Archive for tag: acupuncture

Head Hurt?

2015-07-31_1What part? Back of the head, near the neck? Top of the head? Forehead? Feeling a tight band wrapped around the whole darn thing? Is it pulsing and throbbing, sharp and stabbing? Maybe you just have a dull empty feeling going on deep inside your melon.

Each of these headaches is recognized in and treated by Traditional Chinese Medicine. If you present in a TCM clinic with the chief complaint--or even an associated complaint--of "headache," the questions will roll forth to more fully understand the condition.

What does it all mean? Isn't there just an acupuncture point equivalent to Excedrin? Yes and no. There are some acupoints that are indicated for basically any type of headache, and it will probably be effective to some extent. But, if we can diagnose thetypeof headache then we can select more specific points that address both the current pain in the head and also the root of the problem.

Here's a breakdown of some of the common types of headaches in TCM, what's causing them, and how your acupuncturist might treat them:

The Full Frontal Headache

2015-07-31_2It hurts across your forehead. Sometimes feels warm, too.

  • Root is likely in the Stomach, which is called "yang ming" in TCM. Accumulated heat will create a sharp frontal headache. Conversely, deficiency of the Stomach can create a dull frontal headache.
  • Treatment principles include relieving frontal headache pain using points like Yin Tang and DU23pluseither clearing heat from the Stomach using points such as LI4, ST8, ST44, and LI11, or tonifying the Stomach using points such as ST36, SP6, UB20, and CV12. Regulate your diet and stress to help harmonize the Stomach.

The Vertex Headache

2015-07-31_3_smallIt hurts on the top of your head. Sometimes it's throbbing, too.

  • Root is Liver-related, which is called "jue yin" in TCM. Because the Liver channel runs to the top of the head, it's easy for excess yang or heat to fly up there when you're flying off the handle. A Liver blood deficiency can cause a (dull) vertex headache, but more often it's the throbbing type up there and it's caused by Liver Yang Rising. Sometimes the Gall Bladder also gets involved, and the headache is also temporal.
  • Treatment principles include relieving vertex pain, pacifying the Liver, and subduing Yang, using points like GB20, LV2, LV3, GB9, and Tai Yang. Stop stressing out--get your blood pressure under control. Or, in the rarer case that your vertex headache is actually from Liver blood deficiency, then your points would include LV8, SP6, and KD3.

The Occipital Headache

2015-07-31_4 It hurts low down in the back of your head into the neck. You're probably coming down with a cold, too.

  • Root is an external invasion by a pathogenic factor. While TCM would probably say you have a Wind-Cold invasion, they also show understanding of the microbes carried on such a "wind" by the way a small insect is under the breeze in the character used to write it. When you've been exposed to a Wind, it attacks the back of your neck and fights to take you down right there.
  • Treatment principles include expelling the Wind and perhaps also warming the Cold. Points would include UB12, UB13, DU14, GB20, LI4, and LU7. While GB20 is a local point in the area that actually hurts, the strategy here is simply expel the wind, and the headache should follow it out.

There are more, but that's enough for today. If you have an empty feeling headache, a Kidney deficiency is likely involved. If your whole head feels like it's being wrapped up and squeezed, we call that "tai yin."


For information, make your appointment at the Acupuncture and Oriental Medicine clinic now. :) The Whole Health Center is on our NUHS campus at 200 E. Roosevelt Rd in Lombard; you can schedule an appointment at (630) 639-9664.

Cheech and Chong?

2015-07-24_a1No, I said Si Shen Cong. Next question: You want to stick the needles where? Or, patients will stop me in my tracks with a firm "I don't want needles in my head." What's happening here? No big deal, I'm just trying to utilize the Four Spirit Alarm extra point set on the top of your head. 

Does it sound alarming? Painful? I can understand that. Needles in the head doesn't soundfunto most people, but rest assured it usually doesn't hurt. The scalp is a shallow place, not too full of fleshy, innervated muscles.

