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.

Tuesday, 20 December 2022

Chewing muscles on the face and jaw pain and tightness.

The temporalis muscles

The temporalis muscle (temporal muscle) is a broad fan shaped muscle on each side of the head covering much of the temporal bone. It is not facial expression muscle, but one of the mastication muscles (chewing muscles). It is attached to the mandible (jaw) and to the skull’s temporal bone, or temporal fossa. It is one of the muscles involved in jaw movement (lift the jaw and retract the jaw) and is the most powerful chewing muscle of the temporomandibular joint. You can see and feel the muscle contracting while the jaw is clenching and unclenching. The muscle is innervated by a branch of trigeminal nerve.

The masseter muscles

One of the strongest chewing muscles is masseter muscle. It consists of two heads: superficial head starts from the maxillary process of the zygomatic bone and the anterior two thirds of the inferior border of the zygomatic arch and inserts into the angle of the mandible and inferior half of the lateral surface of the ramus of the mandible; the deep head starts from the posterior third of the lower border and from the whole of the medial surface of the zygomatic arch and inserts into the upper half of the ramus of the mandible. This muscle involves jaw movement.

Monday, 19 December 2022

What are facial expression muscles? How do they wrinkle the face?

Muscles on the forehead

The frontalis muscle (frontal belly) is the muscle on the forehead. It is a thin, quadrilateral form. There is a pair of them. There are no bony attachments. The medial fibers are going downwards and connected with the muscle fibers below including the Procerus; the corrugator and the orbicularis oculi. They attach to the skin of eyebrow. Its lateral fibers also mix with the latter muscle over the zygomatic process of the frontal bone. The muscle fibers move up and join the galea aponeurotica (tough fiber layer on the head). The frontalis muscles lift eyebrows when looking up and wrinkle the forehead horizontally by pulling the scalp back. The muscle is innervated by facial nerve. The antagonist muscle is orbicularis oculi muscle.

Procerus muscles and corrugators

The procerus muscle arises from the nasal bone and inserts into the skin over the lower part of the forehead between the two eyebrows. Its fibers blend in with those of the frontalis muscles. Its contraction pulls the skin between the eyebrows downwards producing horizontal wrinkles between the eyes over the bridge of the nose.

The corrugators supercilli muscle is a small muscle at the medial end of the eyebrow. It originates from the medial end of the superciliary arch and its fibers pass upward and laterally and end at the deep surface of the skin above the middle of the orbital arch. It is beneath the frontalis muscle and above the orbicularis oculi muscle. Contracting of this muscle draws the eyebrow downward and medially creating the deep vertical wrinkles between the eyebrows. It is known as frowning muscle.

Muscles surrounding the eyes

The orbicularis oculi muscle is the ring like muscle surrounding the eye. It originates from the nasal part of the bone and goes all the way laterally surrounding the border of the orbit forming a broad and thin layer. It spread over the eyelids, temple and down to the cheek. The orbital orbicularis is the orbital portion of the muscle. It forms a complete circle without interruption. The upper part blends in with the frontalis and corrugators muscles.  Palpebral orbicularis is the palpebral portion of the muscles responsible for the involuntary eye blink. Contraction of this muscle causes the eye to close or blink. The orbital portion can be consciously controlled. Contraction of the muscle also causes the wrinkles at the out corner of the eye which are known as crow feet. For example, as under the sun, the skin of the forehead, temple, and cheek is drawn toward the medial angle of the orbit, and the eyelids are firmly closed. The skin is folded especially radiating from the lateral angle of the eyelids. The antagonist of this muscle is the levator palpebrae superioris muscle.

Muscles in the cheek

There are four muscles on the cheek: They are lying in the cheek from middle to lateral, from cheek bone to the upper lip: They are the levator labii superioris alaeque nasi, the levator labii superioris muscle, the zygomaticus minor, the zygomaticus major. They form the nasolabial groove, from the side of the nose to the upper lip. This line is deepened in expressions of sadness. These muscles draw the angle of the mouth upward and backward in smiling. These muscles’s contraction creates tension on the cheek, deep nasolabial groove, gummy smile and wrinkles the cheek.

Levator anguli oris is a deep facial expression muscle on the cheek. It originates from the canine fossa of maxilla, inferior to the infraorbital foramen. It elevates the angle of the mouth and deepens the nasolabial lines and facilitates smiling.

There are two muscles on the cheek by the mouth.

The risorius muscle arises in the fascia over the parotid gland and, passing horizontally forward, inserts onto the skin at the angle of the mouth. It is a narrow bundle of fibers, broadest at its origin lying superficial to the platysma. It is known as the ‘smiling muscle’ as its contraction draws the angle of the mouth outward and produces a smile.

The buccinator muscle is a thin quadrilateral facial muscle by the mouth. It originates from maxilla and mandible bones and fibrous band behind the third molar. It is the main muscle of the cheek, that provides it with structure and tightness. The muscle goes towards and inserts to the angle of the mouth. It contributes to smiling and chewing.

Muscles on the nose

Nasalis is a paired muscle that covers the dorsum of the nose. It originates from the maxilla crawls upwards on the back of the nose and ends there and blends in each other from the opposite side at the back of the nose. This muscle dilates the nostrils, depresses the nostril wings and wrinkles the nasal skin.

Muscles surrounding the mouth

There are a few groups of muscles around the mouth.

The orbicularis oris muscle is the muscle encircling the mouth and it lies between the skin and the mucous membranes of the lips. The orbicularis oris muscle is a complex of muscles in the lips that encloses the mouth. It consists of four independent quadrants that connects each other which gives it a look of circular. It blended in with other expression muscles on the face. When it contracts, it closes the mouth and puckers the lips creating vertical wrinkles around the mouth.

Muscles below the mouth draw the corner of the mouth down.

The depressor anguli oris is a muscle that originates from the mandible and inserts on angles of the mouth to depress the angle of the mouth.

The depressor labii inferioris muscle is a muscle of the face that draws the lower lip down and slightly laterally. 

The mentalis muscle elevates and protrudes the lower lip and wrinkles the skin of the chin.

The platysma muscle is a broad sheet of muscle originated from the the fascia covering the upper parts of the pectoralis major and deltoid going upwards to lower cheek and blend in with the muscle around the mouth. It draws the lower lip and corner of the mouth outward and downward.

Muscles lift up the upper lip. Muscles in the cheek involves in lifting upper lip. These muscles include the levator labii superioris alaeque nasi, the levator labii superioris muscle, the zygomaticus minor, the zygomaticus major and Levator anguli oris. They originate from cheek bone and all end in upper lip.

The risorius muscle and the buccinator muscle pull corner of the mouth outwards.

Platysma Muscles

The Platysma muscle is thin like a flat sheet situated within the subcutaneous tissue of the neck. It originates from the fascia that covers the clavicle, the acromial region and the superior portions of the pectoralis major and deltoid muscles. It arises across the neck up to the lower face. It inserts onto the lower border of the mandible or the skin of the lower lip and attaches to the skin and subcutaneous tissue of the perioral region, and to the muscles surrounding the mouth. The platysma blends with the depressor anguli oris and depressor labi inferioris muscles and reinforces their actions. It also contributes to the formation of the orbicularis oris complex and the formation of the modiolus.

 

Saturday, 17 December 2022

Having painful leg? acupuncture can help.

The leg is the section of the lower limb extending from the knee to the ankle. There two bones the tibia or shinbone together with the smaller fibula bone. Muscles in the legs move the ankle, foot and toes. There are three muscles at superficial layer: the calf muscles, including the gastrocnemius and soleus are the muscles at the back of the leg and plantaris. Achilles tendon is attached to the calcaneus bone in the heel. There are four muscles in the deep compartment of the posterior leg: the popliteus, tibialis posterior, flexor hallucis longus and flexor digitorum longus. These muscles contract to flex the foot — such as when standing on the tiptoes — and flex the toes. They also stabilize the ankle joint and foot and to maintain the body’s balance. There are four muscles in the anterior compartment of the leg; tibialis anterior, extensor digitorum longus, extensor hallucis longus and fibularis tertius. They invert the foot at the ankle joint and extend the toes. There are two muscles in the lateral compartment of the leg; the fibularis longus and brevis. They turn the sole of the foot outwards.

Most common leg pain results from wear and tear, overuse, or injuries in joints or bones or in muscles, ligaments, tendons or other soft tissues. Some types of leg pain can be caused by problems in the lower spine where the nerve to the leg originates and then travels to the legs, such as slipped disk, sciatica.

Leg pain can be mild that comes and goes, or severe that makes it difficult to sleep and walk. The pain is often described as aching, throbbing or burning and it can be accompanied by numbness, tingling and muscle weakness. For leg pain treatments, finding the cause is important and treatments depend on the causes.

Shin pain
Shin pain is pain on the front of the lower leg between the knee and the ankle. It can hurt directly over the shinbone all the way or over the muscles that are on the inner or outer side of the tibia. It can be a dull aching, or sharp and severe pain. It can be one or both shin with large area across whole length of the shin bone. This pain is usually caused by overuse from irritation of the muscles or other tissues in the leg. The cause is not clear, but it is suggested that running and repetitive weight bearing on the legs leads to inflammation of the soft tissue around the shin bone.

Leg muscle cramps are common, and it usually occurs in the calf muscles. It can also happen in any other leg muscles. When it happens, the muscles in the leg suddenly become tight and painful which will last seconds to minutes. After the cramping has passed, pain and tenderness in the leg can stay for some time.

Acupuncture is amazingly effective for leg pain. For example, a 35-year-old woman had pain in front of leg along the shin bone for two years. She had 8 sessions of weekly acupuncture treatment. After 6 weeks, the pain completely disappeared.


Friday, 16 December 2022

Abdominal muscles, abdominal pain and acupuncture

Chronic abdominal pain

Fortunately, in most of cases the chronic abdominal pain is not caused by severe illness, but it can be depressing if the abdomen is always painful. There are many problems that can cause abdominal pain.

