Welcome to my blog, discover acupuncture with Dr Maggie Ju

Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Wednesday, 18 October 2017

Rib pain and muscle cramps around the rib cage

Rib cage known as thoracic cage is formed by vertebral column, ribs and sternum. It encloses the heart, big blood vessels and lungs and protects them from damage. There are 24 ribs in human. Rib cage is attached by muscles of the neck, thorax, abdomen and back and covered by the fascia and the skin.

Rib cage pain can happen. The pain can be sharp, dull or achy. It can be caused by heart and lung conditions, fracture of ribs and other bone conditions. If you have rib cage pain, you need to see doctor to find out the underlying causes. Rib cage fascia inflammation and muscle spasm are a common cause of rib cage pain.

Muscles attached rib cage

Intercostal muscles are the muscles between ribs. They move rib cage and play an important role in breathing. Other muscle attached the ribs include that the serratus anterior muscle is a broad, curved muscle located on the side of the chest; the pectoralis minor muscle is the smaller of the two sets of muscles that connect the bones of the chest to the shoulder and upper arm; the external abdominal obliques have their origins along the lateral ribs 5 through 12 and internal abdominal obliques.

The sternum or the breastbone, is a long, narrow flat bone at the front of the rib cage. The muscles attached the sternum include the sternocleidomastoid, pectoralis major, sternohyoid, and sternothyroid muscles. The xiphoid process is the lower end of the sternum provides an important attachment point for the tendons of the diaphragm, rectus abdominis, and transverse abdominis muscles.

Acupuncture can help rib cage pain and rib cage muscle spasm.

Thursday, 14 September 2017

Beta endorphins, chronic fatigue and acupuncture

β endorphins are endogenous opioid neuropeptides and peptide hormones or endogenous morphine like substance originated from within the body. β endorphins are produced in the brain. Recent research suggested that cells of the immune system are also capable of beta-endorphin synthesis. In the peripheral nervous system (PNS), beta-endorphins produce analgesia by binding to opioid receptors and then inhibiting release of substance P, a key protein involved in the transmission of pain. In the central nervous system, beta-endorphins similarly bind opioid receptors. However, instead of inhibiting substance P, they exert their analgesic effect by inhibiting the release of GABA, an inhibitory neurotransmitter, resulting in excess production of dopamine. Dopamine is associated with pleasure. They decrease feeling of pain and produce a feeling of euphoria. They also modulate appetite, release sex hormones and enhance immune response. Stress and pain are the two most common factors leading to the release of β endorphins. They act on the opiate receptors in a similar way to morphine and codeine, but endorphins don’t have addiction or dependence effect. With high endorphin levels, we feel less pain and fewer negative effects of stress. The body produces endorphins by responding to exercises. Endorphin release varies among individuals, which means that two people who exercise at the same level or suffer the same degree of pain will not necessarily produce similar levels of endorphins. Acupuncture stimulates β endorphins release and reduces pain feeling and stress.

If you are tired all the time, you might have low β endorphins in immune cells. A study was involved in 16 patients with chronic fatigue syndrome. They found that β -endorphin concentrations in the immune cells of chronic fatigue patients were significantly lower than in healthy subjects. Another study on patients with chronic fatigue syndrome and fibromyalgia has shown that β endorphins level was significantly lower in these patients. Acupuncture releases β endorphins and is beneficial to patients with chronic fatigue and fibromyalgia.

References
Adam S Sprouse-Blum etc Hawaii Med J 2010, 69:70-71
Conti F et al Clin Exp Rheumatol (1998) 16:729-32
Panerai AE et al Clin J Pain (2002) 18:270-3

Sunday, 20 August 2017

Acupuncture can help to reduce skin aging

Skin blood flow significantly decreased with increase in age. Skin blood flow is 40% less at age 65 than at age 25. This is because skin blood flow decreases with decreased pumping blood from heart; skin blood flow significantly decreased with increase in total cholesterol and systolic blood pressure; less blood is redirected to the skin from other part of the body; blood vessel movement is impaired with aging and blood vessels are not relaxed to increase the blood flow.

Acupuncture increases blood perfusion and reduces skin aging

Acupuncture is used to treat many conditions in China. Its mechanism is based on meridian theory which is not accepted by Western medicine theory. Recent years researchers are trying to find how acupuncture works from a scientific aspect. Many research data suggested that acupuncture improves blood perfusion. For example, there was a study of acupuncture on 140 healthy volunteers. In this study, acupuncture was applied in LI4’ skin blood flow was measured using a Moor full-field laser perfusion imager before and after acupuncture stimulation. Recently study has shown that stimulating LI4 also increased facial blood flow and hand blood flow. After acupuncture of the right LI4 acupuncture the change ratio of mean blood flux in the left LI4 was increased significantly compared with the control group 60 minutes after acupuncture stimulation. Another study has shown that acupuncture at LI4 and LI11 increased blood circulation along the meridian. Study at ST36 point also has suggested increased skin blood perfusion around the acupuncture point in healthy subjects. In 22 healthy volunteers acupuncture at PC6 point increased microcirculation blood perfusion units along the meridian. Increased blood circulation was also seen at the back acupuncture point study. This also demonstrated in some conditions For example, in a study patients with dysmenorrhea were treated with acupuncture. After 10 sessions of acupuncture treatment, microcirculation was increased and the symptom scores, pain index, and visual analog scale decreased significantly in treatment group.

