Pain Management

Low Back Pain

Back pain is among the most prevalent health complaints of mankind. There are variable reasons to cause low back pain. Soft tissue injuries, sprains and strains, disc problems, and other causes could all be the cause of back pain. These problems mostly do not occur by accident, but rather gradually develop through cumulative degenerative processes. 

Back pains appear through any feeling of an ache anywhere in the back. Modern research work has shown that pregnancy, depression, obesity, smoking as well as performing strenuous physical activities predispose one to back pains. They may be mild and severe but in most cases they do clear within a short time. 

It is important to understand what really cause back pain in order to treat the problem.

In Traditional Chinese Medicine, all the pains are resulted from blockage of free flow of Qi.

Qi can be described as energy, material force, electromagnetic current, matter, ether, vital force, or life force. Qi travels throughout our entire body in channels or meridians reaching every aspect of our body. Then how does the free flow of Qi and blood in the body become impeded, so as to cause pain?

1. An external invasion of wind, cold, dampness, or heat may invade the lower back region causing pain. If our defensive Qi or immune system is weak we become more susceptible to external invasions.

2. The Qi and blood can stagnate due to trauma (i.e. lifting, repetitive strain over time, an accident or similar sprain).

3. There may be an insufficiency of Qi or blood creating a sluggishness or stagnation of flow throughout the channel(s). This is an internal cause or weakness with a number of possible etiologies such as poor diet, insufficient rest coupled with too much activity or overwork (i.e. busy lives, excessive sex), overuse of drugs, chronic illness, heredity weakness, an excess of the emotions fear and anxiety, and general aging as our Qi is naturally declining.

In my opinion, emotional stress is less known cause of back pain but impacts a lot. Prolonged emotional stress creates a sympathetic dominant state in the autonomic nervous system and leads to decreased blood flow to most of the organs, muscles and peripheral tissues. When blood flow to the lumbar muscles is decreased, the muscles become tight, lose flexibility, and are easily fatigued.

Therefore my treatment approach addresses all aspects of back problems both biomechanical and psycho-emotional using acupuncture, massage, cupping, TDP lamp, herbal medicine, consultation for proper diet, exercise, and stress management.

Neck & Shoulder Pain

Neck and shoulder muscle tension and stiffness is an extremely common complaint.

Neck pain can be very frustrating and irritating; so much so that the phrase "a pain in the neck" has become a metaphor for all kinds of other irritants. Because of its position and range of motion, and because it plays a vital role in the support of the head, the neck is more subject to injury than any other portion of the spine.

The neck is a crucial part of the body which very readily reflects the state of tension and stress typical of the rushed life-style of industrialized countries which causes tensing of the neck muscles and pulling of the head backwards.

Tightness at the top of the neck can influence autonomic nervous functioning and prolonged period of tension can cause a various symptoms such as headache, lack of concentration, poor memory, insomnia or irritability.

Most neck and shoulder stiffness results from a variety of factors including continuous mechanical strain and emotional stress.

Wrong position for a prolonged time often causes neck and shoulder stiffness. For example, sitting in front of a computer and typing for extensive periods of time causes a lack of circulation in the tissue and fatigue of the muscles involved.

Also sudden force such as a car accident (whiplash) can cause neck pain.

Constant emotional stress is also a huge factor to neck and shoulder stiffness, especially in today's stressful society. Prolonged emotional stress creates a sympathetic dominant state in the autonomic nervous system and leads to decreased blood flow to most of the organs, muscles and peripheral tissues. When blood flow to the neck and shoulder muscles is decreased, the muscles become tight, lose flexibility, and are easily fatigued. In this case, patients also suffer from other internal problems such as digestive problems, constipation, insomnia, irritability, cold hands and feet etc.

In terms of Chinese Medicine, "pain" is due to stagnation of vital energy, called Qi. Neck and shoulder pain simply means bad circulation of Qi in the affected area. Constant stress can aggravate the circulation of the whole body, resulting in making the neck and shoulder pain worse.

Therefore, Chinese medical treatment to neck and shoulder stiffness and pain deals with both mechanical and emotional aspects. The best result can be obtained by acupuncture, massage, cupping, TDP lamp, herbal medicine, consultation for proper diet, exercise, and stress management.