Smooth muscle is in the walls of hollow internal organs, such as the arteries, intestines, bladder in the abdomen. When they contract, the organ is squeezed. Most of the abdominal pain is visceral pain which is pain arising from the internal organs. 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. If stomach or intestine wall becomes spasm, this may result in pain. So do kidneys, gallbladders and other internal organs. When the uterine smooth muscle becomes spasm, menstrual cramps occur. It is often deep, dull or dragging and is typically diffuse and poorly localised. It can be associated with nauseas, vomiting, and changes in heart rate or blood pressure. It can also evoke strong emotional responses. There can be a referred pain which is pain experienced at a site distant from source of the pain. It is due to the convergence of different afferents on to the same neurones in the spinal cord.

The abdominal wall muscles are skeletal muscles extending from the superior border of the pelvis to the inferior border of the ribcage. There are four pairs of muscles: transverse and rectus abdominis and the internal and external obliques.

Abdominal muscles and chronic abdominal pain

The rectus abdominis muscles

The rectus abdominis muscles are a pair of long flat muscles lie vertically along the middle line of abdomen. Each muscle is divided by narrow bands of tendon into four muscular bodies. It originates from the edge of the pubis bone and the pubic symphysis in the pelvis and ends at the inferior edges of the costal cartilages of the fifth through seventh ribs and at the lowest point of the sternum. The rectus sheath is a covering connective tissue surrounding the rectus abdominis muscles where the internal and external oblique muscles attach. The thick mass of white fibrous connective tissue is in the midline of the abdomen and joins the two rectus abdominis together. The important function of rectus abdominis muscles is to flex the spine when they contract. Contraction of the abdomen results in increased pressure within the abdominopelvic cavity and is useful to push substances out of the body during exhalation, defecation, and urination. It helps delivering a baby. If there are trigger points present in these muscles, you could feel the pain at the abdomen, lower and mid back region. The symptoms include pain at the low abdomen, period pain, stomach cramping, heart burn chest pain, indigestion, nauseas, vomiting bloating, genital pain, bladder problem, low and mid back pain etc.

Transverse abdominis muscle

Transverse abdominis muscle is the deepest muscle on the front and side abdominal wall. It lies between the rib cage and pelvic bone. It starts from the back thoracolumbar fascia, from the top inner surface of the lower six ribs, from the bottom front of the upper edge of the pelvic bone and inguinal ligament and it ends at the front abdominal midline. It is a very important core muscle in compressing the abdomen, providing thoracic and pelvic stability and supporting abdominal visera. It maintains good posture and helps to deliver a baby for pregnant women. Trigger points in transverse abdominis could contribute to the abdominal pain and low back pain.

External and internal oblique muscles

The external abdominal oblique muscles are a pair of muscles that lie on the lateral and anterior sides of the abdominal wall. They are broad, thin and on the top layer of the abdominal muscles. They start from ribs 5-12 and end at the midline of the abdomen, pubis and iliac crest of the hip bones. Contraction of this muscle makes lateral bend and rotation of the spine, flexes the spine and pulls the chest downwards and compress the abdominal cavity.

The internal abdominal oblique muscles lie on the lateral and anterior sides of the abdominal wall just underneath the external abdominal oblique muscles and above the transverse abdominal muscle. It bends the spine forward and bring the shoulder of the side forward and it also bend the spine sideway and rotates it. It compresses abdominal contents and assists digestive process and breathing. If trigger points are present in these muscles, the pain can be felt in following area, in the side, the waist area, the groin area, the low abdomen, across the upper back below shoulder blades, across the low back just above hips, stomach pain, testicle pain, pelvis pain bladder pain.

Chronic abdominal pain may be present for weeks to months, or even years. Bloating is a common symptom accompanied with chronic abdominal pain. Most people have experienced this symptom, when the abdomen is stretched, puffy and uncomfortable. The common cause is constipation which is caused by too little fluids and fibers and lack of exercises. Food allergy and intolerance can be caused excess wind production causing bloating. Inflammation in abdomen such as irritable bowel syndrome can lead to bloating. Pain conditions such as low back pain, hip pain, abdominal pain can accompany bloating because of alteration of the nerve activities. Acupuncture can help reduce bloating and some chronic abdominal pain such as indigestion, inflammatory bowel diseases or muscular pain, benign ovarian cysts, pain with frequent urination, and muscular pain from the abdominal muscles.

Urologists use acupuncture to treat bladder pain.

 

Thursday, 15 December 2022

Which acupuncture points used for your slipped disk?

A slipped disc is a condition in which the disc in the spine is torn and the central part inside comes out. It causes chronic back pain. The pain often begins in the lower back and over time it spreads to other parts of the body. Sometime there is no symptom. This is because the slipped part of the disc is small which will not affect nerves or spinal cord. If sciatic nerve is affected the pain could travel from the low back, through the buttocks and down the legs to the feet as stated above.

Acupuncture does not make slipped the disk go back but acupuncture treatment can help to release the pain and other symptoms. Which acupuncture points are most used to treat slipped discs? A study analysed data from recent 10 years. They found 49 main acupuncture points from 173 studies. there were 10 most common used acupoints on Bladder Meridian [Geshu (BL 17), Xiaochangshu (BL 27), Shenshu (BL 23), Dachangshu (BL 25), Pangguangshu (BL 28), Guanyuanshu (BL 26), Weizbong (BL 40), Zhibian (BL 54), Chengshan (BL 57), Kunlun (BL 60)], 2 on Gallbladder Meridian [Huantiao (GB 30), Yanglingquan (GB 34)], 2 on Governor Vessel [Yaoyangguan (GV 3), Shuigou (GV 26)], 2 on Stomach Meridian [Zusanli (ST 36), Juliao (ST 3)], 2 on Spleen Meridian [Sanyinjiao (SP 6), Xuehai (SP 10)], and the rest were extra points (Huatuo Jiaji) and Ashi points. The selected acupoints were most located on the lumbosacral region, leg and fewer located on the face, back and local part.
Which points do your acupuncturist used? 

Wednesday, 14 December 2022

What is connection between water and the skin?

The skin contains 64% water. Water makes the skin elastic and smooth. Water is constantly lost from the body through sweat, urine and breath. Without regular top-up water, the body became dehydrated. The skin is vulnerable to dehydration, due to such as large area exposure to outside of the world. Dehydration causes skin wrinkles and is also related to dry, scaly skin and irritant dermatitis. Dehydrated skin loses its glow and looks dry, dull, saggy and flaking. Drink plenty of water to prevent the skin from dehydration. Exposure to cold, wind and low humidity makes the skin dehydrated; this is due to water loss and poor circulation from the skin. Excessive alcohol can make skin dehydrated. Avoiding harsh environment and keeping healthy life style can protect the skin from dehydration. Drinking plenty of water is essential to keep the skin hydrated.

Tuesday, 13 December 2022

Which acupuncture points are used for your back pain?

Why acupuncture is effective for low back pain?

There are several mechanisms that explained the effectiveness of acupuncture on pain relief. Acupuncture stimulates nerve endings located in muscles and other tissues leading to production of endorphins and other neurohormonal factors. Acupuncture reduces inflammation by releasing vascular and immunomodulatory factors. Acupuncture increases local blood circulation and improves muscle stiffness, joint mobility and swelling.

Standardization of acupuncture points for low back pain

Acupuncture treatment for specific patients with chronic low back pain vary widely across practitioners. If you go and see a few different acupuncturists, you would get acupuncture at different points. There are no standardized acupuncture points for any conditions. A study has shown that twenty diagnoses and 65 acupoints were used at least once; and only one point UB23 was used for every patient by most acupuncturists. In China standardization of acupuncture points was encouraged to achieve best outcome of the treatment. There was a study compared the efficacy of standardized acupuncture and individualised acupuncture points. In this study up to 15 sessions of acupuncture treatments were offered. 78 patients were in the standard acupuncture group and 72 patients were in the individual acupuncture group. Both acupuncture interventions were applied by the same medical doctor specialized in western general medicine (25 years of clinical practice) and trained in Chinese medicine with 20 years' experience in treating low back pain with acupuncture. The result has shown that the average pain severity after 8 weeks and 26 weeks did not differ significantly between both groups. This study has shown the possibility of standardization of acupuncture treatment for chronic back pain patients. However in real world, there is no standardized acupuncture points for back pain. If you see different acupuncturist, you have got different acupuncture points and different effects. Which acupuncture points do your acupuncturist used? 

Acupuncture points are frequently used in lower back pain

There are over 400 acupuncture points in human body according to Chinese medicine theory. The selection of appropriate acupuncture points is the first step to obtain therapeutic effects. Lee SH et al analysed acupuncture points from 53 studies using modern techniques to extract most commonly used acupuncture points. There were 33 most frequently used acupoints for lower back pain (LBP). The most frequently used acupoints in the treatment of low-back pain were BL23 (51%), BL25 (43%), BL24 (32%), BL40 (32%), BL60 (32%), GB30 (32%), BL26 (28%), BL32 (28%), and GB34 (21%). All local acupoints for LBP are on the Bladder and the Governing vessel especially at the low back position of these meridians. Most of the distant acupoints are on the Bladder and Gallbladder meridians. The acupoints include seven acupoints (BL23, BL24, BL25, BL26, and BL32 as local points and BL40 and BL60 as distal points) on the bladder meridian and two acupoints (GB30 as a local point and GB34 as a distal point) on the gallbladder meridian.

Monday, 12 December 2022

Which muscles are involved in knee pain and leg pain?

Three sets of muscles in the upper leg all attached to the knee joint. As mentioned above, pectineus, satorius and quadriceps are in anterior group; hamstring muscles are in posterior group; adductor magnus, adductor longus and adductor brevis and gracilis are in medial group. Tensor fasciae continuing with iliotibial tract are in the lateral side. Inflamed iliotibial band is one common cause of pain on the outer side of the knee.

