This causes pain.  The pain trumps the itching sensation and you no longer feel the annoyance.  But the scratching causes inflammation and irritation in the area.  The scratch causes more itch and the cycle continues.

Pain trumps itch because the sensations are felt through many of the same nerve endings.  Although researchers looking at itch specifically are finding more itch specific pathways in the spinal cord and brain.

Itching takes a toll on people’s lives.  This annoying symptom keeps people awake at night, distracts from daily activities, and leads to habitual irritation of the skin.

The causes of itching

Itching can be caused by several conditions.  Sometimes you know what causes the itch such as a mosquito bite.  Or it may occur from inflammatory skin diseases like eczema.  It may occur in other conditions such as psoriasis and even acne sometimes.  In lichen simplex for example, itching is caused by anxiety or being nervous.   Elderly patients may have pruritus which from unknown causes.  Some serious diseases such as cancer, liver disease, and HIV can cause itching.

But even seeing another person scratch or thinking about itching can cause an itch sensation.

Acupuncture and Chinese Medicine Causes of Itch

Acupuncture and TCM discusses has long discussed the many causes of itching. Chinese medicine imagines a complex interaction between the environment and the body.

Imbalances in the body or the environment cause the itch. Common causes of itching are heat, dampness, and wind.  These are descriptions of different presentations of the disease.

Each herb or acupuncture point is chosen to correct that specific imbalance.  If the skin is red and dry, then heat may be predominating.  If there is swelling and weeping, then it may be caused by dampness.

Acupuncture can be used for treating acute itching in atopic dermatitis as well as other conditions. I like to use auricular acupuncture and magnets which help to reduce itch in between sessions.  Acupuncture may work to stop itch through similar mechanisms as pain relief.

photo: Tambako the Jaguar

A recent research report examined acupuncture treatment of itch in atopic dermatitis (1).  This study was quite sophisticated.  They compared acupuncture versus antihistamine treatment to reduce itching.  They also compared acupuncture and antihistamine to an acupuncture and an antihistamine placebo.  Finally, they looked at if acupuncture was better for preventing the itch or treating the active itching.

The acupuncture was stronger than the antihistamine in its ability to reduce itching.  In fact, the acupuncture was the only clinically relevant reduction in the itch.  While the antihistamine also reduced itch, it was not as strong as the acupuncture.  Also, acupuncture did not have any cognitive adverse effects which were induced by the antihistamine.

Both the antihistamine and the acupuncture were stronger than their placebos.

Interestingly, acupuncture performed before the itching was induced was not as effective as acupuncture done after the patients were itching.  So it is important to think about the timing when treating the itch.

How does acupuncture reduce itch?

The authors theorized that acupuncture reduction of itch may act through the similar pathways as pain reduction including the release of endogenous opioids and neurological pathways. Acupuncture may also reduce inflammation which is a significant in atopic eczema.

References:
1. Pfab F, Kirchner MT, Huss-Marp J, et.al. . Acupuncture compared with oral antihistamine for type I hypersensitivity itch and skin response in adults with atopic dermatitis: a patient- and examiner-blinded, randomized, placebo-controlled, crossover trial. Allergy. 2012 Apr;67(4):566-73.

A recent report at the Experimental Biology 2012 meeting suggests that acupuncture helps to stimulate muscle tissue regrowth.  The research group showed that acupuncture reversed the decrease in muscle mass in mice and in the mRNA expression level of the E3 ubiquitin ligase atrogin-1.

A story from the acupuncture clinic

This report is very important because it helps to explain why acupuncture can help patients can regain strength after an injury.

It is quite common for patients to come to the acupuncture clinic with chronic injuries and pain that are not improving.  These patients are very diligent in seeking help yet their muscle weakness and pain are stubborn.

I have a patient who is in her 60’s who had an injury from falling.  After her injury it was very difficult to regain muscle strength and decrease her pain despite physical therapy.  She had weakness in her arm and shoulder.

I recommended that in addition to the acupuncture she continue with physical therapy.  Within two weeks her muscle strength improved almost 50%.   After two months of treatment she had very little pain and her muscle strength almost completely returned.

This is an exciting theory to explore new ways acupuncture helps to reduce pain and improve health.

photo: Journal of Cell Biology

Conventional medication often is not completely successful in treating the symptoms. Many patients have been turning to acupuncture Chinese medicine for help.  In our New York City acupuncture clinic, we often use acupuncture, acupressure, and herbs to reduce the symptoms of sinusitis, especially during the spring allergy seasons which can exacerbate the sinusitis symptoms.

