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Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
February, 2001, Vol. 01, Issue 02
"Not Now, I Have a Headache!"
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
Sometimes Useful, but Not Inevitable
One of my instructors said that the most difficult part of treating a headache in China is figuring out whether the client has one or not.In China, it apparently is an accepted excuse for calling in sick to work, so many people show up at the clinic for a doctor's excuse.
In the U.S., it seems as if headaches are considered an inevitability of a stressful and busy life. An employer would not likely consider letting someone off work for a bodywork treatment! "Take some aspirin and get back to work!" would be a more likely response to an employee moaning about a headache.
When I interview clients and find they get headaches, they seem surprised when I ask detailed questions. "Can you help with THAT?" they ask, hardly daring to hope for relief. Luckily, it's fairly simple. By asking about the frequency, location, timing and quality of the pain, you can determine what is causing the imbalance and how to treat it. Accurate assessment of the problem is essential to get to the root cause.
You probably already know this, but it bears repeating. If a client comes to you in a state of disease you don't understand, refer, refer, refer! If a headache comes on suddenly, severely or is accompanied by nausea, tell the patient to use the acupressure point at the tip of the index finger to dial 911. I had a 41-year-old female client with those symptoms. She died in the parking lot in front of a hospital from a subarachnoid hemorrhage. Other causes of headaches that need medical intervention include meningitis, cerebral tumor, hypertension and ear infections. Be safe and get a medical diagnosis!
Looking at Patterns
In Chinese medicine, to reach an accurate assessment of a client's condition we need to look at the overall pattern based on the five elements and the zang-fu (the energetic actions of the organs); the quality of the pain; what makes it better and worse; and the location of the pain. I will give an example of each and delve more deeply into assessment by location, based on the meridians.
Five-element and zang-fu pattern discrimination look deeply at where the client is physically, emotionally and spiritually. These aspects have never been thought of as separate in Asia; they never suffered the Cartesian mind/body split as we did in the West.
When people have constipation, they are having trouble letting go of physical waste. This may manifest on an emotional level as well, in not being able to let go of waste in their lives. Maybe they are holding on to a lost love or friends that are obviously toxic to them. In Chinese medicine, these are all manifestations of a metal imbalance - encompassing the lung and large intestine meridians. So the treatment is the same, whether they are physically or mentally having trouble letting go of wastes. It's the same imbalance, which could result in headaches. There are approximately 17 different five-element/zang-fu types of headaches, so I obviously can't go into each one in this article.
The quality of the pain is going to give other information. For example, a dull ache indicates a deficiency condition. Slow, deep-but-gentle pressure with the intention to tonify is used to treat this condition. Sharp pain means there is an excess condition; quicker movements are used to disperse, going away from the head.
What makes the headache better or worse also gives useful information. For example, the person who says that their headache gets worse after they have sex has a kidney qi deficiency. If having sex relieves their headache, then it is most likely due to liver fire or liver qi stagnation.
Treating by Location
Determining the location of the headache is essential in developing a treatment plan in conjunction with zang-fu pattern discrimination. The four areas of the head (and corresponding headaches) are listed below:
Taiyang headaches are treated by working on the two taiyang meridians: the bladder and small intestine. It is important to work on local points, like GB 20, as well as distal points on the bladder and small intestine, like BL 60 and SI 3. All of these have a powerful affect on the neck and occiput region. A chronic headache in this region could be due to a kidney qi deficiency manifesting in the bladder meridian.
Temporal shaoyang headaches need gall bladder and triple heater meridian treatment. GB 8 and taiyang are useful local points. The distal points are on the shaoyang meridians - TH 5 and GB 41. I often teach GB 41 to clients with migraines. Someone once told me, "That's so funny! Whenever I have a headache, I'm intuitively drawn to pressing that area of my foot, and it helps!"
The location of this headache follows the course of the gall bladder meridian, which has a very close relationship with the liver. I can guarantee that the liver is somewhere behind the cause of that headache, whether it is liver-fire, liver-yang or liver-wind rising. Keep this in mind when you are doing a more detailed assessment.
Yangming frontal headaches require large intestine and stomach meridian balancing. A common mistake is to treat a headache in the forehead region with bladder meridian points, when in actuality, stomach and large intestine are much more effective. The stomach meridian internal pathway begins at LI 20, and as it goes up alongside the nose, reaches the forehead from BL 1.
Maybe the most famous acupressure point for headaches is LI 4, located on the webbing between the thumb and index finger. It is quite effective for headaches as a distal point, but only for yangming headaches! People that have tried this point with other types of headaches are most likely convinced this acupressure stuff is a bunch of hooey. Along with LI 4, use ST 44 as another distal point. Effective local points for this type of headache are St 8, yintang and ST 3. A yangming headache often is caused by dampness (tx SP 9) or phlegm (tx ST 40). Symptoms pointing to these pathogenic factors are a heavy, muddled feeling in the head, a sticky tongue coating and a rolling pulse. Brace yourself for a long haul, though, since these are the most difficult pathogenic factors to resolve!
Finally, jueyin headaches are at the top of the head. This is related to the liver meridian, which has an internal pathway up to that area. An effective local point is DU 20; an excellent distal point is LV 3. A jueyin headache could be due to deficient qi and blood as well. Best to look at all signs and symptoms.
The above examples are more useful for those who have gone through a complete program of Asian bodywork therapy. ABT is an ancient healing art that allows you access to a person's core being. You aren't going to get it by reading an article. Get out there and learn it! It's a whole new way of being in and relating to the world.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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