How I Pick the Points!

One of the most common questions I get in my clinic is, “How do you know which points to use?” Really, it’s the same way your MD knows which drug to prescribe or referral to give, lots and lots of training.

If you’ve watched my other videos, you’ve probably figured out by now that Acupuncture is a physical medicine and not an energy medicine. It works on the muscles, blood vessels, nerves and immune system. Despite the conventional wisdom that this is all very mystical, quite a lot is known about the mechanism of Acupuncture, particularly in the treatment of pain. If you have advanced education in physiology or medicine, I highly recommend reading Donald Kendall’s The Dao of Chinese Medicine, printed by Oxford University Press! I don’t get any kickbacks for recommending it; I just think it’s a great book.

For the regular folks out there, these videos will help you understand what is going through my mind when making a point selection. It’s all very physiological and straightforward! It doesn’t even require chanting or channeling or any other mystical intervention!

If you liked those, check out some of our other videos!

Dry needling

What is qi? It’s not what you’ve heard!


Why do my symptoms come back?

Unfortunately, Acupuncture (as well as any other neurological rehabilitation) is not a one and done therapy. Due to a property called neuro-plasticity, neurological changes in the body require repeated input before they become permanent.

In this video we explain how poor function and chronic pain come about, why they seem to come and go before they go for good and what changes in the body once the results become permanent. Enjoy!

For more videos about natural medicine check out:

What is Qi?

Function = Health

Acupuncture is NOT Energy Medicine

and the ever popular Dry Needling



Acupuncture Helps Arthritis

Many people in San Francisco are looking for a natural, drug-free way to treat their arthritis pain. We boast an incredibly active population in the Bay Area, and people don’t want to give up on being involved in life just because they now have arthritis. However, the desire to stay active can lead to a daily regimen of anti-inflammatory drugs. These drugs are primarily over the counter, so other than being bad for your stomach, most people assume they are safe.

If you were watching the news in 2004, you probably remember Vioxx being pulled off the market due to its connection with heart attacks. The FDA then recommended all similar medications be labeled as possibly dangerous to heart health. What most people don’t know is that medications like Advil (Ibuprofen) fall in this category as well. In fact multiple studies have shown that ibuprofen increases risk of death from heart disease in healthy people. It also interferes with the effectiveness of aspirin therapy in those with cardiac risk. Other studies have shown that NSAIDS (non-steroidal anti-inflammatory drugs) make arthritis worse! That’s right, they have been shown to impede tendon, cartilage and bone repair. “Wait!” you say, “I thought I was supposed to take these drugs for these problems, and now you’re telling me that I am making the problem worse?” Sadly, yes.

So now you want to remain active, even with your arthritis, but you don’t want to risk your stomach, heart and the cartilage you are trying to protect. What now?

Acupuncture has been shown to be wildly effective in the treatment of Arthritis pain. And the reason, in this author’s opinion, comes down to circulation. Arthritis basically consists of two problems: inflammation and low blood flow. The major types of arthritis, Osteoarthritis, Rheumatoid arthritis and Psoriatic arthritis have varying degrees of the two issues with Rheumatoid and Psoriatic being more inflammatory and Osteo being more related to poor circulation.

In Chinese Medicine, the terminology was determined before we had all of these medical explanations. Therefore we often use simple words to explain these conditions. A more inflammatory condition would be called “heat,” and a problem with lack of circulation would be called “cold.” In fact, if you take a thermal scan of a joint, you can, in fact, see that inflammatory conditions are hot (red) and low circulation conditions are cold (blue). We treat these problems with opposite methodology, therefore it is very important to properly evaluate the condition.

Once your arthritis has been properly diagnosed as hot, cold or some combination of the two, treatment can commence. That treatment will focus on correcting the issue. The answer to both problems is in the circulation.

Blood performs two basic roles:

1. To bring nutrients and oxygen to an area

2. To take debris or waste away and eliminate it

Let’s call #1 the milk man and # 2 the garbage collector.

Now the problem with the cold condition (low circulation) is that the milk man can’t get in to deliver the milk. Now the joint is starving. It doesn’t have the proper nutrient flow it needs to stay healthy. This results in a degradation of the tissue. Just like a lack of food would cause you to waste away over time.

