Acupuncture is highly focused on treating the correct imbalance at the correct time.  As the acupuncture treatment progresses, the imbalances will change and the acupuncture point prescription will change.

For example, in acupuncture for overactive bladder   the initial acupuncture treatment will focus on relaxing the bladder and calming the mind.  After the intense discomfort and symptoms are corrected, the acupuncture will focus on boosting the energy, or qi, in the body to prevent the symptoms  from returning.

The first part of the acupuncture treatment calms the bladder by getting heat out of the body.   This may use acupuncture points such as KD2 and KD 3, Ren 2, GB 34, and ST 40.  The will help the bladder and calm the feeling of urgent and frequent urination.  The second part of the acupuncture treatment will be focused on boosting up the qi which will relieve the residual symptoms and provide longer term relief.   Acupuncture points such as KD 3, SP 9, Ren 4 and 6 are very helpful.

In China, the term Chinese medicine (in Chinese it is called Zhong Yi 中医) often refers to the practice of Chinese herbal medicine.  Although it can also refer to the entire practice of Chinese medicine. While acupuncture refers to acupuncture and moxibustion.

Some of these therapies are performed only by experienced physicians, such as prescribing complex herbal formulas or doing acupuncture. But others are considered more home remedies.  This may include  folk herbal remedies for common colds or manual therapies such as gua sha which can be used for nausea, car sickness, the common cold, and other common illnesses.

Common ideas in Chinese Medicine

While the therapies are diverse, done both by physician and family members, they all rest on the holistic view of the body and health that developed over 2000 years ago.   A primary idea is that health is a state of balance in the body and between the body and the environment.  The body has qi, energy, which flows through channel and meridians.  Also, that environmental factors such as cold, heat, and dampness can cause illness.  And these environmental factors represent certain illness within the body.

For example, if you have a cold, a physician may write an herbal prescription to release the heat to help you get rid of the cold.  But the home remedy of gua sha spoon massage on the neck and upper back can also release the heat.

Chinese Medicine: An Evolution of Ideas

Many of the dominant concepts in Chinese medicine were discussed in the early books of the Yellow Emperor’s Inner Classics as well as the Treatise on Cold Diseases.  Although they referenced older works, they are no longer in existence.    Over the years, physicians and scholars have debated these ideas evolving into the contemporary tradition of modern Chinese Medicine.

Yet, it is important to understand that Chinese medicine is an evolving tradition.   These are not static concepts, but ideas that scholars, physicians and even individual family lineages have expanded on and explored.  Chinese medicine has a strong tradition of writing, discussion, and debate. There is a great diversity of ideas.  Through experience and training a Chinese Medicine practitioner will develop their own style.

For example, certain physicians believed that the best way to use Chinese medicine for psoriasis was to clear heat and toxins from the body.   However, other physicians believed that psoriasis developed from internal cold and the body must be warmed. These debates continue today.

In fact, some of the significant therapeutic strategies of modern Chinese medicine physicians were not developed until recently.  As I mentioned in my last post, the development of electro-acupuncture for pain was only developed within the last century, a relatively short time for the history of Chinese medicine.

Acupuncture Microstim

Electro-acupuncture stimulator

In our New York City Acupuncture clinic, we use the Pantheon Research microstim machine.  This is one the highest quality machines ensure a safe and effective treatment.  Microstim means that the amplitude of the electric stimulation is much smaller.  This is much more comfortable for the patient.

Acupuncture Point Selection

Selecting the best acupuncture points is important when using the electro-acupuncture.  The acupuncture points should be chosen based upon the type of pain, the location of pain, and the muscle tightness.

This is particularly important when using acupuncture for shoulder pain.  For example, if there is an acute shoulder pain with a tight knot on the corner of the shoulder blade or on the apex of the shoulder, then the leads can be placed on acupuncture points surround the area of pain.

If the spasm is very reactive to pressure, the muscle will resist too much stimulation.   In that case, the leads should be placed on the acupuncture points along the effected acupuncture channel a little distance from the pain.

What is the optimal duration for electro-acupuncture?

The optimal time for electro acupuncture pain relief is 20 minutes.  My preference is to perform electro acupuncture for 20 minutes.  Afterwards, twirl the acupuncture needles to stimulate them and continue with 15 minutes more of regular acupuncture.  This helps to get the pain relief and anti-inflammatory effects of both the electro acupuncture and regular acupuncture.

What is the best frequency for electro-acupuncture?

