There are many different styles of acupuncture. Depending on the practitioner, they may gravitate towards a more energetic approach to treatment or they may utilize a musculoskeletal based approach. Most acupuncturists integrate the two styles while a practitioner utilizing only dry needling would avoid a holistic energetic approach.

The term dry needling came about as a way for other practitioners to utilize the benefits of acupuncture (needling into musculature) without having to become an acupuncturist.

Now of course, a non-acupuncturist pain therapist providing dry needling to treat back pain isn’t going to look at your tongue, feel your pulse, or ask questions about your urinary bladder meridian because they are only using the needles with one intention - to affect local tissue and musculature.

The term “dry needling” is relatively new compared to the ancient history of Chinese medicine. It refers to the fact that the needles are not inserting any fluid into the body, they are “dry”. The needles used in your acupuncturist’s office are the same needles used for dry needling in your physical therapist’s office. If your acupuncturist is looking through their “anatomy lense” during treatment they are inserting these needles into trigger points and motor points, just like other professionals providing dry needling. In Chinese medicine we like to call these areas of needle insertion "ashi points".

For the purpose of pain relief and injury healing, dry needling is a technique adapted from an orthopedic style of acupuncture. The difference lies in the accompanying modalities and techniques.

Acupuncture is currently one of the most widely studied medical interventions, and much of the literature used to justify the clinical legitimacy of dry needling is drawn from acupuncture research studies. As of now, there are no objectively determined standards of education, curriculum and national examination in place for dry needling and there are no standards for clinical mentorship.

If you would like to read more about clarifying the myths and misinformation around dry needling and acupuncture, visit the American Society of Acupuncturists at www.ASAcu.org

This article by has been taken directly from the incredibly educational website www.evidencebasedacupuncture.org. There is a plethora of information about acupuncture research on their website if you're interested in taking a look. 

                               ACUPUNCTURE FOR PAIN, AN EVIDENCE BASED SUMMARY

PAIN IS A GLOBAL PROBLEM
Over 1.5 billion people worldwide suffer from chronic pain. Nearly one third of American adults experience chronic pain, and almost one in five surveyed Europeans indicated they have moderate or severe chronic pain. The three most common sources of chronic pain are low back pain (29%), neck pain (16%), and severe headache or migraine pain (15%).

PAIN CAN BE ACUTE OR CHRONIC
Acute pain warns you that you have been hurt. It starts suddenly, and when the injury heals, the pain stops. In acute injury, the pain is due to pressure from inflammation in the tissues and nerves at the site of the injury. This inflammation leads to the swelling that is observable and is part of the body’s healing response.
Chronic pain continues after the injury has healed, lasting for weeks, months, even years. In chronic injury, nerve signals that were active during acute injury continue to send messages that the body is in pain. Although chronic pain is not completely understood, it is potentially due to nerves that have become damaged. New research also suggests that chronic pain can come from a malfunction in the way the brain ‘maps’ sensory information.

PAIN AND QUALITY OF LIFE
Nearly two-thirds of people with chronic pain report problems sleeping. Lack of restorative sleep often makes the pain worse, thus resulting in a frustrating cycle of pain and sleeplessness. Unrelieved pain can result in longer hospital stays, increased re-hospitalizations, increased outpatient visits, and decreased ability to function, leading to lost income and insurance coverage. In addition to the financial burden that comes with chronic pain, the emotional costs to patients and family can be high as well.
Chronic pain constitutes a tremendous expense to employers in healthcare and rehabilitation costs, and lost worker productivity. Migraine is the 3rd most prevalent disease on the planet and a 2015 study showed that headache pain was the most commonly attributed cause of lost productive time at work in the U.S.

