients were instructed to not change their medication throughout the study period, or to use over-the-counter drugs or herbal supplements. This is very important because in the real world, due to the high risks associated with hypertension, patients with high blood pressure should keep their medications unchanged while first seeking acupuncture care. If your numbers go down far enough, then of course you can talk with your prescribing M.D. about changing your drug therapy. But, especially in the case of hypertension, it is important to always have an M.D. monitoring your prescription drug therapy.
Acupuncture's holistic treatment of the body can also have a healthy influence on blood pressure.
Anxiety, which does not cause hypertension, but which can cause temporary spikes in your blood pressure that could potentially damage the cardiovascular system, is greatly alleviated by acupuncture.
Insomnia, which might be linked with hypertension, is also relieved with acupuncture.
And while researchers aren't sure if high stress is linked with hypertension, activities known to reduce hypertension can also reduce your stress level. A key example is exercising 30 to 60 minutes per day.
The point of mentioning anxiety, insomnia and stress is to remind readers that acupuncture is a holistic medicine that is capable of treating patterns in the body not just limited to a patient's chief complaint. And sometimes, when treating what might appear to be unrelated symptoms, your primary symptoms improve.
Thursday, January 27, 2011
Part 1. Journal Studies
In my previous entry I talked about the treatment of pain with acupuncture and TCM. Here are a sampling of research articles.
Study Shows that Acupuncture Effective in Treating Carpal Tunnel Syndrome
This study, published in the May 2009 Clinical Journal of Pain, showed that acupuncture was as effective as corticosteroids in treating carpal tunnel.
Low Back Pain
Acupuncture was proved to have a long-term pain-relieving effect in a randomized placebo-controlled study. The study found a significant improvement for the treatment group in return to work, quality of sleep, and analgesic intake, with effects lasting up to six months. The results were published in the December 2001 Clinical Journal of Pain.
Another study examining Low Back Pain, published in 2006 by the American Medical Association, randomly placed patients into one of three experimental groups; full acupuncture treatment, minimal acupuncture treatment*, and no acupuncture treatment. Results showed acupuncture was more effective in reducing low back pain intensity than no acupuncture in patients with chronic low back pain. Most outcome variables tended to be slightly better in the acupuncture group compared with the minimal acupuncture group.
Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise.
This study showed that both raw and heated ginger reduced pain after an exercise induced muscle injury. The New York Times covered this article, although I recommend reading the original abstract because it's shorter and more clear. Ginger is a common cooking and medicinal herb in TCM, although I've never heard of a TCM practitioner using it alone for treating muscle pain. We normally combine it with other herbs to make larger formulas, or use it in medicinal cooking.
The take home message is that acupuncture can be very effective in treating pain throughout the body. And it is a very safe treatment method.
Compare this with a common way that people treat their pain - using over-the-counter NSAIDS (non-steroidal anti-inflammatory drugs) such as advil, motrin and aleve. A recent study in the February issue of the British Journal of Sports Medicine showed that while many athletes use NSAIDS on and before race day, most do not know about serious possible side effects, including kidney failure and gastrointestinal bleeding.
While I am a huge proponent of advancing acupuncture research, I also want to remind people that we do not need to wait for further studies to know that acupuncture is a safe and effective treatment option that can not only help people recover from pain and injury, but can optimize training and performance.
Study Shows that Acupuncture Effective in Treating Carpal Tunnel Syndrome
This study, published in the May 2009 Clinical Journal of Pain, showed that acupuncture was as effective as corticosteroids in treating carpal tunnel.
Low Back Pain
Acupuncture was proved to have a long-term pain-relieving effect in a randomized placebo-controlled study. The study found a significant improvement for the treatment group in return to work, quality of sleep, and analgesic intake, with effects lasting up to six months. The results were published in the December 2001 Clinical Journal of Pain.
