Wednesday, January 23, 2013

Super-Easy Elderberry Syrup Recipe for Cold & Flu Prevention

My daughter & I have been faring pretty well so far during this virulent cold and flu season ("knock on wood"). This is not evidence-based or scientific --- BUT, my hunch is been to attribute our robust winter immunity to our daily spoonful of my homemade elderberry syrup.

(That... along with doing our best to follow my nine simple lifestyle adjustments for winter health.)

Elderberries (also known as sambucus or sambucol) have long been used in European folk medicine to prevent and treat the symptoms of the common cold and flu, as well as excess mucous and sore throat. These tiny purple-blue berries are typically found growing in moist areas along rivers, roads and in forests. They are rich in anti-oxidant flavinoids and anti-inflammatory anthocyanin, as well as potassium, beta carotene, calcium, phosphorus and vitamin C. Clinical research has shown that elderberry extract can shorten the course of a flu infection and decrease the severity of flu symptoms. Evidence suggests that elderberry extract inactivates influenza virus.

Elderberry syrup is available in health food stores. But it is also super-easy to make at home. You can make large quantities for a lot less money, AND you can control exactly what goes into it.

Elderberry syrup is delicious for grown-ups and kids. Medicinal in its own right, it can be used to disguise a dose of herbs or other medicinals that your kid might resist.

The recipe I use comes from Emily Bartlett, L.Ac., pediatric acupuncturist and mama-blogger at

Her recipe is made with fresh ginger - used in Chinese medicine to warm and protect the digestion as well as fend off colds. Cinnamon is an immune booster that helps to relieve pain. Raw honey (which balances the extreme tartness of the berries) contains micro-nutrients and enzymes which support your body. I often add other herbs and spices as I cook my brew-- like cloves, cardamom pods/seeds, orange peel,  or anise (all of which warm the body, fight viruses and stimulate digestion and assimilation.) Small amounts of other cold/flu prevention like astragalus, osha, or echinacea root can be decocted with elderberries as well to enhance the medicinal effect, although the elderberries also stand well on their own.

Take 1-2 teaspoons daily during cold and flu season (taking an occasional break for a day or two), increasing as needed if you start to feel rundown. When you're sick, take one teaspoonful every 2-3 hours.
For children under two, add the syrup to hot water to kill off any microbes in the honey.

Elderberry syrup is great right from the spoon, but you can also drizzle it over pancakes, yogurt or ice cream. Personally, I stir a spoonful into my daily homemade kombucha drink.

Elderberry Syrup Recipe Ingredients:

  • 1 cup dried elderberries* 
  • 4 cups filtered water
  • 4 quarter-inch slices of fresh ginger
  • 2 cinnamon stick
  • 3 cloves
  • 1 cup, raw honey
*Dried elderberries can be ordered from Mountain Rose Herbs or Pacific Botanicals. In Berkeley, I've founded them at Lhasa Karnak and Berkeley Bowl.

Elderberry Syrup Cooking Method:

  1. Add all ingredients except for the honey into a medium saucepan.
  2. Bring to a boil, and then lower heat to medium.
  3. Continue simmering for 30-45 minutes until the liquid is reduced to half.
  4. Before the liquid cools, strain it through a fine mesh strainer.
  5. Allow the liquid to cool to about 118F (to preserve the enzymes in the raw honey), and gently combine the warm reduced berry liquid with the raw honey.
  6. Store in a jar in the fridge for a few weeks. For longer storage, freeze in jars or into ice cube trays to defrost for later use.

Links to More Articles by Stephanie Doucette, L.Ac., on Cold & Flu Prevention with Chinese Medicine:

Featured Acupuncture Points: Hua Tou Jia Ji for Sponylosis Pain & Organic Illness

The hua tou jia ji points are a special set of points that exist outside the commonly-used meridian pathways. They are frequently used in the treatment of pain and illness.

Jia Ji = "Lining the Spine"

Jia ji means "lining the spine," and this is exactly where these points are found.

The hua tou jia ji form two rows, running the length of the spine from the neck to the sacrum. They are located 1/2 cun (or "body-inch")* from the midline of the back.