ACUPUNCTURE IS EXCELLENT FOR PAIN
Acupuncture is widely known for its effectiveness in the treatment of pain. Its unique role in reducing suffering in patients experiencing pain is one of the main reasons it has become so popular around the world. The research is plentiful on the effects of acupuncture on specific painful conditions, as can be seen throughout evidencebasedacupuncture.org. For acute pain, a systematic review of 13 trials found that acupuncture was more effective than both sham needling and injection with painkillers.
For chronic pain, in the largest study of its kind to date, 454,920 patients were treated with acupuncture for headache, low back pain, and/or osteoarthritis in an open pragmatic trial. Effectiveness was rated as marked or moderate in 76% of cases by the 8,727 treating physicians. In a 2-year retroactive survey of over 89,000 patients published in 2016, 93% of patients said that their acupuncturist had been successful in treating their musculoskeletal pain.
A meta-analysis of 17,922 patients from randomized trials concluded, “Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo.” A follow up study with this data looking at long-term pain relief, found that the benefits of acupuncture persisted 12 months after treatment ended.
Another study in the journal, Current Opinion in Anesthesiology, in the paper titled ‘Acupuncture for Chronic Pain: an Update and Critical Overview’ concluded that “mounting evidence supports the effectiveness of acupuncture to treat chronic low back, neck, shoulder, and knee pain, as well as headaches. Additional data are emerging that support the use of acupuncture as an adjunct or alternative to opioids, and in perioperative settings.”

Again, 93% of 89,000 patients reported successful treatment for musculoskeletal pain with acupuncture            (American Specialty Health 2016).

HOW ACUPUNCTURE WORKS FOR PAIN
The mechanisms underlying how acupuncture is so effective for treating pain have been researched extensively for over 60 years. While there is still much left to learn about acupuncture mechanisms and the human body in general, the neural pathways from acupuncture point stimulation, to the spinal cord, to the deactivation of the pain centers in the brain, have been mapped. Acupuncture has been demonstrated to activate a number of the body’s own opioids as well as improving the brain’s sensitivity to opioids. A number of other biochemicals involved in pain reduction have been found to be released or regulated by acupuncture stimulation, including ATP and adenosine, GABA and substance P.

In the context of ineffective and often dangerous pharmaceutical options for pain, acupuncture represents a safe and effective alternative with a long track-record of successful use.