References
Tsuchida Y J Dermatol Sci (1993) 5:175-81

Tuesday, 11 July 2017

Hypothalamic-pituitary-adrenal axis, adrenal fatigue and acupuncture

Stress causes changes of many systems in the body. In response to stress, the level of various hormones changes, such as glucocorticoids, catecholamines, growth hormone and prolactin. This allows the body to cope with stress situation. Hypothalamic-pituitary-adrenal axis consists of a serial of endocrine organs including hypothalamus, pituitary gland and adrenal glands. In response to stress, this axis is activated to promote survival. Stimulation of this axis results in hypothalamic secretion of corticotrophin-releasing factor (CRF). CRF then stimulates the pituitary to adrenocorticotropin (ACTH), 8-lipotropin and 3-endorphin. Plasma levels of these hormones can increase two- to fivefold during stress in humans. ATCH stimulates adrenal glands to produce glucocorticoids which are a class of steroids. cortisols stimulate the formation of glucose and activates antistress and anti-inflammatory pathways. Stimulation of the pituitary-adrenal axis is also related to release of catecholamines which increased cardiac output, skeletal muscle blood flow etc.

Two small adrenal glands are above the kidneys. These glands produce various hormones. As mentioned above, cortisol is one of them and it helps the body deal with physical and psychological stress. Adrenal fatigue is not a proven medical condition but a description. When you are stressed, your adrenal glands might not be able to work properly. This may cause you to feel very tired. However there is no evidence there is anything wrong with the adrenal glands and also there is no specific investigation or treatment for adrenal fatigue. Adrenal fatigue is a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems etc. Acupuncture can help to improve these symptoms.

If you suspect that your fatigue is caused by adrenal insufficiency, you can get adrenal glands checked by blood tests. Adrenal insufficiency (Addison's disease) refers to inadequate production of hormones by adrenal glands. Signs and symptoms of adrenal insufficiency may include: fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness, loss of body hair, skin discoloration (hyperpigmentation).

Sunday, 25 June 2017

What do hormones do to you? balance hormones with acupuncture

What is hormone?

Hormones are produced in the endocrine glands. There are many endocrine glands in the body, such as the pituitary gland, thyroid, adrenal glands, and pancreas, testis in men ad ovaries in women. These glands produce specific chemicals and these chemicals act on the target organs and play a role in body function such as growth, metabolism, sexual function, reproduction and mood etc. Hormones are powerful molecules and only a tiny amount can cause big changes in the body. Too much or too little hormones can cause serious conditions. For example, if ovaries don’t produce enough hormones ie oestrogen and progesterone, it can cause infertility. If pancreas does not produce enough insulin, it can cause diabetes.

Hormonal balance is very important to the health. If the hormones are not balanced, there are many signs to indicate.

Irregular periods and spotting, Women in reproductive ages have regular periods. If the periods are not regular, or there are spotting between periods or missing periods. This indicates that the hormones are not balanced. They should not have vaginal bleeding between the periods, but many women experience spotting (light vaginal bleeding) between their periods sometimes. This is considered not normal. If you have difficulty to get pregnant and you have persistent spotting every month, this could be the problem. One of the common causes of spotting is hormone imbalance. Eostrogen and progesterone levels drop causing uterine lining breaking down which leads to spotting. Chronic acne, chronic acne is caused by excess of adrogens. If your acne does not clear up for long period of time, this indicates imbalanced hormones. Chronic fatigue and headaches, if you always feel tired, this can be caused by imbalanced hormones. Periodic headaches can be caused by imbalanced hormones. Mood swing and depression, hormones imbalanced can affect the brain and cause mood changes and depression, sleep problems and poor memory. Digestion problems such as bloating, diarrhea, stomach pain, nausea, appetite changes etc. Other signs include vaginal dryness, loss of libido and breast changes.

Light period, Periods are menstrual bleeding from the uterus. Every month hormones produced in the ovaries have cyclic changes. These changes cause uterine inner lining shed from the uterine wall and bleeding from the uterus. The normal bleeding days are 5 days from 4-7 days and the normal blood loss during the period is between 20-60 ml. The period with less 20 ml of blood loss is light period. Imbalanced hormones causing thin uterine lining is the common cause for this. Inflammation in and around the pelvis is another common cause and this can cause tension and block the blood flow to the uterus. If your period is too light, this could affect you from getting pregnant, because the uterine lining is not good enough for embryo to implant into the uterus and pregnancy would not occur.