Pain between shoulder blades

The area of the spine between the shoulder blades is one of the most tired and strained areas of our back. This area is called the thoracic spinal column and has a natural curve forward or convexity. It is located between the cervical spine and the lumbar spine, both curving in the opposite direction, forming a concavity. This puts extra strain on the thoracic part of the spine.

The pain is located between the shoulder blades, close to the spine – maybe one to two inches away from it – and either on the right or left side. The area is usually described being as big as a loonie or a toonie.

The pain can vary from mild to excruciating, but has a tendency to be severe, especially when people are tired or stressed. I have known several patients who had morphine injections on a regular basis right into the pain point, because that was the only way to –temporary- suppress the pain. Normal physiotherapy and chiropractic treatments only gave a short relief and the pain would always come back. In severe cases the pain would radiate from the back along the ribs to the front.

Almost all of our daily activities are directed forward; think about driving, typing, writing, painting eating etc. These activities make the convexity even stronger. Along the spine are muscles that connect the different vertebrae to each other. When the natural curve is constantly over strained, these little muscles become over worked and their blood supply decreases. As a result too much debris is built up in the muscle and this creates tension and pain. Eventually only a little bit overuse is enough to trigger the pain and this becomes worse over the years. This is an example of a repetitive strain injury.

Another possibility for this pain is irritation of the intercostal nerves. These nerves run from the vertebrae to the front of the body, between the ribs. These nerves are very sensitive and a wrong posture for a prolonged time or too much muscle tension can irritate them and cause a very intense pain.

As we can see the main reason for the development of this pain is bad posture and repetitive strain.

The reason that this pain is so severe and long term is that people only seldom take the trouble to really improve their (working) posture and try to break through the repetitiveness. Most patients who develop this pain have a sitting (computer) job.

It is obvious that the first thing to do is teach the patient the mechanics of the area and the injury. Without that no treatment will work and the pain can become so strong that it becomes disabling.

When the proper instructions are given, the spine needs some mobilization techniques in extension direction (from convex to concave) and some good home exercises. A very good exercise is the towel exercise: role up a small towel into a foot long towel roll. Put the roll on the floor and lie down on top of it, so that the roll is positioned lengthwise between the shoulder blades. The neck is free, head on the floor, arms next to the body, palms up and knees bent. Stay in that position for 15 minutes, three times per day. This will help restore the natural curve of the spine.

Acupuncture is ideal to relieve muscle spasm and tension in this area, because of the localized character and the relatively small size of the lesion. The needles can find the right ‘hot spot’ better then any other approach. Acupuncture will at the same time improve the blood flow, increase the flow of energy and relax the muscles. Distal points can be used on meridian points that are related to the situation. The needles will help the brain send a flow of endorphins to the area to suppress the pain.

Acupuncture, mobilization and postural correction are the ideal combination to fight this very severe and stubborn pain. Even then it will still take some time before this pain can be brought under control.


Rotator Cuff Injury

The rotator cuff is made up of the various muscles and tendons in the shoulder that connect the upper arm bone to the shoulder blade. They also help hold the ball of the upper arm bone firmly in the shoulder socket. The shoulder has the greatest range of motion of any joint in our body.

A rotator cuff injury is fairly common and can involve any type of irritation or damage to the rotator cuff muscles or tendons. The most common problems are tendinitis, when one of the rotator cuff tendons becomes inflamed due to overuse or overload (especially common in athletes), bursitis, when the fluid-filled sac (bursa) between the shoulder joint and rotator cuff tendons become irritated and inflamed, and muscle or tendon strain or tear, which can happen with tendonitis that is left untreated, or with stress from overuse.

Injuries are most commonly caused by normal wear and tear of daily life, poor posture or slouching, a sudden fall (and using our arms to break the fall), lifting a too-heavy object or lifting improperly, pulling something heavy, or repetitive arm activities, especially those done overhead, that cause stress to the shoulder.

Symptoms may include shoulder pain, tenderness and weakness, loss of shoulder range of motion, and a tendency to keep the shoulder inactive. Pain is the most common symptom of rotator cuff injuries, and may be experienced when reaching overhead, behind the back, lifting, pulling, or sleeping on the affected shoulder. A severe injury, such as a large tear may cause continuous pain and muscle weakness.