Another study examining Low Back Pain, published in 2006 by the American Medical Association, randomly placed patients into one of three experimental groups; full acupuncture treatment, minimal acupuncture treatment*, and no acupuncture treatment. Results showed acupuncture was more effective in reducing low back pain intensity than no acupuncture in patients with chronic low back pain. Most outcome variables tended to be slightly better in the acupuncture group compared with the minimal acupuncture group.
The British Medical Journal in 2005 published an article reporting that adding acupuncture to standard treatment is superior to standard treatment.
Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise.
This study showed that both raw and heated ginger reduced pain after an exercise induced muscle injury. The New York Times covered this article, although I recommend reading the original abstract because it's shorter and more clear. Ginger is a common cooking and medicinal herb in TCM, although I've never heard of a TCM practitioner using it alone for treating muscle pain. We normally combine it with other herbs to make larger formulas, or use it in medicinal cooking.
The take home message is that acupuncture can be very effective in treating pain throughout the body. And it is a very safe treatment method.
Compare this with a common way that people treat their pain - using over-the-counter NSAIDS (non-steroidal anti-inflammatory drugs) such as advil, motrin and aleve. A recent study in the February issue of the British Journal of Sports Medicine showed that while many athletes use NSAIDS on and before race day, most do not know about serious possible side effects, including kidney failure and gastrointestinal bleeding.
While I am a huge proponent of advancing acupuncture research, I also want to remind people that we do not need to wait for further studies to know that acupuncture is a safe and effective treatment option that can not only help people recover from pain and injury, but can optimize training and performance.
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*You might be now wondering, "what is the difference between full and minimal acupuncture treatments?" The answer to this question is contentious within the field of acupuncture research and deserves a blog entry of its own. The short answer is that when designing a study, researchers would prefer that their patients (i.e., research subjects) do not know what experimental group they are being placed in. This is half of the "double blind" design that is universally agreed to be the gold standard in research, with the other half being that the researcher delivering the experimental intervention (in this case, the acupuncturist) doesn't know which of the interventions she is delivering.
Minimal acupuncture is a type of "sham acupuncture." And sham acupuncture is a type of intervention that is aimed at making the subject believe that they are receiving acupuncture while (in a perfect world) not receiving any benefits of a true acupuncture treatment. In other words, sham acupuncture is intended to be perceived as an intervention by the subject but to have zero treatment affect. The trouble is that most sham treatments affect acupuncture meridians in some way and therefore can't truly be considered the same as not receiving a treatment at all.
Minimal acupuncture is a type of "sham acupuncture." And sham acupuncture is a type of intervention that is aimed at making the subject believe that they are receiving acupuncture while (in a perfect world) not receiving any benefits of a true acupuncture treatment. In other words, sham acupuncture is intended to be perceived as an intervention by the subject but to have zero treatment affect. The trouble is that most sham treatments affect acupuncture meridians in some way and therefore can't truly be considered the same as not receiving a treatment at all.
From a practical standpoint, what you end up with is many acupuncturists on one side of the argument saying, "we understand the need for double blind studies, but the way they are currently being implemented is erroneously biased against showing acupuncture's efficacy" and some western trained researchers sticking to their point that "the gold standard of research ought to also apply to acupuncture research so that we can distinguish efficacy from placebo."
Harvard Medical School has looked into this, and if there's interest I can write more about this topic.
In the end, the take home message is that while acupuncture research can't neatly fit into the double blind design model, acupuncture research is continuously providing us with a growing database of helpful studies that show that acupuncture is effective in treating many conditions.
Monday, January 17, 2011
The Top 10 Reasons People Visit The Acupuncturist: 1. Something Hurts
Pain is by far the top reason that people seek care from an acupuncturist.
This discomfort could be an old knee injury from high school that gets creaky in the cold weather, a repetitive stress injury from computer use, low back pain due to heavy lifting, a stiff neck due to a job that requires a lot of sitting, or a sports injury that strains the musculoskeletal system. Fibromyalgia and chronic pain are also common.
This discomfort could be an old knee injury from high school that gets creaky in the cold weather, a repetitive stress injury from computer use, low back pain due to heavy lifting, a stiff neck due to a job that requires a lot of sitting, or a sports injury that strains the musculoskeletal system. Fibromyalgia and chronic pain are also common.