Right up there on the top, slightly to the back, you'll find a special set of four points calledSi Shen Cong. Chinese pronunciation sounds something like "Shee Shen Chong." English pronunciation sounds more like "Cheech and Chong." It's ok, just keep working on it.


One translation calls this extra point "God's Cleverness." We use it for improving concentration, memory, focus, or other related indications. In TCM treatment strategies, it helps to "calm the Shen," or "relax the mind and settle the spirit." In adults, this 4-point combination could be indicated in cases of wind stroke, headaches, epilepsy, and dizziness. In children, traditionally this point combination was used for slow development, mental retardation, and recently for ADHD.

2015-07-24_cIn clinic today I polled my fellow interns to see how often they add the point "Governing Vessel (GV) 20" into the mix when using Si Shen Cong. Why would someone do this? Well, as I argued, it just seems like the right thing to do. GV20 is a masterful point, located smack in the center of the four needles used in Si Shen Cong. Its indications are similar, not shocking, considering they are all within a couple of inches of one another.

GV20, also called the "Hundred Convergences" in English and "Bai Hui" in Chinese, you can find this point on the midline of the head, five cun back from the anterior hairline. GV20 is generally used for two indications--pulling things up or pulling things down. How can it do both, you ask? Well, Chinese medicine is magical, don't you know.


GV20 is indicated for prolapse, thus it can pull things up. Whether it's your uterus, rectum, bladder, or vagina that's prolapsed, GV20 can help put it back up where it belongs. Same goes for hemorrhoids--other items that should not be hanging down.

2015-07-24_e2015-07-24_fGV20 is indicated for yang rising in the top of the body. Think headaches, hypertension, dizziness, red eyes, irritability, tinnitus, seizures, and more! Interestingly, in these cases, GV20 at the top of the head is paired with anchoring points found at the extreme lower end of the body. For the horrible conditions mentioned here, Liver 2 would be an effective paired point.

Whether you're rectum has prolapsed, you've been dealt a massive vertex headache, or you just want to improve your concentration and focus for the upcoming test, you might want to give needles in the head a chance. When your acupuncturist suggests "Si Shen Cong," now you'll know it's not Cheech and Chong she's referring to. But they're fun, too.

Should a Veteran be Homeless?

I think not. Yet, there are around 50,000 homeless veterans in the U.S. on any given night -- despite a 33% drop since 2010! "The U.S. Department of Veterans Affairs (VA) states that the nation's homeless veterans are predominantly male, with roughly 8% being female. The majority are single; live in urban areas; and suffer from mental illness, alcohol and/or substance abuse, or co-occurring disorders."

This is where acupuncture comes in, friends. The National Acupuncture Detoxification Association (NADA) protocol, specifically, is helping veterans with PTSD manage stress, addictions, difficulty sleeping, and other behavioral and mental health conditions. NADA uses a standard set of ear points -- Sympathetic, Shen Men, Kidney, Liver, and Lung -- stimulated either with needles or with ear seeds.

Since it was established in the Bronx in 1974, the NADA protocol has brought relief not only to veterans, but also others in need of assistance with addictions, from food to illegal drugs. How does it work? The acupuncturist -- or one of over 10,000 health care professionals trained specifically in NADA protocol -- inserts the five sterile, stainless steel, one-time use needles into the ear and lets them remain for up to 45 minutes. Then, we take them out. It's simple. It's fast. It's cheap. It's effective.

2015-07-10_nadaWhat are patients saying about the NADA protocol? "...improved program retention, a more optimistic and cooperative attitude toward the process of recovery, as well as reductions in cravings, anxiety, sleep disturbance and need for pharmaceuticals." 

On Friday, June 26, NUHS Chief AOM Clinician Dr. Hyundo Kim and a group of acupuncture and oriental medicine interns headed downtown to the Chicago National Guard Armory to offer free PTSD ear seed treatments to homeless veterans. That's right -- NADA can get even easier! When needles aren't appropriate or convenient, we can still stimulate the ear points of the NADA protocol with stick-on ear seeds. The added bonus is that the patient can essentially take the treatment "to go," and can squeeze the seeds, reactivating the points, for the next few days.


