Acupuncture and Nutrition Clinic – Houston

One of my patients recently needed gum surgery and was in a lot of pain after the procedure. Her dentist prescribed pain killers but my colleague said that she did not like to take medications. I offered her an acupuncture treatment and during the treatment she said that felt significantly more comfortable, relaxed and had less pain. I spoke to her a couple days later and she said that the day after acupuncture she had minimal dental pain and was able to avoid taking pain medication altogether. I was glad that the acupuncture treatment had been so helpful and I decided to take this opportunity to do some research regarding this subject since it appears that most Americans are unaware of acupuncture’s effectiveness for dental pain.

Research regarding acupuncture for the treatment of dental pain appears to have started in the West in the early to mid 1970’s but has been a part of Chinese medicine for centuries. Most research in the west found acupuncture to be effective for dental pain, as well as for temperomandibular joint pain (TMJ) and post surgical dental pain. Two important review articles that are still referenced today concerning dental pain and acupuncture were published in 1998 by Ernst & Pittler and in 2002 by Ted Kaptchuk. The investigators from these two review articles found that out of sixteen acupuncture trials for the treatment of dental pain, twelve of these trials had adequate methodology and concluded that “good evidence exists that acupuncture is effective for relieving dental pain.”

In my practice I have found acupuncture to be helpful in managing dental pain. Many patients have described acupuncture to be effective in minimizing acute dental pain and others have acquired pain relief while waiting for their dentist to perform a root canal. You may wish to consider acupuncture for post surgical dental pain especially if you are sensitive or allergic to analgesics or like my colleague, prefer to avoid pain medications altogether. Try using plain clove oil for tooth pain or our mouthwash formula made from Chinese herbs that is helpful for gingivitis, mouth sores and thrush.

References

• 1. Ernst E, Pittler MH: The effectiveness of acupuncture in treating acute dental pain: a systematic review Br Dent J 1998, 184:443-447
• 2. Ernst E, White AR: Acupuncture as a treatment for temporomandibular joint dysfunction. A systematic review of randomized trials Arch Otolaryngol Head Neck Surg 1999, 125:269-272
• 3. Kaptchuk, T: Acupuncture: Theory, Efficacy, and Practice. Ann Intern Med. 2002; 136:374-383.
• 4. Lao, L., Bergman, S., Hamilton, G., Langenberg., Berman, B., Evaluation of acupuncture for pain control after oral surgery, a placebo controlled trial. Arch Otolaryngol Head and Neck Surg. 1999; 125:567-572.
• 5. Rosted P. The use of acupuncture in dentistry: a review of the scientific validity of published papers. Oral Dis. 1998;4:100-4.

What to do when someone has multiple areas of pain? Fibromyalgia is a good example of pain, aches and muscle soreness all over the body and/or at multiple joints. I recently had a patient come in with back pain, sciatica pain, knee pain, hip pain and neck and shoulder pain. The frequent question being is can more than one area of pain be treated at one time?

Another patient recently reported “I tried acupuncture many, many years ago. It’s probably about 15 years ago. It didn’t seem to do much for me at that time. Since then I’ve tried chiropractic, physical therapy, including epidurals. Epidurals helped me for about a year, but when I took it the second time around it wasn’t much help. So I was wondering if there had been any change in the treatments which could help the pain.”

I told this man that there are variables that can affect outcome. The main variable is how long a patient has had a certain condition. The longer it’s been around, the longer it usually takes to resolve, especially if one wants to do it gently and naturally without the use of drugs or shots. Patients typically come to my office when Western medicine can no longer help beyond giving drugs to alleviate the pain. Many patients do not like the efffects that pain medication or steroids have on their bodies.

Also, with regard to prior experiences with acupuncture, outcomes can be influenced by frequency, proximity of repeat treatments and duration of treatments. For long standing problems, it may not be unusual to need 20 or more treatments. One of my teachers, Dr. Tan, explains acupuncture treatments this way. “Acupuncture is like a therapy. The treatments build on each other over time.” When my patients tell me they feel better after the first treament, I am honest with them and tell them it’s a very good sign they responded so quickly, but “what I can’t promise is how long this treatment is going to hold.” Like chemotherapy or psychotherapy, the treatments build on each other for maximum effectiveness.