So how does acupuncture address these types of pain?
First of all, acupuncture treatments increase the amount of endorphins in the body. These are the chemicals that make the body feel good during exercise, pain, feelings of love, and during sex. Endorphins chemically resemble the opiate morphine which explains its analgesic effect, and ability to promote a feeling of well-being.
But how strong could a painkilling chemical be if it just comes from your own body?
Well, I can remember when I was a kid I went to the emergency room with my parents because my little brother needed a couple stitches. When we arrived we saw a little hyper boy running around the waiting room, dashing up and down the little slide, and happily playing with all the toys.
That boy went in to see the doctor right ahead of my brother, and when he came out we were shocked to see his arm in a full cast! He’d broken his arm in two places!
How had he been able to run around and play like a healthy child when in just a few minutes x-rays would show he’d suffered a major trauma? He was experiencing an endorphin rush that commonly follows traumas such as broken bones. That story has always reminded me of the power of endorphins - our body's natural pain killers.
Another avenue of pain relief is through the nervous system; acupuncture has a profound calming effect on the nervous system, and in this way can regulate nerve impulses transmitting pain.
Acupuncture also reduces inflammation, which is often a component of pain. For instance, we all know that there will be inflammation in a newly sprained ankle. But there can also be inflammation in the gastrointestinal tract that causes discomfort, such as in the stomach lining. Acupuncture’s strong effect on reducing inflammation is very helpful in this situation!
Lastly, in situations where an increase in circulation will help an injury heal faster, acupuncture is very helpful. By increasing blood flow and thus oxygen and nutrient delivery patients often find that they heal faster and can comfortably return to activities faster.
So that is the short story of pain relief from a western perspective. But what about pain relief from the perspective of Traditional Chinese Medicine?
When a patient comes in for help with pain we ask them some questions about the pain so that we can devise an individually tailored treatment.
Then we might put needles on the acupuncture points near the site of the pain (a local point), or we might treat points on that channel in an area of your body that is not currently in pain (a distal point).
An example is someone who reports sharp, fixed headaches on their forehead, that are aggravated by applying pressure, and relieved when doing exercise. The location of this headache indicates that the Yangming channels are being affected with blood stasis. For treatment we would needle yangming points on the lower legs and forearm, as well as a few points to increase circulation. Herbs to treat the blood stasis could also be prescribed.
Lastly, while most people think of acupuncture as something you do after you get hurt, it is also a tool to optimize athletic performance and help prevent injury. More about that in a later post....
Also, as this post is getting quite long, I'll save my sampling of research articles for my next post.
When a patient comes in for help with pain we ask them some questions about the pain so that we can devise an individually tailored treatment.
- Where is the pain located?
- Does this location stay fixed, or does the pain move around?
- Can the quality of pain be described as dull, sharp, heavy, cramping and/or burning?
- When pressure is applied is the pain alleviated or aggravated?
- Does applying heat alleviate the pain? What about applying cold?
- Was the onset of the pain slow and gradual, or sudden?
- Does the pain feel better with movement or rest?
- Is the client feeling any melancholy, depression or anxiety related to this pain?
Then we might put needles on the acupuncture points near the site of the pain (a local point), or we might treat points on that channel in an area of your body that is not currently in pain (a distal point).
An example is someone who reports sharp, fixed headaches on their forehead, that are aggravated by applying pressure, and relieved when doing exercise. The location of this headache indicates that the Yangming channels are being affected with blood stasis. For treatment we would needle yangming points on the lower legs and forearm, as well as a few points to increase circulation. Herbs to treat the blood stasis could also be prescribed.
Lastly, while most people think of acupuncture as something you do after you get hurt, it is also a tool to optimize athletic performance and help prevent injury. More about that in a later post....
Also, as this post is getting quite long, I'll save my sampling of research articles for my next post.
Friday, January 14, 2011
The Top 10 Reasons People Visit The Acupuncturist
Lately I've been going to a lot of networking events, and the most common question I encounter revolves around the theme of what types of conditions acupuncture can treat.