BY RUSSELL, D. L.Ac, CMT, DNBAO & HOPPER KOPPELMAN, M. DAC, MSC, MSC
​
​References:
1. National Center for Health Statistics (2006) Health, United States, 2006 [Online] Available from: https://www.cdc.gov/nchs/data/hus/hus06.pdf [Accessed 12 Sept 2017].
2. Johannes, C. B., Le, T. K., Zhou, X., Johnston, J. A., & Dworkin, R. H. (2010). The prevalence of chronic pain in United States adults: results of an Internet-based survey. The Journal of Pain : Official Journal of the American Pain Society, 11(11), 1230–1239. https://doi.org/10.1016/j.jpain.2010.07.002
3. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;13:287–333. doi: 10.1016/j.ejpain.2005.06.009.
4. National Center for Health Statistics (US. “Health, United States, 2016: with chartbook on Long-term trends in health. Hyattsville, MD. 2017.”
5. Moseley, G. L., & Flor, H. (2012). Targeting cortical representations in the treatment of chronic pain: a review. Neurorehabilitation and neural repair, 26(6), 646-652. DOI: 10.1177/1545968311433209
6. Fried, N. T., Elliott, M. B., & Oshinsky, M. L. (2017). The Role of Adenosine Signaling in Headache: A Review. Brain Sciences, 7(3). https://doi.org/10.3390/brainsci7030030
7. National Center for Complementary and Integrative Health (2015) NIH Analysis Shows Americans Are In Pain. [Online] Available from: https://nccih.nih.gov/news/press/08112015 [Accessed 12 Sept 2017]
8. The CHP Group (2014) The Cost of Chronic Pain:How Complementary and Alternative Medicine Can Provide Relief. [Online] Available from: https://www.chpgroup.com/wp-content/uploads/2014/12/CHP-WP_CAM-Chronic-Pain_Sls_12.12.2014.pdf [Accessed 12 Sept 2017].
9. Abdel Shaheed, C., Maher, C. G., Williams, K. A., Day, R., & McLachlan, A. J. (2016). Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 176(7), 958–968. https://doi.org/10.1001/jamainternmed.2016.1251
10. Krebs EE. Effectiveness of opioid therapy vs. non-opioid medication therapy for chronic back & osteoarthritis pain over 12 months. Inannual meeting, Society for General Internal Medicine, Washington DC 2017.
11. Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452. DOI: https://dx.doi.org/10.15585/mmwr.mm655051e1
12. Schuchat, A., Houry, D., & Guy, G. P. (2017). New Data on Opioid Use and Prescribing in the United States. Jama, 318(5), 425–426. https://doi.org/10.1001/jama.2017.8913
13. Deyo, R. A., Korff, Von, M., & Duhrkoop, D. (2015). Opioids for low back pain. BMJ (Clinical Research Ed.), 350, g6380. https://doi.org/10.1136/bmj.g6380
14. Motgahre, V. M., Bajait, C. S., & Turankar, A. (2016). Prescription pattern and adverse drug reaction profile of drugs prescribed with focus on NSAIDs for orthopedic indications at a tertiary care hospital. Skin. https://doi.org/10.18231/2393-9087.2016.0007
15. Bally, M., Dendukuri, N., Rich, B., Nadeau, L., Helin-Salmivaara, A., Garbe, E., & Brophy, J. M. (2017). Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ (Clinical Research Ed.), 357, j1909–13. https://doi.org/10.1136/bmj.j1909
16. Cai, S., Garcia Rodriguez, L. A., Masso-Gonzalez, E. L., & Hernandez-Diaz, S. (2009). Uncomplicated peptic ulcer in the UK: trends from 1997 to 2005. Alimentary Pharmacology & Therapeutics, 30(10), 1039–1048. https://doi.org/10.1111/j.1365-2036.2009.04131.x
17. Bally, M., Dendukuri, N., Rich, B., Nadeau, L., Helin-Salmivaara, A., Garbe, E., & Brophy, J. M. (2017). Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ (Clinical Research Ed.), 357, j1909–13. https://doi.org/10.1136/bmj.j1909
18. Xiang, A., Cheng, K., Xu, P., & Liu, S. (n.d.). The immediate analgesic effect of acupuncture for pain: a systematic review and meta-analysis.
19. Weidenhammer W, Streng A, Linde K, Hoppe A, Melchart D. Acupuncture for chronic pain within the research program of 10 German Health Insurance Funds–basic results from an observational study. Complementary therapies in medicine. 2007;15(4):238-46.
20. American Specialty Health Incorporated Health Services Department. (2016). Acupuncture: Does Acupuncture Provided Within a Managed Care Setting Meet Patient Expectations and Quality Outcomes?, 1–12.
21. Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., MacPherson, H., Foster, N. E., et al. (2012). Acupuncture for Chronic Pain. Archives of Internal Medicine, 172(19), 1444. https://doi.org/10.1001/archinternmed.2012.3654
22. MacPherson, H., Vertosick, E. A., Foster, N. E., Lewith, G., Linde, K., Sherman, K. J., et al. (2016). The persistence of the effects of acupuncture after a course of treatment. Pain, 1–22. https://doi.org/10.1097/j.pain.0000000000000747
23. Yin, C., Buchheit, T. E., & Park, J. J. (2017). Acupuncture for chronic pain: an update and critical overview. Current Opinion in Anaesthesiology, 1. https://doi.org/10.1097/ACO.0000000000000501
24. Longhurst, J., Chee-Yee, S., & Li, P. (2017). Defining Acupuncture’s Place in Western Medicine. Scientia, 1–5.
25. Zhang, Z.-J., Wang, X.-M., & McAlonan, G. M. (2012). Neural Acupuncture Unit: A New Concept for Interpreting Effects and Mechanisms of Acupuncture. Evidence-Based Complementary and Alternative Medicine, 2012(3), 1–23. https://doi.org/10.1016/j.brainresbull.2007.08.003
26. Harris, R. E., Zubieta, J.-K., Scott, D. J., Napadow, V., Gracely, R. H., & Clauw, D. J. (2009). Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on μ-opioid receptors (MORs). NeuroImage, 47(3), 1077–1085. https://doi.org/10.1016/j.neuroimage.2009.05.083
27. Zhao, Z.-Q. (2008). Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology, 85(4), 355–375. https://doi.org/10.1016/j.pneurobio.2008.05.004

By Allison France

With the early arrival of winter our bodies are just as confused as our minds. While we know you are already wearing scarves, supplementing zinc and drinking ginger tea we wanted to give you one more trick that may help your immune system navigate cold season. 