Also, one much take into account their age, lifestyle, daily actitivies, exercise, diet and stress. These all affect how the body heals.

So, back to the issue of multiple areas of pain. When there are so many areas that have pain I can either chase the pain and put needles all over the areas of pain or try to come up with a strategy that can efficiently move energy all over while still targeting some areas of pain. So many areas of pain makes me think of Times Square in NYC at rush hour. All lanes in all directions are backed up, everyone’s honking and nothing is moving. My typical approach to this is to create energy flow all over the body and then see what pain is left over. It’s called a global treatment and moves energy at the various levels that it flows in the body.

Because the channel system is a closed circuit system, it’s easy to move all twelve channels with just a few needles. Once energy is moving smoothly, there is less pain and then I will be more inclined to do a targeted treatment of the pain that is left over.

A common question people ask is if I can help with pain that’s been around for many years. I recently received a call asking if acupuncture could help a man who had a twenty year history of back pain. He reported the pain as being on and off over the years until the last two years when it has become more of a chronic problem.

When I hear that a patient has had pain for 20 years on and off, it makes me think of a smoldering flame waiting for a gust of air which then fans the fire (increased pain). I usually ask about the history of auto accidents, falls or physical traumas. Especially when the diagnostic tests such as MRI’s or X-Rays are inconclusive and there is no apparent problem beyond general aging issues with the lumbar vertebrae.

When there has been a history of physical trauma like a serious fall or accident when younger, the tendency is usually to brush it off, especially if all that is felt is a little soreness and achiness. When young, active and busy, life keeps going without paying much attention to general aches and pains. Those aches and pains get better, but perhaps not completely and they smolder just under the surface as the aging process continues. And then 20 years, even 30 years later, all of a sudden, there is a flare up and increase in pain and no recent memory of what could have caused the pain. Sometimes its hard to find an apparent reason for the pain. In reality, the area that was hurt many years before ends up coming back to haunt if it’s not properly addressed at the time of the initial accident. Sometimes all it takes to fan the flame years later is a awkward move or stress and then there’s a flare-up.

The first thing to do when the pain is severe is to go the doctor. You want the diagnostic tests to rule out anything serious and/or to get an idea of what is going on with the low back or area of pain.

When I asked my patient about the diagnostic test results he said “the best they can tell is I got a problem with my L3-4 and L4-5, those discs.”

Lumbar disc problems are the most common cause of low back pain that I see in the clinic. Lumbar 3, 4,5 and the first sacral disc are the usual culprits. Sometimes you get your mid back pain in your thoracic spine area but when it comes to low back pain, that’s really where most of the problem is, quite often from a fall or accident. Frequently when there is no obvious source of pain the doctor will tell the patient it’s age associated arthritis.

So what would I do if you came in with this type of complaint? I would take a history and get a sense of where the pain is. Does it radiate out to your side or to your hip? Does it go down your leg? Does it go down the side of your leg or the back of your leg or is still pretty much located in your low back and buttocks area? Once I have a pretty good idea of the channels that are affected, I will come up with a strategy of points to treat the problem.

Over the years I have received extensive training in various styles of acupuncture. One of the methods is called the Balance Method. In general, the needles rarely get put in at the location of the pain. I will identify the painful channels or meridians and then treat areas opposite and farther away but that have a relationship with the channel(s) that have pain. For example, if the pain is on the lumbar spine and across the low back, I might put some needles in the back of your head to treat the end of the channel where the lumbar pain is and where it mirrors your lower vertebral column. I might also put some needles in your opposite shoulder and upper arm to mirror the buttock or low back or on the hand, behind the knee or side of the ankle that correspond to the channel of pain.

Then we can play show-and-tell and have you move in a way that usually causes pain. We then see what happens to the pain. In the majority of cases, there is relief on the table.

I can generally tell within four to eight treatments if I can help you. I won’t have you come for six months and say, “Oh, by the way, this isn’t working.” I’m pretty clear in terms of being able to help a patient. If a patient is not getting any relief between four and eight treatments, then sometimes surgery is required or another set of diagnostic tests to see if something was overlooked. I have sent patients to a neurosurgeon or for another MRI or X-ray if there’s no relief. I can usually tell by how the patient responds to the acupuncture if this modality is a right fit.

