Posts Tagged ‘healing process’
Apr 10, 2012
The power of the body to heal and change is remarkable. It is important to understand that the healing process is not linear. Some days are better than others. This is true not only for acupuncture, but for most changes in our lives.
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.
Dec 27, 2011
As the year is coming to a close, I am looking over much of the writing I’ve been doing over the year.
In 2011, I wrote many articles explaining how acupuncture works. Here are some of my favorite.
- Acupuncture and the Healing Process
- How Much Time are Acupuncture Needles Retained
- How Long is an Acupuncture Treatment
Chinese Medicine Diagnosis
If you have a specific question about acupuncture or Traditional Chinese Medicine, let me know in the comment section.
Dec 12, 2011
For the last 50 years, the placebo effect has been a dirty word. Real interventions make a physiological change in the body. Placebos do nothing but convince the patient that something is different. Reality states otherwise. Ted Katpchuk, an acupuncturist and Chinese medicine doctor who focuses on the placebo effect in his research, wants to change all that.
In last week’s New Yorker, an article focuses on the placebo and the scholars who think about and examine the placebo.
What is a Placebo?
One of the difficult and fundamental questions is what is a placebo? We’ve come to believe a placebo is an inert intervention. A sugar pill.
In most clinical trials of medication, or even with some physical interventions, a group of people with a given condition are given active therapy or medication. The outcomes in this group are compared with a group of people who are given a placebo, but most often are not told which group they are in. Usually both groups improve, even people give the placebo. If the medication is successful, the people on active medication will improve more. The the placebo group improvement is called the placebo effect.
The placebo effect is thought to stem from a belief that a given intervention will help. People convince themselves that the medication is working, and miraculously it does. But the placebo does not change the body physiologically. Or so we thought.
Is the Placebo Inert?
One colossal challenge to the concept of a placebo, is that many studies have shown that a placebo is not inert. Meaning that your body has physiological reactions to taking a placebo. This could mean that belief in a specific drug or intervention actually stimulates your body to heal.
This is particularly true with chronic pain. Early placebo studies have shown that placebo intervention for pain relief actually influence the releases natural pain killers in your brain.
The All Encompassing Placebo
Many of the placebo researchers go further. A placebo is any aspect of a given intervention that may help you feel better, but without a specific physiological interaction with the body. This idea encompasses the whole experience of an individual. The environment of the office, the taste of the pill or tea, and how much the practitioner listens to you. The article even discusses how different colors and shapes of pills have various placebo effects.
A powerful concept in placebo research examines how a given intervention, be it medication, massage, or surgery, is more than simply the intervention itself. For example, my statistics professor at Mount Sinai would often discuss the fact that the clinical trial itself is a placebo. Patients in a clinical trial tend to do better on their medication than the general public. This could be because they feel special, receiving a new medication, being treated by expert doctors with a large staff at their disposal. Then, in the general public, the medications tend to work less well.
Doctor Patient relationship
Kaptchuk would like to explore how best to harness the power of placebos in the healing process. He has focused on the patient doctor interaction as placebo. He even ran a clinical trial of a placebo intervention on IBS where the patients were actually told they were taking a placebo, and that it had clinical efficacy in the past. And amazingly, it worked.
However, this dilemma brings a difficulty with the word placebo. Doctor patient relationship is a skill. A skill that many medical schools have begun to teach, as we loose this skill to technological advances.
Perhaps careful explanation, a caring tone, and an ear to listen can be called a placebo, as it is a non-specific intervention. It is not a chemical pill or an herbal remedy. However, it is also a skill, that can be developed and improved. Kaptchuk would certainly agree with teaching how to wield the healing power of the doctor patient relationship.
Yet, the placebo has a negative tone with the medical establishment, and also much of the population, because we are being fooled into getting better. Perhaps there needs to be a new name for a non-specific intervention.
Placebo: The Social Stigma
What is radical about the placebo idea is that nobody wants to believe that a placebo helps them. And its not just Western medical physicians. Acupuncturists, Chiropractors, and other modalities, as well as patients, fight against the idea that whatever intervention is helping, is a placebo. That means its all in your head.
Kaptchuk and others want to change this stigma. Even if the placebo is all in your head, so what. You feel better. You’re healthier and that’s what counts. But what’s interesting, in some cases, the placebo intervention can actually alter physiology of the body.
A Placebo or Common Sense
A comforting office environment has often be chalked up to placebo. But why would you not want to be comfortable in a doctor’s office with soothing colors and music? It is nerve wrecking enough to go to the doctor. And stress has a real effect on the body. It is just common sense to make the office nice.
I think there is a danger when discussing design of a pill and patient doctor interaction both as placebo because this could reduce the importance of the doctor patient relationship.
Acupuncture itself is an interesting question about the placebo effect. I have a hunch that Kaptchuk believes that acupuncture has a real physiological effect, as he has been involved in many studies comparing acupuncture physiology to placebo physiology, and there is often a difference. But it is not discussed in the article, because the point is that it helps people feel better.