Yin Qiao San is an herbal formula used in Chinese medicine to prevent an external pathogen (ahem, a cold) from taking root in the body and forcing you to surrender to the couch. It is imperative to take this formula the moment the first sign of illness arrives; the dry or scratchy throat that makes you run for a double dose of vitamin C or the fatigue that seems to hit out of nowhere when you notice those around you are also battling fatigue and extra runny noses.

This formula comes in pill form, tea or a liquid tincture. We often recommend the liquid tincture because it is easy to carry outside the house and somewhat soothing to the back of the throat. The flavor is a bit strong so it’s best to chase with water, but once you realize how effective it is at keeping colds at bay, you won't mind the taste. Our recommendation is to keep a bottle on hand in your vitamin cabinet so you don’t have to rush over for an appointment to pick it up. The trick to this formula is catching the symptoms before they take root and fully manifest. The herbs in this formula clear heat and therefore are best for the cold symptoms that include sore throat, headache, thirst and fever. Although it’s called a cold, we’re really look for those symptoms that are manifesting as heat in the body. 

If you aren’t feeling well but don’t have any of the above heat symptoms you’ll need a different formula. Chinese herbs work in concert with one another to treat the root pattern underlying the presenting symptoms, therefore there is no one formula that treats “sore throats” or “headaches”. Instead, the formula must be matched with a variety of symptoms that are indicating a specific underlying pathology. In the case of this formula, it can generally be used for colds that are accompanied by symptoms of heat and dryness. 

Ask about Yin Qiao San at your next appointment with either Andrea or Allison or schedule an herbal consult if you would like some more information on Yin Qiao San and to stock up for the next 5 months of cold prevention that we have ahead! Be well.  

By Andrea Rivera
​
Patients often have extra curiosity or surprise when I insert needles into their ears. “Why do you put needles in the ear?”  For practitioners, it’s just another area of the body to utilize in treating our patients, the same as needling one’s leg, arm, face, or scalp. However, like scalp acupuncture, auricular acupuncture has its own unique theoretical basis as well as different developments and research compared to traditional body acupuncture. Both had their historical origins in ancient China. Technically, auricular acupuncture can be used alone to treat various conditions of the body. 

Body acupuncture is based upon a system of 12 meridians which run throughout the surface of the body as lines of energy force. The ear, however, is a self-contained microsystem that affects the whole body. When we treat the ear, we locate points on it based on an anatomical arrangement of the body onto the ear with the brain and upper portion of the head being on the lobe and the rest of the body following in order to the top of the ear. The body is imaged onto the ear in the fetal position, this makes the spine lie along the raised ledge of the ear, that ledge is called the antihelix.
 
This mapping of the body onto the ear was put into place by the pioneering work of Dr. Paul Nogier in France. I like the story so I’ll share what I’ve read. In 1950, Nogier was “intrigued by a strange scar which patients had in the external ear.” He found that the scar was due to a treatment for sciatica involving cauterization of the antihelix by a lay practitioner, Mrs. Barrin. The patients were unanimous in stating that they had been successfully relieved of sciatica pain within hours, even minutes, of this ear cauterization. Barrin had learned of this auricular procedure from her father, who had learned it from a Chinese mandarin. Nogier later stated “I then proceeded to carry out some cauterizations myself, which proved effective, then tried some other, less barbarous processes.” A simple dry jab with a needle “also led to the relief of sciatica if given to the same antihelix area, an area of the ear which was painful to pressure.” He had already studied the works of a French acupuncturist and was open to the use of acupuncture needles. From the low back area on the antihelix and further experimentation, the rest of the body was mapped onto the ear. 

The theories of what is happening during auriculotherapy are many. I tend to favor the endorphin theory (endorphins are natural pain relieving biochemicals, ear and body acupuncture have been found to raise blood serum and cerebrospinal fluid levels of endorphins). We can also look at innervation of the ear and see that branches of the trigeminal, auricular, occipital, and vagus nerve** run through the ear and by needling over (not into, let it be known we’re never needling into nerves, anywhere) the free nerve endings create communication with those nerves and what they control. 