A comprehensive approach to chronic sinusitis

When it comes to treating chronic sinusitis, it is important to include many of the modalities used in acupuncture therapy.   I use acupuncture, acupressure, and sometimes Chinese herbal remedies to help relieve the symptoms of chronic rhinosinusitis, help people reduce medication, and avoid surgery.

Large Intestine 4

The acupuncture therapy targets acupuncture points on channels that help reduce pain and pressure in the sinuses.   Acupuncture points can be located on the arms or legs on channels which travel to the sinuses.  These points are LI 4, LI 11, Lu 5, SP 9,  ST 36, St 44, GB 34, and SJ 5.  For some people, acupuncture points on top of or near the sinuses are needed.  These points can include LI 20, ST 4, Bi Tong, and Yin Tang.

Acupuncture points selection is based upon the imbalances which cause the condition.  For example, acupuncture discusses the circulation of energy, or qi, in the body.  If there too little qi, a common cause of sinus headaches, then the qi should be boosted with ST 36 and SP 9.  But if there is more heat which often happens with inflammation, acupuncture points such as LI 11 or ST 44 should be selected.

Acupressure on the neck, head, shoulders, and back helps to increase circulation, decrease pain, and drain the lymph.   I will also instruct my patients on a self acupressure routine for patients to perform on their own. Often, patients will begin to feel relief after a few acupuncture sessions.

It is important to understand that acupuncture is not an either or when it comes to your conventional therapies for chronic sinusitis.  The first goal to is help you feel better.  When you are consistently feeling better you can work with your physician to reduce the amount of medication.

Research on the Integrative East West Medicine approach

A paper was recently published examining an east west integrative treatment protocol for patients with recurrent chronic rhinosinusitis (1).

The treatment involved a combination of the patient’s current therapies, most often nasal corticosteroid spray and nasal irrigation in addition to acupuncture, acupressure, dietary modifications, lifestyle modifications, and self-acupressure.  As you can see, the researchers used a pretty comprehensive approach.

The study was small with only eleven patients. But it showed potential for this therapeutic approach. The patients, overall, reported improvements in their physical functioning, social engagement, less needing to blow their nose, and an improvement in their ability to concentrate.  I hope that larger studies will be conducted to further explore the power of acupuncture to relieve symptoms, reduce dependence on medications, and help people avoid surgery.

1. Suh JD, Wu AW, Taw MB, Nguyen C, Wang MB.  Treatment of recalcitrant chronic rhinosinusitis with integrative East-west medicine: a pilot study. Arch Otolaryngol Head Neck Surg. 2012 Mar;138(3):294-300.

The story explains the that one reason migraines occur is because of bursts of electrical activity in specific areas of the brain.   Often they begin in  the visual center, which is why people will get auras from migraines.  Then it will travel through different regions explaining why there can be so many different symptoms related to the migraine headache.

Originally women were thought to get more migraine was because women cannot handle stress.  However, now researchers are seeing links between hormone imbalances and migraines.

Acupuncture for Migraine headaches

Migraine headaches are very commonly treated with acupuncture.  In our clinic, we use acupuncture and acupressure as an effective remedy to reduce the symptoms and frequency of migraines. Here are some testimonials from our patients who have found relief from migraine headaches with acupuncture.

Read more on acupuncture for migraine headaches:

• Acupuncture Treatment for Headaches and Migraines
• How Acupuncture works to Treat Migraine Headaches

Change happens slowly.  People don’t wake up one day and everything is better.  It is a gradual improvement.  You can’t learn how to play the piano or tai chi overnight.  What’s more, gradual change is more sustainable.

Acupuncture is not like a pill or surgery.  We are not cutting anything out of the body.  Acupuncture is simply reminding the body to be healthy.  For some acute conditions, such as a back spasms, acupuncture can work rapidly.  But most people come for chronic long term health concerns, such as interstitial cystitis or overactive bladder, which can take time.  Most patients have seen many other doctors and specialists before they come to see me.

The length of treatment depends largely on your health concern, the severity of the condition, and how long you’ve had it can all be factor.  For example, in overactive bladder, we will look for changes in the intensity and frequency of the bladder spasms.  Along the course of healing, some days will be better and other days will be worse. We want to see some changes within four to six acupuncture sessions.  The full treatment course is generally twelve to sixteen visits.

The symptoms of bladder spasms can be intense, impacting your work, education, and social life. Bladder spasms can occur in overactive bladder, interstitial cystitis, and other conditions.

Acupuncture is an excellent way to reduce bladder spasms. Acupuncture works by resetting the body to be healthy and allowing the bladder to relax.