Harnessing the Placebo
The field of studying the placebo itself is young. It questions central tenets to clinical research and shows that our bodies can physically heal ourselves of certain chronic conditions. We do not just react to medication, but also to caring, touch, and the environment.
Like much of good science, these studies bring up more questions than they answer. What is the most important aspect of placebo to focus on. Soft voice, listening to the patient, the examination. Or is it the office lighting, soft colors, and music. As the definition expands, the concept of the placebo can encompass almost anything.
Probably the best way to harness the power of many aspects of the placebo is by not calling it a placebo. Doctor patient relationship, a comforting healing environment, and physical touch are all words that don’t have the placebo stigma. These all help the patient get better, which is what is most important.
Lack of social acceptance in the public and medical community is a challenge that the research will not be able to overcome.
Nov 11, 2011
I like to say that the acupuncture healing process is like hitting the reset switch. It works in the body to correct once healthy pathways that were knocked off kilter.
There is a process to getting to the root cause of the issue in order to reset the body. Like peeling off layers to get to to the core issue.
Many patients come to me with intense symptoms, often severe pain. The first goal is to reduce the pain to make them comfortable. Then we work on correcting the root issue causing the pain which can lead to long term relief.
In acupuncture and Chinese medicine we call this treating the root and the branch, that is treating the branch symptoms and the root cause. This is the key to the healing effect of Acupuncture and Traditional Chinese medicine.
Oct 15, 2008
The majority of Americans are in chronic pain or have experienced it. More and more, people are seeking acupuncture for relieve of all types of chronic pain, from back pain and neck pain, to headaches and migraines, or chronic pelvic pain.
Pain can affect almost every system in the body and develops from many sources.It can occur from a chronic immune disorder, after an infection, from a physical injury, or from emotional stress. Often, pain stays around a long time after an injury has healed.
As a teenager, I first sought out acupuncture to treat my own chronic pain. For several years I suffered from back pain. It was quite severe for my age, keeping me from playing sports, getting regular exercise, and fully enjoying myself. No one knew what it was from and everyone had their own theory: I was growing too fast, growing too slow, my muscle didn’t develop, or my muscles were too tight. After trying various remedies, and being called a complainer by my not so friendly general practitioner, I tried Chinese medicine. It was the only thing that stopped the pain.
How does Acupuncture address pain?
Acupuncture addresses pain by helping the body heal itself. It not only treats symptoms, like taking a painkiller, but also corrects imbalances in the body, thereby, allowing the body to heal itself.
Recently, several scientific studies have attempted to figure out what exactly this healing process is. To explain a few of the concepts, I’ll use my back pain as an example. Although, I feel the pain in my back, the perception of pain is created in the brain. Acupuncture works not only to heal the pain locally, in my back, but also in my brain. Unlike other approaches, acupuncture treats both sources of the pain.
Often, the acupuncture itself focuses on the location of the pain. In my case, it was the lower back.The fibroblasts, the cells of the connective tissue in the area, actually grab onto the needle.The ends of the cells then wrap themselves around the needle.[i] Then the cells begin to change shape and rearrange their own support system, probably working to correct injuries.This is also a method for cells to communicate with one another, so one cell can broadcast messages of self-healing to other cells in the tissue.[ii] In addition, the nucleus begins to expand, which signals the first stages of gene expression to repair the cell and the tissue around it.
The phenomenon in which the body grabs onto the needle has been known to Chinese medicine physicians for thousands of years and is described as “getting the qi” which should feel similar to a fish biting a hook. As a practitioner, this is how I know when the point is stimulated correctly. I can actually feel the body grab the needle, which tells me that the body is reacting well to the treatment.
Acupuncture Healing the Whole Body
While the acupuncture treatment may be focused on the painful area, the purpose of each acupuncture treatment addresses the whole body. As I mentioned before, one way acupuncture addresses the whole body is through the brain.
We forget a lot of things, like where we put your keys or our mother’s birthday. But, the brain does not like to forget pain. Often, the brain remembers pain long after an injury has healed itself. Using an fMRI scanner, a scan that tracks blood flow within the brain, scientists have shown that acupuncture can change the brain patterns for those with chronic pain.
One of the best studies that used fMRI focused on individuals with carpel tunnel syndrome.[iii]After the treatment, the pain was greatly reduced and the nerve health of the arm was improved. In addition, the carpel tunnel pain pattern within the brain was much more like that of a healthy person than before the treatment.
Working both at the area of pain and in the brain, acupuncture helps to reduce chronic pain by reteaching the body to be healthy.As we learn more about acupuncture we are also discovering how much the ancient clinical science of acupuncture and Chinese medicine has to add to our knowledge of the human body.
[ii] Langevin HM, Bouffard NA, Badger GJ, Et. al. SubcutaneousTissue Fibroblast Cytoskeletal Remodeling Induced by Acupuncture: Evidence for Mechanotransduction-Based Mechanism. J Cell Phys. 2006; (207): 767-774.