Two sets of muscles in the lower leg are also attached to the knee joint: extensors at the front and flexors at the back. The soleus muscle together with the its superficial muscle gastrocnemius are known as calf of the leg. Calf muscle is at the back of the leg which originates from the distal end of the femur through the calcaneal (Achilles) tendon and ends to the calcaneus of the heel. It flexes the knee.

Sunday, 11 December 2022

Thoracolumbar fascia and back pain

Thoracolumbar fascia and back pain

The thoracolumbar fascia or lumbodorsal fascia or thoracodorsal fascia is a deep fascia at the back of the posterior thoracic and abdominal region. It goes up and is continuous as nuchal fascia on the back of the neck. It wraps around deep muscles at the back. It is made up of three layers: anterior, middle and posterior. The anterior layer is the thinnest and the posterior layer is the thickest. Psoas major muscle lies in the front of the anterior layer; Quadraus lumborum muscle is between the anterior and middle layers; the erector spinae muscles and transversospinales muscles are between the middle and posterior layers; Latissimus dorsi and serratus posterior inferior muscles lie at the back of the posterior layer.

Thoracolumbar fascia injury or overuse can cause inflammation of the fascia leading to pain and tightness at low back, shoulder and hip, difficulty of breathing, difficulty of walking, muscle weakness etc.

Acupuncture can release the facia effectively to release back pain. 

Saturday, 10 December 2022

Neck pain, fascia and nuchal ligaments in the neck.

Fascia and nuchal ligaments in the neck

Surrounding muscles, blood vessels and nerves, there is a layer of fibrous tissue called fascia. In the neck, there are a few layers of fascia that support the structure of the neck. Some of the fascia blends in the ligament at the midline of the neck. This ligament is the nuchal ligament in the neck.

Nuchal ligament attaches the bottom of the skull and extends all the way along midline of the neck down to the last cervical spinous process (from the seventh cervical vertebrae, the lowest cervical vertebrae on the neck). It limits the flexion of the neck and provides sites for attachment of some muscles including trapezius, splenius capitis, rhomboid minor and serratus posterior superior and cervical spinalis. Ossification, fibrosis and inflammation of the ligament result in neck stiffness and pain.
Neck pain, tried acupuncture? 

Friday, 9 December 2022

Which muscles in the thigh is involved in thigh pain?

Thigh is the area between the hip and the knee. There are a few groups of muscles in the thigh. Anterior group include pectineus, satorius and quadriceps (rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. Posterior group includes hamstring muscles (semimembranosus, semitendinosus and biceps femoris. Medial group include adductor magnus, adductor longus and adductor brevis and gracilis. The lateral is tensor fasciae which continues with iliotibial tract. The iliotibial tract, also known as the iliotibial band, is a thick strip of connective tissue connecting several muscles in the lateral thigh. It arises at its proximal end from the tendons of the tensor fasciae latae and gluteus maximus muscles and then travels along the lateral side of the thigh and across the knee joint, inserting on the lateral epicondyle of the tibia.

Thursday, 8 December 2022

Quadriceps femoris related thigh and knee pain, acupuncture can help

The quadriceps femoris also known as the quadriceps extensor, quadriceps or quads is agreat extensor muscle of the knee and it is a four headed muscle on the front of the thigh or four separate portions of the muscles. They all have their own names. All four parts of the quadriceps muscle join together forming one tendon which extends to the patellar lligament on the knee.

Rectus femoris is in the middle of the thigh, covering most of the other three quadriceps muscles. The rectus femoris muscle starts as two or three heads from pelvic bone. The straight head attaches to the anterior inferior iliac spine, and the reflected head attaches to the superior rim of the acetabulum and capsule of the hip. Sometimes there is a recurrent head that arises from the anterosuperior angle of the femur’s greater trochanter. All the heads join, and the belly of the muscle then runs down the anterior thigh to attach by a broad aponeurosis to the base of the patella.

The rectus femoris muscle not only extends the knee but also flexes the hip. If the thigh is fixed, contraction of this muscle helps to tilt the pelvis forward. Trigger points of this muscle can be present on front of the hip joint and knee joint. If trigger points are present in this muscle, one can feel thigh pain and tightness and deep aching in the knee.

The other three lie deep to rectus femoris and originate from the body of the thigh bone, femur.

Vastus laterlis is on the outside of the thigh; trigger points of the muscle can be found on the outside of the thigh. vastus medialis is on the inside of the thigh; trigger points of this muscle can be found at the inside of the thigh. Vastus intermedius is in the middle, underneath the rectus femoris.

Acupuncture can help release trigger points of these muscles and reduce thigh and knee pain.

Wednesday, 7 December 2022

What is pelvic bone?

The hip bone or pelvic bone is a large flat bone connected with sacrum and coccyx of the lower spine. Two hip bones join each other at front midline and join together with sacrum and coccyx at the low back forming pelvis surrounding the pelvic cavity which accommodates bladder, reproductive system and bowels.

The hip bone is formed by three parts: illium, ischium and pubis.

The ilium is the highest and largest part of the hipbone consists of the body and wing.

The ischium is the lowest part of the hip bone and made up of three parts–the body, the superior ramus and the inferior ramus.

The pubis is at the anterior of the hip bone. It is divided into the body, superior ramus and inferior ramus.

The hip bone has a few groups of muscles attached as follows

The abdominal muscles include the abdominal external oblique muscle (attaches to the iliac crest) , the abdominal internal oblique muscle (ataches to the pectin pubis) and the transverses abdominis muscle (ataches to the pubic crest and the pectin pubis),

The back muscles include the multifidus muscle (attaches to the medial surface of the posterior superior iliac spine, the posterior sacroiliac ligaments and part of the sacrum)

The gluteal muscles include three gluteal muscles: gluteal maxmus muscle, gluteal medium muscle and gluteal mininus muscle. They all arise from the outer surface of the hip bone and

The lateral rotator group of muscles include piriformis muscle, superior gemellos muscle, obturator internus muscle , inferior gemellos muscle and obturator externus muscle.

Adductor group of muscles include adductor brevis, adductor longus, adductor magnus, adductor minimus, pectineus, gracilis and obturator externus.

Hamstrings include long head biceps femoris, semitendinous and semimembranosus

Two muscles at the anterior of the thigh rectus femoris muscle and sarturius muscle

One shoulder muscle--- the latissimus dorsi muscle (attaches to the iliac crest ).

They serve the origin of many muscles which involved in lower limbs movement. The body anchors the origin for the superioe gemellus muscle; the ischial tuberosity known as sitting bone anchors the origin for the inferior gemellos muscle and hamstrings; the superior ramus is a partial origin for the internal obturator and external obturator muscles; the inferior ramus anchors the origin for the adductor magnus muscle and the gracilis muscle.

Neck pain, stiff neck and poor posture, Tried acupuncture?

Neck pain and a stiff neck

The levator scapula muscle located at the back and side of the neck connecting the neck with the shoulder is most affected. These muscles can be strained by everyday activities: for example, sleep in an awkward position, use a computer for a prolonged period, have a bad posture or have some sports injury such as swimming sudden fall, hold a phone between the neck and shoulder etc. Anxiety and stress can cause tension in the neck muscles leading to neck pain. Tight muscles are often chronic. Tight muscles block blood circulation of the body and muscles don’t get enough nutrition and become weak and easily get further damage. Because of blocked energy supply, you will feel tired all the time. Poor posture is a common cause of tight neck and shoulders. This causes overuse some groups of muscles and causes micro injury to the muscles which become tight to protect themselves from further injury. Furthermore the tight neck will make poor posture worse. It becomes a viscous circle.

Tuesday, 6 December 2022

Which muscles are involved in hip pain? Release hip pain with acupuncture.

The muscles of the hip joint are the muscles involved in movement and pain in the hip. There are four main groups of them.

Gluteal group

The gluteal muscles include the gluteus maximus, gluteus medius, gluteus minimus as mentioned above.

Tensor fasciae latae originates from the anterior part of the outer lip of pelvic bone and inserted about the junction of the middle and upper thirds of the thigh.

Adductor group

This group include five muscles: the adductor brevis, adductor longus, adductor magnus, pectineus and gracilis. They all originate on the pubis and insert on the medial, posterior surface of the femur, with the exception of the gracilis which inserts just below the medial condyle of the tibia. When they contract they move the thigh inwards.

Iliopsoas group

The iliacus and psoas major are the two muscles that belong to illiopsoas group. The pain and trigger points related to iliopsoas is at the hip, the low back and upper thigh. Walking and standing upright can be painful, if there are trigger point present in these muscles.

Lateral rotator group

This group comprises six muscles including the externus and internus obturators, the piriformis, the superior and inferior gemelli and guadratus femoris. These six muscles originate at the lower part of pelvic bone and insert on the top of the thigh bone.

Acupuncture can help reduce hip in most of the cases. For example, A woman aged 37 had left hip pain for 10 years. The pain was always there, sometimes it got worse, and sometimes it got better but it never went. It was a dull aching and throbbing pain. Walking made the pain worse. After 8 weekly acupuncture treatments the pain has completely gone. With one-year follow-up, the pain didn’t come back.

Monday, 5 December 2022

What is cluster headaches?

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 again is effective to reduce cluster headaches.

Which muscles are involved in low back pain?

The Gluteal muscles

The gluteal muscles are a group of three muscles making up the buttocks: the glutes maximus, gluteus medius and the gluteus minimus. They originate from the back of the pelvic bone ilium and sacrum and end on the thigh (femur).

The largest and the most superficial of the three gluteal muscles is the gluteus maximus. It makes up a large portion of the shape and appearance of the hips. The functions of the muscles are extension, abduction, external and internal rotation of the hip joint.