Acupuncture can help improve hormone balance and reproductive blood flow and improve the chance to get pregnant.

Hormones and pain

Many chronic pain conditions have cyclical variation. This variation is related to menstrual cycles. Clearly period pain is a typical one. Other conditions such as chronic pain syndrome, chronic pelvic pain, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome (IBS), interstitial cystitis (IC) and migraine can also show cyclical variation. Research has shown that chronic pain symptoms occur when oestrogen levels are low or fall rapidly. This supports the use of the combined oral contraceptive pill (COCP) to give a more constant hormonal level can improve pain and other symptoms. β-endorphin produced in the brain had a potent analgesic effect, and up to 33 times more potent compared to morphine on a molar basis. Acupuncture treatment raises β-endorphin level and improves pain.

Oestrogen and menopause

Menopause is when a woman’s periods stop permanently. This could be a life change in the women. As women are approaching menopause, the ovaries function is declining and the body makes less oestrogen and progesterone. Eostrogens are produced in adrenal glands and fat instead of ovaries. The periods become irregular and less frequent and eventually stop. Menopause occurs naturally when a woman is in her 50s, but some women may experience early menopause in their 30s or 40s. Due to hormones change, there are some symptoms associated with it. The most common symptoms is hot flushes --- suddenly feeling hot and going red in the face. These may be associated with bouts of sweating during the day as well as at night. It is also common to find that the vagina feels dry and uncomfortable, which may make sex painful. Other symptoms include tiredness, irritability, trouble sleeping, feeling depressed and less interest in sex.

For most women, menopause is not an illness, but a phase of natural transition in later life. Sometimes the symptoms associated with menopause can be distressing and they may last for several years. If you are bothered by the menopause symptoms, you need to do something to help. Acupuncture is a natural way to help to reduce menopause symptoms such as hot flushes etc.

Hot flushes are the most common symptom of the menopause. Three out of four menopausal women have hot flushes. The symptoms include a sudden feeling of heat which can be accompanied sweating, palpitation, red flush, sleep disturbance, and mood changes. The severity varies from woman to woman. Estrogen levels decline in menopause, norepinephrine levels rise, leading to an upregulation of hypothalamic serotonin receptors, which are involved in temperature regulation. However, absolute estrogen levels are not solely responsible for hot flashes, because researchers have found no significant correlation between plasma, urinary, or vaginal estrogen levels and the appearance of this symptom. Instead, it is the relative decline in estrogen levels that appears to mediate these central changes in norepinephrine and serotonin. Significantly lower levels of plasma beta-endorphin levels were found at the onset of the hot flushes than five to 20 minutes before. These changes affect the brain temperature control center causing hot flushes.

Treatment suggested effectively for hot flushes is HRT. Apart from medication, do you know acupuncture can stop hot flushes? Acupuncture is effective for controlling hot flushes by stimulating the body releasing b endorphins It has no side effect and is a safe method to treat hot flushes.

Hot flushes treatment HRT vs acupuncture

Hot flushes are the most common symptoms of menopause. Most women experience hot flushes going through the menopause. Women with hot flushes can have sudden feeling of heat and sometimes a red, flushes face and sweating. If this happens at night, they are called night sweats. It may disturb sleep. The severity varies from person to person. Some women have occational hot flushes, while others have it every hour. Hot flashes happen when the bloodvvessels near the skin's surface dilate to cool, making you break out in a sweat. Some women have hot flushes for a very short period of time during menopause, while others may have it for several years or for the rest of their lives. The cause of hot flushes is not clear. They may be caused by hormone changes affecting the body’s temperature control. Recent study has shown that beta endorphins level is low when women have hot flushes.

Hormone replacement therapy known as HRT is recommended by doctors. It can help with hot flushes in many women and other symptoms including vaginal dryness and mood problems. When you stop HRT treatment the hot flushes may come back. Also there is risk of taking HRT including risk of blood cloting, breast cancer, endometrial cancer.

Hot flush, acupuncture is a good choice of treatment

Due to the risk of HRT, an alternative treatment is a good choice. Acupuncture is an effective treatment for hot flushes and is recognised as an effective way to reduce hot flush and there are no side effects and no risk of cancer. The possible mechanism is that acupuncture releases beta endorphins in the body. Borud et al performed a randomised controlled trial to study effectiveness of acupuncture for hot flush. 10 sessions of acupuncture were given to acupuncture group and advice on self-care was for control group. The results showed that acupuncture group has significant improvements in hot flush, sleep and other symptoms. Borud also analysed 16 clinical trial studies. Some studies showed that acupuncture reduces about 50% in hot flush frequency comparing with no specific treatment; the effect of acupuncture on frequency is smaller than that oestrogen therapy. They concluded that acupuncture reduces hot flush. Sunay D et al carried out a sham controlled clinical trial to investigate effect of acupuncture on hot flush and hormone levels. They not only showed that acupuncture relieved hot flush, but also showed that acupuncture lowered LH levels, increased oestrogen levels.

