Welcome to my blog, discover acupuncture with Dr Maggie Ju
Friday, 27 September 2019
Acupuncture releases trapezius muscle fatigue, increases muscle activity and reduces pain in nonspecific neck pain
Pain caused from the upper trapezius includes headaches on the temples, facial, temple or jaw pain, pain behind the eye, dizziness, neck pain, stiff neck, limited movement, intolerance to weight on the shoulders. Pain caused by middle trapezius includes headache at the base of the skull, mid back burning pain or aching along the spine or to the top of the shoulder. Pain caused from the lower trapezius includes headache at the base of the skull, aching on the top of the shoulder, neck, mid back and/or upper shoulder pain; pain at the back of the shoulder blade which could go down the inside of the arm to the ring and little fingers.
A recent research investigated immediate effect of acupuncture on electromyographic activity of the upper trapezius muscle and pain in patients with nonspecific neck pain. Fifteen patients with nonspecific neck pain and 15 healthy participants participated the study. They received one session either acupuncture or sham acupuncture as a control. The electromyography (EMG) signal of the upper trapezius muscle was recorded before and after acupuncture treatment. After acupuncture treatment, pain was significantly reduced and significant decreases in the EMG amplitude were identified for the nonspecific neck pain group. This research suggested that muscle fatigue and decrease of activity of the upper trapezius muscle was found in nonspecific neck pain patients. Acupuncture contributes to pain relief among patients with nonspecific neck pain.
Calamita SAP et al J Manipulative Physiol Ther. 2018 Mar - Apr;41(3):208-217. doi: 10.1016/j.jmpt.2017.09.006.
Tuesday, 17 September 2019
Tendon is a tough band of fibrous connective tissue that usually connects muscle to bone. It is responsible to transmit muscle force to the bone. A healthy tendon is up to twice as strong as the muscle, making the body of the tendon unlikely to tear before the muscle unless the tendon has already been weakened by degenerative changes. The effects of ageing, wear and tear, genetic pre-disposition and inflammation are known factors contributing to tendon injuries. Injured tendon can cause pain, loss of limb function and prevent exercise and activities of daily living. Injured tendons heal by fibrotic repair and are highly prone to re-injury.
Tendons consist of collagens, proteoglycans, glycoproteins, water and cells. It takes over 100 days to make new collagen.
The healing time for injured tendon varies. Tendon healing can be largely divided into 3 overlapping phases, inflammatory, repairing and remodelling phases: The initial inflammatory phase lasts about 24 hours. During this time erythrocytes, platelets and inflammatory cells migrate to the wound site, recruit tendon blast cell and clean the site of dead tissues and then initiate new collagen synthesis and deposition. After a few days of injury the repairing phase begins. Tendon fibroblast synthesise abundant collegan and other extra cellular matrix components. After 6 weelsthe remodelling phase starts. This phase is characterised by decreased cellularity and decreased collagen and glycosaminoglycan synthesis. During this period, the repair tissue changes to fibrous tissue, this again changes to scar like tendon tissue after 10 weeks. After 10 weeks remodelling continues
Treatment at an early stage can be as brief as 6–10 weeks. Once it becomes chronic the treatment can take 3–6 months. The effective treatment might take 9 months or longer when it is chronic. Knowing these timelines is part of creating an effective treatment plan.
Acupuncture helps release the pain. Acupuncture helps with tendon injury
Acupuncture is used to treat tendon injury and it improves pain and functional activity in patients with tendinopathy. This is suggested that acupuncture can modulate both anti-inflammatory and mechanotransduction molecular pathways which can increase type I collagen synthesis. Collagen synthesis is the main factor that influences tendon biomechanical properties. Therefore one reason of acupuncture for tendon healing is that acupuncture increases synthesis and subsequent reorganisation of type I collagen during tendon healing process.
Chronic pain is pain that lasts more than three months. It’s a very common problem. Results from the 2012 National Health Interview Survey show that:
About 25.3 million U.S. adults (11.2 percent) had pain every day for the previous 3 months.
Nearly 40 million adults (17.6 percent) had severe pain.
Individuals with severe pain had worse health, used more health care, and had more disability than those with less severe pain.
Acupuncture is a top choice for chronic pain management according to NIH.
Clinical investigators have found that chronic pain patients often have lower-than-normal levels of endorphins in their spinal fluid. Acupuncture activates endorphin systems and increases levels of endorphins in cerebrospinal fluid.