(*The cun is the metric used in locating acupuncture points on the body. A cun is equal to the widest distance across a patient's thumb, and the size of a cun is of course relative to the size of the patient.)

Traditionally, there are 34 jia ji points, one on either side of each of the twelve thoracic (upper back) and five lumbar (lower back) vertebra. Over time (i.e. over the last two thousand years), acupuncturists have expanded this to include therapeutic points along the cervial vertebra (neck) and the sacral foramina (buttock).

Hua Tou: Exceptional Physician

The Physician Hua Tou
The hua tou jia ji points are attributed to Hau Tou, one of the most exceptional and legendary physicians in the history of Traditional Chinese Medicine. Hua Tou was estimated to have been born around 110 CE (in the late Han Dynasty), and is said to have lived an unprecedented 97 years. He is most famous as a surgeon, alleged to have been the first person to use herbal anesthesia in surgery. He was also skilled in the use moxibustion, acupuncture and herbal medicine. Finally, he is said to have developed a series of Daoyin or "qigong" exercises, based on movements of five animals, for the cultivation of health and longevity.

The Physican Hua Tou
Long before the advent of modern anatomical knowledge, Hau Tou realized that stimulating points lining the spine could dramatically impact pain or organ function.

So, How Do Hua Tou Jia Ji Points Work?

Fundamentally, stimulation of the hua tou jia ji points affects the spinal nerves emerging from the corresponding spinal segment and the neural reflex arc. By stimulating or relaxing the paravertebral muscles at the jia ji points, the acupuncturist can address degenerative conditions of spinal vertebra, alleviate pain and weakness due to spondylosis, and improve physiological function of organs and tissues innervated by corresponding spinal nerves. 

Like all other acupuncture points, hua tou jia ji points can be stimulated with acupuncture needles, moxa or massage. 

Incidentally, a couple thousand years after the ancient Chinese had been using the jia ji points to heal people, chiropractic and ostepathic physicians began using spinal adjustment for similar effects.

Pain & Injury

I was inspired to look more deeply into hua tou jia ji points because one of my orthopedic medicine teachers, Matt Callison, L.Ac., highly recommends the use of these points, in combination with select other points, in treatment of pain syndromes due to spondylosis.

Spondylosis, or degenerative osteoarthritis of the joints between the spinal vertebra or neural foramina, is not uncommon in patients over forty. The condition can cause pressure on the nerve roots with subsequent pain, weakness or numbness of the muscles innervated by that nerve. An example is sciatica.

In the clinic, a practitioner must determine exactly which muscles are affected and which spinal vertebra are at play in a spondylosis-related pain symdrome. The practitioner treats the hua tou jia ji points level with the spinal nerve innervating these muscles. He/she may additionally stimulate motor nerve points on the affected muscle(s) to release spasm or stimulate innervation. Points on antagonist muscle(s) may also be treated, along points along the affected meridian pathway above or below to promote enhance flow through the muscle tissue.

Internal Medicine

The hua tou jia ji points are not just used to treat pain. In fact they can be useful in treating any medical condition. 

In Chinese medicine theory, the jia ji points can be used to regulate the qi and blood of the corresponding internal organs. Palpation of the points helps to diagnose organ pathology.

Looking to western medical anatomy, we know that degeneration or displacement of any vertebral joint can cause hypo- or hyper-tonicity of paravertebral musculature, placing pressure on the spinal nerve roots and affecting organs, tissues, muscles and bones innervated by the spinal nerves. Stimulation of the appropriate hua tou jia ji point, then, can help to strengthen or relax paravertebral muscles, freeing the spinal nerve, and improving the physiological function of corresponding structures. Stimulation of jia ji points is known to affect both the posterior and anterior rami of the spinal nerves

Stimulation of jia ji points around the third thoracic vertebra (T3), for example, is known to affect the lungs, bronchi, pleura, chest and breasts. Treating the jia ji points at T6 affects the stomach, T7 & T8 the spleen and pancreas; cervical vertebra 7 the thyroid gland (as well as many shoulder & elbow injuries); and so on. Points around the first cervial vertebra at the base of the neck can affect the pituitary gland, the scalp, brain, inner and mid-ear and the sympathetic nervous system. Treatment of these points can be useful in conditions like neurasthenia, insomnia, hypertension, migraine headache, chronic fatigue, vertigo and impaired immunity.