This was a call from one of my monthly radio shows taking call in questions.

“I would like to ask the Acupuncture & Nutrition Clinic if they can help my husband. He is 67 years old and has a lot of hip pain. He is still very active and very much works 40 or 60 hours a week. The pain radiates down the side of his leg into the knee area. Do they think that they might be able to help that?”

Our response: “We treat a lot of hip, low back and sciatic type pain. Pain down the side of the legs does sound like a type of sciatica that’s coming from the low back, maybe the hip. We do treat a lot of sciatica at our clinic. The usual location of needles would be on the opposite shoulder. We would actually needle various joints of the shoulder because that mirror-images the hip and then down the middle of the upper arm to the elbow which would mirror the knee. Once the needles are in we would ask him to move in a way that normally would elicit pain. If it’s better, then we’ve done our job well. If not, we need to go back and reassess our diagnois of the channel problem. Sciatica down the side of the leg is actually a very treatable condition.”

We frequently tell patients to remember that acupuncture is like a therapy: chemotherapy or psychotherapy. The treatments build on each other until the body is able to maintain the “re-routed” circuitry. If someone has had a condition for 20 years, it’ going to take more than a few treatments to make it better. It’s good to be realistic in those expectations.

Even if you think about one month of treatment per year. Obvioiusly that’s a lot of treatments and its doubtful that many treatments would be necessary. But the take home message is about being patient and recognizing that Chinese medicine is a gentle form of medicine that nudges the body to work in a way that it used to know how to do. There is memory. Once you really promote healing in the area that’s hurting or diseased, the body will respond in the majority of cases.

I frequently have patients who experience neuropathy, numbness, pain and tingling in their feet.

Neuropathy is a fairly common problem that many acupuncturists see. Either with or without diabetes. I have found that treating the pain and burning of neuropathy is usually faster than treating the numbness. However, many of my patients, sometimes even after the first treatment, notice reduction in the shooting pain, and get some feeling back in their feet.

Of course, reducing or eliminating the pain of neuropathy is a great relief. Many patients complain that much of the pain tends to be worse at night. Once the pain and burning is gone, there is eventual improvement with the numbness. In my experience, numbness takes longer to treat. Although the numbness associated with neuropahty takes time to treat, acupuncture concurrently provides indirect benefits to the whole person. Some of those additional benefits include improved energy, better sleep, a sense of calm, relaxation and overall experience of well-being.

I’ll tell a quick story about my dad. He had come to visit while I was still in school studying Chinese medicine. He shared with me that he was experiencing some neuropathy, mainly numbness on the bottom of his feet. He told me that he’d been to the best doctors and they all said, “There’s nothing that we can do for you. It’s just the way it is.”

At that time, I said, “You know, Dad, from my studies, I’ve heard that acupuncture might help stimulate some of the nerve endings and bring some feeling back to your feet. Why don’t I just take you to one of my professors?” And after one treatment, he got some feeling back in his toes, especially in his big toe which is an important toe if you’re going to be driving or doing a lot of walking. So, he had been given “that’s it” type of storyline from the doctors and he got some feeling back in his toes after one treatment. I find that’s the case with many of my patients.

A patient I had previously treated for back pain came to see me a couple of weeks ago. It had been more than three years since her last visit where she had reported feeling great. Since I had not seen her for quite a while, I had assumed no news is good news. Not the case.

At the time of her first visit back, she told me she was having horrible hot flashes and sweating (making her hair curl), constant stomach pain, diarrhea, (six times a day for six years). In addition, she was extremely anxious, not sleeping well, and quite frankly, sick and tired of being sick and tired.

This patient reported she had forgotten how well she felt after her last experience with acupuncture. When her stomach pain became overwhelming she did the right thing by going to her medical doctor to try and figure out what the problem could be. She went through all the possible medical tests at their disposal to find that there was no Western understanding of her stomach pain. After numerous attempts at finding the cause, she remembered the last time she felt better. She couldn’t believe she had actually forgotten.