At that Chicago Stand-Down event, held in June, homeless veterans are brought together in a single location to access community resources and supplies needed to begin addressing their individual problems and rebuilding their lives. Our group of volunteers provided ear seed treatments while other groups provided everything from a hot meal to a bag of clothing to an eye exam. I saw booths for flu shots, HIV tests, dental services, and Reiki. That day -- that one day -- those homeless veterans had a full-service experience.


Representatives were on-site to match them with shelters, jobs, and the benefits they earned for their service to the United States of America. They were welcomed, they were appreciated, and they were valued.

Ear-icular Egg-corns

This weekend I saw an article about the word "eggcorn" being added to the dictionary. Perfect, I thought. Someone has finally justified my mispronunciation of the word "acorn." After all these years, I've been vindicated.


No. That's not what happened. Apparently, a word has been created, tested, and formalized for these types of circumstances. When enough people say a word incorrectly enough times, it can become a legitimized word. You can't just be totally crazy and wrong, though, mind you. You have to misuse a word and have it be somewhat close to making sense. Then you can be legitimized.

2015-06-05_dic"For all intensive purposes," "a mute point," "an averse reaction," "old timer's disease," and "soup chef." All wrong. Look again -- it should read "for all intents and purposes," "a moot point," "an adverse reaction," Alzheimer's disease," and "sous chef." Notice how the words commonly used are technically wrong, but still actually kind of correct? Now there's a word for that, and that word is, appropriately, an "eggcorn."

What do eggcorns have to do with TCM? Well, thanks for asking. Some of my favorite intentional misspeaks just happen to be related to auricular acupuncture, or, as I call it, "earcupuncture." Closely related is the way that I call the ear apex the "earpex." Sometimes, I just can't help myself. It's like the words are out there just calling me to stick them together. Maybe I'm not even misspeaking; I'm just making new contractions. You're welcome.

Today, on this new day, just one week after Merriam-Webster added "eggcorn" to the dictionary, I feel confident in using my slightly off the beaten Daoist path terminology. I'm using earcupuncture, or earicular acupuncture, I'm bleeding the earpex point to lower blood pressure, and I'm not apologizing. Words that are wrong but self-explanatory enough to be right are OK in my book.


Also, ear acupuncture is important. It's powerful, it's fast, it's easy, and it's cheap to perform. People need to become more familiar with this modality of Traditional Chinese Medicine, but the sterile statement, "I'm going to insert needles into your ear now," doesn't always go over well with patients. Can an eggcorn or two lighten the mood? Can a spoonful of humor make the needle slide in more smoothly?


Why does auricular acupuncture work so well that I'm willing to mispronounce it to help new patients accept it? The theory of auricular acupuncture is that the ear is a microsystem, where every body part is represented and connected to a particular point on the ear. Red spot on the antihelix? Maybe it's revealing your knee pain. Really sore when I squeeze your lobe? Could be your tooth infection screaming for help.


Say it how you like. Whether it's ear acupuncture, ear-icular acupuncture, or earcupuncture, just try it out. I won't judge you on your pronunciation. Will it hurt? Maybe. Here's a secret tip. Sometimes we don't even use needles on the ear points. We have these things called "ear seeds," and they definitely don't hurt. If you could handle the feel of a Band-Aid with a piece of dirt stuck to it, then you'd be fine with ear seeds. Just squeeze and enjoy the pain relieving benefits. It's easier than sticking an acorn to your earlobe.

Acupuncture or ER?

No one likes to be wrong. No one likes to admit that his or her medicine is not the best. When a patient walks into the room seeking treatment, we each want to be the one to say, "Yes, we can help you." While acupuncture has successfully treated the masses for thousands of years, and has been recommended by the World Health Organization for dozens of conditions and diseases, it's not the only tool in the shed in 2015.


On Thursday at Cook County Hospital, I sat at the computer in a treatment room entering the subjective information from an existing patient presenting with a new chief complaint -- left calf pain. We'd treated her in the acupuncture wing of the outpatient pain clinic before, but her chief complaint was usually lower back pain. Initially, I thought "another case of sciatica," as I worked through her SOAP note and mentally scanned the best acupuncture points for the job.