A 2008 Turkish acupuncture study demonstrated the efficacy of hua tou point stimulation in treating organ disease. Treatment of selected hua tou points, along with the corresponding shu points (1.5 "body inches" lateral to the hua tou points), the study concluded,

"affects the visceral organs in many ways. For example, it dilates the bronchus, affects the heartbeat, stomach motility, urinary bladder contractions and so on. Acupuncture's effects can be explained as viscero-cutaneous,  cutaneo-visceral, cutaneo-muscular, and viscero-muscular reflexes. ... Changes in visceral organs caused by application of acupuncture can be explained as modulation of the sympathetic and parasympathetic systems."

The hua tou jia ji points are one of many tools in the acupuncturist's toolkit.

If you or someone you care about suffers from pain or illness,
call 510-495-5752 or email,
to learn more about how acupuncture and Traditional Chinese Medicine can help.

Wednesday, January 16, 2013

Frankincense & Myrrh: Pain-Relieving Herbs

In honor of the Epiphany (which just passed on January 6th) and because I'm writing a series on pain management with Chinese medicine, the herbs I'm featuring this month are frankincense & myrrh.

Most of us have heard of frankincense & myrrh as the gifts (along with gold) which the three Magi brought to the Baby Jesus. (As I've recently learned, the celebration of Epiphany marks, according to western Christians, the arrival of the Magi in Bethlehem.) The story of the Magi -- distinguished foreign gentiles who journey "from the East" to pay homage to Christ-child -- evokes awe-inspiring themes of cross-cultural communication and exchange.

Many readers of this blog might not be aware that frankincense and myrrh are regularly used in Chinese herbal medicine. In Chinese, they are known as ru xiang and mo yao, respectively.

Like the story of the Magi, frankincense and myrrh themselves evoke themes of migration and cross-cultural exchange. Both substances are tree resins. Long ago, traders from the Middle East traveled the Silk Road to bring these herbs to China.

In the West, frankincense and myrrh have been used for embalming, as incense, or as ingredients in cosmetics, fragrant oils and perfumes.

But how have they been used medicinally?

In China, frankincense and myrrh became prized for their effectiveness in healing injuries and wounds.

In his book A Tooth from the Tiger's Mouth: How to Treat Your Injuries with Powerful Healing Secrets of the Great Chinese Warriors, New York-based martial artist & acupuncturist, Tom Bisio, writes:

"The two herbs often appear together in herb formulas because they act synergistically to kill pain, crack blood stagnation, and regenerate flesh in cases of non-healing wounds. Xue jie (dragon's blood) is a reddish tree resin similar to frankincense and myrrh. It is also included in many injury formulas. Xue jie was used in Europe in the sixteenth and seventeenth centuries to reduce the pain of gout."

Though somewhat different in nature, frankincense and myrrh both function to:
  • Break up blood stagnation and facilitate the movement of blood and circulation at the site of an injury,
  • Alleviate pain,
  • Reduce swelling, and
  • Regenerate tissue and heal lingering sores.
Obviously, they are important injury-healers and should be a part of any sports medicine acupuncturist's first aid kit.

They're also useful in internal medicine. The alleviate epigastric and abdominal pain due to blood stagnation. In gynecology and obstetrics, they are useful in cases of amenorrhea, menstrual pain and postpartum pain. (Keep in mind that these internal pains can be due to causes other than "blood stagnation." Other herbs should be selected in these cases.) Frankincense and myrrh can also ease chronic rheumatic pain with inflammation and swelling, and break down and disperse necrotic and scar tissue.

Returning to the story of the Magi, one is tempted to think that these two precious resins were actually a perfect gift for the Virgin mother. A priority for promoting postpartum healing is to disperse and clear old, congealed blood from the uterus, reduce swelling and heal uterine tissue. Frankincense and myrrh might have been just the treasures that the New Mother needed.