How do we decide where to place the needles? We look for localized skin surface changes such as discolored areas, flaky skin, tenderness, or lowered skin resistance (electrodermal activity of the area is high) and this presents to the practitioner as a “soggy” area when pressed. These are the effects of micro-vasoconstriction. Heightened activity in specific sympathetic nerves leads to the regional reduction of blood circulation, which then leads to cellular damage in small areas of the skin that overlie the ear. A needle in these areas should then improve blood flow and balance that heightened activity. 

Although the ears can be just as sensitive to needling as areas on the body, most people report less nervousness and discomfort with ear acupuncture! I also find that once I get the ear needles in, the deep relaxing effects of the treatment really kick in.

Thanks for reading! 

**The vagus nerve is considered “the mind-body connector” and gives us that “gut feeling”. It influences eye contact, human emotion, and detects the unexpressed nuances of communication. It begins in the brain, traverses the head, down the spine, into ears, lungs, heart, liver, spleen, gallbladder, kidney, pancreas, intestines, reproductive organs, and the ureter. To affect the vagus nerve alone is a great reason to needle the ears!

Reference:
Oleson T. Auriculotherapy Manual: Chinese and Western Systems of Ear Acupuncture. 2nd ed. Los Angeles: Health Care Alternatives; 1998, p.1-25

​

By Andrea Rivera

We have a TDP lamp, and we love it!

The TDP (short for the Chinese word Te-Ding Dian-ci-bo Pu, Special Electromagnetic Spectrum) is the gangly looking contraption hanging out in our treatment rooms. It has also been referred to as a Far Infrared Mineral Lamp. As practitioners, we like to use the lamp over the areas of complaint or areas we think could benefit the most while acupuncture needles are in place. We like to think that the electromagnetic waves (the good kind) and heat it emits increases the efficacy of the needles as well. We may also use it before we massage trouble areas as a way to “pre-heat” the musculature. We are able to feel a softness in the tissues after they’ve been exposed to the lamp. The tissue becomes warm pliable putty in our hands. We generally keep it in one area for 15-25 minutes.

In our practice we apply our lamp most commonly to provide temporary relief of minor muscle and joint pain or stiffness. The TDP lamp is also able to reduce joint pain associated with arthritis, to induce an increase in local circulation where applied, and to relax muscles. It can also reduce muscle spasms, and aid in the healing of minor sprains and strains. This is the cut and dry of it. Where it came from and how it works is quite neat and a little complex, if you’re curious, read on.

The story goes that early in 1970's, an odd and interesting phenomenon was noted at a century-old ceramic factory in a rural area in China. This factory had extremely poor working conditions. The workers there stood in mud for much of the work day and the new production manager recognized these abject working conditions, becoming concerned that the workers would be troubled with arthritis and other related ailments due to these conditions. After some investigation, it was found that the side effects of standing in the mud were the opposite of the original concerns. They found that there was not a single case of arthritis among the workers. After interviewing elderly factory employees, the same findings were indicated: no residual effects of any kind were found among the people who had been employed at the factory. Upon a full-scale scientific investigation, scientists discovered a single anomaly: an electromagnetic reading in the far-infrared spectrum emanating from the kiln used to fire the ceramics. Analysis of a metallic slag in the kiln, accumulated over years of buildup, showed it was made up of 33 minerals. These minerals happen to correspond with 33 essential minerals in the human body, and when heated sufficiently, radiate far infrared energy exactly like the human body. Scientists worked feverishly to reproduce the effect in a portable device, resulting in the TDP lamp.

The key part of this lamp is its heat-treated black clay, which contains 33 different essential mineral elements for the human body. Most heat lamps use a common infrared bulb. When activated by a built-in electric heating element, the ceramic plate emits a unique spectrum of electromagnetic waves in the infrared range of 2 to 25 microns which is compatible with the bio-spectrum waves released by the human body. This allows for maximum absorption. The absorbed energy promotes microcirculation, metabolism, and strengthens the immune system as well as tranquilizes pain in the body. In China, the TDP Lamp is called a 'Miracle Lamp' because it does not give off any visible light and it has been widely used to treat over 100 chronic conditions.