Gluteus maximus starts from the posterior gluteal line of the inner upper ilium crest, the posterior surface of the lower part of the sacrum and the side of the coccyx, aponeurosis of the erector spinae, sacrotuberous ligament and the fascia covering the gluteus medius. The gluteal maximus go downward and lateralward and insert into iliotibial band and glutealtuberosity. It extends and laterally rotates the hip and extends the trunk. Gluteus maximus injury is a common source of the low back pain. Trigger points are often presents at the originated fibers. The pain can radiate to the thigh, knee, leg and even foot like sciatic pain.

Erector spinae muscles

The erector spinae muscles are a group of muscle and tendons lying along the side of the spine. They arise from the anterior surface of the tendon attached to the medial crest of the sacrum, spinous processes of the lumbar and last two thoracic vertebrae, the supraspinous ligament, the innerpart of the iliac crest and the lateral crest of the sacrum. They extend up through lumbar, thoracic and cervical regions. This group of muscle include iliocostalis, longissimus and spinalis. The erector spinae make the back straight and rotate the back from side to side. Injury, strain chronic inflammation to these muscles may cause back spasm, pain and stiffness.

Others

The quadratus lumborum is a deep muscle at the back that runs from the last ribs and transverse processes of lumbar vertebrae to the top of the pelvis. It is quadrilateral in shape and forms posterior abdominal wall. When one side of the muscle contract, it flexes the spine laterally; when both side of the muscles contract, it extends the spine; it helps expiration and inhalation; and when it contracts on one side, it elevates pelvic bone. If trigger points are present in this muscle, it is a common source of low back pain. This is often caused by overuse, poor posture, stress, strain and tension from twisting, bending or lifting improperly etc.

The psoas major muscles are the deep muscles by the sides of the spinal column. They go downwards to the pelvic bone and end at lesser trochanter of the femur. Illacus muscles start from the interior side of the pelvic bone. The psoas major and the illacus muscles join together and form the iliopsoas. These muscles connect the core and lower limbs and they flex the hip joint, bend the spine forward and laterally and raise the spine from supine position. The pain and trigger points related to iliopsoas is at the low back and upper thigh. Walking and standing upright can be painful, if there are trigger point present in these muscles.

Sunday, 4 December 2022

Skin absorption, What is it? Why it is important?

The skin is a barrier of the body. Its out layer is responsible for keeping water in the body and keeping other harmful chemicals and pathogens out, making skin a natural barrier to infection. However, it does allow some chemicals to pass through and enter the body. This is so called skin absorption which refers to transporting chemicals from the outer surface of the skin into the skin or even into other part of the body when skin exposed to chemicals or cosmetic products. Absorption of substances through the skin depends on duration of contact, concentration and solubility of the substance as well as physical condition of the skin itself. When applying skin products, it is important that the product is not toxic. If it is toxic, it is not only harmful to the skin, but also it can get into the body causing harm to the whole body.

Which neck muscles get involved in neck-shoulder pain?

Muscles at the neck

The neck is the centre of muscle network of the upper body. The cervical spine and the muscles and ligaments are at the back of the neck. The cervical spine is made up of seven vertebraes between which is a disc. Spinal cord is within the spine and protected by the spine. Nerves come out from the cervical spine and innervated the neck and arms.

There are many muscles connect the neck to the head, shoulders and the back.

Trapezius muscle

Trapezius is a large triangular muscle superficially located at the neck and upper back. It connects the neck to the head and shoulders and upper back and middle back. Apart from trapezius there are many muscles connecting the neck to the head and shoulders.

Muscles connect the neck to the head. As mentioned above some muscles connect the neck to the head contributing to the head and neck movement. They are Semispinalis captisis which is deep to the trapezius muscle is originated from the four to seven cervical vertebraes and the upper seven thoracic vertibraes. Beneath this muscle there are five other muscles including rectus capitis posterior minor,rectus capitis posterior major, rectus capitis anterior, rectus capitis lateralis, obliquus capitis superior. Splenius capitis and Longissimus capitis are originated from lower cervical spine and upper thoracic spine and attach to the head.

Muscles connect the neck to the shoulder blades and the back

Levator scapulae muscle

Levator scapulae muscle is the muscle located at the back and side of the neck. It originates at the transverse process of the first to fourth cervical vertebrae and inserts at the superior corner of the scapula. It rotates and flexes the cervical spine laterally, when one shoulder is fixed. It flexes and extends the cervical spine, if both the shoulders are fixed. It lifts up the shoulder when the spine is fixed. This muscle pain presents a stiff and painful neck. The pain is characterised at the one side of the neck and the upper shoulder and it may go down to the shoulder blade and between shoulder blades. The pain limits the movement of the head.

The rhomboid muscles

The rhomboid muscles include the rhomboid muscle major and the rhomboid muscle minor. They connect the shoulder blades to the vertebras (C7-T5) to adduct the arm and pull the shoulder blades towards to the spine. Cooperating with levator scapulae muscle they lift up the medial border and downwards rotate the shoulder blades. The rhomboid muscle major also holds the shoulder blades onto the ribcage.

The serratus posterior superior

Deep to the rhomboid muscles is the serratus posterior superior. This muscle originates at the C7-T3 vertebras and attaches at the second to the fifth ribs under the shoulder blade. It elevates the ribs to aid diaphragm for deep breath.

The splenius cervicis are originated from T3-T6 and inserted to the C1-C3 transverse process. The cervical part of the illiocostalis muscle ends at the cervical transverse processes.

The semispinalis cervicis are originated from the transverse processes of C4-T10 and attach to the spinous processes of C2-C4. They extend, rotate the head and spine.

In the neck there are also some intrinsic muscles such as multifidus, minor deep intrinsic muscles, rotators between and process of the vertebras to stabilise the vertebral column.

Saturday, 3 December 2022

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 upper 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.

Rhomboid major and minor muscles

Below Levator scapulae muscle are Rhoboids including rhomboids minor and rhomboids major.

Rhomboid minor and Rhomboids major are muscles on the back connecting the shoulder blade with the spinal column. Rhomboids major is just below the rhomboid minor. They are deeper to the trapezius starting from spinal column C7 to T5 and inserting to the medial border of the shoulder blade. They keep the shoulder blade pressed against the back and retracted the shoulder blade toward the spinal column. The innervation to these two muscles is from C4-C6 nerve root on the neck.

Trigger points present in trapezius and/or Rhomboids are a common cause of upper back pain.

The serratus posterior superior

Deep to the rhomboid muscles is the serratus posterior superior as mentioned above.

Acupuncture needles are inserted in trapezius trigger points are an efficient way to release upper back pain.

Friday, 2 December 2022

Shoulder pain and rotator cuff disorders

Rotator cuff disorders

Rotator cuff disorder is another common cause for shoulder pain.

The rotator cuff is a group of tendons and muscles in the shoulder, connecting the upper arm to the shoulder blade as mentioned above. The rotator cuff tendons provide stability to the shoulder; the muscles allow the shoulder to rotate. The rotator cuff keeps the joint in the correct position, allowing it to move in a controlled way. Rotator cuff disorders occur when these tendons and muscles get irritated or damaged. The disorders include inflammation of the tendons or bursa, impingement (a tendon is squeezed and rubs against bone), calcium building up and tears of the tendons. The most common causes are 1) normal wear and tear. Rotator cuff is damaged due to years of using the shoulder and changes in the rotator cuff, for instance thinning and wearing of the tendons and reduced blood supply. 2) overuse. Activities involved in using rotator cuff a lot such as tennis, swimming or painting or using over a prolonged period can stress or injure the rotator cuff. 3) rotator cuff injury. Too much over head lifting or throwing sports etc can injure rotator cuff.

The symptoms include pain and weakness in the shoulder and it is worse during the activities when the arm is above shoulder level – for example, when brushing the hair; when the arm is moving away from the body; pain is in the front and side of the shoulder.
Acupuncture is very effective to release shoulder pain. 

Thursday, 1 December 2022

Which muscles are related shoulder pain?

Muscles surrounding the shoulder joint

Trapezius muscle

Trapezius muscle attaches to the base of the skull and extends down until mid back and laterally it inserts to the shoulder blades. It is involved in the shoulder blades movement

Pain caused by middle and lower part of the trapezius can present burning pain or aching on the top of the shoulder. Also pain caused by the lower part of the muscle can present upper shoulder pain; pain at the back of the shoulder blade which could radiate to the inside of the arm to the ring and little fingers.

Latissimus dorsi

Latissimus dorsi is the largest flat muscle in the back.

It originates from the inferior thoracic and lumbar vertebrae, sacrum, iliac crest, and the four most inferior ribs, runs laterally up through the back, inferior part of shoulder blades and inserts to the upper front of the humerus. This muscle plays a role in shoulder joint movement such as adducting the arms, extending the shoulders and rotating shoulder joints medially. Tight latissimus dorsi and the trigger points in the muscles could be one of the causes of shoulder pain, forearm pain, pain between shoulder blades, shoulder blades and pain in front of shoulder.

There are seven muscles that connect the upper arm to the shoulder blades.

Rotator cuff

Rotator cuff is a group of four muscles including supraspinatus muscle, the infraspinatus muscle, teres minor muscle, and the subscapularis muscle. They connect the scapula to the head to the humerus (arm) , stabilize shoulder joint and contribute to shoulder joint movement including abduction, internal rotation, and external rotation of the shoulder. Rotator cuff problem such as injury or overuse of these muscles can cause shoulder pain which is characterised as pain around the shoulder and reduced shoulder joint movement.

Teres major muscle

Teres major muscle also connects shoulder blades to the upper arms starting from lower angle of the shoulder blade and ending at the upper arm in the front of the shoulder. The teres major muscle is involved in adducting the arm, stabilising the humeral head, extending the shoulder and rotating it inwardly. The teres major trigger points cause pain at the back of the shoulder which can radiate to the front and side of the shoulder and down the backside of the arm.

