Acupuncture is a valuable treatment for chronic pain from the head to toes (No 6 hip pain)

The hip joint is a ball and socket synovial joint. It is one of the most flexible joints in the body which allows a great range of movement. Because of hip joint, walking, running and jumping become possible. It supports the body’s weight and bears the force of the strong muscles of the hip and leg when standing, walking, running etc. The hip joints have very important roles in retaining balance, and for maintaining the pelvic inclination angle. Surrounding the hip joint are many tough ligaments that prevent the dislocation of the joint. The strong muscles and tendons of the hip region also help to hold the hip joint together and prevent dislocation. Hip pain is a common condition that can be caused by a wide range of problems. The precise location of the hip pain can help to find out the underlying cause. Hip pain on the outside of the hip referred to the upper thigh or outer buttock is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround the hip joint. Injury of ligaments, muscles and tendons and fasicas around the hip joints is a common cause of hip pain. Hip bursitis is a common condition for hip pain. Hip bursitis is an inflammation between the thighbone and nearby tendons. The pain is from outer side of the hip. Tendinitis: there are many tendons around the hip connecting buttocks to the hip bone. These tendons can get inflamed causing outer side of hip pain. IT band syndrome: IT band is a long band f connective tissue that runs from the hip to the knee on the outer side of the thigh. If IT band is injured and inflamed, it causes our side of hip pain. Tight gluteal muscles and IT band and they pull the bone that they attached causing pain on the hip. Hip pain can also a referred pain from low back.

Acupuncture is a valuable treatment for chronic pain from the head to toes (No 5 low back pain)

95% of back pain occurs in the lower back. Lower back area is bordered by the bottom of the rib cage and the buttock creases. If you have lower back pain, you are not alone. About 80 percent of adults experience low back pain at some point in their lifetimes. At most of the time there is no cause found known as non-specific low back pain. The pain can be from mild to severe, from a dull, constant ache to a sudden, sharp pain in the lower back region. Acute low back pain is short term which lasts a few days to a few weeks. Chronic low back pain persists for 12 weeks or longer. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Low back pain affects people’s life greatly in recent years. A study ranking the most burdensome condition, low back pain jumped to the third place in 10 years’ time in 2010 from the sixth in 1990, with only ischemic heart disease and chronic obstructive pulmonary disease ranking higher. Non-specific low back pain presents burning or stabbing pain, tension, soreness, stiffness in the low back area, but it can be also shooting pain to the legs or up to the back or forward to the abdomen. Other symptoms can associate with low back pain such as abdominal pain, bloating, constipation, diarrhea etc. The pain is persistent or recurrent. Joints, discs, muscles, tendons, ligaments and fascias in the back may contribute to symptoms.

Acupuncture is a valuable treatment for low back pain.

Acupuncture is a valuable treatment for chronic pain from the head to toes (No 4 upper back pain)

Upper back is the region between the shoulder blades, or between the neck and the waist. This is so called thoracic back pain. The pain is this region is very common. Symptoms can vary from person to person. The pain can be mild or more severe which might affect daily activities and sleep. It could be a sharp pain in one spot or a general achiness that comes and goes. The pain can be referred up to the neck, shoulder, down to the low back and around to the abdomen. There may be other symptoms associated with the pain such as acid reflex, bloating, stomach-ache, tight chest etc. In most of cases, the pain is nonspecific which means the cause is not clear or unknown. Pain in the upper back is usually the result of poor posture, muscle overuse, or injury.

Stooping in a chair over a desk is a good example. This may cause a loss of strength in the muscles. Over time, the weakening of muscles may lead to pain in the area as they experience strains or irritation; the pressure from gravity and the body itself pushes on the spine, neck, discs, and ligaments and can lead to pain and other complications. Overusing back muscles is another common cause of upper back pain. repeating the same motions over time may cause muscle strain, tightness and irritation. A traumatic injury at the upper back can also lead to back pain after the injury is healed.

Acupuncture is a valuable treatment for upper back pain.

Acupuncture is a valuable treatment for chronic pain from the head to toes (No 3 shoulder pain)

Shoulder joint is the most mobile one in the body. It moves the shoulder forward and backward, up and away from the body and also moves the arm circularly. Shoulder consists of bones, joint, cartilage, muscles, tendons and ligaments. If something goes wrong with the shoulder, it will cause pain and reduce the movement. With aging the soft tissues surrounding the shoulder tend to degenerate, and older people are likely to get shoulder problem. Soft tissues injury around the shoulder is very common and this will cause shoulder pain. The pain can come on gradually or abruptly, and it may range from mild to severe often accompanied with limited motion. The common causes of shoulder pain include

no 1: rotator cuff injuries and irritations: due to tears and inflammation of rotator cuff, the symptoms include pain or stiffness in the shoulder when you lift your arm above your head to brush your hair or when you reach behind your back.