Relieve & Heal Pain with Chinese Herbs

Acupuncture is becoming increasingly popular in the west as a remedy for pain. A less well-known fact is that Chinese herbs are also extremely effective in treating pain. Like acupuncture, herbal medicine can address any type of pain, regardless of its origin. This includes visceral (organ) pain, or musculoskeletal pain resulting from tissue degeneration, overuse or sport injuries.

Over three hundred Chinese herbs are commonly and combined into formulas to address, in nuanced and complex ways, the roots of physiological dysfunction and pain.

Many Chinese herbs kill pain, but painkilling herbs are not mere analgesics that mask pain. In cases of visceral pain, they improve circulation, clear metabolic waste, and help to restore proper physiological function of organs and organ systems.

For musculoskeletal pain, Chinese herbs can help speed healing of injuries and reduce complications or likelihood of re-injury. Chinese herbs reduce swelling and inflammation, break up accumulations of blood and fluids and restore normal circulation to injured areas.

So, in contrast to pharmaceutical pain medication, Chinese herbs do not have negative side-effects. When prescribed by a skilled herbalist, they stimulate healing and improve physiological function, i.e. "positive side effects"

How Herbs are Administered for Pain:

Chinese herbs are most commonly taken internally, either in the form of teas cooked from raw herbs, pills, or powdered extracts. From the Chinese sports medicine (or martial arts) tradition, we also have many ways of applying herbs to injuries externally--in the form of liniments, poultices, plasters and soaks.

Chinese herbs are almost never used singly. Rather they are used in formulas (with anywhere from two to 20 herbs in combination). Formulas allow a multi-pronged approach to disease processes or pain syndromes.

I'm hoping to write more soon about herbal first-aid and injury treatment strategies.

Here I simply want to introduce some of the ways in which Chinese herbs are used to address pain.

In Traditional Chinese Medicine, herbs are grouped into categories based on physiological function. I'll review some of the categories most commonly involved in the treatment of pain syndromes.

Pain Caused by Lack of Circulation of Qi & Blood:

There is a famous Chinese saying: "Bu tong ze tong, tong ze bu tong" which means "free flow: no pain, no free flow: pain." A fundamental strategy for relieving pain in Chinese medicine is to re-establish proper circulation of energy, blood or body fluids.

Two major categories of pain-relieving herbs are:
1. Herbs that Regulate Qi, and
2. Herbs that Invigorate Blood.

Pain resulting from the lack of energetic circulation (or Qi stagnation) is dull and achy in nature. Its location is more difficult to specify. Pain resulting from Blood stasis, on the other hand, is sharp, deep, and easily localized.

Qi stagnation or Blood stasis occurring in the organs manifests as pain in the chest or abdomen. In western terms, this can be related to physiological organ dysfunction or degeneration related to any number of disease processes. It can relate to increased blood viscosity or fluid accumulation resulting from inhibited circulation.

There are several herbs in the Chinese pharamacopeia that treat pain in the chest and abdomen due to qi stagnation and blood stasis. Many of the qi moving herbs are citrus peel (the famous chen pi, or aged tangerine peel) or fruits and flowers (even rosebuds). 

Pain in the extremities, low back or head is attributable to qi and blood stagnation in the meridian pathways. It is easy to understand how the impact of an injury or overuse of a body part can impede proper circulation. With an impact, blood flows to an injured area, bringing white blood cells and nutrients to clean up, heal and rebuild the injured area. Part of the healing process is clearing this stagnation of blood and fluids and restoring proper circulation.

Some famous blood-moving herbs are salvia root (dan shen), which has a particular affinity for the heart, turmeric (yu jin) --pictured right, peach kernels, safflower flowers, and frankincense and myrrh (which are used frequently in healing traumatic injuries).

Reducing Inflammation:

Inflammation is basically the flow of blood and immune-agents to an injured area. Part of the injury healing process is to reduce inflammation in order to restore normal circulation and blood flow to an injured area. The Chinese pharmacopeia has a wide range of herbs used to clear heat and dampness from the body. These are often used to treat pain and injury characterized by redness, swelling and inflammation. 