Treatment for rotator cuff injuries typically involves rest, over-the-counter pain relievers, and gentle stretching. Physiotherapy may be recommended to help heal the injury, improve flexibility of the rotator cuff, and develop shoulder muscle strength. Depending on the severity of the injury, full recovery may take from several weeks to several months. In more severe or chronic cases, treatment may involve corticosteroid injections or surgery. About half of the time, a rotator cuff injury can heal with self-care measures or exercise therapy.

Acupuncture can be very helpful in dealing with rotator cuff injuries. Treatments can help to relieve the inflammation, pain and muscle weakness and stiffness caused by the injury, which can speed recovery and bolster the body’s self-healing mechanisms. This makes acupuncture an excellent option in treatment of rotator cuff injuries, as it can complement other treatment therapies and can reduce the length of recovery time. Acupuncture can also be of particular benefit to lagging injuries that seem to just not want to get better. In addition, acupuncture helps the body to function better, and so can help to strengthen the shoulder and promote its proper functioning. In Chinese medicine, rotator cuff injuries are often due to an obstruction of the flow of qi-energy and blood to the shoulder, causing pain and weakness. Acupuncture can remove these blockages to allow full circulation of qi-energy and blood to the shoulder, allowing it to receive the nourishment it needs for proper functioning. In addition, a person may also have internal balances or weaknesses that make him or her particularly prone to a shoulder injury of some sort. By determining the cause of the pain and looking at each person’s individual health, we can not only resolve the pain and weakness that is being experienced, but we can also strengthen the body so that it is functioning in better health and less prone to a repeat injury or pain problem in the future.

Headaches/Migraine

Headaches

Headaches are a common ailment and can make life very difficult. Headaches can have a wide range of causes, but often the causes are not well understood by Western medicine, and in most cases do not have an identifiable underlying physical cause. To make matters worse, headaches can often be a rebound effect of the very medication that people take to relieve them. Medications are usually the standard treatment method, however some chronic daily headaches are resistant to all medications.
Fortunately, acupuncture can offer both immediate as well as long-term relief. In Traditional Chinese medicine (TCM), a number of factors are always considered in headaches. These are constitution, emotions, overwork, diet, accidents, childbirth and external pathogenic factors (such as common cold). There are a few ways to diagnose the cause of headaches, one is according to the where the headache is located on the head and which meridian is being affected, another is according to the pain type.  
A headache on the top of the head is part of the liver channel and is commonly due to a liver-blood deficiency; this type of headache gives a dull pain and will usually improve when lying down. A headache on the sides of the head indicates gallbladder channel and is commonly due to too much heat or fire in the liver. This headache will be sharp and/or throbbing.
Headache behind the eyes, a frequent location for migraines, is also due to liver-blood deficiency if the pain is dull, or liver heat if the pain is sharp and severe. The forehead is part of the stomach channel and is either a stomach deficiency if the headache is dull, or stomach heat if it is sharp.
The back of the head is part of the bladder channel and if headaches in this area are chronic, it usually indicates a kidney deficiency manifesting on that channel. An acute headache on the back of the head is most commonly due to exposure to cold weather and usually indicates the beginning stage of a common cold.

If the whole head is affected and the pain is chronic, it is due to a kidney-essence deficiency. The kidney essence is said to nourish the brain, if it is deficient and the brains lack this nourishment there will be a chronic dull headache with a sensation of emptiness.
When diagnosing according to pain type, dull pain means deficiency. A feeling of heaviness is characteristic of dampness or phlegm obstructing the head and preventing proper circulation. A distending headache that is throbbing, bursting, or pulsating is typically due to the liver (liver-heat). Stabbing headaches with a sensation of very intense pain and fixed in one location are due to blood stasis. Stiffness or tension headache is commonly due to overactive heat in the liver if chronic and invasion of cold if acute.  
There are other factors that can be used in understanding headaches such as what aggravates or eliminates the headaches, including time of day, activity/rest, weather, emotions, food, posture, time of month, and if there is relief or more pain with palpation.
Overall, this analysis gives an acupuncturist a very accurate picture of what is causing the headaches, therefore treatment is very targeted and effective. In fact, it is common for people to see relief after one or a few acupuncture treatments, although more treatments are often needed to resolve the problem. And long-term relief is possible- many patients reduce or eliminate their need for headache medication through acupuncture, demonstrating the effectiveness of this safe and natural therapy.


