resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.