The lower frequencies of electo-acupuncture, such 2hz, 4 hz, or 10hz, can address both pain and inflammation.  Most of the time, I use 4hz or 10hz, for most joint pain.   These low frequencies can also be useful for insomnia and anxiety in some people.

Is there is chronic muscle tightness that is causing pain, the higher electro-acupuncture frequencies can sometime be effective.  In my last post I wrote about electro-acupuncture for a patient with Chronic Pelvic Pain Syndrome.

Electro-acupuncture stimulator

Electro-acupuncture is very similar to regular acupuncture.  That is 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, the release of natural pain killers in the body, as well as decreases inflammation.

Electro-acupuncture is most often used for chronic pain and inflammatory conditions.  The pain relief with electro-acupuncture can be so dramatic it has been used for certain types of surgery in China.

History of Electro-acupuncture

Electro-acupuncture for pain, much like other medical discoveries, was somewhat of an accident.  In the early 20th century, acupuncture doctors were looking for a way to enhance bone healing by adding electrical current to an acupuncture treatment.

While it did not speed the bone healing, the physicians found it worked wonderfully for pain relief.  A new therapy in the long history of acupuncture was born.

How to use Electro-acupuncture

There are many choices when using the electroacupuncture.  This is where the art and skill of the acupuncture technique comes into play.

Electro-acupuncture leads

The first is what points to put the leads on.  Each lead has 2 clips.  You can put them on two acupuncture points that are relatively close together if you want to focus on relaxing a specific region of the body, such as the lower back.  Or you can put them farther away if you want to increase circulation in the channels.  It is important to place the leads ipsilaterally, that is only one side of the body and not cross the spine.

Then one chooses the frequency.  Generally, I use a lower frequency between 4hz and 10hz.  This is because the low frequency has been shown to decrease both pain and inflammation (1).  The higher frequency, such as 100hz or 200 hz can be powerful for reducing pain, but not as much reduction of inflammation.

After the points and the frequency for electro-acupuncture have been selected I will turn the simulator on.  We gradually increase the amplitude of the each lead until the patient gently feels a light tapping.  The body generally adjusts and you feel the tapping only for a few minutes.

Success is in the details: How to select frequency

Frequencies can be changed in order to focus on different types of pain.  This can be useful for a short stimulation for acute muscle spasm.  Or it can help someone who has been experiencing chronic pain with persistent pain or partial relief some lower frequencies, I will use a higher frequencies of electro-acupuncture to stop the pain.

For example, recently I was working with a patient with chronic pelvic pain syndrome.  After 2 months of treatment with acupuncture and electro-acupuncture, we were able to reduce the pain to less than half of the initial pain levels.  But there was a persistent low level of pain remaining.

I changed from low frequency to high level frequency electro-acupuncture at 200hz on lower back and pelvic regions using acupuncture points such as Bladder 23, Bladder 35, and Gall Bladder 30 for 10 minute treatment.  After 3 weeks of this additional treatment, the pain was reduced to almost nothing.

References:

1. Lixin Lao section on electro-acupuncture for pain relief in review article.  For full article, please see

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.

Acupuncture Channels

I like to think of the acupuncture channels as an map of the body to address pain in specific areas. The acupuncturist will try to locate the area of the pain and determine which acupuncture channel is effected. The most powerful acupuncture treatment will address the acupuncture points for that specific channel.

It is particularly important to focus on the proper acupuncture channel when treating complex chronic pain conditions, such as chronic pelvic pain syndrome. In chronic pelvic pain syndrome, the pain can be located throughout the pelvis, pelvic floor, genitals, hips, lower back, or buttock. Careful examination and precise location of the acupuncture points helps to create a more accurate and effective treatment.

The acupuncture points I select focus on the most effected acupuncture channels. For example, if there is pain and sensitivity on the lower abdomen or near the lower ribs, the GB channel may most effected. In this case, I would uses the acupuncture point GB 34 near the knee. If there is pain in the pelvic floor, the LIV channel is often imbalanced. I may choose points such as LIV 3 or LIV 5 on the lower leg or foot.

Acupuncture points close to the pain

In addition to acupuncture points far from the pain, some powerful acupuncture points will be located close to the pain. For chronic pelvic pain syndrome, many sensitive points are located on the lower abdomen, hips, and pelvis. These acupuncture points may also be used if they are tender or sensitive.

The primary way acupuncturists can focus the treatment for chronic pain in specific places because of the acupuncture channels.   Acupuncture channels connect different parts of the body and run along different places in the body.  The acupuncture channels create a type of map that interconnects different regions of the body.