Some herbs which clear heat and dampness are gardenia fruit (zhi zi)--pictured on the left-- and a trio of herb known as the "three yellows" or "three huangs:" huang qin or skullcap/scutellaria root, huang lian or coptis rhizome, and huang bai or phellodendron cortex. The three huangs have an affiinity for the chest, upper abdomen and lower abdomen respectively. Together, they clear heat, inflammation and infection from the whole body.

Chronic Pain: 

Some chronic pain is considered, from a Chinese medicine perspective, to result from "pathogenic factors," such as cold, dampness and/or wind, which have entered muscles, joints, bones or connective tissue as a result of prolonged injury or weakness. These factors -- cold, dampness, wind -- cause pain by disrupting the circulation of Qi and blood in the injured areas. Again, there is a range of herbs to choose from which clear these "invading pathogenic factors," warm the body and restore healthy circulation. In selecting specific herbs to be used, careful attention must be given to the nature and pattern of pain:
  • Pain characterized by wind tends to migrate from joint to joint.
  • Cold-pain is severe, fixed, worse with cold weather, and characterized by reduced joint mobility.
  • Damp-pain is characterized by fixed pain, swelling, heaviness and numbness.
A variation on this is hot painful obstruction, characterized by redness, swelling and inflammation of the joints characteristic of rheumatoid arthritis. Herbs that dispel wind, heat and dampness are used in treating this kind of pain.

Bone-Healing & Kidney-Strengthening:

Another category of herbs that is frequently used in the treatment of pain is herbs that tonify the Qi of the Kidneys. Chronic low back pain is often due to Kidney Qi weakness. Also Kidney tonics strengthen and heal broken bones. Du zhong (eucommia bark)--pictured left, gou ji (cibota rhizome), and xu duan (Radix Dipsaci Asperi) are some examples of herbs that tonify the Yang of the Kidney, heal fractures and alleviate back pain.

Herbs that Guide to Body Regions:

Finally, certain herbs have particular affinity to certain parts of the body. They are often added to a formula specifically to guide herbs to an injured or painful area. For example:

The herb, niu xi, or achyranthes root has an affinity to the lower body. Amazingly, it also invigorates the blood and expels blood stasis and strengthens bones and connective tissue and heals joints. It is frequently used in formulas for patients with low back or knee pain.

The twigs of the mulberry tree, or sang zhi -- pictured right, have an affinity for the shoulders and arms, where they help alleviate joint pain characterized by wind & dampness.

Gui zhi, or cinnamon twigs--pictured below, also guide to the shoulder. Cinnamon is warm, whereas mulberry twigs are slightly cooling. So, in treating shoulder pain, we need to consider whether the pain is characterized more by cold or heat.

Chuan xiong, translated as Szechuan lovage root or ligusticum, has an affinity for the head, moves blood, treats blood stasis and expels wind. It is an important herb to consider in treating headaches due to common cold, fatigue or weakness. (However, we want to be extremely cautious in using this herb to treat migraines or any headaches resulting from excess blood flow or energy in the head, since chuan xiong basically increases blood circulation and raises energy to the head.)


General Tonification & Regulation:

A Chinese herbal pain formula may combine a number of different herbs to address pain from different angles, as discussed above. In cases of chronic (non-acute) pain, a skilled herbalist will always consider the underlying constitutional weaknesses or imbalances of the patient. Why is the pain lingering? Why do the injuries not heal? Why is there chronic inflammation? A formula for chronic pain will always address these underlying imbalances. Most commonly, Qi and Blood need to be tonified. The organs responsible for the production must be strengthened and regulated so that affected tissues are supplied with enough nutrients to heal. If there is low-grade inflammation, herbs will be used to clear what is called "deficiency" heat. And so on.

Chinese herbs are amazing.

If you or someone you care about suffers from pain, consider herbal medicine along with acupuncture and other pain management regimens. Also, if you sustain an injury, take advantage of Chinese herbs and acupuncture to speed your healing and prevent chronic pain and reinjury.