With the inflammatory condition (heat), we have too much stuff stuck in one place (usually fluid), and we need the garbage collector to come and take it away. If the garbage collector is not removing the garbage, it will build up and rot. Believe me, your joints are not good place to store the garbage of your body, and your body will revolt if you leave it there.

While this is a vast oversimplification, it is a good illustration of the importance of blood circulation. So what does Acupuncture have to do with this?

Acupuncture’s entire job is to manipulate the circulation of the body. We (Acupuncturists) choose points that are designed to increase or reduce fluid, blood or oxygen in a certain area. That’s all we do. Through thousands of years of experimentation, protocols for affecting the circulation in specific areas (whether that be a joint or an organ) have been developed. As long as the condition is correctly analyzed and the practitioner is trained in the proper treatment approach, the chosen points will work to correct the circulation problem.

So what will this mean in the case of arthritis? How will you know your circulation has been brought back to normal? We could take a thermal scan, and these scans have been used to show the immediate effects Acupuncture has on circulation. But the most important issues to most people with arthritis are pain level and mobility. It turns out that these indicators are quite effective in determining the success of treatment. In other words, if you feel better and can move better we can assume that the Acupuncture is working to correct the circulation problem in your joints.

Link: what to expect at your first visit

For more on how to know when you’re better: link to Acupuncture Done Correctly Gets Results

Vioxx recall: http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm103420.htm

Articles on Acupuncture and Arthritis:

http://www.webmd.com/rheumatoid-arthritis/guide/arthritis-acupuncture

Beware of herb suggestions in this one, they’re not entirely accurate: https://www.acufinder.com/Acupuncture+Information/Detail/Acupuncture+for+Arthritis

 

I’d ignore the insurance coverage advice here. Often insurance coverage of Acupuncture is not what it appears to be: http://www.arthritistoday.org/treatments/alternative-therapies/complementary-therapies/acupuncture-gets-respect.php

http://www.livescience.com/8236-acupuncture-arthritis.html

http://health.usnews.com/usnews/health/briefs/arthritis/hb050103c.htm

We really don’t put all these needles in your face. They just love these pictures, because they are so dramatic: http://www.washingtonpost.com/wp-dyn/articles/A14316-2004Dec20.html

More on the heart and stroke dangers of ibuprofen:

http://www.drugs.com/ibuprofen.html

http://www.usatoday.com/news/health/2010-06-11-nsaids-heart_N.htm

Ibufprofen interferes w/ aspirin effectiveness: http://www.mayoclinic.com/health/heart-attack/DS00094/DSECTION=prevention

Ibuprofen causes cartilage damage:

http://www.chiroweb.com/archives/15/22/06.html

http://www.orthosupersite.com/view.aspx?rid=18588

You can find thousands more references on the internet if these are insufficient!

Acknowledgements:

Thanks to Bob Doane, LAc and his office manager Kim for changing my understanding of Acupuncture and circulation. http://www.acupuncturewellness.net/robert-doane/


Acupuncture Done Correctly Gets Results

People in Pensacola are busy—maybe busy fishing, sailing and surfing, but we’re busy. We don’t have time to spare for approaches that don’t produce real results. It’s great to lie down for a thirty minute Acupuncture treatment and relax to soothing nature sounds. But who has time for a nap if a little stress relief is all you get? You could go to the beach for that.

I’ve met so many new patients who have had Acupuncture in the past. When I ask if it worked, they reply, “I’m not sure.” Many of them aren’t even exactly sure what they were being treated for or what the desired outcome of the treatment was. This confusion comes about because people often equate “natural” or “holistic” with some kind of subtle, below the surface change that is not obvious. I myself have gone to the health food store and bought a homeopathic remedy (before becoming an Acupuncturist), say for muscle soreness, and not really been able to tell if it had an effect. This doesn’t necessarily mean homeopathy doesn’t work—I honestly don’t know if it does or not—but it reinforces the idea that drugs, whether I approve of them or not, produce obvious results and natural approaches do not.