Since acupuncture relies on a careful evaluation of signs, symptoms, tongue and pulse within a logic system that is often quite different than the western medical logic, we acupuncturists don't always first think in terms of western disease diagnosis. After all, we might get five different patients with the same western diagnosis of "stomach ulcer," but in our system they are all exhibiting different patterns which require unique treatments. In other words, the way that we diagnose takes into consideration the western diagnosis, but uses that just as a starting point for further differentiation.
However, in the United States I think it's important that acupuncturists clearly convey the types of ailments that acupuncture can help, so that people know when to recognize that a trip to see us would be helpful! For example, a new client comes to me complaining of tennis elbow. During the initial intake, I find out that she also suffers from insomnia but didn't know acupuncture could help improve her sleep. If she hadn't overdone it with her backhand, she might have never known it was a treatment option.
In this spirit, I am going to start out my new blog by making posts about the Top 10 Reasons People Visit The Acupuncturist. This is in no way scientific; I just did a quick mental list of all the patients I've treated over the past several months and came up with this collection. When possible, I'll link my blogs up with applicable research.
My Top Ten List (in no particular order or importance or prevalence):
In each future entry I'll make my way down this list.
If you are an acupuncturist and commonly treat something that I haven't included please leave a comment with your experiences!
If you are someone wondering if acupuncture could help you then my advice is to make an appointment with a licensed acupuncturist near you. Acupuncturists need to do an initial intake before we can concretely let you know what your treatment options are.
To make an appointment with me, you can either visit www.acutuneup.com and make an appointment online, or call my office at (510) 545-2283.
- "What problems do people come to you for?"
- "What diseases are you trained to treat?"
- "Can acupuncture help with my child's headaches?"
Since acupuncture relies on a careful evaluation of signs, symptoms, tongue and pulse within a logic system that is often quite different than the western medical logic, we acupuncturists don't always first think in terms of western disease diagnosis. After all, we might get five different patients with the same western diagnosis of "stomach ulcer," but in our system they are all exhibiting different patterns which require unique treatments. In other words, the way that we diagnose takes into consideration the western diagnosis, but uses that just as a starting point for further differentiation.
However, in the United States I think it's important that acupuncturists clearly convey the types of ailments that acupuncture can help, so that people know when to recognize that a trip to see us would be helpful! For example, a new client comes to me complaining of tennis elbow. During the initial intake, I find out that she also suffers from insomnia but didn't know acupuncture could help improve her sleep. If she hadn't overdone it with her backhand, she might have never known it was a treatment option.
In this spirit, I am going to start out my new blog by making posts about the Top 10 Reasons People Visit The Acupuncturist. This is in no way scientific; I just did a quick mental list of all the patients I've treated over the past several months and came up with this collection. When possible, I'll link my blogs up with applicable research.
My Top Ten List (in no particular order or importance or prevalence):
- Something Hurts: (including Back Pain / Sports Injury / Injury due to sedentary job / Chronic pain)
- Hypertension
- Stress / Anxiety / Depression
- Fertility (including men...!)
- Headache
- Insomnia
- Gynecological Issues: (including Menstrual Cramps / Hot Flashes / Cycle related mood slumps / Fatigue after childbirth / Mastitis)
- High Blood Pressure
- Trouble losing weight / Feeling low energy
- Digestive Issues (acid reflux, pain, indigestion)
- Frequently catching colds (Yes, I'm cheating by sneaking an eleventh in. But it's so common that I don't want to leave it out!)
In each future entry I'll make my way down this list.
If you are an acupuncturist and commonly treat something that I haven't included please leave a comment with your experiences!
If you are someone wondering if acupuncture could help you then my advice is to make an appointment with a licensed acupuncturist near you. Acupuncturists need to do an initial intake before we can concretely let you know what your treatment options are.
To make an appointment with me, you can either visit www.acutuneup.com and make an appointment online, or call my office at (510) 545-2283.
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