Sunday, January 13, 2013

Relieve Low Back Pain with Acupuncture & Integrative Medicine

Low back pain is extremely common, affecting anywhere from 75 to 90 percent of people at some point in their lives. Low back pain is second only to the common cold as a cause of lost days at work and the most common cause of disability. It is one of the most common reasons to seek medical care, including acupuncture. In fact, one of the top reasons that people get acupuncture treatments is for low back pain.

In spite of the large number of pathological conditions that can give rise to low back pain, up to 85 percent of the cases are classified by physicians as 'non-specific'.

Incorporating Chinese medicine and western orthopedic perspectives, here's how I help patients relieve and manage low back pain.

Two Perspectives: East Meets West

Diagnostically, I always seek to understand a pain or injury syndrome from both a Western orthopedic medicine perspective and from a Traditional Chinese Medicine perspective.

Western Orthopedic Assessment:

From a Western orthopedic perspective, I take into account diagnoses the patient may have already received from other medical practitioners and view the patient's x-ray or MRI images. Then, I ask the patient a range of questions about specific location(s) and nature of pain and perform a series of orthopedic exams of the lumbar and pelvic regions in an attempt to isolate causative factors. From a Western perspective, we must consider nerves, muscles, connective tissue and postural imbalances.

Some patients with low back issues experience pain or parathesia (weakness or numbness) sensations that refer into the buttock, hip and/or leg. In some cases, this referred pain is true sciatica, or nerve pain, resulting from nerve impingement originating from the spine. In cases of true sciatica, an understanding of the nerves innervating the legs and the geography of dermatomes can help a practitioner isolate which spinal nerve root is impinged (typically L4, L5 or S1) . On the other hand, sciatica-like sensations often have causes other than spinal nerve root impingement. These include: pathology of the facet joints of the lumbar vertebrae, tearing of the intervertebral disk's annulus fibrosis, sacroiliac joint/ligament pathology, trochanteric bursitis, tension of the piriformis or other muscles. Differential diagnosis is important in determining and treating the cause of pain.

An assessment of bony structure of the pelvis is also important. Anterior, posterior or lateral tilt or rotation of the pelvis can cause wear and tear on the bony structures of the spine and/or the intervertebral disks. Structural imbalances are indicative of imbalances among the muscles which stabilize the legs, the waist and the pelvis. (Typically we find that certain muscles are tight and short, while their paired antagonist is weak.) Muscle imbalances and pelvic disparities are, of course, mutually reinforcing and often exacerbated by our daily habits and activities (too much sitting, poor posture, etc.) The good news is that pelvic disparities can be corrected by acupuncture treatment or therapeutic massage of appropriately-selected muscles, tendons and meridian pathways--as well as by exercise therapies.

Traditional Chinese Medicine Assessment:

When low back pain is examined from an Asian medicine perspective, it is seen as a disruption to the flow of Qi within the area and associated with a specific disharmony and is treated accordingly.

The disruption of Qi that results in low back pain is usually associated with the following three disharmonies:

Weak Kidney Qi
In Traditional Chinese medicine, the lower back is referred to as the “dwelling of the Kidneys”. The majority of chronic low back pain conditions are associated with Kidney deficiency. Pain related to Kidney deficiency is typically dull and erratic. It is usually aggravated by fatigue and improves with rest.

Stagnation of Qi and Blood
When the flow of Qi along the meridians that traverse the lumbar region becomes congested, it is referred to as the stagnation of Qi and blood. This presents with a severe stabbing pain that is worse with rest and better with movement, tender to touch and can be accompanied by stiffness and tightness. Qi and Blood stagnation is more often seen in an acute injury or acute exacerbation of a chronic pain syndrome or imbalance.

Invasion of Cold and Dampness
Cold, damp type pain is generally worse in the morning and when the weather is cold and damp. This type of pain improves with movement and the application of heat. Stiffness and contraction of back muscles that is aggravated by immobility indicates cold predominance. Swelling, numbness and a heavy sensation are indicative of dampness. Cold and dampness are often considered to "set in" after an acute injury as the injury becomes chronic. This includes tissue adhesions that form as a result of inflammation and limit mobility. From a Chinese medicine perspective, it is important to receive prompt treatment for a pain or injury condition, because weakness or cold and dampness are likely to exacerbate lingering, non-healing injuries.