Migraines

Migraines are severe, chronic headaches that can cause significant pain for 4 to 72 hours. The frequency with which these headaches occur varies from person to person, from several times a month to much less frequently. A typical migraine attack may include symptoms of moderate to severe pain on one or both sides of the head, head pain with a pulsating or throbbing quality, pain that worsens with physical activity, pain that interferes with regular activities, nausea, and extreme sensitivity to light and sound.

Although much about the cause of migraines isn’t understood, genetics and environmental factors seem to both play a role. They may be due to changes in the trigeminal nerve, a major nerve in the head or imbalances in brain chemicals such as serotonin (which drops during migraines). Migraines may be more common in people under 40, in women, and in people with a family history of migraines. Stress, certain foods, strong stimuli (such as lights, sounds or smells), disruptions to sleeping patterns, physical exertion, changes in the weather, medications, and hormonal changes can all trigger migraines.

From a Chinese medicine (TCM) perspective, migraines can be caused by a combination of inherited constitution and lifestyle factors such as diet and stress, including emotional stress and overwork. Over time these factors can contribute to a pattern of imbalance that leads to migraines. Because there are different causes for migraines, the symptoms that are experienced will differ from person to person, and so will the treatment. 

Initially, acupuncture can help to relieve both the severity and frequency of migraine symptoms. In fact, it is common for people to see relief after a few acupuncture treatments, although more treatments are typically needed to resolve the problem.

As treatments progress and begin to rebalance the body, the frequency of migraine episodes begins to decrease. And long-term relief is possible- many patients reduce or eliminate their need for migraine medication through acupuncture, demonstrating just how effective an option acupuncture can be.

Upper Back Pain

Upper back pain can be a common problem for a few reasons, a lot of which have to do with our lifestyle. Because we spend a lot of time sitting, we can put extra strain on the upper back as well as create postural problems. This, combined with lack of exercise which weakens the muscles in the upper back, can lead to upper back pain. Also, many of us carry tension in the shoulders, neck, and upper back, leading to further pain. The spine is a connected unit, so problems in the neck or lower back can lead to pain in the upper back as well.

The two most common causes of upper back pain are muscular pain and joint disorders. Muscular pain can develop easily in the large upper back muscles, either due to lack of strength, or injury from overuse through sports, work, or repetitive use. Joint dysfunctions can also lead to upper back pain. Because the vertebrae in the upper back are connected both to each other and to the ribs, there is more possibility for problems. Problems can arise where the ribs connect to the vertebrae, such as with a rib fracture or a rib that shifts out of place.

In the treatment of upper back pain, exercise and postural correction are very important. Acupuncture can also help in the healing process, by helping to relieve pain, inflammation, and stiffness and strengthen the area. By looking at what is causing the pain, we can determine how to correct the problem. Is it due to trauma, whether through an injury or over time through poor posture or repetitive stress? Is it due to our external environment such as too much exposure to cold, heat, damp, or wind? Or is it due to an underlying internal imbalance that is weakening the musculo-skeletal tissues?

While working very well for dealing with the pain and inflammation of upper back pain, acupuncture can also help to strengthen the upper back and to correct internal imbalances that may be contributing to weakness or pain or hampering proper healing. 

Hip Pain

Hip pain is a common problem that can have a wide variety of causes. The exact location of the hip pain can usually provide clues as to the underlying cause. Problems with the hip joint itself typically cause pain on the inside of the hip or the groin. Problems with the muscles, ligaments, tendons and other soft tissues that surround the hip joint will typically cause pain on the outside of the hip, upper thigh or outer buttock.

Because the hip is of course connected to the rest of the body, hip pain can sometimes be caused by problems in other areas of the body, such as the lower back or knees, called referred pain. 

Acupuncture is a great option for pain and musculo-skeletal problems and typically yields very positive results in all types of pain problems, both chronic and acute. 

In Chinese medicine (TCM) pain is often a due to an obstruction of the flow of qi-energy and blood throughout the body’s meridians or channels. Because qi-energy and blood circulation is what allows the body to perform its regular functions and also to heal when injured, any time the flow is blocked, problems inevitably develop and pain occurs. Acupuncture focuses on removing these blockages to allow full circulation of qi-energy and blood through the body, resolving pain and weakness and allowing the area to function properly again.