There are other promising research data supporting the effectiveness of acupuncture in hot flushes in menopausal women. Recently Baccetti et al from Italy conducted a randomized trial to investigate the effect of acupuncture treatment for hot flushes. One hundred women in spontaneous menopause with at least three episodes of hot flushes daily were randomly allocated to two treatment groups (50 per group): Women in group A were given diet, self-massage training, and treatment with acupuncture, and women in group B (the control group) were given the same diet and self-massage training. 6 weeks acupuncture treatments were offered for these women. They found that treatment with acupuncture significantly reduced the occurrence of hot flushes and sudden sweating. They also found that other symptoms including sleep disorders, tightness in the chest, irritability, bone pain, feeling depressed were also significantly improved after acupuncture treatments. They suggested that Acupuncture in an integrated system that includes therapeutic techniques such as diet therapy and Tuina self-massage can be used to treat hot flushes and selected symptoms in postmenopausal women.

A study of acupuncture on hot flushes was performed by Borud EK et al from the National research Center in Complementary and Alternative Medicine University of Tromso Norway in 2006/2007. There were 267 participants with hot flashes. Mean age was 53.8 year old. 134 women were in acupuncture group receiving 10 sessions of acupuncture treatment over 12 weeks. The most frequently used 10 acupuncture points were SP6, HT6, KI7, KI6, CV4, LU7, LI4, LR3, ST36 and KI3. 133 women were in control group receiving self care only. In acupuncture group 67 women responded to the acupuncture treatment. 64 women did not respond to the treatment. There were no serious side effects found in acupuncture treatments.


References

Borud EK et al Acupunct Med (2009) 27:101-10

Borud EK et al Menopause (2009), 16: 484-93

Borud E et al Auton Neurosi (2010), 157: 57-62

Sunday D Acupunct Med (2011), 29: 27-31

Baccetti S et al J Altern Complement Med (2014) May 14


Monday, 1 May 2017

Because of pain receptors, it is why you feel the pain. Acupuncture releases pain

Because of pain receptors, it is why you feel the pain. Acupuncture releases pain

If there is injury somewhere in the body, it leads to the feeling of pain. Pain is a vital function of the nervous system. It is both a sensory and emotional experience, affected by psychological factors such as past experiences, beliefs about pain, fear or anxiety. We feel the pain because we have pain receptors in the body. Pain receptors are specialized sensory receptors. They are responsible for the detection of noxious stimuli (including mechanical, thermal or chemical stimuli), transforming the stimuli into electrical signals (these signals will then be conducted to the brain). Inflammatory mediators (such as bradykinin, serotonin, prostaglandins, cytokines, and H+) are released from damaged tissue and can stimulate pain receptors directly. They can also act to reduce the activation threshold of the receptors so that the stimulation required to cause activation is less. This process is called sensitisation. Acupuncture can stimulate the body to release anti-inflammatory substances to reduce the stimulation of the pain receptors and desensitize the pain receptors to release the pain.

Three types of pain

Somatic pain is caused by the activation of pain receptors in either the body surface skin and connective tissues or musculoskeletal tissues. It is usually dull pain or aching. Generally speaking, somatic pain is usually provoked by activity and relieved by rest. It is often caused by inflammation, trauma, excessive activity, vigorous stretching, and muscle contractions etc.

Visceral pain is pain coming from the internal organs. It is deep, dull or dragging pain. It can be associated with autonomic changes such as nausea, vomiting, and changes in heart rate or blood pressure. It can also evoke strong emotional responses. Visceral pain is triggered by smooth muscle distension or contraction, stretching of the capsule surrounding an organ, ischaemia and necrosis, or irritation by chemicals produced during inflammatory processes. Referred pain could occur at a site distant from source of the pain. It is due to the convergence of different afferents on to the same dorsal horn neurones in the spinal cord.

Neuropathic pain is caused by damage to nerves in the central or peripheral nervous system. For example, trauma, diabetes mellitus, ischaemia etc can cause the damage. Pain is burning or like an electric shock. Pain is likely spontaneous.

Acute pain vs chronic pain

Acute pain usually comes on suddenly and goes away a few weeks to a few months, if the cause has gone and is treated properly. For example, sudden pull of the back muscles causes back muscles damage and acute back pain. The pain could be severe and accompanied by anxiety and emotional distress. It goes within a few days to a week time. If acute pain persists, it can become chronic. Chronic pain is pain that usually lasts longer than six months, such as headache, back pain, neck pain, and shoulder pain. Chronic pain can cause stress on the body and mind, such as tense muscles, limited ability to move around, a lack of energy and fatigue, anxiety, change of mood, depression and agitation etc.

Acupuncture can help both some acute and chronic pain.