Almeida Mdos S et al Acupunct Med (2014) 32:178-82
Thursday, 18 July 2019
Since the incision is usually made below the pubic hairline, you might not see your scar at all. It'll look red or pink for several months but eventually it fades to a pale, flat, thin line. Some women create bigger, thicker, or raised scars than others. If your scar is itchy or painful after a few months there is inflammation. Acupuncture can help to reduce inflammation of the scar to make the scar smoother.
A recent review has studied efficacy of acupuncture in treating scars following tissue trauma. All studies reported positive outcomes for the use of acupuncture for scar symptoms, though treatment frequency, duration, number of treatments and points used varied between studies.
Scars Burn Heal 2019 Mar 11;5:2059513119831911. doi: 10.1177/2059513119831911. eCollection 2019 Jan-Dec.
Tuesday, 16 July 2019
Eczema comes from the Greek word to boil and is used to describe the symptoms of the condition: red, dry, itchy, skin which can sometimes become weeping, blistered, crusted, scaling and thickened. The main symptom of eczema is skin rash associated with itch. Scratching can fire up the skin rash and makes the itching worse. Itch can be severe enough to interfere with sleep, causing tiredness and irritability. The symptoms can sometimes be severe while other times less severe. Some people only have small patches of dry skin, but others may experience widespread red, inflamed skin all over the body. atopic eczema can affect any part of the body, it most often affects the hands, insides of the elbows, backs of the knees and the face and scalp. Many things can flare up atopic eczema: such as heat, dust woollen clothing, pets and irritants including soaps and detergents, cold and infections, teething in babies, food allergies and stress.
Acupuncture is effective for atopic eczema. For example, a recent study involving in thirty participants with eczema. They were received four weeks of acupuncture treatments. All eczema symptoms were improved in 4 weeks’ time.
Kang S et al Complement Ther Med2018 Dec;41:90-98. doi: 10.1016/j.ctim.2018.08.013. Epub 2018 Sep 10.
Wednesday, 15 May 2019
Acupuncture was widely accepted in treating chronic pain such as lower back pain, knee knee pain, and headaches etc. It is adapted into a conventional biomedical practice based on anatomy, neuroscience, pathology and evidence-based medicine. A recent review analysed efficacy of acupuncture in treating scars following tissue trauma to assess the current level of evidence for the use of acupuncture for treating abnormal scars such as hypertrophic or other symptomatic scars. They found five case studies, one retrospective cohort study, one cohort study and three clinical trials that investigated the use of acupuncture for scars. The result has shown that all studies reported positive outcomes for the use of acupuncture for scar symptoms; however, treatment frequency, duration, number of treatments and points used varied between studies.
The mechanism involved is that mechanical stimulation of sensory receptors induces neuropeptide release that further stimulates chemically sensitive nociceptors and leads to neurogenic inflammation of the scar tissue, disrupting and prolonging the healing process. Acupuncture treatment stimulates mechanoreceptors and nociceptors in the skin and underlying tissue and is suggested to enhance the activity of inhibitory neural mediators, thereby modulating neurogenic inflammation
Tuckey C et al Scars Burn Heal 2019 Mar 11;5:2059513119831911. doi: 10.1177/2059513119831911. eCollection 2019 Jan-Dec.
Wednesday, 20 March 2019
Muscle mass decreases with aging. This seems to be most prevalent in the seventh decade and beyond. Research has shown that a 0.5% to 1.0% loss of muscle mass per year after 70 years of age and a 4.7% loss compared with peak mass in men and 3.7% decrease for women per decade.
Muscle protein synthesis is deceased without much change in degradation. This suggests that muscle turnover and repair capacity is likely decreased with age.
Muscle basal metabolic rate is deceased, insulin resistance is increased, and higher percentage body fat mass is increased. All these contribute to the decrease in lean body muscle mass. Other contributing factors include decreased physical activity, lower hormone excretion, nutritional deficits, and chronic inflammation.
With aging, muscle endurance capacity declines 10% per decade (as measured by maximal oxygen consumption) and aerobic energy production is decreased with age. Decrease in endurance can be due to the reduced number of mitochondria (energy provider) and the subsequent reduction in mitochondrial-based aerobic enzymes
With aging muscle fibers also change with increased percentage from type I muscle fibers and decreased type II muscle fibers. Type I fibers are small, slow-contracting, low-tension output fibers with many mitochondria and aerobic enzymes for energy production. These fibers are highly resistant to fatigue and are capable of metabolizing fat for energy expenditure. Type II fibers are much larger and faster contracting fibers that produce large tension output but fatigue quickly. with age, there is less of a contribution to tension output from the higher tension type II fibers because the lower tension–output type I fibers are now more predominant. Overall, the muscle mass of the elderly is smaller and weaker because of the loss of type II fibers.