While musculo-skeletal problems like hip pain may be due to external causes such as a fall or an overuse injury, internal weaknesses of the body can complicate or aggravate a problem once it is there. Imbalances will contribute to weakness in the hip and make it more prone to injury, as well as more slow to heal. A good example of this is a deficiency of the kidneys, which gradually weaken as we age. This weakness can make us more prone to lower back pain and hip fractures or pain because this area is very closely tied to the health of the kidneys. By improving overall health and correcting imbalances that have an influence on the hip, we can strengthen and improve the health of the hip area so that it functions better and is less prone to future injury down the road- all good news for those suffering from hip pain.

Sciatic Pain

The sciatic nerve is the longest nerve in your body, running from the spinal cord to the buttock and hip area and down the back of each leg, and about the size of your little finger. Sciatica is a condition where the sciatic nerve is irritated. The most telltale symptom of sciatica is pain that radiates along the path of the sciatic nerve- from the lumbar area to the buttock and down the back of the leg. The pain can be anywhere from a mild ache to a severe sharp or burning pain, numbness or weak muscles along the nerve pathway, and tingling or pins and needles feeling in the toes or foot.

The irritation of the sciatic nerve can be the result of pressure from muscles that are too tense or too short, a bulging disc in the lumbar vertebral column that pushes on the nerve, an inflammation of the nerve, or bad posture or heavy work that involves a lot of lifting and bending over. The pain can be severe and often gets worse while sitting too long, driving, bending over and lifting heavy objects. Sciatica is a widespread injury and about 40% of us will eventually be affected by it in some form. Sciatic pain will sometimes be the sign of a herniated disc and it is certainly wise to pay attention to it in an early stage and get expert advice.

In Western medicine sciatica can be treated by many different health care professionals. The massage therapist will loosen the tension in the muscles of the back and leg, in order to relieve the sciatic nerve, the physiotherapist will give exercises to improve posture and stretch muscles and can apply ultrasound or interferential current. The chiropractor will align the spine in order to relieve pressure on the nerve. The doctor can prescribe painkillers or anti-inflammatories and the surgeon can do surgery to remove the bulging of the disc or contributing problem.

In Traditional Chinese Medicine (TCM), sciatica is considered to be a lower back problem, an area that is strongly influenced by the bladder and kidney channels. Sciatica can be differentiated into different types, depending on the exact cause. Damp-cold invading the back channels can occur in both acute and chronic cases, causing a dull, heavy, radiating pain that may be worse with cold or dampness. Sciatica due to stagnation of qi-energy and blood in the back area can cause either an acute or chronic condition that is aggravated with the absence of movement. Sciatica due to kidney deficiency will result in a chronic condition because of the fact that weak kidneys are unable to properly nourish the lower back area, making it susceptible to injury and dysfunction. This type of sciatica has a slow, gradual onset and typically will get worse in the evening and with fatigue.

Acupuncture can be extremely effective in the treatment of both acute and chronic back pain, including sciatica, regardless of how long the condition has been present. Sciatica often takes longer to treat than other types of back pain, but acupuncture can produce great results, both in treating the pain and in addressing the underlying weakness that is contributing to a sciatic problem.

Often in cases where there is a stubborn problem that doesn’t seem to respond to treatment, acupuncture can remove the blockages and open the doors for healing. Combined with exercises and postural advice, is a very valuable tool in treating sciatica.

Knee Pain

The knee is a complex joint that works much like the hinge of a door, allowing the joint to move backward and forward, but also has the ability to twist and rotate. This makes the knee joints especially vulnerable to damage, which is why they typically sustain more injuries than do other joints.

The knee joint is made up of the thighbone (femur), the two lower leg bones (the tibia and the fibula), and the patella, a bone that slides in a groove on the end of the femur. These bones are held together by four main ligaments, large bands of tissue that connect the bones together and help stabilize the knee joint during motion. Other structures in the knee include tendons (fibrous bands of tissue that connect muscles to bones and allow you to straighten or extend your leg), the meniscus (a C-shaped cartilage that cushions the knee joint), and bursae, (fluid-filled sacs that cushion the knee joint, allowing the ligaments and tendons to slide across it smoothly).

