Docs say use acupuncture before opioids for back pain

It happened on Feb 14, 2017 Valentine’s Day – publication of NEW Guidelines for the treatment of acute, sub acute and chronic back pain.  In the Annals of Internal Medicine for the American College of Physicians  three tiers of intervention to help common back pain are cited.

Acupuncture, Physical therapy, massage and home therapies such as heat and exercise including Tai Chi and yoga are TIER 1 and 2 and should be performed first.  Only after these have failed should anti inflammatories and muscle relaxants be used.  Opioid pain medications are the last resort. They should be used only when all other methods have not provided pain relief say the new Guidelines.

Take a look at this summary:

http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

The implications of these new guidelines are far reaching –  the standard of care is now to use therapies instead of drugs. These Practice Guidelines will pressure the health insurance system to provide better coverage for acupuncture and other modalities.

Insurance coverage now  for acupuncture is anything but standard. In my practice over two thirds of the patients are not covered. And then there is the situation where the policy benefit covers acupuncture after a monster deductible ($5000 or more) is met, which for most folks is very hard to meet so it is essentially a non benefit.

The really good news about the Guidelines is that folks can get better with the support of their doctors without the use of addictive drugs. It is estimated that over 3 million Americans are addicted to prescription opiates.

Acupuncture for chronic low back pain is safe, effective, has no side effects and provides multiple benefits such as improved energy, mood, and sleep,

 

Does it Feel Sometimes You’re Going Crazy? – What You Need to Know About Anxiety.

acupuncture-for-anxiety

Anxiety can be a very puzzling condition. It can creep up on you at the worst of times, seemingly unrelated to what’s going on in the moment. It defies efforts to control it, and its very existence is cause for more anxiety.

According to the National Institutes of Health, about 40 million Americans, or 18 percent of the population suffer from some kind of anxiety disorder. The symptoms of anxiety are broad, and include chest tightness, feeling short of breath, numbness and tingling of your hands or feet, heart palpitations, a racing heart, a general feeling of doom, or the certain knowledge that your very life is in danger.

While it’s true that for many people anxiety can seem random, for others, there are predictable triggers. People who have been victims of or exposed to traumatic events, emotional abuse, or threats understand the source of their anxiety. Unfortunately, a large percentage of people don’t know why they’re anxious, which can make the situation worse. For them, their anxiety can produce feelings of powerlessness and the fear that they may be going crazy.

It’s important to know that there can be physiological causes of anxiety, which may include digestive problems, hormonal imbalances, heart issues, overuse of caffeine, and side effects from prescription medications. In addition, there is evidence that anxiety runs in families. Researchers have suggested that familial anxiety may be genetic in nature, but also may be due to similar brain chemistry, shared life events, and even personality similarities.

In Chinese medicine, anxiety may be related to a number of different patterns, and is generally tied to one (or more) of the following organ systems:

The Spleen. Your Chinese Spleen is responsible for the process of digestion. It takes food in, digests it, takes what it needs to nourish you, and gets rid of the rest. Essentially, your Spleen is responsible for producing your body’s energy and blood. A common sign that your Spleen isn’t working well is that your digestion is off, causing things like heartburn, bloating, gas, stomach pain, constipation, or loose stools.

Each organ system has an emotional aspect, and the emotion related to the Spleen is worry. If you think of ideas as food for thought, worry is a bit like indigestion of the mind. You take in ideas, keep the ones that serve you well, and let go of those that aren’t useful to you. Worry is rumination of the mind; you continue to chew over ideas—mostly those that are fearful or aren’t useful—and are unable to let them go. Over time and out of control, this is the stuff of anxiety.

The Heart. You know rationally that your Heart is mainly responsible for circulating your blood, but in Chinese medicine, your Heart is also the keeper of your thoughts, emotions, memories, and spirit. You know intuitively that your Heart is associated with feelings, as you can have a broken heart, know something deep in your heart, and thank someone from the bottom of your heart.