Patrick N. Siparsky et al https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874224/
Friday, 15 March 2019
One of the first muscles to cause headache and neck pain is trapezius. This is a broad triangular muscle at neck and upper back, one of the largest superficial muscles at the back. It attaches to the base of the skull and extends down to the neck, the upper back until mid back; laterally it inserts to the shoulder blades. There are three functional regions to the muscle: the Upper, middle, and lower trapezius, and each region has its own function: upper region moves the shoulder blades and support the arms; the middle region retracts the shoulder blades and the lower region rotates and depresses the shoulder blades.
Acupuncture can effectively release muscle spasm.
Granham N et al from McMaster University, Hamilton Canada analysed existing data to provide the evidence for recommendations on physical modalities for acute to chronic neck pain. The data included was from January 2000 to July 2012. Their result showed that short term pain relief- moderate evidence of benefit: acupuncture, intermittent traction and laser were shown to be better than placebo for chronic neck pain. Moderate evidence of no benefit: pulsed ultrasound, infrared light or continuous traction was no better than placebo for acute whiplash associated disorder, chronic myofacial neck pain or subacute to chronic neck pain. There was no added benefit when hot packs were combined with mobilization, manipulation or electrical uscle stimulation for chronic neck pain, function or patient satisfaction at six month follow-up. They concluded that the current state of the evidence favours acupuncture, laser and intermittent traction for chronic neck pain.
Liang Z et al in China studied the effect of acupuncture on chronic neck pain. 178 patients with chronic neck pain were recruited. These patients were allocated into two groups 88 in acupuncture group and 90 in control group which received acupuncture and placebo treatment respectively. The Northwick park neck pain questionnaire (NPQ), visual analogue scale (VAS), short from 36 health survey (SF-36) and doctor’s judgement were applied for measuring effectiveness. The effect was assessed before treatment, immediately after the treatment, at the end of first month of follow-up and at the end of third month follow up. They found that the NPQ, VAS and SF 36 scores in acupuncture group were significantly improved after the treatment and the two follow-ups compared with before the treatment. Acupuncture group had better effect than that for control group. They concluded that acupuncture has immediate effect and lasting effect for chronic neck pain.
Another research of effectiveness of acupuncture on neck pain by Dong and Lin was published recently. They compared different effects of acupoints. 60 patients received acupuncture 5 times a week for 2 weeks. The Pain Rating Index (PRI, VAS and Present Pain Intensity (PPI) were measured before and after the treatments. They found that the scores were significantly reduced.
Friday, 8 March 2019
First of all, inflammation in reproductive system affects fertility. Inflammation in or around ovaries affect egg development, egg quality and ovulation. Inflammation around fallopian tubes could stimulate tube spasm affecting egg and embryo passing through. Inflammation in uterus affects implantation. Even if there is inflammation in pelvic area or abdominal area could make environment not supporting fertilization and pregnancy.
Secondly, blood stagnation that is poor blood circulation in pelvic area causes poor egg quality in ovary and poor nutrition in uterus. This affects fertilization and implantation.
Thirdly, hormone imbalance is another important factor affecting fertility. Imbalanced hormone affects egg development; as a result, poor quality egg was produced. Imbalanced hormone could cause anovulation. Also imbalanced hormone affects uterine inner lining preparation which makes implantation harder.
Finally stress could affect fertility. Stress hormone called cotisol is made from progesterone in female and testosterone in male. If one is stressed, the body keeps making stress hormone which would exhaust sex hormone and this compromise fertility.
About fertility acupuncture
Women work hard with potentially increased sympathetic activity which causes poor pelvic circulation. Also there are more potential environment toxins to ovary. Many women have difficulty to get pregnant and seek help. Fertility acupuncture is an effective method to help women getting pregnant. What do you expect from fertility acupuncture? There is tons of information from internet about fertility acupuncture. There are many amazing stories that a few sessions of acupuncture helped women become pregnant. Are these stories true? I believe that this could happen from my experiences. Some women do get pregnant after a few sessions of acupuncture treatments. This really depends on what is the cause of the problems. However not everyone gets pregnant very quickly. If you see an acupuncturist for fertility treatment, you need to be prepared and have realistic expectation. If you do not get pregnant after a few sessions, don’t be discouraged. This is not because acupuncture does not work to you, but because it takes longer for you than for anyone else. Everyone is different. After a few sessions of acupuncture, some women get pregnant while others only start to see changes. Acupuncture works for infertility and this is based on scientific evidence. Acupuncture could tackle these four issues by stimulating the nerve endings at particular acupuncture points. It improves reproductive system blood flow and reduces inflammation; it regulates hormone level to correct hormonal imbalance; it reduces stress.