According to Alternative Medicine Magazine, “Although the wave lengths of far infrared radiation (FIR) are too long for the eyes to perceive, we can experience its energy as gentle, radiant heat, which can penetrate up to 3.5 inches beneath the skin. Among FIR's healing benefits are its ability to stimulate inflammation, which is necessary for a period of time in order to heal injuries such as a pulled muscle. FIR also appears capable of enhancing white blood cell function, thereby increasing immune response and the elimination of foreign pathogens and cellular waste products. Additional benefits include the ability to stimulate areas of the brain which control the production of neurotransmitters involved in biological processes as sleep, mood, pain sensations, and blood pressure thus enhancing the delivery of oxygen and nutrients to the body's soft tissue and the removal of accumulated toxins by improving lymph circulation."

Many of our patients especially enjoy the lamp in the winter months, due to it’s deeply warming effect. We’ve even had a patient buy a lamp of her own after she found it to be incredibly effective in comforting her raynauds symptoms and surrounding muscle and joint pain. She found the TDP lamp to give her relief while a far infrared bulb was quite irritating and resulted in unwanted inflammation. It’s hard to say why she found that one is better than the other, perhaps the clay plate’s spectrum was easier for her to absorb. At any rate, we’re enjoying having one more effective tool in our toolbox and hearing the positive feedback from our patients.

Cheers to good old fashioned heat, electromagnetic waves, far infrared radiation, and mineral rich clay!

As many of you reading this know, I have been away on maternity leave for the past month. In honor of my return to the office, I am taking a moment to share a bit of my story. Of course I could write for days about Parker, my now one month old baby boy, but I will refrain from doing too much of that and focus on the bit that relates to Acupressure. But first, I will shamelessly share a photo... or perhaps two.

And with those out of the way, I can continue!

I went into labor hoping to avoid as much medical intervention as possible. Being an acupuncturist, it’s no surprise that I believe in the power of the body’s innate ability to heal and care for itself. This being said, I chose to deliver at a hospital where I could have access to any help that became potentially necessary. I have no regrets for this choice, and am beyond grateful for the nursing staff that helped me through the birthing process. But this post is about the incredible influence acupressure had on my experience. Acupressure is similar to acupuncture, but instead of using needles to access points on the body, firm pressure is applied.

The star of this story is LI4. Many of you know this point. If you’ve been to acupuncture it may have been used for pain or “stagnation” somewhere in your body. If you have headaches or menstrual pain there is a very good chance your practitioner included this point in your treatment plan. It stands for Large Intestine 4 and is located in the soft tissue between your thumb and pointer finger. Go ahead, pinch around in that area. Tender? It usually is.

Going into labor, I admit that I didn’t have much of a structured plan for how I would get through whatever mystery was lying ahead (this was my first pregnancy). I did however have a handful of acupuncture points for pain relief that I wanted my husband to know about. Being a good sport, he packed away my 20 page print out on “Natural pain relief techniques for childbirth using Acupressure” by Debra Betts and promised to read through it when we got to the hospital. As all procrastinators can relate to, the print out remained nicely folded in his hospital go-bag without ever making an appearance. But it didn’t matter - there was really only one point that seemed to be necessary in the heat of the moment.

LI 4.

I had a relatively short active labor, but had it not been for my husband pinching this point with all his might, I’m not sure I would have made it through without begging for an epidural. You see, I was part of the mere 10% or so of people who choose not to have an epidural in the hospital setting. Because of this point, I was able to achieve my goal. Nurses told me later that the epidural anesthesiologist rolled her eyes when she heard I was a first time mom hoping not to use pain medication. She said she’d give me about an hour before I was changing my mind. Again, if not for LI 4, she would have been right!

A skeptic would argue that pinching anywhere on the body could take the mind away from the pain of the contraction and therefore be helpful. Maybe... but after my experience I’d beg to differ. And for any of you that have experienced childbirth, it’s incredibly hard to imagine that a simple “pinch” could reduce the pain of pushing an 8 lb human through the birth canal. But alas, I’m here to tell you that it did. The few contractions I had to endure without a pincher grasp on LI 4, were a near 50% more intense than the ones where my husband was obediently gripping the point like his life depended on it. Research presented by Michael Corradino, a doctor of acupuncture and oriental medicine as well as the founder of Neuropuncture LLC, suggests that this point reduces pain by stimulating the hypothalamus to release beta endorphins (poly-opioid peptides that regulate the perception of pain) to block pain signals.