Friday, 28 April 2017

Muscle tone, muscle aging and acupuncture

Muscle tone and muscle tension

When one relaxed, one must think the muscles must completely rest without any activity. Actually this is not the case. Muscles in the body are constantly in contracted state which creates muscle tone. Muscle tone is formed from the continuous and passive partial contraction of the muscles at resting state. Because of the muscle tone, muscles are resistant to passive stretch. It helps maintain posture, balance and respond to sudden pull and stretch. If a sudden pull occurs, the muscles are automatically increased the tension to prevent the body from danger. Generally speaking, low tone increases flexibility and decreases strength and high tone decreases flexibility and increases strength. However there are many exceptions. For example, if the muscle becomes cramped, it loses its strength. Poor posture can result in high muscle tones in related group of muscles.

Muscle tension is formed when muscles remain semi-contracted involuntarily for a period time. Muscle tension can be caused by stress and inflammation. One can feel headache, muscle pain, muscle tightness and stiffness. Muscle tension is a condition in which some muscles of the body remain semi contracted status. It is typically caused by the physiological and/or psychological stress. The tension could happen anywhere in the body. Face and back are common places of accumulation of tension. You may feel tightness and tension or you may not feel anything. Factors affect muscle tension: lack of sleep, excessive nervous system activity such as too busy schedule, excessive exercises, expose to the cold, too much coffee, smoking, chronic inflammation, fatigue, poor posture, anxiety etc.

Muscle changes with aging and muscle tightness, acupuncture can help

With aging changes in the skin and hair are common and more noticeable. People might not realise that muscles are also changing with aging. This change could start at age 30 and accelerate at age 50. Muscle fibres reduce in number and shrink in size. Muscle tissue is replaced more slowly and lost muscle tissue is replaced with a tough, fibrous tissue. Also changes in the nervous system cause muscle to lose tone and ability to contract and become rigid. Muscle loses strength because of a decrease in the production of anabolic hormones such as testosterone, growth hormone and insulin-like growth factor-1 and impairment of protein production. This can contribute to fatigue, weakness and reduced tolerance to exercise. The types of muscle fibers are affected by aging as well. The numbers of muscle fibers that contract faster decrease much more than the numbers of muscle fibers that contract slower. Thus, muscles are not able to contract as quickly in old age.

With aging bone has changed as well. Bones lose calcium and other minerals and become less dense. This change becomes dramatic after menopause due to hormones change in both female and male. With aging joint movement becomes stiffer and less flexible because the amount of lubricating fluid inside the joints decreases and the cartilage becomes thinner. Ligaments also tend to shorten and lose some flexibility, making joints feel stiff. Also the connective tissue within ligaments and tendons becomes more rigid and brittle. This change also limits the range of motion of joints.

What to do?

Exercise can prevent many age-related changes to muscles, bones and joints – and reverse these changes as well. Exercise can make bones stronger and help slow the rate of bone loss; muscle-strengthening can increase muscle mass and strength; Stretching helps maintain joint flexibility; walking is a good exercise for maintenance of bone mass.

Acupuncture is a good way to release muscle tension. Acupuncture helps improving blood circulation and improves nutrition and oxygen supply to the muscles and bones and improves metabolism of muscles and bones. Acupuncture helps reduce inflammation, release and repair any damage of the tendons and ligaments.

Muscles tightness, acupuncture can help.

Muscle tightness is that muscles feel tight and stiff which is caused by muscle contractions. Some people feel pain of muscles. Muscle tightness often develops from overuse, trauma, stress or illness. Muscles shorten over time and they become weaker over time. Muscle contraction leads to ischemia and degeneration of the muscle fibers which further weaken the muscles. Loss of balance can occur. Muscle tightness also increases the risk of muscle strain or tearing of muscle fibers during activity. It is important to maintain flexibility to relieve muscle tightness and reduce risk of injury.

Fascia is dense connective tissue sheets and it plays an important role in transmitting force in human posture and movement regulation. Fascia is usually seen as having a passive role, transmitting mechanical tension which is generated by muscle activity or external forces. However, there is some evidence to suggest that fascia may be able to actively contract in a smooth muscle-like manner and consequently influence musculoskeletal dynamics. Myofibroblast cells are a special type of cells with smooth muscle like contractility. These cells are present at skeletal muscle tendons, ligaments and many organ capsules. They are also reported in fascia. The density is higher in younger people. Fascia contraction contributes to the tension and stiffness of the muscles, such as back pain, frozen shoulder and headaches etc. Releasing fascia contraction could improve muscle tension and stiffness.

Tendon also has aging changes. There are many cellular and vascular changes within the aging tendon. As a result the aged tendon becomes weaker than it used to be and more likely to tear or get overuse injury, when there is increased stress and strain. With aging process, the density of tendon cells decrease and nucleus becomes bigger, long and thin; cell metabolic activity decreases such as protein and amino acids synthesis. Extracellular changes occur with aging: for example, Elastic fibers and water content decrease which contribute to the tendon stiffness and gliding reduction; collagen content changes little, but the relative amount of collagen, volume density and mechanical stiffness increase due to decrease of water content; collagen synthesis and mechanical properties, solubility decrease. Blood Vessels in tendon change. Tendon blood flow and the number of capillaries per unit of surface area decrease with increasing age. The decreased arterial blood flow and thus decreased nutrition and oxygen transport have been suggested to be the main etiological factors behind the age-related tendon degeneration.