Acupuncture therapy for bladder spasms

Acupuncture theory is based upon the idea that channels connect different parts of the body. These channels act like a communication system in the body. For acupuncture to be effective at treating bladder spasms, the correct acupuncture points must be used.

Specific acupuncture channels can be related to bladder spasms. The Bladder channel is one of the very important channels. This channel runs from the inner canthus of the eye, over the scalp, down the back, and to the outside of the foot. Points on the lower back, such as UB 28, UB 32, and UB 33 are very important for bladder spasm. Points near the ankles, like UB 60 is also helpful.

The Spleen and Kidney channel acupuncture points can also be helpful. The spleen channel runs from the inside of the big toe up the leg. Acupuncture points such as Spleen 9 and Spleen 6 are both very effective. Kidney 3 is on the inside of the ankle. The Ren channel is located on the center line of the front of the body. Acupuncture points such as Ren 3 and Ren 4 are also very effective for bladder spasms.

Electroacupuncture for bladder spasms

Electro-acupuncture is very similar to regular acupuncture. The acupuncture point selection is generally the same and the treatment time is also similar. Electro-acupuncture provides additional small amount electric stimulation to the acupuncture needles. The electric stimulation enhances muscle relaxation.

Acupuncture and Arthritis Symptoms

Acupuncture for arthritis of the back

Pain and stiffness are the most common symptoms from arthritis.  Arthritis can effect both small joints, such as the hands and feet, as well as larger joints, such as the hips, back, knees, and shoulder.   Arthritis may cause your joints to crack, swell, and have limited movement.

Acupuncture works to relieve pain and stiffness of arthritis by stimulating the release of natural pain relievers, such as opioids, as well as regulating pain relieving opioid receptors.  Acupuncture also changes the way the nervous system feels pain, helping to relieve pain for long periods of time.   In addition, acupuncture has an anti-inflammatory effect, reducing the circulating inflammatory hormones in the blood (1).  Many clinical trials of acupuncture have shown acupuncture to be effective for reducing pain in patients with arthritis (2).

Acupuncture view of Arthritis

Most people with arthritis experience greater pain in the cold and damp weather.  In acupuncture and Chinese medicine, the reason this occurs is because the cold and damp impede circulation in the joints.  The lack of circulation leads pain, stiffness, and swelling.   The goal of the acupuncture is to increase circulation and warm the joints to relieve pain.

What is the Acupuncture treatment for arthritis like?

During the first visit, we will complete a medical history and physical examination, which focuses on an examination of effected and painful joints.  Acupuncture diagnosis and treatment focuses on identifying the specific root imbalance causing the condition and tailoring the treatment for you.

In addition to the acupuncture, treatment often includes manual therapies such as tui na (acupressure), cupping, and heat.  Electroacupuncture is particularly effective for pain relief in arthritis.

Acupuncture is most effective through a treatment course.  The treatment should decrease pain and inflammation and improve mobility in the joints.  Many people find rapid relief, within a few weeks of beginning the treatment. For others, it may take longer to have an effect. Generally, patients come in for acupuncture once to twice a week depending on the severity, and gradually get acupuncture less frequently.  The treatment course generally last 2-4 months.   Often, patients will experience be long lasting pain relief.

References:

1. Napadow V, Ahn A, Longhurst J, et.al. The Status and Future of Acupuncture Mechanism Research. J Altern Complement Med. 2008 September; 14(7): 861–869.

2.  Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AMK, Hochberg MC. Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee: A Randomized, Controlled Trial. Annals of Internal Medicine. 2004; 141(12):901910.

Acupuncture for Back Pain

Acupuncture does not hurt.  We use very thin sterile solid needles which means they do not feel like a doctor’s needle.  Upon insertion, some points can feel a prick, but many do not feel anything.  The acupuncture needles remain in the acupuncture points for 20-30 minutes.  Patients can feel numbness, tingling, warmth, heaviness, or movement at the acupuncture point.  All of these feelings are good.  At some acupuncture points the muscles will twitch.  This is particularly true when using acupuncture points such as GB 30 for treating acupuncture for sciatica and acupuncture for chronic low back pain. Acupuncture is very relaxing and people will often fall asleep while lying on the massage table.

Traditionally, acupuncturists have called the feeling of acupuncture as “de qi.”  The has been translated as “getting the qi” which means the acupuncture points has been adequately stimulated.  In China, patients will tell their acupuncture doctors “zhong” which means heaviness, when the acupuncture point has been adequately stimulated.