Normally, all of these structures work together smoothly. But injury and disease can disrupt this interplay, resulting in pain, muscle weakness and decreased function. A knee injury can affect any of the bones, cartilage and ligaments that make up the knee joint, as well as the ligaments, tendons, or fluid-filled sacs (bursae) that surround your knee joint.

The symptoms of knee problems can vary widely because of the number of structures involved and the range of injuries and diseases that can cause knee pain. Knee pain can be caused by an injury due to sports or a car accident, an awkward landing from a jump or fall, repetitive stress or overuse of the knee joint, sudden stopping or turning (such as in sports), hyperextension of the knee joint, degeneration of the knee joint from aging, and diseases like rheumatoid arthritis, osteoarthritis, and gout.

Acupuncture can be an effective way to treat knee pain. First we must find out the quality of the pain we are dealing with in order to understand the cause. For example, if we have a feeling of heavy pain we will know that a damp pattern is involved. A damp pattern occurs when the body’s internal functions are disrupted, causing the body to retain excess moisture, kind of like a basement. People with this pattern will notice more predominant pain in damp weather. If the pain is heavy and burning then we have damp-heat, or if it is heavy and cold, we have damp-cold. Sharp pain would mean blood stasis. A common pain for older people is weak, achy knees, which would mean a kidney deficiency.

It is also very important to understand where the pain is located around the knee. There are 6 energetic meridians that travel through the knee. When we understand which meridian is being affected, it can help us to understand which organs are being affected to determine the most important and effective acupuncture points to use.

By understanding what lies behind the pain, we are able to go deeper into the problem to resolve the contributing causes. Acupuncture can be very effective to give the body the stimulation that it needs to resolve these internal imbalances so that healing can occur. It can help to relieve pain, as well as to promote healing and strengthen internal weakness that makes the knee joint vulnerable, making acupuncture a treatment option that is safe, effective, and free from negative side-effects.

Ankle Pain

The ankle joint is an intricate network of bones, ligaments, tendons and muscles. It is built for both strength and flexibility, as it needs to bear the weight of our body while also having the flexibility for the various surfaces we walk on. The ankle joint can be prone to various types of injury and pain and ankle pain may be experienced on the inside or outside of the ankle or along the back where the Achilles tendon connects the muscles in the lower leg to the heel bone.

Most ankle pain results from a sprain, which occurs when the ankle rolls over the foot, causing a ligament to stretch or tear.  Sprains are often sports-related but they can also occur when walking on an uneven surface of from taking a misstep.  Ankle pain can also be caused by injury to any of the bones, ligaments or tendons in the ankle. Any kind of ankle injury will also affect our gait or walking pattern and in a chain reaction, the knee joint, hip joint, SI joint and spine become involved and so ankle pain can have far-reaching consequences.

As with other pain or injuries in the body, Chinese medicine (TCM) usually diagnoses ankle pain and injury as a blockage or lack of proper circulation of blood and qi-energy in the affected area. These blockages lead to pain, weakness, and an inability for the ankle to heal properly because it cannot receive the proper nourishment to do so. Acupuncture helps to remove blockages, increase circulation of the blood and energy, and also resolve any imbalances in the meridians that may be causing a weakness in the ankle and leaving it prone to injury or strain.

In the early stages of an injury, acupuncture can help to remove blockages and promote blood flow to the ankle, as well as relieve swelling and pain. With injuries in the middle stage of healing, acupuncture can help alleviate swelling and pain in the ankle, and promote healing of the tissues and bones. In later stages of injury, where the ankle has become rigid and weak, acupuncture can help to relax the tendons and remove blockages to regain movement and strength in the ankle. 

In all cases, acupuncture helps to strengthen the body and promote better functioning so that the body is better able to heal and to resolve the problem fully. Whether we are dealing with acute or chronic ankle problems, acupuncture can help to boost the body’s healing so that we can regain our health and return to our regular day to day functioning.

Foot Pain

Between the heel bone and the toes runs a strong fascia or ligament. It is made of connective tissue and supports the arch of the foot. The foot has two arches, a length arch and a width arch. The length arch is the one most commonly affected by plantar fasciitis. When the arch is round and strong the bones of the foot are in the right position and there is balance in the foot. When the arch flattens, a lot of strain on the bones and surrounding ligaments is created, resulting in pain, which can easily become excruciating, if not treated properly.

