By the time I began the study of acupuncture, in 1992, I had already been leading herb walks for twenty-four years. I wasn’t too sure if I really wanted to be sticking sharp needles in people, but the study of acupuncture was a requirement in California (and many other states) to obtain a license to practice Traditional Chinese Medicine (TCM). In many states, this license gives similar legal status to physicians, allowing the practitioner to order medical tests for their patients, accept many kinds of insurance, and order worker’s compensation. Recently, the California legislature passed Senate Bill 341, and Governor Davis signed it into law. The bill more clearly defines the “scope of practice” for California practitioners of Oriental medicine and acupuncture, stating, in effect, that licensed practitioners can prescribe “nutrition, diet, herbs, plant, animal, and mineral products, and dietary supplements,” as well as “heat, cold, and magnets” to help prevent and reduce the symptoms and ailments of their patients. Other states have similar laws, and I expect the practice of Oriental medicine to make further headway in these states. Clearly, acupuncture has come a long way since the first demonstrations were performed in the United States in the early 1970s.
When I went to China to study acupuncture and herbal medicine, I saw the insertion of needles used for the treatment of numerous symptoms and diseases, including cancer, gastritis, epilepsy, and all manner of pain syndromes, especially lower-back pain. Acupuncture is especially suited for the reduction of pain—it stimulates nerves, inducing a local immune response to promote healing and reduce inflammation, and interacts with pain and sensory nerves.
After studying with some fine acupuncturists and observing surprisingly good results in my clinical practice, I have come to the conclusion that acupuncture really works well for some conditions. I often combine acupuncture with electroacupuncture, moxibustion, hot and cold therapy, polarity therapy, and the application of herbal oils and compresses.
For most conditions, especially chronic ailments such as chronic fatigue syndrome, hepatitis C, or irritable bowel syndrome, I always combine the treatment with herbal formulas. The herbs work well with acupuncture to help direct the vital energy of the body where it is needed, or to relieve symptoms such as nausea or headaches by improving the health of internal organs.
Recent statistics show that one out of five adults in the United States will have lower-back pain at some point in their lives. Acupuncture is becoming a major treatment for back pain in many countries, and a recent meta-analysis of twelve controlled studies supports the effectiveness of acupuncture in the treatment of back pain.
I’d like to tell you about two particular patients I’ve had that came in with lower-back pain to illustrate how “excess” types and “deficiency” types are treated.
Two different cases
Doreena came into my clinic with chronic lower-back pain that she had lived with for many years. She looked tired and worn out, and she told me that she really had to drag herself out of bed in the morning. I looked at her tongue and it was completely free of the normal thin white coating a healthy tongue should have. The tongue body was very red and her pulses were thin and “deficient.” As I questioned Doreena, it became clear that the back pain was usually worse if she got up and exercised or stretched. This limited her movements and even normal daily activities such as shopping.
Mike came in with lower-back pain that got better with movement and stretching, and worse when he sat for long periods of time. He told me that he had to get up at halftime during his weekly football game and go outside and walk and stretch. He had trouble sitting at work and had to take frequent breaks to stand and stretch. Mike’s tongue was normal, or with a slight yellow coating toward the back. His pulses were “tight.” I could feel underlying tension. Mike had a classic case of back pain due to stagnation. Generally, he had an excess condition.
According to TCM principles, excesses are “reduced” or drained away with draining techniques. Certain needle techniques allow the practitioner to reduce the excess and relieve the stagnation by invigorating the blood and qi (vital energy).
For pain due to underlying deficient conditions, on the other hand, the practitioner will “supplement” or tonify the qi so that it can move properly in the channels and meridians, which relieves the pain.
For Doreena, I prescribed a diet rich in protein and a fish oil supplement to reduce inflammation and strengthen her muscles, tendons, and ligaments. High-carbohydrate diets often provide short-term relief of pain and fatigue, but in the long run will worsen deficiency conditions.
For Mike, I recommended a diet high in fiber, fruits, and vegetables to help with elimination of toxins and other pro-inflammatory wastes.
Tonifying or restoring good vital energy for people with deficiency is always more difficult than resolving excess conditions, and it usually takes more treatments over a longer period of time. I tell my patients to expect at least three months of treatments for deficiency types of pain syndromes. Excess syndromes can sometimes be resolved within a week or two.
Mike came into the clinic once weekly for three weeks. His treatment consisted of needle insertion in the “4 gates,” a great needle prescription to help calm and open his liver and reduce pain. I also needled points on his lower back and around his sacrum, with excellent results. For faster results, I applied electricity between sets of needles. This causes the muscles to contract rhythmically, releasing the stagnation and quickly reducing pain. Although Mike said it felt “very weird,” he always came back for more. When I was in China, I watched the muscles in the lower backs of patients strongly contracting for thirty to forty minutes at a time as the patients groaned with the effort, so that one would assume they would never come back. But at the end of the treatment, they gave us a big smile and got off of the table. Two days later they were in again for another treatment.
I treated Doreena for more than one year, often twice weekly. She steadily improved, and was literally a test case for any new treatment I wanted to try, including moxibustion, herbal compresses, herbal oil massage, and hydrotherapy. She was interested in finding anything that could help reduce the pain and discomfort and strengthen her back. I needled points in her lower back, along the spine. These are called back shu points, and besides strengthening the lower back, moving the blood and qi, and relieving pain, the points also have a beneficial effect on the kidney, spleen, and liver systems. The shu points are often needled and then small pieces of moxibustion are placed over the needles and ignited to produce heat and smoke. This is thought to warm the area and promote the circulation of blood and qi, speeding healing.
Acupuncture and pain
I tell patients to consider acupuncture for any kind of pain, including back pain, neck pain, shoulder pain, and knee pain. I have seen very good results with knee pain. Many types of injuries respond to acupuncture, including sprains and strained or torn muscles, tendons, or ligaments. Treatments for these ailments usually work quickly, within a day or two to a week or two. As a generally strengthening treatment, acupuncture is helpful, along with herbs and diet, for many chronic ailments, including irritable bowel syndrome and arthritis.
The fear of needle pain sometimes keeps people away from the acupuncture office. Surprisingly little pain is felt when the acupuncturist has a lot of practice and is skilled at inserting the needles. Small-gauge needles can also be used for sensitive individuals. In my experience, these needles cause very little sensation.
Christopher Hobbs’s case studies are gleaned from his thirty years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the new correspondence course Foundations of Herbalism. Visit his website at www.christopherhobbs.com.
“Case studies” is not intended to replace the advice of your health-care provider.