No2: Calcific tendinitis. Calcium deposits embedded within the rotator cuff tendons and this caused the pain.

No3: Adhesive capsulitis. Known as frozen shoulder. Adhesive capsulitis is caused by a thickening and stiffening of the tissues around the shoulder joint. Typical symptoms are shoulder pain and restricted shoulder movement.

No4: Osteoarthritis can affect shoulder as well thigh less common than knee and hip.

Treatment for shoulder pain is aimed at relieving pain and preserving range of motion of the shoulder. Acupuncture is a valuable treatment for shoulder pain.

Acupuncture is a valuable treatment for chronic pain from the head to toes (No 2 Neck pain)

The neck is made up of vertebrae bones, cervical discs absorbing shock between the bones, ligaments, and muscles. It supports the head, allows for movement and it is the most flexible part of the spine. Inflammation, or injury can cause neck pain or stiffness. The characteristic of the neck pain include aching, burning or stabbing or shooting pains with stiffness and tightness. The pain may get worse by holding the head in one place for long periods, such as when driving or working at a computer; It is often accompanied with muscle tightness and spasms and decreased ability of turning the head, and headaches. Neck pain is very common. About 2 in 3 people had neck pain at some point in their life. A survey in the UK has shown that 1 in 4 women and 1 in 5 men between ages 45 and 75 had current neck pain.

The common causes of neck pain or stiffness include muscle tension and strain, poor posture and overuse, such as sitting at a desk for too long without changing position, sleeping with the neck in a bad position, neck injury during exercises, sports, accidents and falls. Activities like painting a ceiling, or swimming breaststroke with the head in a fixed position that involve tilting the head back against the neck can cause neck pain. During these incidents, the muscles and ligaments at the neck were injured and inflamed. Neck pain is often accompanied with shoulder pain and headaches.

Acupuncture is a valuable treatment for neck pain.

Acupuncture is a valuable treatment for chronic pain from the head to toes (No 1 Headaches)

Headaches

Headaches are one of the most common chronic pain conditions; most people experience them at some point in their life.

Tension headaches

Tension headaches are the most common form of headaches. Tension-type headaches can be either episodic or constant. In most cases, they are mild to moderate in severity and occur infrequently. But a few people get severe tension headaches. The typical tension headache produces a dull, squeezing pain on both sides of the head. People with strong tension headaches may feel have a tight band around the head. The shoulders and neck can also ache. Pain spread to or from the neck. Fatigue, emotional stress, or problems involving the muscles or joints of the neck or jaw can be a trigger of tension headaches.

Migraines

Migraines occur less often than tension headaches, but they are usually much more severe. In typical cases, the pain is on one side of the head, often beginning around the eye and temple before spreading to the back of the head. The pain is a pulsating, throbbing pain and it may be accompanied by blurred vision, light-headedness and nausea. A migraine can come on without warning, but about 20% of migraines begin with one or more neurological symptoms called an aura. Without effective treatment, migraine attacks usually last for a few hours to a few days

Cluster headaches

Cluster headaches are uncommon but very severe headaches. The pain always strikes one side of the head typically located in or around one eye and is very severe burning or sharp pain. The affected area may become red and swollen, the eyelid may droop, and the nasal passage on the affected side may become stuffy and runny. The attack starts abruptly and lasts for 30 to 60 minutes. This type of headaches tends to come in clusters, with one to eight headaches a day during a period of weeks, months or a couple of years. In between clusters, there may be no headache symptoms, and this headache-free period can last months to years.

Acupuncture is a valuable treatment for headaches.

Primary ovarian insufficiency? Tried acupuncture?

