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, 20 March 2019

How muscles change with aging?

Muscles controlled by the brain provide the force and strength to move the body. With aging muscles are change.

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.

References

Patrick N. Siparsky et al https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874224/

Friday, 15 March 2019

Acupuncture treatment is recommended for acute and chronic neck pain

Neck spasm occurs when the muscles in the neck contract involuntarily and sudden tightening of the muscles can cause severe pain. The pain come up suddenly. Other symptoms accompanied with the pain include problems moving the neck and shoulder, increased pain when moving the neck and shoulder, headaches, dizziness or tingling at the neck. Neck spasm can be caused by a few reasons: repeated or prolonged movements of the neck, sitting at one position for a long time, poor posture, turning suddenly while sleeping, carrying too much weight at one shoulder or one arm, cradling a handset against neck, stress, and dehydration.

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

What affects your fertility, how can acupuncture help?

Four key factors affect fertility

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.

References

Zheng CH et al Evid Based Complement Alternat Med (2012)2012:543924

Thursday, 7 March 2019

Thigh pain and numbness? Do you need treatment?

Thigh pain
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.

Thigh numbness
Meralgia paresthetica (MP) or lateral femoral cutaneous neuropath is a condition that also causes thigh pain and numbness. It is caused by injury or entrapment to the nerve that innervates to the thigh called the lateral femoral cutaneous nerve. This causes numbness or pain in the outer thigh. Pain is constant burning or lightening on the outer side of the thigh which is also extending to the outer side of the knee or spreading to the buttocks. It could be accompanied with numbness or tingling in the same area.

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.

References
Alexander RE Acupunct (2013) 31:435-9

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