This assumption is flatly false. Chinese medicine (this includes Acupuncture and Herbal Medicine) administered after a proper evaluation and diagnosis should show concrete results within the first month—at the longest. Many patients experience a positive change—for example an obvious reduction in pain—during or after the very first treatment. More complex problems, however, may require a series of treatments to start to see a positive effect. That brings up the question, how do you know you are getting a positive effect?

In most Acupuncture offices, the patient report is the only measure of progress. And that patient report may be as vague as the answer to, “How are you doing today?” As people tend to have various factors which would influence the answer to such a question, this is not a very accurate way to gauge success. For example, if your car got towed this morning, the answer would likely be fairly negative. What we do at Gulf Coast Wellness is create a set of data at the initial exam that we then measure success against at the follow-up exams. Of course, this approach would require actually doing exams.

So what is this data? It’s simply a combination of percentage improvement on chief complaints and number of tests that were originally positive and are now negative. Let’s look at what that means.

Chief complaints are the issues that you come in hoping to resolve. For example, if someone has low back pain and migraine headaches, and these are the two problems they most want to get rid of, these would be their chief complaints and the main focus of the treatment. Someone else may come in for digestive problems, insomnia and arthritis pain. The chief complaints vary with every patient. The improvement in chief complaints is measured either by comparing a survey of the current frequency and intensity of the problem or by patient report—that is, the patient says, “My back pain is 60% better than when I started.”

The tests done at the initial exam follow the chief complaints. Range of motion exams will be performed on any joint that hurts or that may be involved in causing a nearby area to hurt. This is similar to the exam you would expect to receive from an MD. The pulse and tongue will be examined on every single patient; these are Chinese Medicine’s secret weapons. They allow us to see what’s happening inside the body. At our office, we also perform palpation exams. This means that we press on a lot of Acupuncture points or organ reflex areas to see which are tender. The resulting pattern can help inform treatment. Blood pressure, weight, and other measurements are commonly taken as well.

Periodically, all tests are re-measured and compared to the initial result. This is called a re-examination. The results of this re-examination tell whether or not you are improving at the expected rate. The value of this is two-fold. One, we are not overly influenced by an optimistic patient. For example, someone reports feeling 80% better, but the more objective tests show only a 30% improvement. Two, we are not overly influenced by a patient who is discouraged. For example, their frequency/intensity survey shows a 70% reduction in the frequency of their pain. Today, however, is part of the 30% and they are feeling down about their results. This causes them to underreport their improvement. Weighing the subjective and objective against each other allows us to get a clearer picture.

Why get a clearer picture? Because this is where treatment adjustments should be made. If a patient is not progressing as expected, we had better change the treatment approach immediately. They may require a different point prescription (the Acupuncture points used in the treatment), the addition of a modality (herbal medicine or nutrition, for example), increased treatment frequency or a different approach altogether (such as a referral to a different practitioner). If the patient’s condition is resolving faster than expected, they may actually need less treatment than previously anticipated. In this case, a particular modality may be removed or the treatment frequency may be reduced.

At Gulf Coast Wellness we graph these results to obtain an easy to interpret picture of a patient’s progress. Anyone can understand that a graph moving steeply upward is excellent, and one moving downward is not good. Through experience, we know what kind of graph shape represents average, excellent and poor results, and we can use these shapes to help inform continuing treatment.

If diagnosis is correct, then treatment should be correct. If treatment is correct, results will follow. Therefore, by monitoring results, it can be determined whether or not diagnosis and treatment are actually correct. In other words, if you are getting Acupuncture, and you’re not sure if you’re getting results, it is likely that either diagnosis or treatment (or both) are incorrect.

 

Acknowledgments:

I didn’t make up tracking results all on my own. I was trained extensively by Curry Chadoir, LAc of Acupuncture and Holistic Health Associates http://www.holisticacupuncture.net/

I refined many of my methods through internship with Robert Doane, LAc of Acupuncture and Wellness Center http://www.acupuncturewellness.net/robert-doane/

Both of them are extremely generous with their time and expertise. If you are an Acupuncturist reading this, I highly recommend finding a way to learn what they have to teach.