The emotion most closely tied to your Heart is joy. So, knowing that your Heart is closely tied with your emotional health in general, anxiety or any other strong emotional upsets are considered to be related to the Heart system, in that joyfulness is not thriving. In most cases, we would call anxiety malnourishment of the Heart, and this malnourishment often comes from the Spleen. Remember, the Spleen produces energy and blood from the nutrients it has digested. When your digestion is off, or if you’re not getting enough of the right foods, your Spleen can’t make the blood necessary to nourish your other organs, most notably your Heart.

The Kidney. Your Chinese Kidney system is the deepest of all the organ systems. It is home to your body’s vital substances of Yin, Yang, and Essence—the stuff of your body constitution. Passed down to you from your parents, your body constitution is responsible for how you will grow, how you will mature, your fertility, and even how you will age. Your body constitution is greatly impacted by your lifestyle and how well you take care of yourself. Essentially, you can be dealt a bad hand constitutionally, but live a long life through good diet and self-care. And on the flip side, you could have a very strong constitution, but squander it away by working too hard, partying too much, and not eating well.

Your Kidney is the organ system most profoundly damaged by stress and its partner, anxiety. From a Western perspective, long-term, chronic stress, impacts your adrenals, which sit right above your Kidneys. Stress over a long time causes the adrenals to work overtime, which fires up anxiety. A Western diagnosis of adrenal fatigue that comes from long-term stress, overwork, and anxiety is considered to be a severe Kidney depletion in terms of Chinese medicine.

The good news is that if you or someone you know struggles with anxiety, Chinese medicine can help in a number of ways. Your practitioner would begin by determining the source of your anxiety and what organ systems are involved. While it’s important to treat the source of your anxiety, it’s also vital to work to calm your symptoms.  Acupuncture can be incredibly effective in calming anxiety, as it affects chemicals in your brain in a good way. Research has found that acupuncture increases the production and circulation of feel-good endorphins, which can produce a calming and relaxing sensation, both during and after your treatment.

In addition to acupuncture, your practitioner may prescribe an herbal formula to augment your treatment. They may also discuss food choices based on Chinese dietary therapy. In addition, lifestyle changes may also be a part of your treatment, and may involve stress relief, strategies for calming, and breathing techniques. I have found EFT, Emotional Freedom Technique, also known as Tapping to be an excellent method to lower anxiety. For EFT, Acupuncture points are lightly tapped with fingertips while speaking release phrases — a great technique folks can perform between acupuncture sessions.

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Natural Skin Care and The Role of Chinese Medicine

Natural Skin Care and Chinese Medicine

In Chinese medicine, we practitioners have a number of ways to determine the state of a patient’s health. We ask questions, examine, palpate, look at their tongue, and feel their pulse. We also look at the health of a patient’s skin, which often offers up clues that we wouldn’t otherwise see. That’s because your skin is actually the largest organ system in your body. And your health, good or not so good, will show up in the color and condition of your skin.

In Chinese medicine, your skin is actually governed by your Lungs, which is a system of functioning that goes beyond just breathing in and out. While the Lung and skin link may seem counterintuitive at first, think about your Lungs as the protector of the exterior of your entire body. Imagine this: with every single breath you take, your Lungs are coming into contact with the outside world. Therefore, your Lungs are considered to be the most exterior of all your organs, and as such are tasked with caring for the exterior of your body. This includes the opening and closing of your pores, your body hair, immunity, and your skin.

When working with my patients, their skin gives me all kinds of signs as to what is going on with their health. Some examples:

Easy Bruising

-This is not just the occasional bruise; it’s having lots of bruises and not knowing how you got them, or running into something and knowing that you’re going to have a purple whopper. Being an easy bruiser is a sign that your Qi, or energy, isn’t holding things in place very well. One of the tasks of your Qi is to contain things, and chronic bruising tells me that your Qi is weak and isn’t holding blood in the vessels as well as it could.