Primary ovarian insufficiency (Premature ovarian failure): The ovary is unique in the female endocrine system in which follicle is developed every month and matured egg is released. Ovary produces sex steroids, which are necessary for development of reproductive organs and maintaining bone density and general health. Regular monthly menstruation after ovulation is an indication of healthy ovarian function. Menopause, permanent cessation of menses occurs at age of around 50. If menopause occurs before age 40, this is considered to be premature, called primary ovarian insufficiency which is a subclass of ovarian dysfunction. The main symptoms of this disorder are no periods for at least 4 months, sex steroid hormone deficiency and high follicle stimulating hormone (FSH). It is worth mentioning that about 50% of women with primary ovarian insufficiency have intermittent ovarian function causing irregular menses. Symptoms of estrogen deficiency are at present in many, but not all patients, which include hot flashes and night sweats, sleep disturbance, and intercourse pain. Acupuncture can help some women with POF restore their menstrual cycles. It is worth trying.

Infertility: Acupuncture is a valuable therapy for female infertility.

Hormones required for fertility. There are three organs involved in hormone production in women: hypothalamus, pituitary gland and ovaries. We call them hypothalamus pituitary ovarian axis. Hypothalamus releases Gonadotrophine-releasing hormone (GnRH), which acts on the anterior pituitary gland to release follicle-stimulating hormone (FSH) and Luteinising hormone (LH). FSH stimulates oestrogen release from ovary, whereas LH stimulates progesterone secretion from the corpus luteum in ovary. Ostrogen has a negative feedback effect on pituitary gland reducing gonadotrophine secretion; Progesterone has a negative feedback effect on hypothalamus and pituitary gland, reducing LH releasing.

Key steps for fertility in women. Many ovarian follicles in ovaries in reproductive age women grow stimulated by FSH, but normally only one of them become mature and are released from the ovary each period cycle (we call it ovulation) triggered by LH. The egg released travels through a fallopian tube where fertilisation occurs when a sperm penetrating into the egg and then the fertilised egg will travel to the uterus and implant in inner lining of uterus where the fetus may grow. Thus pregnancy begins. If for any reasons, any of these factors are interrupted, it will result in infertility.

Women's infertility could be caused by many diseases, though some of it is without underlying causes or the underlying causes could not be found.

Causes of female infertility:

Ovulation disorders:

First of all, hormonal problem will cause anovulation. As we already know, hormones mentioned above are very important for fertility. Ovulation depends on the balance of these hormones; any disruption of the hormone balance can cause anovulation. These could be results of three levels: 1, Ovaries fail to produce mature eggs. In this case ovaries do not produce normal follicles causing immature eggs which cannot be ovulated. Polycystic ovary syndrome is the common condition of this category. 2, Hypothalamus does not function well. Hypothalamus is the start of hypothalamus-pituitary-ovarian axis. If hypothalamus fails to produce or release GnRH, the hormonal system will lose the balance, immature eggs will be produced. 3, Pituitary gland is not normal. FSH and LH produced by pituitary gland are very important hormones for egg development and maturation. Pituitary gland disorders will result in abnormal FSH and LH level causing ovulation problem.

Secondly, Scarred ovaries could lead to anovulation. For instance, surgery, endometriosis and pelvic infection might cause ovary scars in which case ovaries may fail to ovulate.

At last, other ovarian problems are responsible for anovulation, for example, premature ovarian failure.

Fallopian tube problems:

Fallopian tubes can become constant spasm, mild adhesions and complete blockage. One of the common causes for this is pelvic or abdominal infection that affects fallopian tubes. Other one is pelvic or abdominal surgery causing adhesions. The eggs cannot pass through the blocked tubes causing infertility.

Endometriosis:

Endometriosis causes infertility, because the overgrowth causes adhesion and it could scar ovaries, block fallopian tubes or disrupt egg implant in uterus, depending on where it grows.

Uterus disorders:

Some uterus problems could result in infertility, such as fibroids, polyps probably because of obstruction of the uterus or fallopian tubes.

Cervical mucus problem:

Hormone imbalance, for instance, too little estrogen or too much progesterone causes abnormal cervical mucus which makes it harder to conceive.

Other risk factors:

Obesity is a growing issue in many countries. Body mass index (BMI) (kg/m2) is used for definition. According to world Health Organization (WHO) standard, a BMI of 18.5-24.9 is within a normal range; 25-29.9 is overweight and ≥30 is obese. Obesity has negative effects on many aspects of women’s health. Fertility is one of them. Obese women are more likely to experience infertility, they are more likely not to response to fertility treatment and there is high risk of miscarriage and low live birth rates. Obesity associates with infertility from the impact on many aspects. Previous studies have shown lower number of oocytes retrieved; poorer egg quality due to impaired oocyte maturation and fertilization; poorer embryo quality. The reasons for these are: obesity is related to alterations in various hormones, such as LH. In addition, obesity increases insulin, glucose, or free fatty acids and changes in some proteins. Obesity is also linked with polycystic ovary syndrome (PCOS). Systemic inflammation may contribute to the causes of infertility in obesity.