According to the nursing staff, loosely 80-90% of hospital deliveries in Missoula are done with an epidural. I wonder how that percentage would change with the regular use of LI 4. Granted, I respect that many women don’t have the same arguably insane drive to forgo pain medication... but there are certainly a handful that arrive at the hospital with the hope of experiencing childbirth sans pain medication and end up electing to have the epidural.

If you fall into the small percentage that want to utilize every resource before opting for the epidural, don’t overlook the usefulness of acupressure. And perhaps, have your partner become familiar with the points (there are more than just LI 4) before you are huffing and puffing through contractions! And lastly, I will leave you with the reminder that no matter how your labor and deliver goes there is no right or wrong way to bring a baby into the world. Once they’re in you arms, the rest is history.

By Andrea Rivera
​
     I'm going to talk about sleep and insomnia from the Traditional Chinese Medicine (TCM) point of view. I’m using what I’ve learned from a very successful sleep specialist, Damiana Corca, and the leader of sleep studies in TCM, Hamid Montakab. 

     It wasn’t until I started talking regularly about people’s sleep patterns (via asking detailed health history information before acupuncture sessions and herbal consults), that I realized just how many people don’t experience healthy sleep, or don’t realize that their sleep patterns are troubled and a larger problem than they think. Did you know that insomnia is considered CHRONIC when a person suffers from some type of insomnia for at least three nights a week for over a month? That’s not a very long time. I think that many people continue on with disturbed sleep this often for months, even years, without addressing it.

               So what is healthy sleep? These are a few of the  basics on what TCM considers healthy sleep:

• Falling asleep within 20 minutes, if it takes longer than 30 minutes, this is considered insomnia. Note: on the other hand, if your head hits the pillow and within seconds of laying down or in less than 5 minutes you fall asleep, you could be sleep deprived.
• Waking once and falling back to sleep easily is considered normal. Any trouble going back to sleep, waking twice or more (even to urinate) is too much for people to get back into proper states of sleep. 
• Achieving proper depth of sleep. Sleep that’s not too superficial where you’re easily wakened by the smallest sound. Your sleep is also superficial if you’re experiencing dream disturbed sleep throughout the night.
• Getting 7 to 9 hours of sleep. 6 hours of sleep only works for some people, the ones who can function well and remain healthy have slept 6 hours their whole life. These people are rare. 
• Waking rested with good energy. Your body and mind feel revitalized. You don’t wake too early, or before your desired and intended amount of sleep. 

                                            To contrast, any kind of insomnia may present like this:

• Reduced sleep time due to difficulty falling asleep, frequent waking for various reasons, and early waking.
• Superficial sleep due to mental restlessness, disturbing dreams, snoring, BRUXISM (teeth grinding, which so many people report as a problem), respiratory difficulties, and physical agitation like restless leg syndrome, pruritus (itching), and general discomfort or pain (secondary insomnia). 

     From this we gather that healthy sleep is achieved by reaching the proper depth and length of sleep. 

     In TCM, insomnia is a symptom, not a disease. Certain patterns of disharmony will result in disturbed sleep. Chinese medicine diagnoses the underlying patterns causing insomnia. When sleep issues are present without any obvious environmental cause, TCM can target the body’s imbalances to harmonize energies and create the internal environment necessary to achieve healthy sleep.

     The standard approach to treating insomnia is with medications. Unfortunately, drug therapies present troubling side-effects like dependency. According to Montakab, sleep that is induced by hypnotics is not physiologically normal:

• Benzodiazepines (your hypnotic, sleep-inducing, anti-anxiety, muscle relaxing drugs) and opiates reduce Stage 4 sleep, the increase in total sleep time being due to an increase in Stage 2 sleep. So although you are sleeping, you're not experiencing the normal and necessary length of stages.
• ​Antidepressant drugs cause reduced REM sleep.

*Something else I want to note here is that alcohol is not a good sleep aid. Alcohol initially causes sleepiness but often has a rebound effect later in the night that will seriously disturb sleep quality, whether you wake up or not. 

     Your practitioner can also provide council on achieving proper sleep hygiene and making lifestyle changes geared toward better sleep.  I’ve started treating sleep with almost every patient I see, no matter what their chief complaint is, and have seen it improve other areas of their health simultaneously. Healthy sleep is the cornerstone of healing.