Dr Maggie Ju Acupuncture London Chelsea, North Kensington, Notting Hill, and Richmond

Shoulder impingement is a very common cause of shoulder pain. It occurs when a tendon or bursa in the shoulder rubs bones of the shoulder. Overhead activity of the shoulder, such as lifting is a risk factor for shoulder impingement syndrome. The main complaint is pain and it is persistent and affects everyday activities. The pain is on the top and outer side of the shoulder, and it is worse at night which can affects the sleep; It causes pain when reaching up behind the back or reaching up overhead. It can affect daily activity such as putting on the top. There is weakness in the arm and shoulder and restricted shoulder movement. Over time, impingement syndrome can lead to inflammation of the rotator cuff tendons (tendinitis) and bursa (bursitis). Rotator cuff tendon extends to the top of the shoulder joint. Shoulder impingement can start suddenly or come on gradually. If not treated appropriately, the rotator cuff tendons can start to thin and tear. A study investigated acupuncture

Sex steroid hormones act at a number of sites in both the peripheral and central nervous systems and in both reproductive and non-reproductive tissues. They play a role in pain conditions. Many clinical pain conditions vary with hormonal state. For example, the probability of experiencing a painful condition increases with increasing pubertal development. Sex differences in the prevalence of painful conditions appear after puberty. Variation in symptom severity across the menstrual cycle affected by ovulation and menstruation occurs in a number of clinical pain conditions, such as the pain of dysmenorrhoea, the symptoms of temperomandibular joint (TMJ) dysfunction, fibromyalgia, Irritable Bowel Syndrome (IBS), Interstitial Cystitis (IC) and migraine. The use of the combined oral contraceptive pill (COCP) to give a more constant hormonal level can sometimes improve pain symptoms. During pregnancy, the cyclical fluctuations in hormones stop. Many clinical pain conditions improve during p

Tendon is a tough band of fibrous connective tissue that usually connects muscle to bone Tendons are highly organized connective tissues that transmit muscle force to the bone. Tendons are resilient during the development of tension, but flexible enough to carry on its function. In the resting state, the collagen fibrils exhibit a wavy conformation. As a tendon is stretched, collagen fibrils begin to straighten out, and, as a result, the tendon becomes stiffer with increasing application of mechanical strain. The transition from tendon to bone and from tendon to muscle is progressive to allow an efficient load transfer minimizing stress concentrations. A healthy tendon is up to twice as strong as the muscle, making the body of the tendon unlikely to tear before the muscle unless the tendon has already been weakened by degenerative changes. The effects of ageing, wear and tear, genetic pre-disposition and inflammation are known factors contributing to tendon injuries. Tendons consist

What is ectopic pregnancy? Ectopic pregnancy is that the fertilized egg implanted outside of the uterus. The commonest site is in the fallopian tube. The egg will not develop a baby, but it is threatening condition for the pregnant women. Ectopic pregnancy occurs in 1% pregnancy. The risk factors include pervious pelvic inflammatory disease, infertility, tubal surgery, intrauterine contraceptive device and previous ectopic. Patient has positive urinary pregnancy test. Patient presents lower abdominal pain and slight vaginal bleeding. Ultrasound shows empty uterus and may identify ectopic embryo. If the egg dies before it can grow larger, the pregnancy terminates and the tissue is absorbed in the woman’s body. In this case, the pregnancy test becomes negative. If the pregnancy is left to grow, there is a risk that the fertilized egg grows larger and causes the tube to rupture which can cause life threatening internal bleeding. The signs of tube rupture are sudden severe sharp abdominal

Age affects fertility in women Women are born with all the eggs they ever have. Women are most fertile between the ages of 18 and 31. When women are getting older, their egg quantity and quality are declining. They become less fertile. There is clear evidence of an age-related decline in female fertility. By the time women reach 35 years of age, their fertility is declining markedly. This presents that the number and quality of eggs decrease; also genetic abnormalities and spontaneous abortion increase noticeably with female age. A study involved in 1000 women in pregnancy showed that 71% of women aged 30 conceived within 3 months whereas only 41% of women aged 36 conceived within 3 months. A negative effect of increasing male age particularly in the late 30s was also found. A study involved 2112 women in pregnancy showed that increasing age for both men and women take longer time to conceive. There were some other studies presented similar results. There is a significant decline i

The role of fallopian tube is in reproduction The fallopian tube is a part of the women’s reproductive system. It plays an essential role in gamete transport, fertilization and the early development of the embryo. The tube contains inner lining and smooth muscle wall. In the inner lining there are two major cell types are the ciliated and secretory cells. The fallopian tube goes through cyclical changes responding to estrogen and progesterone levels. The ciliated cells are low in height during the menstrual periods of the cycle, increasing during the follicular phase to reach their maximal height in the periovulatory period. Around the time of ovulation, the secretory cells reach peak activity. In the luteal phase, both cell types reduce in height. Fallopian tubes are very important for normal fertility. They play a key role in picking up eggs and transporting eggs, sperm and embryo. When an egg is release, it takes about 8 hours to reach the site within fallopian tube. The fallopi

How much acupuncture treatment is adequate? This is the most frequently asked question from patients. This is a good question, but it is difficult to get accurate answers. The effect depends on the points chosen by the acupuncturists If you go to see different acupuncturists, you would probably notice that different acupuncturists do acupuncture differently. Many different styles of acupuncture practice exist. Acupuncture is so individualized and there is no agreement on the optimal acupuncture treatment for any particular condition. Birkeflet O et al did a research about the agreement of acupuncture diagnosis and treatment in 30 infertile and 24 previously pregnant women. These women were examined for traditional Chinese medicine (TCM) patterns by two acupuncturists who would independently decide on the TCM patterns and the prescription of acupuncture points. They found that 39 different TCM patterns and 36 different acupuncture points were used. Poor to no agreement was found for

Skin blood flow significantly decreased with increase in age. Skin blood flow is 40% less at age 65 than at age 25. This is because skin blood flow decreases with decreased pumping blood from heart; skin blood flow significantly decreased with increase in total cholesterol and systolic blood pressure; less blood is redirected to the skin from other part of the body; blood vessel movement is impaired with aging and blood vessels are not relaxed to increase the blood flow. Acupuncture increases blood perfusion and reduces skin aging Acupuncture is used to treat many conditions in China. Its mechanism is based on meridian theory which is not accepted by Western medicine theory. Recent years researchers are trying to find how acupuncture works from a scientific aspect. Many research data suggested that acupuncture improves blood perfusion. For example, there was a study of acupuncture on 140 healthy volunteers. In this study, acupuncture was applied in LI4’ skin blood flow was measured

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

What is hormone? Hormones are produced in the endocrine glands. There are many endocrine glands in the body, such as the pituitary gland, thyroid, adrenal glands, and pancreas, testis in men ad ovaries in women. These glands produce specific chemicals and these chemicals act on the target organs and play a role in body function such as growth, metabolism, sexual function, reproduction and mood etc. Hormones are powerful molecules and only a tiny amount can cause big changes in the body. Too much or too little hormones can cause serious conditions. For example, if ovaries don’t produce enough hormones ie oestrogen and progesterone, it can cause infertility. If pancreas does not produce enough insulin, it can cause diabetes. Hormonal balance is very important to the health. If the hormones are not balanced, there are many signs to indicate. Irregular periods and spotting, Women in reproductive ages have regular periods. If the periods are not regular, or there are spotting between