Obese women respond poorly to ovulation induction resulting in fewer oocytes harvested, they required higher doses of gonadotrophins and took longer to ovulate. They have lower pregnancy rates and increased risk of early pregnancy loss. Obesity is associated with a significant rise in failure in assisted reproduction. Weight loss makes menstrual cycles regular and increases the chance of spontaneous ovulation.

Drugs, such as chemotherapy drugs and anti-depressants may cause infertility.

Environmental factor: such as exposure to lead could compromise fertility.

Smoking, alcohol and stress are recognised as risk factors.

Age, Women's fertility is linked to age. After 35 year old, the fertility is declining significantly.

10 Tips for your acupuncture treatments

With years of practicing acupuncture, my passion at acupuncture grow dramatically. If you want to seek acupuncture treatment for whatever reasons, there are 10 tips based on Dr Maggie's experiences.

No1, Keep open minded. How acupuncture works is not clear yet. All current mechanisms are theories and they need to be proved by science. However acupuncture does help many people with various conditions and it is why acupuncture becomes more and more popular.

No2, Acupuncture is amazing. It waits for you to discover by trying for the treatment. Acupuncture has lots to offer, from antiaging to releasing physical problems such as chronic pain, to helping psychological issues such as anxiety, stress etc.

No3, Acupuncturists are different. Some are better than others. This is easily understandable and applies to any professionals. Why should all acupuncturists have to be the same and why there should be champions in other professionals.

No4, The key for successful acupuncture treatment is the acupuncture points chosen by the acupuncturists. None of the acupuncturists chooses the same points.

No5, Acupuncture is like medicine. There is dosage which comprise the points and numbers of needles used in the treatments, the duration of the sessions, the frequency of the treatments and the total sessions received.

No6, Your expectations. Keep realistic expectations. Any treatments including acupuncture take some time to show effects.

No7, Monitoring the effects. You need to know how to monitor the effects and progress of acupuncture treatments to see if it works.

No8, People are different. Different people have different reactions to acupuncture treatments.

No9, Don’t worry that acupuncture can make your condition worse. There is no side effect of acupuncture treatment and acupuncture doesn’t make your condition worse.

No10, Take your chance. If you give it a time and a chance, you will provide yourself an opportunity to get better and healthier again.

Shoulder pain treated with acupuncture case study

Shoulder pain (SP) is one of the most common musculoskeletal pains. The conventional treatments include pharmacotherapy, physiotherapy and exercise. However, these options aren't satisfactory. Acupuncture is one of the options that are effective for shoulder pain. Here is a study showing this. In this study, 30 patients with age from 38-73 with shoulder pain were selected. Average shoulder pain duration was 3.8 years. 50% received medical treatments at least before 6 months but the pain was still there. These patients received 10 sessions of acupuncture. The result has shown that pain score was decreased significantly on the sixth session (-27.3%) and tenth session (-43%). The muscle stiffness was reduced for all patients. The improvement in shoulder function at the tenth acupuncture session reached 44%. The response of acupuncture therapy was variable among patients. It changed according to patients' age and symptoms duration. Of course a good response was statistically correlated with younger age and recent pain.This study provides additional data on the potential role of acupuncture in the treatment of shoulder pain. Acupuncture is beneficial and effective for relieving pain and improving shoulder function. It can be a good alternative, especially, for patients developing adverse effects related to drugs.

References
https://ard.bmj.com/content/74/Suppl_2/1219.1

Having shoulder pain and tried acupuncture?

Frozen shoulder syndrome (FSS) causes pain and reduces the range of motion in the shoulder joint. Acupuncture has effect of reducing shoulder pain and improving motion range. A research investigated the short and medium-term effects of acupuncture on pain relief and improvement of shoulder function for frozen shoulder. 21 patients with frozen shoulder participated the study. They received 18 sessions of treatments over 6-9 weeks. Follow-up check at 1, 3 and6 months was carried out. The result has show that Significant pain reduction was observed; shoulder flexion and abduction movement was increased. Acupuncture is effective to reduce pain from frozen shoulder like any other chronic pain condition.

References
J Formos Med Assoc. 2019 May 13. pii: S0929-6646(18)30923-9. doi: 10.1016/j.jfma.2019.03.012. [Epub ahead of print]

What does Western medical doctor say about acupuncture?