Effective treatment of low back pain also integrates both Western orthopedic and Chinese medicine perspectives. Once a diagnosis of the exact structural and/or energetic cause of pain is established, acupuncture or manual therapy is applied. A variety of points are treated including:
  • points around bony structures like facet joints or the sacro-iliac joint,
  • motor points on affected muscles (the point where the motor nerve enters the muscle),
  • points affecting the motor nerve roots as they exit the spine, and
  • points along the specific meridian channels whose energetic blockage is implicated: these are often above or below the site of pain & injury or on the opposite side of the body.
An excellent acupuncturist also takes a holistic view of a patient's condition, making sure to include acupuncture points or apply herbal therapies which treat constitutional patterns underlying a patient's injury. In the case of low back pain, constitutional factors typically include weakness of the Kidney energy, a propensity to Qi congestion or blood stasis, a weakness of the Spleen energy (as the Spleen is responsible for the production of blood and energy & assuring the health of muscles). Stagnation in any of the merdians traversing the low back and pelvis (bladder, gall bladder, Spleen, Kidney, Liver, Stomach) is also a factor. 

The goal of the acupuncturist, in addition to relieving pain, should be to encourage a homeostasis in the patient's body that promotes strength and suppleness to bones, muscles and connective tissues and prevents further pain or injury.

If you or someone you care about is suffering from low back pain, please call 510-495-5752 or email to learn more about how acupuncture and Chinese medicine can help.

Thursday, January 10, 2013

How It Works: The SCIENCE on Acupuncture & Pain Management

People are increasingly looking for natural therapies to relieve painful conditions instead of relying on pharmaceutical medications. Acupuncture can effectively relieve pain anywhere in the body, regardless of its origin, without negative side-effects. Some studies show that the pain relief provided by acupuncture can last for several months.

Studies on Acupuncture & Pain Management:

Acupuncture has become readily accepted in mainstream modern medicine as a viable option for pain management. Studies support its therapeutic effects.

In a German study, published in the Archives of Internal Medicine, 1,162 adults with chronic, lower back pain were divided into groups treated with either the standard pharmaceutical and exercise therapy, commonly used in conventional medicine, or acupuncture. The researchers reported that acupuncture provided relief and lasting benefit to nearly twice as many lower back pain patients as drugs and exercise. Forty-eight percent of the acupuncture patients reported at least a one-third decrease in pain along with improvement in their ability to function, versus 27 percent of the patients treated with conventional methods reporting such benefits.

meta-study published in 2012 in the Archives of Internal Medicine analyzed 29 randomized controlled trials (RCTs) with a total of 17,922 chronic pain patients in five different countries. The study, heralded as "the most rigorous and detailed analysis of [acupuncture] to date," found acupuncture to be superior to placebo and standard biomedical care in the treatment of various types of chronic pain -- including neck pain, shoulder pain, osteoarthritis or chronic headache.

In another recent study published in the Annals of Internal Medicine, researchers from the University of Maryland School of Medicine analyzed 33 studies covering more than 2,100 patients from around the world on acupuncture for low back pain. They found acupuncture provided definite pain relief in the short-term (defined as relief sustained for three weeks after the end of the acupuncture sessions).

How Does Acupuncture Relieve Pain:

According to Chinese medicine theory, simply stated, pain represents obstruction to the flow of Qi in the body. Acupuncture moves Qi, thereby relieving pain.

A famous saying from the two thousand year old classic Chinese medical text Huangdi Neijing (or Yellow Emperor's Inner Canon) summarizes, "bu tong ze tong, tong bu ze tong," or "no free flow=pain; free flow=no pain."

In addition to reducing pain, acupuncture also hastens the healing process by increasing circulation and attracting white blood cells to an injured area.