Athletes, especially those running on hard surfaces, put a lot of strain on their arches and are prone to developing plantar fasciitis. People carrying extra weight and pregnant women also put extra stress on the arch, and the bones and ligaments often cannot recover from the continuous strain. Jobs that require much standing and walking can also contribute to plantar fasciitis, as can wearing shoes with inadequate support. In all cases, the fascia gets overstressed and becomes inflamed.

According to Traditional Chinese Medicine the sole of the foot is primarily the area of the Kidney meridian. It is where the Kidney meridian begins and finds its way up to the chest. Close to the fascia runs the Bladder meridian, so weakness in the Kidney and Bladder meridians can result in plantar fasciitis among other symptoms. Pain and inflammation in Chinese terms are stagnation of blood and qi-energy in the involved meridians, because of a malfunctioning of the corresponding organs.

Allowing the foot muscles to rest and recover is also important- this can mean supporting them with properly fitting shoes, taking a break from exercise or training routine, or reducing the amount of time you spend on your feet while recovering. Plantar fasciitis can be difficult to treat simply because we rely on our feet so much during our day-to-day activities, and this creates a major hindrance to the healing process. Acupuncture, together with some rest, can offer relief in foot pain and improved function in a relatively short amount of time. The key to successful treatment is to address the problem early on, and to treat it fully so as to ensure that there are no lingering problems or that the condition does not recur.

Elbow Pain

The elbow is a complex joint formed by three long bones. Four sets of muscles help move the joint and are attached to the bones by thick tendons. Damage to any of these structures or to the joint's network of nerves, blood vessels and ligaments can lead to elbow pain. 

Most elbow pain results from overuse injuries, often sports-related but also as a result of activities or work that require repetitive arm, wrist, or hand movements. Elbow pain may also be due to arthritis, but the elbow joint is much less prone to wear-and-tear damage than other joints are. Common causes of elbow pain include ligament sprain and tears, golfer’s elbow, dislocation, elbow fracture, tendinitis, tennis elbow, osteoarthritis, or irritation or damage to one of the nerves in the elbow.

Acupuncture can be very effective for the many possible problems of the elbow, both acute and chronic. Acupuncture treatment can relieve pain, aid healing and help prevent future problems with elbow disorders.

Although muskulo-skeletal problems like elbow disorders are typically due to external causes such as a blow to the joint or an overuse injury, internal weaknesses of the body can complicate or aggravate a problem once it is there. So we also look at the overall health of the internal functions to find any areas of imbalance, particularly those that affect the meridians of the elbow. Imbalances will contribute to weakness in the elbow and make it more prone to injury, as well as more slow to heal.

Our bodies are amazing organisms that have the ability to self-regulate and repair themselves. In any disorder the body attempts to minimize, repair and overcome the damage to its normal functions and in many cases, given adequate rest and support, our bodies are able to recover successfully. However, in cases where the body isn’t able to correct a problem on its own, acupuncture is a promising treatment that helps bolster the body’s healing abilities so that we can return to our normal, healthy selves.



Carpal Tunnel Syndrome

The carpal tunnel is a narrow passageway bound by bones and ligaments located on the inside of your wrist. It protects the main nerve to your hand and the tendons that bend your fingers. When there is pressure placed on the nerve, it produces numbness, tingling, pain and over time, loss of strength in the hand, a condition that is known as carpal tunnel syndrome. Pressure on the nerve can stem from anything that reduces the space for it in the carpal tunnel, such as overusing the hand in work, sports and daily activities particularly through repetitive motions, injury to the area, or other health conditions. In many cases, carpal tunnel symptoms may actually be caused by a nerve compression in the neck rather than by a narrowing of the carpal tunnel. Bad posture, for example, can cause compression of the nerves that run down the arm and eventually pass through the carpal tunnel.

In Traditional Chinese Medicine, there are two organs that are commonly involved in many bone and muscle/sinew problems, the kidney and liver. The kidneys produce marrow and control the strength of the bones and the liver controls the state of the sinews (muscle and tendons).