"Sharp pain in the back of my leg," she said, gingerly touching her left calf. I asked, "When did it start, and have you had this pain before?" "Yesterday, and NO," she snapped back at me. "It's so swollen and the pain is sharp right here," she added. She confirmed that there had been no trauma to the area, and I released my grip and let the pack of needles slide deeper down into my lab coat pocket.

I'm kind of new here, and I readily admit that my weakness as an acupuncture intern is ruling out contraindications and sorting out red flags before I start sticking needles into the patient. Can I still needle you if your blood pressure is 150/90? Some books say yes, some sources say no. Acupuncture lowers blood pressure, so shouldn't we go ahead and do it? Refer out! Confusion. "It's normal," everyone assures me. "You'll gain that confidence through clinical experience over time." Well, as a third year acupuncture student, I don't feel like it's been enough time. I walk into the head clinician's office and start presenting the case. Something just this patient.


The beauty of my internship at Stroger Hospital is that although it's not set up to be an integrative treatment experience for each patient, it can transform into one in under 60 seconds. Our calf pain patient came into the acupuncture wing of the pain clinic, but upon suspicion of an emergency situation (yes, we were all thinking "Deep Vein Thrombosis" or "DVT" at this point in the show), we went two doors down the hall and snagged an MD intern to evaluate her presentation from a western perspective, too.


He quickly assessed her signs and symptoms and agreed that we needed to rule out a DVT before moving ahead with her regularly scheduled acupuncture treatment at that time. Within seconds, our integrated team had changed course, explained the testing process to the patient, called over to the ER, and had a nurse transport the patient.

For thousands of years the expansive Chinese empire developed what we now call "Traditional Chinese Medicine," or "Oriental Medicine," of which acupuncture and herbs form the foundation. A complete and effective medical system, the doctors not only placed needles, administered herbal formulas, gave hands-on manipulations, moxibustion, and cupping treatments, but also did bone-setting and any other emergency medicine that was required. Today, in the United States, our scope of practice is generally not so extensive as to include bone-setting, but we respect the completeness of the TCM system in its entirety.


This does not mean, though, that we ignore the advancements of other medical systems or technologies. It means that instead of blindly accepting the often too-invasive and side-effect ridden treatment plans of the mainstream western medical system, we utilize only the elements that we see as truly necessary or complementary to a holistic treatment plan. In short, I LOVE DIAGNOSTIC IMAGING. Sure, it's wrong sometimes, giving false positives and false negatives alike, but overall it gives us a somewhat clearer look inside the human body than what we can piece together by looking at a patient's tongue and feeling her pulses.

I'm not saying that modern diagnostic imaging is necessary for an acupuncturist to be effective in treating modern patients, but it is another tool in the shed nowadays. The shed has grown larger in the past 50 years, but it's also full of a lot of junk. Often the expert walks in, picks up the best tool for the job -- the one he's trained to use most confidently -- and steps over the rest. The skill is being adept in choosing those tools that are best suited for the situation, even if they aren't from the same pile.

"The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease." Thanks, Thomas A. Edison. I like that quote. Doctors of Oriental Medicine, herbalists, and acupuncturists generally give herbs as part of a complete treatment plan, but giving a pill to pop -- whether pharmaceutical, peppermint, or deer antler-- is not the only way to help.


The doctor of the future will be truly integrative. He will skillfully diagnose the patient's whole body, mind, and spiritual condition, drawing from both hands-on examination findings and high-tech imaging of internal structures. In the future, when the patient presents with the new chief complaint of acute calf pain and swelling, we can use modern imaging to quickly rule out the DVT and then use acupuncture to treat her condition and balance her body. We can give her qi gong exercises and dietary changes to support her long-term health and wellness. Thomas Edison will be proud.


Further Reading: The Patient Will See You Now: The Future of Medicine is in Your Hands by Eric Topol