Acupuncture programme for IVF support
Acupuncture has been used worldwide for IVF support for over a decade. There are many promising research results for effectiveness of acupuncture on helping IVF success rates. There are many purposes for the use. Some is to reduce pain on egg retrieval; some is used simply to reduce anxiety and depression during IVF; some are used for improve egg quality etc. If you are having acupuncture for IVF, make sure you know what kind of acupuncture you are getting and what you want.
Which type of acupuncture increased pregnancy rate in IVF? There are three types of acupuncture aiming to increase pregnancy rate in IVF. Type A: acupuncture was performed around the time of embryo transfer. Type B: acupuncture was perfomed around the time of egg collection. Type C acupuncture was performed during the course of ovary stimulation.
Zheng CH et al Evid Based Complement Alternat Med (2012)2012:543924
Thursday, 7 March 2019
Thigh pain is a very common complaint. It presents constant achy throbbing pain sometimes cramping in the thighs or it could be on and off, but the pain does not go away. It could be one thigh or both thighs. This pain could radiate down to the knees, legs and feet or up to the hips. The pain can be felt when sitting and lying down. It could cause trouble walking long distance.
The pain on the outside of your hip, upper thigh, outer buttock or outside of knee is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround your hip joint. Pain killers don’t work well with this kind of pain. Acupuncture is very effective to release the pain and help to restore daily activity.
There was a report that 10 patients with MP were treated with acupuncture. These patients were aged 30-70 years with MP. The causes of MP were not clear. One patient had diabetes and several were obese. Three patients had inflammatory joint disease. Four patients were receiving high doses of analgesics. Average period of symptoms was 3-4 years. All had tried conservative treatment, physiotherapy or injections and two patients had refused surgery. All patients had tender points especially at acupuncture point GB31 and upper lumba spine. This points were less tender after acupuncture treatment. An average 4-5 sessions of acupuncture was given to these patients. Electroacupuncture was applied from second session. The pain scores for all 10 patients improved by at least 50%, including that of a patient with a 20 year history. At 3-36 months follow-up, improvement was 100%. Most patients were able to stop their analgesics.
Alexander RE Acupunct (2013) 31:435-9
Friday, 22 February 2019
Muscle pains are common and almost everyone has sore, aching muscles sometimes. Muscle pain can involve a small area or your whole body, ranging from mild to excruciating and can involve more than one muscle. Most muscle aches and pains go away on their own within a short time, but sometimes muscle pain can last for months. Muscle pain can develop almost anywhere in your body, including your neck, back, legs and even your hands.
Muscle pain also can involve ligaments, tendons, and fascia, the soft tissues that connect muscles, bones, and organs. Muscle pain is most frequently related to tension, overuse, or muscle injury from exercise or physically-demanding work. In these situations, the pain tends to involve specific muscles and starts during or just after the activity. It is usually obvious which activity is causing the pain. Trapezius muscle is a large superficial muscle that extends longitudinally from the skull to the upper back and laterally to the shoulder blade. Its functions are to move the scapulae and support the arms. These muscles are usually overused and painful due to much stress and improper postures.
Acupuncture is a useful tool to release trapezius muscle pain. There were 20 women aged ranging from 18 to 40 years with upper trapezius muscle pain for average 5.55 years. They were treated with acupuncture After 9 sessions of acupuncture treatments, a reduction in pain intensity was observed on the upper trapezius muscle on both sides. The Pain pressure threshold increased significantly on both sides at the end of the treatment. A significant increase in the electromyography values of the trapezius during isometric contraction was observed at the end of treatment.