Deltoid muscles

The deltoid muscle forms the rounded contour of the shoulder and is the big muscle on the shoulder. It has three parts; the front, middle and back. The front part is involved in flexing the shoulder and internally rotating the arm. The middle part is involved in shoulder abduction. The back part is involved in extending the shoulder and externally rotating the arm.

Coracobrachialis muscle

This is the smallest muscle that connects upper arm to the shoulder blade. It plays a part in adduction, flexion, and inward rotation of the arm. It also helps stabilise humeral head within the joint.

Muscles connected chest and shoulder

Pectoralis major and minor muscles

The pectoralis major muscle and the pectoralis minor muscle are the muscles located at the chest They are overlapped.

The pectoralis muscle originated from inner half of the clavicular bone, sternum as well as the cartilage of the sixth or seventh rib and the aponeurosis of the abdominal muscle. The muscle goes laterally and inserts to the upper arm. It adducts the arm and rotates the shoulder inwardly, pull down the shoulder joint and elevated the arm to the front. Pectoralis minor originates from 3-5 ribs and it runs upward and laterally and inserts to the surface of the coracoids process of the scapula. It pulls the shoulder blade downward, forward and inward towards the ribs, stabilizes the shoulder. The trigger point of the muscle contributes to the pain in front of the shoulder that could radiate to the chest, upper arms and all the way down to the inner side of the forearm.

Why can you feel the pain?

Pain receptors

Pain is a signal that is transmitted from the injured part of the body to the brain. Most illness causes pain; therefore the pain signal cannot be ignored. Noxious stimuli elicit tissue damage and activated pain receptors. Activation of pain receptors initiates the process that pain is experienced. Pain receptors are free nerve endings presented in the skin, muscles, joints, bone and viscera. They are sensory receptors that sense and detect tissue damage and then transmit the signal through nerves to the brain. There are three types of pain receptors. First type is skin pain receptors which are in the skin. They can sense pinching, cutting, stretching, temperature, chemicals and other mechanical. If the stimulation is prolonged, these receptors are sensitized and respond more widely. Second type is joint receptors in the joint capsules and ligaments. Third type is visceral pain receptors located in internal organs. Silent pain receptors or sleep pain receptors are these receptors that are normally not responding to noxious mechanical stimulation, however they can become responding to mechanical stimulation (They are awakened and no longer sleep any more) during inflammation and after tissue injury. This is because continuous stimulation from the damaged tissue reduces the threshold of these receptors and causes them to be responding again.

Pain receptors respond as soon as the tissues are damaged regardless the causes. Damaged tissues release substances from lysed cells and newly synthesized inflammatory substances at the site of injury such as globulin and protein kinase, arachidonic acid, histamine, nerve growth factors, substance P, potassium, 5HT and acetylcholine, lactic acid etc. Release of these substances reduces the threshold of the pain receptors and this is so called sensitization. If the receptors are sensitised, low level stimulation which was harmless in origin and did not cause any response before tissue damage can activate the pain receptors causing pain sensation. The response is rapid within 15-30 seconds after injury. The redness appears around the injury site caused by vasodilation and this inflammatory response becomes maximal after 5-10 minutes. Lowered pain threshold is seen in the area.

Wednesday, 30 November 2022

The pain cycle, what is involved?

Pain starts from activation of the nervous system. There are 9 steps of the pain circle:

Step 1: Local inflammation. Anything causing tissue damage such as injury, surgery, or infection can lead to local inflammation. This is the origin of the pain.

Step2: Peripheral sensitization. Local inflammation irritates the nerves lowering the pain threshold causing peripheral sensitization.

Step3: Central sensitization. Nerve signals are transmitted to the brain causing central sensitization.

Step4: Pain sensation. The brain tells you that there is pain in the body somewhere.

Step5: Pain cognitive processes. The brain where is sensing the pain connects other part of the brain where controls emotion causing emotional and behaviour changes.

Step6: Depression and anxiety. The brain where controls emotions is affected by the pain signals and alters its function causing depression and anxiety

Step7: Cortical reorganization. The brain reallocates its task to different parts of the body to reduce pain sensation and help replace the lost function.

Step8: Avoidance and disability. The body will respond the brain demands to redistribute the work causing avoidance and disabililty.

Step9: Muscle spasm deconditioning. Injured and related muscles become spasmed to protect the body from moving and feeling the pain causing muscle waste.

Sunday, 20 November 2022

Pain and acupuncture.

Pain is an unpleasant feeling and a signal in the nervous system that something may be wrong. Pain could be in one area of the body, such as back pain or all over the body such as fibromyalgia.

It could be divided into two types of pain according to the onset and duration.
There are two types of pain: acute and chronic
Acute pain usually comes on suddenly, because of a disease, injury, or inflammation. It can often be diagnosed and treated. It usually goes away, though sometimes it can turn into chronic pain.
Chronic pain lasts for a long time, and can cause severe problems.

There are mainly three types of pain sensations
Pricking pain is caused by a needle, pin prick, skin cut etc. This type of pain is precisely localized from the skin and conducted by the A fibers of the nerves. It is sharp, fast and short duration in nature. This pain is a protection mechanism to the body and warning to the brain that something goes wrong.

Burning or soreness pain is caused by inflammation, burned skin etc. This type of pain is not exact localized and conducted by the C fibers of the nerves. It is characterised as diffuse, slow onset and longer in duration.

Aching pain is a sore pain which is mainly from the viscera and somatic deep structure. It is not precisely localized and carried by the C fibers of the nerves.

There are many ways to release pain. Acupuncture is one of the many treatments for pain relief and it is very efficient.  

Do you know anything about connection among pain, endorphins and acupuncture

Endorphins are neurotransmitters produced in the brain known as endogenous opioids and they can be found in the pituitary gland, in other parts of the brain, or distributed throughout the nervous system. They transmit electrical signals within the nervous system by interacting with opiate receptors in the brain. The action is similar to morphine and codeine, but without addiction or dependence. At least 20 types of endorphins have been found in humans. In response to pain and stress, they decrease feelings of pain and also lead to feelings of euphoria, modulate appetite, release sex hormones, and enhance the immune response. As a result, it makes people feel less pain and less stressed.

Many studies in animals and humans have demonstrated that acupuncture can cause multiple biological responses. Endorphins are released during acupuncture and that the analgesic effects of acupuncture are at least partially explained by their actions. That opioid antagonists such as naloxone reverse the analgesic effects of acupuncture further strengthens this hypothesis.

Wednesday, 16 November 2022

What is pain sensitization?

Pain is a sensation of hurt resulting from the activation of pain pathways by harmful stimuli to lead to tissue damage. Detection of the stimuli is a protective process to help the body prevent injury or to avoid further contact with the stimuli. However in many clinical conditions the pain is no longer protective, but causes harm. The pain in these situations arises spontaneously, can be elicited by normally innocuous stimuli, is exaggerated and prolonged in response to noxious stimuli and spreads beyond the site of injury. This is caused by pain sensitization. There are two types of sensitizations: peripheral sensitization is a reduction in threshold and amplification in the responsiveness of pain receptors. This occurs when the receptors are exposed to inflammatory mediators and damaged tissue. Central sensitization is an enhancement in the function of neurons and circuits in pain pathways. This is caused by increases in membrane excitability and synaptic efficacy as well as to reduced inhibition in central nervous system in response to activity, inflammation, and neural injury. As a result previous non harmful stimuli generate amplified signals. Central sensitization is responsible for many of the temporal, spatial, and threshold changes in pain sensibility in acute and chronic clinical pain settings and exemplifies the fundamental contribution of the central nervous system to the generation of pain hypersensitivity.

Tuesday, 15 November 2022

Knee pain and knee arthritis? acupuncture is the most popular CAM treatment.

Knee osteoarthritis (KOA) is the fastest growing health disorder and the most common cause of disability. This is due to gradual loss of joint cartilage and local inflammatory processes. Nonsteroidal anti-inflammatory drugs, NSAIDs and joint replacement surgery are the treatments in Western medicine. Due to undesirable side effects of long-term pharmacological treatments and knee surgery, complementary and alternative medical (CAM) therapies are increasingly used. Acupuncture treatment represents the most popular form of CAM.

Much evidence from clinical trials and systemic reviews has suggested that acupuncture can be effective in treating pain and dysfunction in patients with KOA.

For example,

A randomised trial on acupuncture in patients with osteoarthritis of the knee from Germany investigated the efficacy of acupuncture compared with minimal acupuncture and with no acupuncture in patients with osteoarthritis of the knee. Patients with chronic osteoarthritis of the knee were randomly assigned to acupuncture minimal acupuncture (superficial needling at non-acupuncture points), or a waiting list control. Specialised physicians, in 28 outpatient centres, administered acupuncture and minimal acupuncture in 12 sessions over 8 weeks. After 8 weeks of treatment, pain and joint function are improved more with acupuncture than with minimal acupuncture or no acupuncture in patients with osteoarthritis of the knee.

A systematic review analysed 114 clinical trials (covering 22 treatments and 9,709 patients). The results indicate that acupuncture can be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term.

Another more recent review analysed 14 randomised control trials involving 3,835 patients and concluded that acupuncture provided significantly better relief from knee osteoarthritis pain and a larger improvement in function than sham acupuncture, standard care treatment, or waiting for further treatment.

A recent multicenter clinical trial studied acupuncture at low pain threshold and high pain threshold patients with knee arthritis. Result showed similar effects in pain reduction at 16 weeks, and acupuncture were more effective than a waiting-list control on all patients regardless of their pain threshold.

References

C Witt et al Clinical Trial Lancet 2005 Jul 9-15;366(9480)

M.S. Corbett et al Osteoarthritis Cartilage. 2013 Sep; 21(9): 1290–1298.

Le Cao et al Saudi Med J. 2012 May;33(5):526-32.

Jiali Liu et al Chin Med. 2022; 17: 67. 

Monday, 14 November 2022

Why are you retaining water? Acupuncture can help reduce water retention.