But that’s really ok. Because you do want to rule out anything serious. Western medicine is the best in the world for diagnostics. Once everything serious had been ruled out (ie cancer, especially since she is a three time cancer survivor) it made smart sense for her to come and try acupuncture again.

It was clear to me that her stomach pain was directly affected and exacerbated by her anxiety. In Chinese medicine there is a direct link between liver channel issues and digestive issues. (There is no real equivalent in Western medicine, so doctors usually prescribe anti-depressants). So I treated her anxiety issues which was in part causing her epigastric pain. That is called treating the root to treat the branch (symptom). In addition, I treated the symptom which alleviated her diarrhea and part of the root problem. She has been diarrhea free for 2 weeks and has had her stomach pain reduced by almost 50%.

I asked her if she would be willing to share her story with you. She sent me the following almost immediately as she has been so pleased with her progress.

I am a very lucky lady! After 6 years of severe, unexplainable stomach pains, 6 doctors, 6 endoscopies and colonoscopies, too many pills to list and no one else to see to find a solution, I sought out the Acupuncture & Nutrition Clinic as a desperate attempt to get help for this severe pain. I had used the Acupuncture & Nutrition Clinic for back pain 3 years earlier and knew that they not only listened, was caring and compassionate, they had completely relieved my back pain. They listened yet again, asked many questions and started to work their magic. We are in our second week of treatment and the pain has already started to subside. For the first time in 6 years, I feel good. Not only is my stomach pain much better, everything feels better. My anxiety has lessoned, my back feels great, my mind is clear and my physical health seems to be much better. Had I not gone to 6 doctors with no relief, I wouldn’t have believed that they could help me this fast. The most amazing part is that everything feels better. There is nothing more important than health and this is exactly Acupuncture & Nutrition Clinic’s philosophy. The better I feel, the happier they feel for me. They truly care and want to help. They are so positive, so reassuring, so compassionate and the best part, it’s painless! I actually like those little needles now. I have learned that they are my friend! I am forever grateful to have found the Acupuncture & Nutrition Clinic and I will continue to go twice a week until I feel that the pain is completely gone. When this happens, I will continue to go back for maintenance forever! Life and my health is so much better because of Acupuncture & Nutrition Clinic! I am a lucky lady! ~Dana~

Over the past few months I have seen a significant number of patients with sciatica pain that radiates down either the back of the leg or the side of the leg. I have a pretty good success rate treating sciatica, either with or without accompanying low back pain. However, I can also usually tell within a few treatments whether acupuncture will solve the problem or manage the pain sufficiently. Quite frankly, people come to me to avoid back surgery and a common question is whether or not I think they will need surgery.  The type of acupuncture I do allows me pretty quickly to tell whether or not they need to go back to the neurologist for a re-evaluation.

If there is pain relief on the table and when walking out of the office, the chances are pretty good that acupuncture will work for them. If there is still pain at the next visit, but the intensity, duration, frequency or location of pain is less, then we are on the right track. The patient is usually already more energetic and hopeful due to better sleep and movement with less pain. However, if the pain returns to its original level with no change within 4-6 treatments, it usually means there is a ruptured disk or equivalent. Surgery will more than likely be required.  For those who are not surgical candidates, acupuncture might help reduce the pain to a more manageable level over an extended period of time.

Just this past week I had a man come in who has suffered with sciatica pain down the back of his leg for a few months. A friend suggested he try acupuncture. After the first treatment I was pretty sure he needed to see a medical doctor although the xrays he had were inconclusive. Because his pain was so intense with little relief after the treatment, I referred him to an orthopedic doctor and a neurologist and suggested he go to the one who could see him first. He called a few days later saying he indeed needed surgery for a ruptured disk.

The good news is that most of the patients who come in get relief.  One of my favorite sciatica stories is of a woman who had been plagued by leg pain down the side of her leg for twelve (12) years. She had stopped traveling, was unable to play with her grandchildren and was in chronic pain. After 5-6 treatments, her pain was significantly reduced and within a few months she was pain free. She has since traveled abroad and within the U.S., plays with her grandchildren and has a full life of movement without pain. She still comes in for maintenance treatment every few months. She has been virtually pain free for 4 years.