As mentioned above that acupuncture can release muscle tightness and relax your muscles.

Muscle knots and muscle pain, acupuncture can help

Muscles in the body are connected and overlapped. This brings the body moving around and doing various activities without problem. Sometimes the muscles can lose some mobility and flexibility. Injury and overuse are common cause for muscles problems. For example muscle knots are one of the common problems. It can happen to any muscles.

Muscle knots are initially formed by muscle fiber contraction or spasm. This is commonly caused by acute injury or chronic overuse. The muscles knots are very sensitive causing stillness and pain. Severity of the pain varies. If the knots are not treated properly, inflammation can persist, and adhesion and scar tissues make the knots and related muscles lose elasticity and the knots become harder and more difficult to get rid of.

Do you know acupuncture can help to get rid of muscle knots effectively?

References

Allen RE and Kirby KA Am Fam Physician (2012) 86:350-5

R. Schleip et al Medical Hypotheses (2005) 65, 273–277

Sunday, 12 February 2017

Fertility acupuncture for women and men

Acupuncture is used to treat infertility for women and men

Infertility is a disorder of reproductive system and it is when a couple failed to achieve a clinical pregnancy after 12 months or more of regular unprotected sex. Getting pregnant for some couples is natural, but for others it becomes difficult. Due to delayed child bearing age, environmental changes, and other reasons, one in seven couples have difficulty to conceive in the UK. After years of trying and no cause found, they could be put on IVF treatment straight away. In 2011, 48,147 women had a total of 61726 cycles of IVF or ICSI in the UK. Is there any other less invasive treatment available to help these couples to conceive?

Acupuncture is an alternative way to treat couples with infertility. Acupuncture is called ancient art. The use of acupuncture treatment in couples seeking fertility care is dramatically increased in last decades. A survey in the US has shown that one in five couples with infertility have tried acupuncture over 18 months of observation period. In the UK treatment for infertility with acupuncture increased fivefold in 10 years time. In Switzerland, Germany and Austria, one third of the fertility centres offer acupuncture treatments. If you are seeking IVF treatment for your fertility, acupuncture treatment as an adjunct treatment helps you to achieve best IVF success rate.

Fertility acupuncture, how does it work?

Is there scientific ground for the application of acupuncture on infertility treatment? Or is it only based on ancient theory? Or is it like some people thinks: acupuncture will work, if I believe it. As a matter of fact, there were many research data available to support this application. Since 1990s, much research has been done in animal experiments and clinical trials. Based on recent research evidences, it is suggested that for women acupuncture mediates endogenous opioid peptides in the central nervous system affecting fertility hormone balance; it increases uterine artery blood flow; it reduces inflammation; and it reduces stress which affects fertility hormone balance. Acupuncture also relaxes fallopian tubes. As a result, it could help improving egg production and egg quality and improving uterine receptivity and embryo implantation. Consequently reproductive health is improved and there is better chance to get pregnant. Acupuncture also helps improving men’s fertility. Research data on this aspect start emerging and suggested that acupuncture can increase sperm counts and improve sperm quality by improving testicular blood flow and reducing inflammation.

If you are interested in TCM (Traditional Chinese Medicine) idea, any blockage of Qi in the body will cause illness in TCM theory. Acupuncture acts at the specific acupuncture points in the meridians and clears off the blockage and makes Qi flowing freely in the body, as a result the organs will function well again. This improves your fertility as well as your overall health.

Acupuncture helps your fertility return after stop contraception methods

Women are fighting not to get pregnant and then fighting to get pregnant. When you start using contraception methods do you ever think about that your fertility will return when you stop? What is the chance to get pregnant, if you want to? A research has shown that women who stopped using a barrier method to achieve a planned pregnancy conceived most quickly: 54% were delivered after one year vs 39% of intrauterine device and 32% of oral contraceptive users. There was no association between fertility and duration of oral contraceptive use: However, short term intrauterine device users (< 42 months) showed a fertility pattern more favourable than seen in those discontinuing oral contraceptives, with increasing duration of intrauterine device use being associated with decreasing fertility. The fertility of women who had used the intrauterine device for 78 + months was the most impaired (28% were delivered by 12 months vs 46% of short term users). What is the chance to get pregnant, if you don’t have fertility problem? 92% will get pregnant during one year at ages 19-26 and 82% will get pregnant during one year at ages 35-39.

Do you know that acupuncture improves ovarian and uterine blood circulation and helps with your return of fertility, after you stop discontinuing contraception methods?