The body is mostly made up with water. It distributed in the blood, muscles, organs and even bones. Sometimes the body holds on to too much of water at particular places causing water retention which feels puffiness and swelling.

The circulatory system including blood circulation and the lymphatic system, the kidneys, hormonal factors, and other bodily systems all help maintain healthy fluid levels.

Water retention occurs when there is a problem with one or more of the body’s mechanisms for maintaining fluid levels. The main symptoms are swelling and discomfort. Water retention can be found in the legs, ankles, feet, the abdomen and chest as well as the face and hands. The symptoms of fluid retention will depend on the area it affects.

If it is in the limbs, feet, and hands, symptoms can be swelling, changes in skin color, shiny or puffy skin, areas of skin that remain indented when pushed in with a finger, aches and tenderness in the limbs, stiffness in the joints, weight gain. If it is in the abdomen and face, the symptoms can be bloating, puffiness of the abdomen, face, and hips, weight fluctuations. You could feel heavier than usual.

Water retention can be a common issue or a sign of a health condition. Acupuncture can help when not caused by a serious health condition.

Interstitial fluid flow is the movement of fluid through the extracellular matrix of tissues, often between blood and lymphatic vessels. System circulation (blood circulation) is the part of the cardiovascular system. It carries the water around the body. The lymphatic system is a part of the circulatory system.

The lymphatic system is responsible for maintaining the balance of the body fluids. Its network of capillaries and collecting lymphatic vessels work to efficiently drain and transport the fluid, along with proteins and antigens, back to the circulatory system. The lymphatic system is not closed system and the vessel walls are not as strong as blood vessels. If the circulation is blocked for various reasons, for example, there is tension on the body, the transportation is disturbed and the fluids cannot be drained properly causing water retention

Acupuncture improves blood circulation, and this was proved by scientific research. For example, Sandberg et al investigated the effects of acupuncture on skin and muscle blood flow. Blood flow recordings were performed intermittently from 10 min prior to the intervention to the end of the trial. They found that skin and muscle blood flow increased after acupuncture stimulation. Another example Kuo et al also studied the effect of acupuncture on skin blood flow. After acupuncture treatment skin blood flow and skin temperature increased.

Acupuncture improves blood flow and the movement of fluid of lymphatic system through the body and the acupuncture needle changes the interstitial microenvironment. This helps reduce water retention and decrease joint inflammation, welling of limbs, and stabilise the weight.

References
Wei Yao et al Evid Based Complement Alternat Med. 2012: 853516.
Sandberg et al Eur Appl Physiol (2003) 90:114-9
Kuo et al Am J Chin Med (2004) 32 :117-29

Thursday, 10 November 2022

Fitness Qigong eight pieces of brocade



Qigong is a technique used in Chinese medicine to create Yin Yang balance and improve Qi circulation. It is an ancient Chinese healing technique that combines body movement, breathing and mental focus. It coordinates the body, breath and mind and opens the flow of energy in meridians used in acupuncture.

One of the purposes that people practice qigong throughout China and worldwide is for exercise and relaxation.

The Baduanjin qigong(八段锦) is one of the most popular forms of Chinese qigong used as exercise. It involves the eight individual movements to improve health.

This exercise is originating from the Song Dynasty. It attributes to the Chinese folk hero General Yue Fei. He taught the exercise to his men to help keep their bodies strong and well-prepared for battle.

Monday, 7 November 2022

Acupuncture for dry eyes, does it work?

Dry eye is a common condition. When tears can’t provide adequate lubrication for the eyes, the eyes become dry. This can be caused for many reasons such as not enough tears or poor-quality tears are produced. This leads to inflammation and damage of the eye's surface.

The symptoms of dry eyes may include: a stinging, burning or scratchy sensation in your eyes, stringy mucus in or around your eyes, sensitivity to light, eye redness, a sensation of having something in your eyes, difficulty wearing contact lenses or night-time driving, watery eyes, blurred vision or eye fatigue. Dry eyes symptoms can occur in certain situations, such as on an airplane, in an air-conditioned room, while riding a bike or after looking at a computer screen for a few hours.

If you have dry eyes, you may experience some complications: such as eye infections and eye inflammation causing pain in the eyes.

Treatments for dry eyes are to control the symptoms of dry eyes.

Acupuncture is effective to release dry eye symptoms. This is proved by many clinical research.

Here is some examples of the research analysis for acupuncture on dry eye symptoms.

First, this review compared the effect of acupuncture with artificial tears treatment and included seven studies and 383 patients. They used tear break-up time (BUT), Schirmer I test (SIT), and cornea fluorescein staining (CFS) to measure the effectiveness of the treatments. They found the overall BUT of patients in acupuncture group was significantly longer than that of the artificial tears group after treatment; the SIT was significantly higher in the acupuncture group than that in the artificial tears group after treatment; the CFS of patients in acupuncture group was significantly improved compared to that in artificial group. They concluded that acupuncture therapy is effective for the dry eye patients, partly better than artificial tear treatment.

The second study investigated the effect of acupuncture for dry eye syndrome after refractive surgery. A total of 18 patients with dry eye syndrome occurring after refractive surgery participated in this study. For 4 weeks, the acupuncture plus usual care and usual care only groups received treatment three times a week. They used aseries of assessments, namely the ocular surface disease index (OSDI) to measure the effectiveness of the treatments. There was a significant difference in the trends of OSDI changes between the acupuncture plus usual care and the usual care only groups. No serious adverse events were reported during the study. They concluded that four weeks of acupuncture treatment in addition to usual care is a feasible treatment for dry eye syndrome after refractive surgery.

More recently a review included nineteen studies with 1126 patients and analysed the effectiveness of acupuncture for dry eye symptoms. They found significant improvement of dry eyes from acupuncture treatment and also concluded that acupuncture treatment is more effective than artificial tears treatments.

References

Lei Yang et al Evid Based Complement Alternat Med. 2015; 2015: 143858.

Jun-Hwan Lee et al Integr Med Res. 2021 Mar; 10(1): 100456.

Bong Hyun Kim et al BMC Complement Altern Med. 2018; 18: 145.

Sunday, 6 November 2022

Eating nuts boosts your fertility

There are certain foods associated with Christmas, and nuts including walnuts, brazil nuts, hazelnuts and pecans are one of them. Where are the ideas from? This goes back to pre-Christian time, the shortest day of the year which is often 21st and 22nd of December. It was celebrated by encouraging light to return. Feast is used to celebrate. In Christian time, Christmas became such an important feast and every luxury item was saved up for it. Nuts were harvested in autumn and were available to store for the big festival. Eating nuts at Christmas became such an important part of the celebration.

Do you know that nuts promote your fertility?

Nuts are important part of fertility nutrition; this is because they contain ample protein, minerals and essential fatty acids. Eating nuts provides vegetable proteins you need and this promotes your ovulation. There is high level of selenium, a natural antioxidant in Brazil nuts and this plays a key role in the early stages of conception. Nuts with the highest content of protein are peanuts 6.7g, almonds 6g and walnuts 4g per oz. Best nuts for omega3 are walnuts 2.2g per1/4cup.

Nuts improved sperm vitality, motility, and morphology. In a study, 75g walnuts per day were added to the diet in male aged 21-35 yr old. The group consuming walnuts experienced improvement in sperm vitality, motility, and morphology, but no change was seen in the group continuing their usual diet but avoiding tree nuts.

Don’t forget acupuncture. Acupuncture increases ovarian blood flow in women and testis blood flow in men and brings all nutrients your follicle needs to the ovary and sperm needs to the testis. Without good local blood flow, the nutrients you eat will not reach your ovary or testis.

References

http://www.history.uk.com/christmas/traditional-christmas-food/
http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2009/May/Follow-Fertility-Diet
Robbins WA et al Biol Reprod (2012) 87:101

Wednesday, 2 November 2022

Do you know that acupuncture can help your posttraumatic stress disorder (PTSD) effectively?

Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a very stressful event.

Symptoms may include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event. Someone with PTSD often relives the traumatic event through nightmares and flashbacks. They may experience feelings of isolation, irritability, and guilt; feeling emotional distressed to something that reminds them of the traumatic event; and avoid thinking or talking about the traumatic event and avoid places, activities or people that remind them of the events. They may also have problems sleeping, lack of interest, depression, difficulty to concentrate and poor memory etc.

Symptoms can vary over time or vary from person to person. These symptoms are often severe and persistent enough to have a significant impact on the person's day-to-day life causing significant problems in social or work situations and in relationships.

A key component of posttraumatic stress disorder is traumatic memory which makes a tremendous impact on physiological and mental capacities and consequently on the individual’s ability to function appropriately in the present.

The treatments for PTSD are limited.

There are pilot studies showing acupuncture may be an efficacious, safe, and acceptable treatment for PTSD. Studies demonstrate that acupuncture can regulate the autonomic nervous system, improve sympathetic/ parasympathetic balance and affect parts of the limbic system and cortical regions associated with memory. Acupuncture results in decreased activation of the brain where control emotion and memory and increase resting-state functional connectivity while the strength of this connectivity was positively associated with corresponding clinical improvement.

References
Amir Assouline et al Translational Psychiatry (2022) 12:110

Tuesday, 1 November 2022

How does acupuncture speed up healing process?

Connective tissues in the body

Connective tissue is the tissue between organs and tissues and it provides structural and metabolic support for other tissues and organs. It links whole body together. All connective tissue consists of three main components: elastic and collagenous fibers, ground substance and cells. Cells are spread through an extracellular fluid. Variations of the fibers and ground substance determine the property of the tissues. For example, Bones, tendons, cartilages have specific forms of fibers and ground substance. There are three types of connective tissues: loose connective tissue, dense connective tissue and special connective tissue such as bone, cartilage adipose, reticular connective tissue and blood etc. Loose connective tissue contains many cells, a loose arrangement of fibers and moderately viscous fluid substance such as the tissue in lymph gland. Dense irregular connective tissue contains a dense network of collagenous fibers arranged irregularly, for example the tissues in joint capsules and muscle fascia are this type of tissue. Dense regular connective tissue which is a special connective tissue contains cells and all aligned fibers and it is found in tendons and ligaments.

