resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Leaving Footprints on Capitol Hill: Tribute to Dr. Kenneth Luedtke (1930-2014)
It was with great sadness that I heard of the passing of Dr. Ken Luedtke.
Unlevel Pelvis in the High-School Athlete: Exploring Causes and Effects
The unlevel pelvis is all too common in the high-school athlete and if not detected, will likely cause a lifetime of musculoskeletal issues. Any provider who doesn't look for this common finding is missing critical information.
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
October, 2001, Vol. 01, Issue 10
Unraveling the Lower Back Pain Puzzle
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
If you've practiced bodywork for more than a day, you've probably encountered a client with lower back pain! It is the single most common complaint from people who walk into my office, no doubt for you as well.Helping patients with lower back pain can greatly increase your skill in accurately assessing this condition, according to Chinese medical theories.
In Chinese medicine, there is never a direct correlation to Western assessment. For back pain or any other ailment, there isn't a silver bullet/magic acupressure point that will fix the problem. As I mentioned in previous articles, if someone has depression, you have to look at the Five Element correlation to effectively treat it. To treat a headache, we have to know where it is located to select meridians that will bring relief, based on the Six Divisions theory.
So, are there different elements that relate to the various types of back pain, or different types of back pain based on location? Nope, sorry! Knowledge of the Five Elements and Six Divisions will help you in treating lower back pain, but they are not the key. The Four Examinations and Eight Principles will give you the clues you need to solve your client's back pain puzzle once and for all. (To confirm your suspicion, just about all Chinese medical paradigms begin with a number, and there are a lot of them!)
The Four Examinations start with listening, as you get an idea of their condition based on the client's voice on the phone. Next is observing ,as you note posture and affect as the client walks in the door and you look at the tongue, face and any abnormalities along the meridian pathways. By now, you are asking questions and touching the client's pulses and meridians. The fun part is taking all of that information and making sense of it all.
Sorting it out is where the Eight Principles come in. Is the client's condition acute or chronic, superficial or deep, hot or cold, excess or deficient? Let's look at the main individual types of back pain to figure it all out.
This type of back pain is chronic, deep, usually cold and of course, deficient. We know that if the client has had the problem for a long time, there is definitely something depleted. Chronic conditions have moved deep into the body, and the pain has a more diffuse, dull nature. The pain is worse at the end of the day when the person is tired; back pain will take the form of a dull ache, rather than a sharp pain. Sexual activity will aggravate it. Kidney energy is something that gradually decreases with age; but too much sex, overwork, stress, drugs and alcohol will deplete it faster.
You will notice general Kidney symptoms, such as a pale face and tongue, frequent urination and fatigue. In addition, if it is a Kidney Yang Deficiency, there will be cold symptoms such as cold feet, and there will be some relief from the pain with the application of heat. If there are general Kidney deficiency symptoms plus a thin and rapid pulse, a red tongue with no coating and a vague, low-level anxiety, there is probably a Kidney Yin deficiency.
This is the type of back pain that gets worse when it is cold and rainy outside. You'll find that heat gives considerable relief. With dampness, there is a heavy feeling. It is excess in that it is caused by a pathogenic factor; you may be able to trace onset of the pain to a specific event, such as the client sitting in front of an air conditioner while covered with sweat. For example, I had one client that said his back pain started from when he was at his son's soccer game, sitting in the cold rain.
Stagnation of Qi and Blood
This is the type of back pain that improves with light exercise. You will find clients who say that when they get up in the morning, their back is sore, but after they move around and stretch for a bit, it feels better. This is a clear indication that there is stagnation blocking the free flow of Qi, causing pain. They usually have a history of a traumatic injury which never was treated properly, so it keeps reoccurring.
You may find that with the latter two excess types of back pain, there is an underlying Kidney Deficiency. Since the Kidneys rule the lower back area, there is an initial weakness that exposed them to injury, or that let in an external pathogenic factor, such as cold-damp. Even if the client didn't start off with much of a Kidney Deficiency, one will be created by long-term problems in the lower back. In any lower back pain treatment, make sure to include techniques that will tonify the Kidneys. Hold the Kidney shu points bilaterally with a tiger's mouth (thumb and index finger apart, like they are chomping the points) as you work up the Kidney meridian with your other hand, starting on the sole of the foot. Use deep, penetrating pressure, but not to the point that it is at all painful. You are trying to encourage qi into that area and sharp pain will make it want to go away. You can think of it like you are attempting to entice a reluctant cat: "Good qi, come on qi, here you go qi..." Use any technique that is going to have that vibe to it. Also, hold the area that is painful and work down the Bladder meridian.
If you are trained in using moxa, that is really one of the best techniques that you can do to add qi to an area. Make sure of course that the client is not showing any Heat symptoms such as a rapid pulse, red tongue/ face, feeling warm or inflammation. Choose points such as the Kidney shu, mu and ashiqi. Think of that little kitty that just likes gentle chin scratches. (Editor's note: For a more detailed explanation of shu and mu points and ashi points (painful points that make that make the client say, "Ah-sh...!") You want to use tonifying circles clockwise with a moxa pole in your right hand as you place the point between a V made by your index and third finger. When you feel your fingers getting warm, you know the point is also warm. You don't want the feeling to be painful to your client, as it will disperse, please read Barbra's columns from the July and September issues of Massage Today.
If the client has either of the later two excess types of back pain, you will need to use techniques that disperse the cold-damp or move the qi and Blood stagnation. For cold-damp, fire cupping is great to use with a TDP lamp. This is a pretty dramatic technique as you take a flaming meatball looking thing on a stick, insert it into a glass cup to take out the air, and quickly place a cup each over Du4 and the ashi/ painful points. This creates a suction and pulls apart the meridians (and fascia), allowing the pathogenic factors to be released. A TDP lamp is specifically designed to warm yang and expel cold. It can be placed over the area for the 10 minutes that you are using the cups. (Note: Do not try either of these techniques without training, as there is as much potential for causing harm as good!)
Another technique that you'll want to learn is gua sha. This is what I use if there is any qi and/or Blood stagnation; I follow this technique with stretching. Put an ointment on the area, such as Tiger Balm or Vicks Vapor Rub, depending on whether the client has cold or heat symptoms. Scrape it with a Chinese soupspoon or a smooth jar lid, just to the point where your client starts to feel uncomfortable. There is quite a contrast to how it feels and how it looks. It has a wonderful opening, freeing effect on the area that had stagnation, although it looks as if you have dragged your client along the road. You can see why caution is advisable!
You may be starting to see how your initial assessment is going to affect how you treat your client. You always will be successful treating points local to the problem, and distal on the affected meridian, but to affect long-term changes, you need to find and treat the underlying pattern of disharmony that is the cause of the problem.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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