Stress affects fertility in both female and male and acupuncture reduces infertility related stress

Psychological stress is strongly associated with infertility. Infertility itself is stressful, due to the pressures, testing, diagnosis, treatments, failures, endless waitings and associated economic costs. There is an association between stress and infertility. Infertility causes stress and stress (both acute and chronic) may cause infertility. Stress can increase after diagnosis of infertility, follow-up appointments, and failed IVF treatments. Coping with various life styles also affects fertility.

Psychological stress affects 30% of women who attend infertility clinics, possibly due in part to infertility diagnosis and treatments. Women with infertility experience emotional stress. They tend to keep things to themselves and delay starting the treatments because of a desire to conceive naturally. This does not happen and makes them very stressed which turn to have negative impact to their fertility. There is a link between infertility and psychological distress. Greil et al studied the variation of fertility specific distress (FSD) associated with different types of infertility. They found that women with infertility have intention to have a child and seek treatment have higher levels of FSD than those women without intention to have a child and don’t seek treatment. Women with primary infertility (They have no prior pregnancy) have higher level of FSD than those women with secondary infertility (They have had at least once prior pregnancy with or without live birth. Older women with infertility tend to have higher distress level than younger women. General distress doesn’t vary between different types of infertility. A study of 430 couples on association between stress and conception showed that decreased conception occurred in those most stressed women. Women received treatment showed less stress and more hopeful. Fertilization of oocytes also decreased when stress increased. Stress acts through different mechanisms, not only by inhibiting the HPA axis but also by altering the concentration of fertility hormones (FSH, GnRH and LH) as well as other substances such as cortisol, opioids and melatonin. It alters the follicular levels of glucocorticoid hormones. The blood flow in the fallopian tubes could be reduced.

Males who experienced more than two stressful life events before undergoing infertility treatment were more likely to be classified below WHO standards for sperm concentration, motility, and morphology. Stress such as a job, life events, and even social strain were seen to have a significant impact on sperm density, total sperm counts, forward motility and morphology. Semen parameters may potentially be linked to stress. Actively coping with stress, such as being assertive or confrontational, may negatively impact fertility by increasing adrenergic activation, leading to more vasoconstriction in the testes. This vasoconstriction results in lower testosterone levels and decreased sperm production. Stress and depression are linked to reduce testosterone and luteinizing hormone (LH) pulsing, disrupt gonadal function, and ultimately reduce spermatogenesis and sperm parameters.

Very recently there was a study about stress on male fertility. This study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed. 27% of them had HADS anxiety and depression score ≥8 which was abnormal HADS score showing stress condition. The persons having abnormal HADS had lower serum total testosterone, higher serum FSH and LH than those of persons having normal HADS. Serum total testosterone correlated negatively with HADS. Sperm count, motility and morphologically normal spermatozoa were lower in persons having abnormal HADS. Abnormal sperm motility and morphology were related to lower testosterone and higher LH and FSH levels. This study suggested that psychological stress affects male fertility and sperm quantity and quality.

Stress is also accompanied with fertility treatment. Before start of treatment such as IVF, fear of failure makes women stressed. Unsuccessful treatment raised stress level, while success treatment makes negative emotion disappeared. Studies found that high stress level reduced IVF success rate and live birth rate. Higher stress level during egg collection and embryo transfer was found in women failed IVF cycles than those who achieved pregnancy in IVF cycles. As mentioned above stress affects women’s fertility. Stress affects the hypothalamic-pituitary-adrenal axis (HPA) altering hormones including CRH, ATCH and cortisol production. These hormones also mediate hypothalamic-pituitary-gonadotropic axis (PG) which is an axis regulating sexual hormone secretion. As a result follicle stimulating hormone (FSH) and luteinizing hormone (LH) level decreased which affects fertility. Coyle M and Smith C conducted a survey to study the health status for women undergoing ART and examined the relationship between health status, traditional Chinese medicine (TCM) and Western medicine diagnosis underlying the cause for their infertility. Women with infertility undergoing ART were recruited and health was checked by TCM and western medicine questionnaire. They found that mental health status not physical function for these women was lower than that for general population. For TCM diagnosis, Qi and blood stagnation was common. And these women tend to have low score in the health questionnaire.

Stress management and stress reduction should be an important part of the infertility management. Lower stress levels improves female and male natural fertility and lower stress levels result in better fertility treatment outcome. Acupuncture is a useful treatment for reducing fertility related stress in female and male.

In vitro fertilisation (IVF) provides great chance for those couples who have difficulty to conceive. However IVF does not always produce pregnancy, actually the success rate is not high. It can be physically and emotionally challenging. Isoyama et al studied the effect of acupuncture on symptoms of anxiety in women undergoing IVF. 43patients participated in the study. 22 patients were in acupuncture group while 21 patients were in the control group. The anxiety level of each patient was analysed before and after treatment. Four weekly sessions were performed. Acupuncture points including HT7, PC6, CV17, GV20 and Yingtang were used for the needling. Their result showed that after 4 week treatment the anxiety score for acupuncture group was significantly lower than for the control group. This indicated that acupuncture can reduce anxiety symptoms in women undergoing IVF.