Large Intesting 4

For example, the Large Intestine acupuncture channel starts on the hand, up the forearm, through the shoulder to the face.  This is why LI 4 on the hand can be very effective for frontal and sinus headaches.

On the other hand, the Gall Bladder channel runs from the toes, along the sides of the body, and then to the sides of the head.  This is why Gall Bladder 34 near the knee can be effective for headaches on the side or temples.

Auricular acupuncture

Auricular acupuncture, or ear acupuncture, is particularly effective for chronic pain.

In acupuncture, the ear lobe provides a map of the body with points for specific areas and organs.

In ear acupuncture, the best way to target the chronic pain is to find the most sensitive points in the ear for that region and place the needle in that acupuncture point.

Acupuncture is not just acupuncture.  In fact, the word for acupuncture in Chinese, Zhen Jiu, actually  translates to “acupuncture and moxibustion”  which shows how central moxibustion is within acupuncture.

Moxibustion is the warming of acupuncture points or needles.  Most often, this is done through burning an herb called mugwort.  It can also be done with heat lamps as well as herbal lotions.

In my office, we use smokeless moxibustion because it is treated and does not create much smoke.

How does Moxibustion work?

Acupuncture and Moxa for Back Pain

Just like with acupuncture, moxibustion focuses on correcting the underlying imbalance in the body.

Because it is warming, generally moxibustion is used when there is cold in the body.  Moxibustion can help to warm the body and add qi as well.  The warmth also helps to increase circulation.

I use moxibustion often. I find it is very helpful for some people with Chronic Pelvic Pain Syndrome, Interstitial Cystitis, chronic low back pain, in addition to other pain or digestive issues.

Boosting the Qi

There is a tradition that one can use moxibustion on the acupuncture point Stomach 36 for 100 consecutive days in order to boost the body’s qi.  I think this therapy is particularly effective for those with poor digestion or asthma due to low energy.

image: superfantastic

Acupuncture and Chinese medicine have understood this seasonal phenomena for thousands of years.  According to acupuncture, cold and damp can become stuck in the joints disrupting the normal function and circulation which leads to pain.

Acupuncture and Chinese medicine work to warm the body and increase circulation leading to a decrease in pain.  Warming the acupuncture points and acupuncture channels helps to dislodge the cold.

How can acupuncture warm the joints?

Needle Head Moxibustion

In the west, most people think of acupuncture as the use of acupuncture needles with acupuncture points.  But really, acupuncture therapy encompasses much more.

In Chinese, acupuncture is not just acupuncture.  Acupuncture is called 针灸 (pronounced Zhen Jiu).  This translates to acupuncture and moxibustion.

Moxibustion refers to the warming of the acupuncture needles or acupuncture points.  Most often it is done with the burning of an herb called mugwort.  It can also be done with a heat lamp or warming herbal extracts rubbed onto acupuncture points or the affected muscle.

By warming the acupuncture points and acupuncture needles with moxibustion, we can stimulated improved circulation and pain relief.

What can you treat with Acupuncture and Moxibustion?   

Moxibustion is very effective for treating many conditions causes by cold.  During the winter in particular, I use it for back pain, arthritis, osteoarthritis, knee pain, and joint pain.  For some women, it is very effective for menstrual cramps.

Smokless Moxibustion

In our New York Acupuncture office, we use smokeless moxibustion.  The herb mugwort is treated in order that when it is used it does not create much smoke when used.

During the past year I have been adding a section to my website focusing on the commonly treated conditions in my clinic.  It is not yet comprehensive, but over the next few months I will continue to build this section.  Currently, I have a number of in depth articles detailing the acupuncture treatment.

Skin Conditions

• Acupuncture and Traditional Chinese Medicine for Eczema
• Acupuncture and Traditional Chinese Medicine for Psoriasis

Chronic Pain

• Acupuncture for Chronic Headaches and Migraines
• Acupuncture for Tension Headaches
• Acupuncture for Sciatica

Urology

• Acupuncture for Chronic Prostatitis and Chronic Pelvic Pain Syndrome
• Acupuncture for Interstitial Cystitis

If you have insurance coverage through Empire Blue Cross Blue Shield, and would like acupuncture, please call 917-887-4946 or e-mail us to qualify your benefits.

We will need some information from you including your full name, insurance number, and date of birth to verify the insurance. Be sure to include the best contact number should we need more information.

Our office must qualify your insurance prior to your visit. We cannot use the insurance for acupuncture unless we have first qualified the benefits.    This is because contacting your insurance company takes time and our office cannot do it at  the time of your appointment.

Read more about New York acupuncture insurance coverage.