Hamstring muscle strain
The hamstring muscle group is made up of three separate muscles: the semitendinosus, semimembranosus and biceps femoris. They originate from the lower part of the pelvis, lie on the back of the thigh and insert into the back of the shin bone. They mainly bend the knee and extend (straighten) the hip joint when contracting. Hamstring strain is a very common condition. When the muscles are pulled, a sudden sharp pain at the back of the thigh can be felt. This pain is sudden onset often after certain activity. The muscle will often feel tight and tender and go into cramp. Walking may be painful. In severe case, there could be swelling and bruising. It is likely to get hamstring strain, if the activities involved in hamstring such as running, jumping or sudden stopping and starting; if you don’t warm up before exercising, if the muscles in front of the thigh are tight since they pull the pelvis forward and tighten the hamstring, if glutes are weak, Glutes and hamstring work together weak glutes can make hamstring overloaded and become strained. Acupuncture can reduce the pain and help hamstring recovery.
The deltoid muscle is a triangular muscle located on the uppermost part of the arm and the top of the shoulder. Like many other muscles, the deltoid can be sore for a variety of reasons, including overuse and tendon injuries. When the deltoid muscle is injured, one may feel pain or tenderness at the front, side, or back of the shoulder, especially when lifting the arm. The injury can be from mild with tightness and slight pain without restriction of movement to severe pain, swelling and severe restriction of shoulder and arm movements. Acupuncture can release deltoid muscle pain.
Suffer from Myofascial pain syndrome (MPS)? Acupuncture can help
Myofascial pain syndrome (MPS) refers to pain and presumed inflammation in the body's soft tissues or muscles. It is a condition of muscle pain. It is a chronic, painful condition that affects the fascia (connective tissue that covers the muscles). It could involve either a single muscle or a muscle group. The main complaint is muscle pain. The pain can be deep, aching pain in a muscle and it can persist or worsen with activity or stress. It can affect one’s sleep. Examination can find trigger points in related muscles and a tender knot in a muscle. The causes include a muscle injury, strain on a muscle, ligament or tendon, disks problem, chronic fatigue, repetitive movement, lack of activities, some medical conditions. Muscle tightness creates trigger points in the muscles. An acute muscle injury or continual muscle stress may lead to the development of trigger points. People who frequently experience stress and anxiety may be more likely to develop trigger points in their muscles.
There are four types of trigger points
An active trigger point is an area of extreme tenderness that usually lies within the skeletal muscle and which is associated with a local or regional pain.
A latent trigger point is a dormant (inactive) area that has the potential to act like a trigger point. It may cause muscle weakness or restriction of movement.
A secondary trigger point is a highly irritable spot in a muscle that can become active due to a trigger point and muscular overload in another muscle.
A satellite myofascial point is a highly irritable spot in a muscle that becomes inactive because the muscle is in the region of another trigger pain.
Acupuncture can reduce myofascial pain effectively by releasing muscle tension and removing trigger points in the muscles.
Friday, 18 January 2019
Tuesday, 15 January 2019
The sagittal suture is a dense, fibrous connective tissue joint between the two parietal bones of the skull.
Down to the back, the sagittal suture moves to the ligaments on the spine.
The nuchal ligament extends from the external occipital protuberance on the skull and median nuchal line to the spinous process of the seventh cervical vertebra in the lower part of the neck. It is the starts of the trapezius and splenius capitis muscles attached to the shoulder and the head separately.
Supraspinous ligament connects the tips of the spinous processes from the seventh cervical vertebra to the sacrum and is the continuous of nuchal ligament down to the spine. Part of the trapezius and latissimus dorsi start from this ligament and connect to the shoulder.
Spinal erectors are a group of muscles and tendons which run from the sacrum or sacral region to the base of the skull. They are paired lying on the left and right of the spine.
Down to the front, the sagittal suture moves to the frontal suture on the forehead. The frontal suture is a fibrous joint that divides the two halves of the frontal bone of the skull.
On the midline of the chest, it raises the pectoralis major and connects to the shoulder.
The white line in the medial line of the abdominal wall (linea alba) is a fibrous structure that runs down the midline of the abdomen from the xiphoid process to the pubic symphysis. It is formed by the fusion of the aponeuroses (deep fascia) of the abdominal muscles, it lies between the left and right rectus abdominis muscles.
The medial line tightness can create tension on the whole body blocking blood and energy circulation. Acupuncture can release tension and improve blood and energy circulation.
Thursday, 10 January 2019
If you have irregular menstrual cycles and want to get pregnant, this could cause problems. This is because 1) it is hard to know ovulation time; 2) the eggs might not good enough in some cycles which reduce the chance to get pregnant. 3) the uterine lining might not develop well due to imbalanced hormones.
Acupuncture can help regular hormone to achieve balanced hormone and reduce stress to regular menstrual cycles to get pregnant.
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