Sweating

-Do you sweat a lot, even when you’re not exerting yourself? In Chinese medicine, we politely call this spontaneous sweating. It means that your Lung Qi is a little weak and it can’t control the opening and closing of your pores effectively.

Dry and Flaky Skin

-If your skin is very dry and flaky, it generally means that the interior of your body is dry, too. In Chinese medicine, we would call that either a Yin depletion or a Blood depletion, or maybe both. That’s because both Yin and Blood are moistening, cooling, and nourishing substances in your body. If your skin is really dry even though you use moisturizer, Yin and/or Blood aren’t doing their job.

Varicose Veins

-When your Blood isn’t moving as smoothly as it could, you may develop varicose veins. They can be in the form of the large, swollen ropey veins or small spider veins. We call this condition Blood stagnation.

Rashes

-Rashes can be the most confounding skin care condition of all. In Chinese medicine, they tend to be related to something called wind—they’re superficial, tend to itch, and often move from place to place on your body. In treating rashes using acupuncture and Chinese medicine, its appearance gives us the most clues as to what’s going on. A very red rash is related to some kind of heat—sometimes deeper in your body; sometimes right on the surface. Conversely, a rash that’s very light in color tends to be associated with cold. A blistered or weepy-looking rash is categorized as damp. Itchy rashes, like hives, are considered to be a wind pathogen in nature. In reality, most people develop rashes that have a combination of things going on. For example, shingles can give you a rash that’s very red, blistered, and itchy. We would consider it to be wind plus damp plus heat.

Similar to Rashes

– Young patients who have acne, and older patients who develop rosacea have some kind of heat, determined by the red appearance of their eruptions. In the case of acne and rosacea, that heat tends to be not only on the surface of the skin, but also deeper in the body.

The bottom line is that your skin reflects the state of your health—both inside and out. Many patients want to know how to improve their health to benefit their skin, because who doesn’t want to have healthy, glowing skin?

There are a number of strategies to support natural skin care health within the framework of Chinese medicine. One important way is to support the health of your Lung system. The most obvious way to keep your Lungs healthy is to use them through intentional breathing. This can take the form of exercise that makes you breathe hard, a Yoga class, or even singing. Any activities that cause you to open your diaphragm and breathe harder are good for your Lungs, and as a result, good for your skin.

Eating healthy food is also a good strategy for supporting natural skin care. Choose mostly plant-based foods in a variety of colors as the basis of your diet. In addition, foods that build up your Qi are also good for your Lungs, and therefore good for your skin. Beyond fruits and vegetables, go for light proteins, such as fish, chicken, or tofu. In addition, foods that are considered pungent or a little spicy in nature also support the health of your Lungs.

Sleep is another way to enhance the health of your skin. There is nothing more apparent in the appearance of your skin than not getting enough sleep. That’s because your body heals and rejuvenates while your sleep, so make sure you’re getting enough—it will make your skin glow!

The Chinese say that strong emotions are the cause of a hundred diseases. And nowhere do strong emotions show up more than on your skin, especially your face. This is especially true of stress. While life happens, and you can’t control many circumstances, you can work on eliminating and dealing with unnecessary stress—your skin will thank you.

Finally, while this is not Chinese medicine, know that the sun is damaging to your skin. Avoid long hours in the midday sun, or wear protective clothing or sunscreen. The sun is considered Yang energy, which is warm and drying, and will cause long-term damage to your natural skin.

The bottom line is that if your skin is acting up, it’s doing so for a reason. Whether it’s a funky rash, athlete’s foot, acne, or a mysterious case of hives, your skin is talking to you. It’s your body’s way of telling you that something is out of balance at a deeper level. There’s good news, however. Chinese medicine and acupuncture can help in most cases. A few sessions on the table, possibly some herbs, and a few dietary tweaks may be the answer.

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