Ross Acupuncture Oakland

Oakland Acupuncture

Winter Health in Four Simple Steps

 

After a long and dry autumn, winter has come. And it’s arguably the most important time of the year for your health. Now is when the ounce of prevention is going to set you up for a healthy and immune-resilient year ahead. According to the Asian medical perspective, the Winter health is all about keeping your yang, or physiological fire, tucked in deep. The goal is to build the fire and energy reserves for use through the rest of the year, when activity is more the focus. Here are the 3 very good ways to accomplish this.

 

  • Go to bed early, sleep late.

 

Follow the lead of the sun. It’s not the time to burn any midnight oil. Start to wind down when it starts to get dark. Turn off your screens, dial down the lights and use those candles that have been collecting dust on your shelf. Use the dark yin time to protect and nourish your yang.

 

  • Dial down strenuous exercise.

 

It may seem counter-intuitive, but building your reserves is not done through strenuous exercise. Sweat actually depletes our yang. All that heat that comes out of your pours is your physiological fire that is no longer there to perform it’s physiological function. And when it’s time to store yang-fire to perform function on into the future, it’s a double loss. It’s a great time for slower and more nourishing exercises, like a yoga and medication practice.

You could also learn Tai Qi or Qi Gong, the Chinese medical exercises that actually build qi and yang through slow and deliberate movements. Because they are slow, does not mean they aren’t intense. They are fantastic at building strength, flexibility and balance.

 

  • Eat warming and rich foods.

The food you eat now is probably the most important in building yang. Meats, stews, roots and seeds, and warming spices are all great things to eat right now, especially for people who tend to have cold constitutions already. Some great yang foods are

  • lamb, chicken and sardines
  • red lentils and quinoa
  • black pepper fresh ginger, star anise and dill

Make sure to eat everything warm and cooked right now (well, always, but ESPECIALLY right now).  Stay away from iced beverages and food right out of the fridge.

 

  • Get some acupuncture and moxa.

 

Your yang can be directly supplemented with acupuncture and moxa treatments. Moxa is the Chinese herb ai ye, or mugwort. The herb is dried and can burned on top of acupuncture needles, or rolled into tubes and burned over the points and channels. The heat enters directly, and works very well to tonify the yang of the body. During the winter months, and few acumoxa treatments can go a long way in terms of preventative health for the rest of the year.

Acupuncture and Dry Needling, Are They the Same?

Acupuncture and dry needling, are they the same thing, or two different therapies? Well, it depends on who you ask. Ask an acupuncturist, the answer is yes, they are the same thing. Ask a physical therapist or athletic trainer, and the answer is no, it is very different. As an acupuncturist, I do fall in line with my fellow colleagues. I think that yes, dry needling is a type of acupuncture. But I also see the physical therapists point of view, that dry needling can be successful without any knowledge of qi or meridians.

Lets look at the definitions and a little history of both.

Definition of Dry Needling

According to the American Physical Therapy Association (APTA) dry needling is a:

“skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuro-musculoskeletal pain and movement impairments.”

We can break that down a little bit, to make it more understandable.

  • Filiform means “threadlike” and a thin filiform needle is an acupuncture needle.
  • Acupuncture and dry needling both use the very thin acupuncture needles, as opposed to a hypodermic needle that injects “wet” substances.
  • Dry needling stimulates trigger points, muscles and connective tissue.

picture of a trigger point in a taugh band of muscle tissue
Trigger points within muscle tissue

What is a trigger point?

According to the APTA again, a trigger points are:

“hyper-irritable spots within a taut band of contractured skeletal muscle fibers that produce local and/or referred pain when stimulated.”

Basically, a trigger point is what we commonly call ‘knots’ in our muscles. When we press on these knots, it is very tender, and often we can feel pain that radiates to other parts of the body. These trigger points are deactivated through dry needling. This penetration by a needle will illicit a local twitch response in the muscle, and this twitch response is what creates the relaxation of the tissues.

Muscles and connective tissue.

The APTA states that dry needling is used to stimulate not only trigger points, but also muscles and connective tissue. Connective tissue is a very broad term for just about everything else in our body. It includes blood, cartilage, bone, tendons and ligaments, fascia, and adipose tissue. It’s my guess the APTA intends to mean connective tissue only as it applies to the neuro-musculo-skeletal system.

But the APTA states that using dry needling on anything other than trigger points isn’t as well researched by western science. Here is where acupuncture and Asian medical theory can explain it’s efficacy very well, and it uses the concepts of qi, blood, essence and meridians to do so. Most Asian Medicine practitioners rely on thousands of years of trial and error for proof of efficacy, not modern medical research. Though there is actually quite a large amount of scientific research that has been done on acupuncture. It is beyond the scope of this post to go into acupuncture theory, but you can give it a google. You’ll have no problem finding information on how it works, from western biomedical models to classical and traditional East Asian theory.