Biomechanisms of Acupuncture & Pain Relief:

Biomedical research indicates that acupuncture has a number of physiological effects. Because of this, there is not a short, simple answer to the question of how acupuncture works. From a western point of view, acupuncture relieves pain through a variety of different mechanisms:
  • Promoting the secretion of naturally-occuring opioids in the body
  • Stimulating gate control and initiating diffuse noxious inhibitor pain suppression
  • Releasing local & systemic neurotransmitters
  • Signaling the brain and influencing autonomic regulatory processes
  • Increasing blood flow and relaxing muscles

The following section is a brief technical review of some of the modern scientific literature regarding the effects of acupuncture. Many are animal studies. (Links to related studies are embedded in text.)

Neurology & Brain Function:

  • Magnetic Resonance Imaging (MRI) of the human brain before and after acupuncture treatment of pain shows dramatic decreases in brain activity -- up to 70%. The decrease in brain activity associated with pain impulses diminishes painful sensations and increases a patient's tolerance for pain. Here's a link to this fascinating study.

Endocrine Involvement & Inter-cellular Communication:

  • In the realm of blood chemistry, acupuncture stimulates the secretion of naturally-occurring opiate subtances (endorphins, enkephalins, and dynorphins). These substances act on the central nervous system to block and modulate pain of both musculoskeletal and visceral (organ) origin. Here's a clinical review entitled "Acpuncture & Endorphins."
  • Acupuncture stimulates local and systemic secretion of neurotransmitters like serotonin and dopamine, which promote relaxation and a sense of well-being, thereby contributing to pain-relief.
  • Research shows that acupuncture can inhibit pro-inflammatory cytokines (molecular messengers between cells), reducing neuropathic pain. This study shows that acupuncture inhibits pro-inflammatory cytokines in patients with chronic headache. Here's another study on the cytokine-inhibiting, anti-inflammatory effect of acupuncture.
  • Studies also show that acupuncture influences leukocyte and lymphocyte levels, which, together with cytokine inhibition, can help fight infection and boost immune response.

Autonomic Nervous System Changes:

  • Acupuncture has been shown to enhance the generation of nitric oxide, which in turn, increases blood circulation, leading to decreased inflammation and increased healing. In one study, acupuncture was shown to increase blood flow in the sciatic nerve, relieving pain & improving the gait of horses suffering from lumbar spinal stenosis.
  • Acupuncture increases blood flow in muscles, leading to decreased inflammation and increased tissue repair.

Other Pain Relief Mechanisms:

  • The neurogate theory, tested on this study on rats, says that fibers that are stimulated by acupuncture could prevent pain input into the spinal cord. The diffuse noxious inhibitory control theory says that by providing a noxious stimulation (i.e. a non-painful stimulation by an acupuncture needle), the body responds by changing the signals it receives from the painful area being treated. You experience this when you bump your elbow, and it hurts less when you rub it.
  • Finally, Japanese researcher Kawakita proposes the polymodal receptor (PMR) theory. Polymodal receptors are nociceptors (pain receptors) which respond to mechanical, thermal and chemical stimuli. These release a variety of neuropeptides which serve as local neurotransmitters. Polymodal receptors are thought to be related to the qi sensation many patients feel with properly inserted acupuncture needles.

A growing body of scientific studies is showing that acupuncture is effective in the relief and management of all types of body pain -- often  more effective than conventional therapies. What is more, acupuncture has potential for preventing pain and promoting healing by:

  • relaxing tissues, 
  • increasing circulation,
  • attracting white blood cells to injury sites,
  • stimulating prostaglandins to reduce inflammation and prevent tissue damage,
  • increasing nerve conduction, 
  • restoring muscle tone,
  • quickening recovery from soft tissue injury, surgery and fracture -and-
  • restoring homeostasis and regulating physiological processes throughout all body systems.

Acupuncture is a supportive adjunct to other pain-management regimens, like physical therapy, bodywork, and exercise programs. It can be incorporated into any treatment or rehabilitation plan as a safe, simple strategy to support health and recover.

Acupuncture has no negative side effects.

If you or someone you care about suffers from acute and chronic pain, please call 510-495-5752, email, or follow this link to find out more about how acupuncture and Chinese medicine can help you.