Loose and dense irregular connective tissue provides a medium for oxygen and nutrients to diffuse from capillaries to cells and carbon dioxide and waste substances to diffuse from cells back into capillaries. They protect organs from stretching and tearing forces. Special connective tissue’s function depend on the types of the tissues.

Fascia is connective tissue made up with collagen. Fascia can be seen between muscles, bones, ligaments and other internal organs.

The deep fascia is a highly vascular structure with a superficial and a deep layer, each with an independent rich vascular network of capillaries, venules, arterioles, and lymphatic channels. The presence of mast cells in deep fascia suggests a protective role similar to other connective tissues. The deep layer has few elastin fibers but does have myofibroblasts, suggesting contractile ability. Any active contraction would need to be controlled by a nerve supply and, indeed, one finds myelinated and unmyelinated nerve axons and Schwann cells in these deep fascial layers.

Any active contraction would need to be controlled by a nerve supply and, indeed, one finds myelinated and unmyelinated nerve axons and Schwann cells in these deep fascial layers. The deep fascia is not just a tough barrier structure of collagen and elastin, but is a metabolically active vascular layer which provides gliding and protective functions(16). Deep fascia has parallel longitudinal collagen bundles and rudimentary elastic laminae, giving it both high tensile strength and elasticity. At the junction between the deep fascia and the muscle, without any special secretory cells, the fascia is able to maintain a lubricating layer of hyaluronic acid (hyaluronan) which, like a hydraulic fluid, allows sliding between the fascia and neighboring muscle. However, when the epimysium is disrupted in surgery, overlying fascia does not remain distinct and does not create a gliding layer over the scar(17). More recent findings show that while hyaluronic acid is a lubricant, breakdown products of this large molecule are themselves tissue irritants(18), and fragments from collagen, elastin, and laminins in the extracellular matrix also modulate activities of inflammatory cells

The architecture of the fascia allows continuity of nerves, blood, and lymph vessels between the sliding tissues. With trauma to the muscle, the overlying fascia no longer produces the sliding layer of hyaluronan. Restoring this natural sliding mechanism becomes the next task for the manual therapist.

Fascia, meridians and acupuncture

Under the skin there is a sheet of connective tissue called fascia. Fascia is mainly made up of collagens and it surrounds the muscles and other internal organs. It can be seen between muscles, bones, ligaments and other internal organs. There are three types of fascia, superficial, deep and visceral fascia. Fascia are flexible and are resistant to tension force, this is because the collagen fibers produced by fibroblasts in the fascia are arranged in a wavy manner. Because of the fascia flexibility, it can transmit mechanical force throughout the body and prevent the body from injury. Fascia also provides support to the nerves and blood vessels in the fascia. Fascia is innervated by sensory nerve endings. If fascia is damaged and/or inflamed, it will lose its wavy pattern and flexibility, fasical adhesion and scaring will cause stiffness and pain.

In Chinese medicine, there is a concept of meridians through which the energy will flow throughout the whole body, but the anatomical basis of meridians is not resolved. The recent research data from scanning connective tissue has suggested that fascia network is clearly matched with meridian network. Disruption of fascia can trigger local inflammation and block energy flow causing pain. Acupuncture can reduce inflammation and unblock the meridians improving energy flow.

Chronic pain recovery, fascia remodelling and acupuncture

Nerve endings are surrounded by fascia tissue and play an important role in pain regulation. Disruption of fascia can stimulate pain receptors and provoke inflammation. Recently chronic low back pain has been suggested starting from the fascia inflammation. Pain-related fear leads to a decreased movement, connective tissue remodeling, inflammation, nervous system sensitization and further decreased mobility. The Lumbar Fascia cross the entire lower back region, and is a key component. The lumbar fascia is thickened in patients with chronic low back pain leading to stiffness of the back. Fascia remodelling is a healing process of recovery. Application of acupuncture helps fascia remodelling and reversing the abnormality of fascia.

How the body heals itself

Tissue repair is involved in the healing process which allows restoration of injured tissue. There are four phases during the healing process: blood clotting, inflammation, tissue growth (proliferation) and tissue remodeling (maturation). Blood clotting is initiated within a few minutes of injury. Plate. The inflammatory phase begins with damage to the capillaries, which triggers the formation of a blood clot and the various recruited cells to migrate into wound, such as inflammatory cells (neutrophils and macrophages), fibroblasts and endothelial cells and damaged tissue and cells, bacteria and other debris are cleared out. In proliferation phase, new blood vessels are formed and new tissue cells are crawling onto the top of the wound bed. Meanwhile the wound contract by gripping the wound edge to reduce the size of the wound and bring the tissues closer; new capillaries deliver nutrients and oxygen for the development of granulation tissue and proliferation of fibroblasts. Fibroblasts differentiate to myofibroblasts which have contractile properties containing stress fibres. The last phase of healing is regeneration and scar formation which is involved in a progressive remodelling of the granulation tissue. In this phase many enzymes and their inhibitors play a major role. Vascular cells and myofibroblasts are reduced in numbers. In the final stage, there are two separate processes: regeneration and replacement. In regeneration process, the new tissue completely restored the portions of damaged tissue to their normal state. collagen is realigned and cells no longer needed are removed. In replacement type of healing, severely damaged tissues are replaced by connective tissue forming scarring.

The healing process can become abnormal. These abnormal repair processes are the result of an impaired remodelling of the granulation tissue. If there is the noxious stimulus, excessive extracellular matrix deposition and the continued presence of myofibroblasts is observed. This excess of extracellular matrix deposition leads to the development of organ fibrosis. The installation and persistence of fibrosis is the consequence of an imbalance between extracellular matrix synthesis and degradation by myofibroblasts.

Acupuncture can stimulate normal healing process and speed up healing process.

References

Ludovic Micallef etc Fibrogenesis & Tissue Repair20125(Suppl 1):S5

Yu Bai et al Evidence-Based Complementary and Alternative Medicine
Volume 2011 (2011), Article ID 260510, 6 pages

Yu Bai et al Evidence-Based Complementary and Alternative Medicine
Volume 2011 (2011), Article ID 260510,

Almeida Mdos S et al  Acupunct Med (2014) 32:178-82.


Monday, 31 October 2022

Acupuncture prevents postoperative nausea and vomiting.

There was a randomized controlled clinical trial for acupuncture stimulation of Neiguan (PC6) for preventing postoperative nausea and vomiting. There were 60 patients who were undergoing craniotomy. They were allocated into two groups: acupuncture group and control group. 30 pateints were in each group. Then regaining consciousness from the surgical anesthesia, patients in acupuncture group received acupuncture immediately and the acupuncture points used were bilateral PC6. The needles were manipulated about 1 min and repeated 10 min after insertion. The needles were left in the place for about 20 min after second manipulation. Patients in control group received no treatment.  Result showed that in acupuncture group one patient had a vomiting from 0-2 hours after acupuncture treatment; one patienthad a vomiting from 2-6 hours after the treatment; and no patients had vomiting 6 hours after the treatment. In contrast, in control group, 11 patients had vomiting from 0-2 hours; 8 patients had vomiting from 2-6 hours; and 8 patients had vomiting from 6-24 hours. The nausea scores were significantly lower in acupuncture group in all three time scale compared with control group. Their conclusion was that acupuncture at PC6 point was effective in preventing and treating postoperative nausea and vomiting in patients undergoing craniotomy.

References

Lu JQ et al Zhen Ci Yan Jiu (2013) 38:245-8

Effectiveness of acupuncture for gouty arthritis

Gout is a medical condition featured by recurrent attacks of inflammatory arthritis called gouty arthritis. The symptoms include a red, tender, hot and swollen joint. In these patients uric acid in the blood is elevated.

Effect of acupuncture for gouty arthritis was evaluated by Lee WB et al. Lee WB et al analysed randomized controlled trials (RCTs) data up to August 2012. All RCTs involving acupuncture in combination with conventional therapy for gouty arthritis were included. There were 10 RCTs involving 852 patients with gouty arthritis. Six studies with 512 patients showed a significant decrease in uric acid in the treatment groups compared with control groups. Four studies with 380 patients showed a significant decrease in visual analogue scale score for the treatment groups compared with control groups. They concluded that acupuncture is efficacious treatment method for patients with gouty arthritis.

References

Lee WB et al Rheumatology (Oxford) (2013) Feb 18 

Friday, 28 October 2022

Acupuncture increases oxygen concentration and blood circulation

Acupuncture is used to various conditions such as fertility, low back pain and other pain conditions, facial treatment etc, however how acupuncture works is still not completely clear. Recent research has suggested many theories to support the application of acupuncture. Acupuncture is suggested to increase oxygen concentration and blood flow in the brain. For example, a study has shown that small increases in oxygen saturation and a significant increase in mean blood flow velocity during acupuncture measured simultaneously at different depths within the right middle cerebral artery. Acupuncture is also suggested to increase oxygen concentration and blood flow in the muscles. For example, acupuncture at trapezius muscle increased in oxygen concentration and blood volume in the muscle. These studies provided a preliminary research data and pointed a direction for future wider studies to provide a mechanism of acupuncture application for many conditions.

References
Litscher G et al (1980) Neurol Res 20 Suppl 1:S28-32

Wednesday, 26 October 2022

What are meridians and acupuncture points



 

Suffer from winter blue? Acupuncture can help

Winter brings with its darker mornings and evenings, and some may feel they hardly see the sunlight at all---going to work in the dark and coming back home in the dark. Many people find themselves feeling sad, blue and even depressed around the winter. The medical name for winter depression is seasonal affective disorder (SAD). It’s fairly common, and it’s more mild than serious. You wake up before the sun even rises, you might start feeling a persistent low mood or lack of energy.