There is perceived stress on the day of embryo transfer (ET). Balk J et al in University of Pittsburgh studied effect of acupuncture on perceived stress and pregnancy rate on the day of ET. In this study, 57 patients with infertility and undergoing IVF or IVF/ISI were involved. These patients were undergoing ET with or without acupuncture as part of their standard clinical care. The result showed that women who received acupuncture treatment achieved 64.7% pregnancy rate while those who didn’t receive acupuncture treatment had 42.5% pregnancy rate. Women with acupuncture had lower stress score both pre-ET and post-ET compared to those without acupuncture. Women with lower stress score had higher pregnancy rate. They concluded that acupuncture reduced stress both before and after ET and it is the possible reason for improving pregnancy rate. Lower perceived stress on the ET may improve pregnancy rate.

Smith CA et al studied the effect of acupuncture on psychological distress for women with infertility. They run a pilot randomized controlled trial to investigate effectiveness of acupuncture for reducing infertility related stress. They found that 6 sessions over 8 weeks of acupuncture could reduce infertility related stress. Women in acupuncture group have less social and relationship concerns. They have improved self efficacy and less anxiety compared to waiting-list control group. Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and time out, the engagement with the practitioner, and an intervention that had very few negative side-effects. Changes were also perceived after treatment with women describing a physical and psychologic sense of relaxation and calmness, and a changed perspective in relation to coping. This suggested that acupuncture may be a useful intervention to assist with the reduction of infertility-related stress.

Polycystic ovary syndrome (PCOS) is characteristic of polycystic ovaries, hyperandrognism, irregular menstrual cycles, and abnormal metabolism including insulin resistance and obesity. PCOS increases risk of depression and anxiety and negatively affects health-related quality of life. Life style change on diet and exercise is essential and proved that this decreased depression and improved quality of life. E Stener-Victorin et al studied the effect of acupuncture and exercises on depression, anxiety and impaired quality of life in women with PCOS. 72 women with PCOS were recruited in the study. 28 women were offered acupuncture and 29 women were offered physical exercise and 15 women were assigned with no intervention. The treatments were lasted for 16 weeks for different interventions. Acupuncture was given twice a week for 2 weeks, once a week for 6 weeks and once every other week for 8 weeks. Total 14 treatments over 16 weeks were offered. Physical exercise program included regular exercise, such as walking, cycling or any other aerobic exercise at a self-selected pace. The frequency of exercise was at least 30 min and at least 3 times a week. This lasted 16 weeks. The assessment was at the end of 16 week treatment and 16 week follow-up after the last treatment. The results showed that depression and anxiety scores were reduced at the end of the treatment and the follow-up in the acupuncture group; the quality of life such as physical, energy/vitality, general health perception and the mental component was also improved in the acupuncture group. The quality of life such as general health perception, physical functioning and emotion was improved in exercises group.

References

Doll H et al BJOG (2001) 108:304-14

http://www.nhs.uk/chq/Pages/2295.aspx?CategoryID=54

Campagne Hum Reprod (2006) 1651-8

Smith et al J Altern Complement Med (2011) 17:923-30

Bhongade MB et al Andrologia (2014) 10.111and 12268

Sharma R et al Reprod Bio Endocrinol (2013) 11:66

Greil AL et al Hum Reprod. (2011) 26:2101-12

Balk J et al Complement Ther Clin Pract (2010) 16:154-7

Isoyama D et al Acupunct Med (2012) 30:85-8

Coyle M, Smith C Acupunct Med (2005) 23:62-9

E Stener-Victorin et al BMC Complement Altern Med (2013) 13:131

Tuesday, 10 January 2017

Numbness on toes and feet, what to do?

Numbness is a loss of sensation or feeling in a part of the body. It's often accompanied by other abnormal sensations, such as a pins-and-needles feeling, burning or tingling. Numb toes and feet are a common problem which generally affects the nerves that supply the toes and feet. The sensory nerves to the toes and feet receive stimulus such as pressure and temperature and send signal to the brain. If the nerve is damaged, the signals are no longer sent to the brain. In this case numbness occurs and the toes and feet are no longer feeling sensation such as touch, heat or cold. Usually this is caused by peripheral nerve damage to the toes and feet. It is rarely caused by the spinal cord or the brain. The numbness of the toes and feet can be often caused by the injury to the toes feet, hips and low back. Generally numbness is not life threatening and some people with numbness don’t bother to get it treated, but numb toes and feet do need to be checked out to find out what the cause is and be treated to prevent further damage due to lack of sensation which increases the chance of injury. Acupuncture can help nerve recovery and improve the numbness.

Which muscles are involved in upper back pain?

Trapezius muscle Trapezius is a superficial broad triangular muscle at neck and upper back, one of the largest superficial muscles at the up...