So, the object of dry needling is to “reduce or restore impairments of body structure and function leading to improved activity and participation.”

Acupuncture and Traditional Asian Medicine

When we talk about the difference between acupuncture and dry needling, the most obvious is the scope of practice. Acupuncture is a complete system of medicine on its own. Not only does it treat pain exceptionally well, it treats everything from colds and flus, gynecological disorders, digestive complaints, heart disease, diabetes and even cancer. The only limit is the skill and experience of the practitioner. Any practitioner of dry needling would never claim they treat any medical conditions other than musculoskeletal and nerve pain disorders. And this is where the argument for a difference in the therapies lies.

But even though every square isn’t a rectangle, every rectangle is a square. You can’t call all acupuncture dry needling, but there is a case that all dry needling is acupuncture.

Ashi points

There is a concept in acupuncture called ashi points. Literally this means “ah yes”, and refers the act of pressing on a tender spot, and the patient says “that’s it, that’s it”. Everybody knows this feeling, and you don’t have to be a massage therapist or doctor to find an ahshi point on another person. Sun Si Mao, a very famous Chinese physician who lived from 581-682 AD, is quoted as saying:

Sun Si Miao is known as the king of Chinese medicine.

“In terms of the method of ashi, in speaking of a person who has a condition of pain, when squeezing, if there is a spot inside [we] do not ask if it is a [recognised] acupuncture point, because [we] located a painful spot and they said, “Ah yes!”.”

This sounds very similar to the above definition of a trigger point.

The first known documentation of this type of acupuncture point is from the Ling Shu, a canonical acupuncture text written between the 2nd and 1st century BCE. It starts with “it is the point of pain that defines an acupuncture point”, and the treatment technique is described as:

“apply rapid insertion and withdrawal …of the needle, and cease when the puncturing begins to effect a cure, irrespective of the period of treatment. Insert the needles into the tender spots on the diseased area. “

This technique is a great description of dry needling as well. Find the tender nodule, insert the needle into the nodule, and rapidly insert and withdraw the needle until the painful nodule is no longer present.

Why Choose an Acupuncturist to do Acupuncture and Dry Needling

There are many advantages to having an acupuncturist perform dry needling. The physical therapists and athletic trainers definitely have an excellent knowledge of anatomy. But there is no comparison with the experience an acupuncturist has with needles. Proper insertion of a tiny needle into a body involves a lot of subtlety. The qi of the practitioner is just as important as that of the patient. A good acupuncturist spends a lot of time creating their own healthy qi. This creates a refinement in the acupuncturists ability.  This refinement, whether it’s dry needling or acupuncture, will maximize effectiveness and safety.

The acupuncturist also has extensive knowledge of how to affect meridians and body systems with acupuncture needles. Many more layers of disease are addressed, at the same time dry needling is performed. Ideas such as dryness of the muscle tissue, qi and blood stagnation and deficiency may be causative factors of painful trigger points.  Both trigger points and the underlying cause are addressed when an acupuncturist performs dry needling.

Dry Needling Research

Dry Needling a Trigger Point in the Upper Trapezius

 

 

 

 

 

 

Does Acupuncture Treat Plantar Fasciitis?

It does! It does I tell you! Acupuncture treats plantar fasciitis, and I’m gonna tell you all about Jimmy’s success story to boot (sorry). But first, lets talk a little bit about what this pesky ailment actually is.

 

This is the plantar fascia.

photo of the bottom of the foot, under the skin where the plantar fasia connects to the heel bone and the toes to support the arch

 

Plantar fascia is a thick band of tissue that connects the heel bone to the toes on the under side of the foot, and supports the arch. It is tension bearing, and acts like a shock absorber and a sort of spring and when you push off during running or walking. The inflammation of plantar fascia is called plantar fasciitis. It can be a nagging problem that comes and goes for years, and can last many months at a time.  Acupuncture is a very effective way to treat it, and avoid prolonged chronic pain.

What does plantar fasciitis feel like ?

The signature symptom of plantar fasciitis is sharp pain at the heel that is present when you first get up in the morning, or first stand after prolonged sitting.

red area at the underside of the heel shows where the plantar fascia becomes inflammed

This pain is present for the first 10-20 minutes or so of walking around, and then it gets better. Usually, while you are active and on your feet, you don’t feel the pain. Once it progresses, you may feel pain radiating up into your arch.