The cause of SAD is not fully understood, shorter days seem to be a main trigger for it. Reduced sunlight in winter can disrupt your body’s internal clock, or circadian rhythm. This 24-hour clock responds to cues in your surroundings, especially light and darkness. At night, the brain produces melatonin, helping you sleep. Light stops the brain producing melatonin to help keep you awake. Shortened daylight in winter may increase the production of melatonin and affect the body’s internal clock or circadian rhythm leading to SAD in certain people.

To cope with winter blue or SAD, eating healthy food, keeping active, taking vitamin D may help. Also light therapy and talking therapy may help too. Don’t forget acupuncture. Acupuncture can help reduce winter blue symptoms such as fatigue, low mood and depression.

Tuesday, 25 October 2022

Acupuncture helps to improve your mood

Everyone has mood changes in some degree, however too much mood changes could be caused by ill health and further affects one’s health. Mood expressions include positive scales like "activity, joy, contemplation, calmness" and negative scales like "anger, irritation, depression, fatigue”. Patients with chronic disease supposed to have dominant negative mood scales. Do you know acupuncture can help you improve mood changes. A research has shown that there was an immediate, fast suppression of unusual slow high amplitude EEG waves in response to acupuncture needle rotation. Also there was a significant improvement on positive mood scales and a decline in negative mood scales after 10 acupuncture sessions. Patients with chronic pain reported a significant decrease of pain intensity after 10 sessions.

Acupuncture is cost-effective compared with counselling or usual care alone in treating depression
There is emerging evidence that acupuncture is effective for treating patients with depression. A study from the University of York UK has shown that acupuncture is also cost effective for treating depression. They compared the cost of acupuncture, counselling or usual care for depression based the price of the interventions. They measured quality adjusted life years (QALYs) in analysis. They found that acupuncture and counselling have higher mean QALYs and costs than usual care. They have shown that acupuncture has an increased cost-effectiveness ratio (ICER) of £4,560 per additional QALY and is cost-effective with a probability of 0.62 at a cost-effectiveness threshold of £20,000 per QALY. Counselling compared with acupuncture is more effective and more costly with an ICER of £71,757 and a probability of being cost-effective of 0.36. Acupuncture is cost-effective compared with counselling or usual care alone.

References

Acker H et al Med Hypotheses (2015) May 22

Spackamn E et al PLoS One (2014) 9:e113726

Monday, 24 October 2022

What is acupuncture? Pain relief with acupuncture.

Acupuncture began in China about 2500 years ago and it is a part of Traditional Chinese Medicine, which is based on theory of meridians (channels). Chinese Medicine believes that energy (called qi) flows around human body freely through meridians without being interrupted. If the channel is blocked resulting that qi cannot pass through the channel, this may cause illness. The acupuncture needles are inserted into certain points of your body along with the channels to unblock the channels.


The effectiveness of acupuncture to treat disorders is still a long standing question in research field. There are many conflicting research results on treatments of different kinds of conditions. Sometimes it is difficult to draw firm conclusions, because of the way that the research was conducted. Researchers are trying hard to perform well designed research using control group and sham acupuncture. For some conditions, the effectiveness with acupuncture treatment is agreed, such as back pain by the researchers.

From clinical point of view (many acupuncturists and patients would agree), acupuncture does have amazing effects for many patients with some conditions, again back pain is a good example. Usually acupuncture is the last treatment that patients want to go through. They have gone through many other treatments without any improvements sometimes for years, so why not try acupuncture and they choose an acupuncturist. The cases like these are more difficult to treat. Surprisingly needles worked. I would not say acupuncture works for everyone and every condition (no medications do), but I did see many patients are no longer living in pain and having much happier life; fibroids and ovary cysts shrunk and disappeared.

Acupuncture has been accepting by more and more doctors and patients as an effective alternative treatment for some conditions. Acupuncture is accepted as complimentary therapy by general medicine based on the theory that the acupuncture needles stimulate nerve endings and this adjusts brain functions. Acupuncture is increasingly popular since last a few decades. Recently a survey showed that about 4.1% of adult population in the survey were using acupuncture in their lifetimes in US. Acupuncture makes great contribution to the healthcare of the UK, with an estimated 4 million sessions provided annually (Hopton AK et al 2012) and about 7% of adult population have consulted an acupuncture practitioner within their lifetime in the UK.

What is the acupuncture procedure like?

It is better to get information about acupuncture procedure before hand; this would give you a peace in mind. What happens during acupuncture? First of all, you will have a detailed consultation. The acupuncturist will ask your questions about your medical history, the illness or symptoms you wanted to treat with acupuncture, illness that acupuncture cannot be performed, such as bleeding problem. Then he or she may examine you and you can also ask questions. According to your history and the examination, the acupuncturist will decide how the acupuncture is performed and you will be advised. You will need to lie down on the treatment bed at the position required for the acupuncture and expose certain area where acupuncture points are selected. Special thin acupuncture needles (They are 25-50 times thinner than injection needles) will be inserted into selected particular acupuncture points in your body. These special needles are sterilised, individually packed, one off and disposable. When the needle is penetrating into your skin, you may feel a bit tingly. The needles may be inserted into your skin about half a centimetre to one centimetre depending on where the acupuncture points are and your reactions to the needles.The length of the course is depending on how individuals respond to the treatments.

How to prepare for acupuncture treatment?

There is no special preparation for acupuncture treatment. There are a few tips that may help to achieve best effects. First of all, you should feel relaxed and be confident to put trust on the acupuncturist that you have chosen. These are very important. You could bring personal listening device to use during the treatment to make you relax more. Anything that makes you nervous or stressful would compromise the effectiveness. Second, eat light meal about 2 hour before the appointment. Empty stomach increases the risk of nausea and dizziness. Heavy food upset your stomach which is not recommended. Third, avoid drinking alcohol during the day of the treatment. Fourth, try to wear loose comfortable cloth. Fifth, get a good night sleep to help maximize the effect. Sixth, bring all test results that you have taken before and a list of medications that you are currently undergoing. Finally, empty your bladder before enter the treatment room.

What do you expect from acupuncture?

Acupuncture helps the body balance and return to its healthy state. Most patients say they feel much better, more energetic and less anxiety with the treatments progressing. There is no more sleepless night, pain goes away and joint moves again. All of these seem a miracle for those who never be treated with acupuncture. Is there really a miracle? Absolutely no miracle. I would advise you to set up a realistic expectation to avoid disappointment.

How quick is the acupuncture effect coming up? It depends on individuals: what the conditions are, how long the illness is and how well the body responds to the treatment. For example, for some pain conditions, the pain can be relieved very quickly, you may feel better instantly, while for other conditions, it may take longer to accumulate the effects. If an illness is there for a long time, which makes the pathological damage well established, it will take much longer time to reverse the process. It is impossible that a ten year long illness disappears completely in a week. Don't give up trying, you would see the improvement of your heath. Positive expectation enhances the effect of acupuncture.

Not all conditions can be treated with acupuncture. Acute and severe conditions are not suitable for acupuncture treatment. For example, if you are suffering from severe chest pain or acute abdominal pain, this may be life-threatening and you need to go to hospital to see a doctor rather than an acupuncturist.

What conditions can be treated with acupuncture?

Acupuncture has been proved an effective treatment to many diseases. There are 107 diseases or symptoms that could be treated with acupuncture listed on World Health Organisation (WHO) website:

http://apps.who.int/medicinedocs/en/d/Js4926e/5.html

Are there any risks with acupuncture?

Generally acupuncture is very safe. Side effects or complications are rare but you may want to know this. Side effects of acupuncture include:

Discomfort when the needle is inserted.

Needle sickness: feeling drowsiness, faint or feeling faint, dizziness, headache, nausea, sweaty.

Bruising or bleeding at the needle point.

Temporary worsening of your symptoms: occasionally there may be transient worsening of symptoms which may last for a couple of days followed by improvement. This is because acupuncture is an invasive procedure and your body reacts strongly to the treatment. These are normal reaction of your body to the treatment.

Damage internal organs or nerves from the insertion of the needles

Infection, disposable needles are used to reduce the risk.



References

Hopton AK et al BMJ Open. (2012)11:2-9

Burke A et al J Altern Complement Med. 2006 12:639-48.

http://apps.who.int/medicinedocs/en/d/Js4926e/5.html

Saturday, 22 October 2022

Fascia thickening, back pain and acupuncture

What is fascia? Fascia is a band or sheet of connective tissue consisting of collagen lying under the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs. Fascia is classified by layer, as superficial fascia, deep fascia, and visceral or parietal fascia, or by its function and anatomical location.

A recent study by Helen Langevin a researcher at the University of Vermont has suggested that people with chronic and recurrent low back pain had 25 percent greater fascial thickness than a low back pain-free group. She concluded that increased thickness and disorganization of connective tissue layers may be an important and so-far neglected factor in human LBP pathophysiology. Another study in Skeletal Radiology, 2005,2 found that pathological Achilles tendons showed increased thickness and 89 percent were painful.

Antonio Stecco, MD, recently completed an unpublished study3 using ultrasonography on chronic (longer than 3 months' duration) neck pain patients, evaluating fascial thickness in the distal third of the SCM and scalenus medius. The deep fascia in both muscles were thicker due to the increased amount of loose connective tissue between the layers of the deep fascia (usually three layers) and the loose connective tissue between the deep fascia and the muscle. Study has shown that there was a correlation between the intensity of the pain and the thickness of the fascia compared to the control patients. Besides the thickening of fascia beneath the deep fascia and muscle, there may be thickening between the superficial and deep fascia, and the intramuscular fascia surrounding perimysium and endomysium.


Acupuncture can help reduce chronic pain.

References
Warren Hammer Dynamic Chiropractic (2012) Vol. 30 Issue 11

Look after your overall health with facial acupuncture

Stress is a natural response of the body to harmful situations, and its symptoms can vary from person to person. Emotional symptoms may incl...