 

What causes plantar fasciitis?

Repetitive strain to the plantar fascia that creates microtears in the tissue and creates inflammation causes plantar fasciitis. This can have many sources:

  1. Excessive running or walking
  2. Improper arch support
  3. Prolonged standing
  4. Tight Achilles tendon and calves, in addition to the above

 

How do you treat plantar fasciitis with acupuncture?

So let’s get back to Johnny. Johnny came in complaining of intense pain in his heel when he wakes up, and after working a full shift as a professional chef. He’s had plantar fasciitis on and off in both feet since he was a teenager, and at present it was mostly in his left foot, along with some calf tightness.

He is an avid exerciser, and running was one of his favorite activities. He hadn’t been able to run at all for the past six months because the pain was too intense after.

When he would wake up, or after a 6 hour work shift, he could make his pain go from an 8-9/10 to a 5/10 by stretching out his foot and calf for about 15 minutes.

The plantar fasciitis treatment plan

After ruling out any other type of ankle and foot injury, like ligamentous laxity, bone spurs, arthritis, nerve pain, we did three different types of treatment for his plantar fasciitis.

Cupping

We started johnny’s treatment by doing cupping on his calf and achilles to loosen up this tight and knotted up soft tissue. I also had him move his foot in flexion and extension with the cups on to further encourage the breaking apart of tight tissues.

Dry Needling

I next found the trigger points in his calves and his Achilles tendon and used acupuncture needles to deactivate them. This is probably the least comfortable portion of the treatment, and the deactivation of trigger points also means a residual soreness after the treatment that resolves in a day or two.

Electro-Acupuncture

After first, cupping and second, dry needling, the last step was inserting acupuncture needles on either side of the ankle, pointing towards the heel. I attached the electro-stimulation machine to the acupuncture needles, and ran a current through the area. This is the part of the treatment that is used to increase the stimulation to the needles, for more blood flow to promote tissue healing. It also immediately works on the brain to stimulate neurotransmitters that decrease pain.

At Johnny’s 7th visit, we added gua sha to the treatment, which is a skin scrapping that addresses the gravely tissue underneath.  We also did direct acupuncture on the attachment of the plantar fascia at the heel. This is a really sensitive area to needle, and if the pain had gone away completely already, I wouldn’t have done this direct needling. But this had been an issue for over 20 years, it needed the direct work.

How long did it take to feel better?

Johnny’s progression was steady and consistent during his treatments. He came once a week, without skipping, and also complied with the home regimens.  Our goal was to stop the pain in the morning and after work, and return to running on a regular basis.

  1. After the first treatment Johnny noticed he was sore for about a day in his calves, but there was less pulling on the bottom of his foot. After his 6 hour work shift the pain was the same in his heel. The next morning after a long shift felt a little better.
  2. At the 3rd appointment, he reported the pain was 15-20% better after a work shift.
  3. When he came in after 4 treatments, he said he went for one run for about a half mile. It was painful after, but he could stretch his feet and the pain went away. Waking up, he felt about 25% improvement in his foot.
  4. At the 6th session Johnny’s foot would be tight after work, and after running a mile, but not painful. Waking up, there was no pain. At this point, Johnny spent about 3-4 minutes multiple times a day stretching his feet and calves. He also did gua sha himself on the bottom of his foot using a Chinese soup spoon.
  5. After 12 treatments the pain in his foot didn’t affect any of his activities. He spent about 3 minutes a few times a day stretching out, which was essential. The pain in the morning was gone, as well as after work. He was running 3-4 times a week, about 4.5 miles each time.

 

This is one of those ailments that responds so well to acupuncture, it seems nuts to not try it.

 

Does Acupuncture Treat Neck Pain?

Can you use acupuncture for neck pain, you ask? Oh yes, yes you can.

A Case Study of Acupuncture for Neck Pain

Let me tell you a very common tale of neck pain. This one involves a lady we shall call Andrea. Andrea works in an office managing projects. Andrea sits in front of a computer for 8-9 hours a day. Already sound familiar? AND Andrea uses a cell phone, a lot. Just like the rest of us.

When Andrea came to see me, she had neck and upper back pain that radiated up and caused headaches. She felt little bit of tingling in one of her arms, at the elbow, but the worst part was the headaches. Her neck pain and headaches increased with desk/computer work, and had been getting worse every day for the week before she came in.

Most Common Cause of Neck Pain

I’m gonna put Andrea’s story aside for a minute, and talk about why neck pain is so common in this technological age. This is why:

People on the street looking at their phones with their head and neck down and forward.
Text neck. It’s real. It hurts.

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