When a problem arises in a joint, whether due to injury or overuse, the body is normally able to recover and heal the tissues. However, with injuries, the qi-energy and blood get stuck and no longer circulate through the joint properly, causing pain. If the quality of blood is generally poor, the injured site will of course take longer to heal or even fail to heal completely. When injury occurs in the case of overuse of a joint, the kidneys and liver are also involved, because the joint may sustain damage if it isn’t receiving a sufficient quality of nourishment and moistening of qi-energy and blood. 

With acupuncture we can reinforce the energy of kidneys and liver in order to strengthen the bones, muscles and tendons to allow them to heal properly and prevent future injury. 

TMJ

The temporalmandibular joint is the joint connecting the upper and lower jaw. TMJ disorders, commonly just called "TMJ", are used to describe pain or dysfunction in this joint. TMJ typically involves pain and stiffness of the joint.  There may also be clicking or popping noted when chewing or opening the mouth fully, like when one yawns.  Or there may be associated symptoms like headaches, neck stiffness, or even difficulty sleeping. TMJ is linked to stress, teeth grinding, dental problems, and excessive gum chewing. 

Of all the joints in the body the jaw joints are the only ones that move simultaneously. This creates problems that are unique to the jaw area. TMJ disorders can occur when the joint’s disc erodes or moves out of its proper alignment, the joint’s cartilage is damaged by arthritis, the joint is damaged by a blow, or the joint muscles become fatigued from overwork. The muscles that move these joints are small and have to work hard- they are involved in speaking, eating, laughing, yawning and singing- and it is relatively easy to overwork them.

Stress can also take a toll on the TMJ joint- a lot of people grind their teeth when they are stressed, nervous, or angry, or during their sleep, which puts enormous strain on the small joints and muscles. We can also cause strain to the area through our eating habits, like biting off hard food like chocolate or carrots. TMJ disorders can cause pain or tenderness in the jaw, aching pain in and around the ear or in the facial muscles, difficulty chewing, headaches, and difficulty opening the jaw.

In Western Medicine, TMJ disorder can be treated with physiotherapy and massage and with exercises, which teach us proper jaw alignment. Usually the results of this treatment are positive. Medications such as anti-inflammatories, muscle relaxants, and cortisone may be prescribed.

Acupuncture can help with TMJ disorder in a number of ways. When it comes to pain, acupuncture can give fast and positive results. Acupuncture can also help reduce inflammation to the area, as well as bring blood and energy circulation to the area, all of which help to promote healing. The muscles will begin to relax and automatically correct the opening movement.

The meridians that have connections to the jaw belong to the Gallbladder, Triple Burner, Small Intestine, Stomach and Large Intestine (partly). A deficiency of Blood and Energy (Qi) in these meridians is usually the cause of the pain. Blood and Qi will stagnate and can cause severe pain and stiffness.

The combination of acupuncture with other therapies and removing stress to the area can help to resolve this disorder. Things that can be done to reduce stress on the TMJ joints include maintaining a relaxed jaw posture, avoiding clenching or grinding teeth, avoiding overusing the jaw muscles such as avoiding sticky or chewy foods and cutting food into small pieces, and working to reduce stress and anxiety.

Chronic Pain

Chronic pain can be debilitating to live with and can interfere with all aspects of daily life. Pain is generally considered chronic if it lasts 6 months or more, and chronic pain may remain constant, or it can come and go. The quality of the pain can be tingling, jolting, burning, dull, aching or sharp.

The cause of chronic pain often isn’t well understood. There may be no evidence of disease or damage that points directly to pain. Or pain may remain after the original injury shows every indication of being healed. It can be due to a chronic condition, such as arthritis or fibromyalgia, but often there is still no clear understanding of the physical cause of the pain. Damage to a peripheral or spinal nerve may also lead to chronic pain, where the damaged nerve, not the original injury, is causing the pain. Nerve damage can result from accidents, infections or surgery.

Researchers think chronic pain may be partly caused by sensitization, a process where the nervous system amplifies and distorts pain, resulting in pain that is severe and out of proportion to the disease or original injury. Sensitization may affect all the pain-processing regions of your nervous system, including the sensing, feeling and thinking centers of your brain. When this occurs, chronic pain may be associated with emotional and psychological suffering.

Treatment for chronic pain often means managing the pain through over-the-counter pain relievers, prescription opioids, cortisone, or NSAIDs (non-steroidal anti-inflammatories). Unfortunately for many, medications often have undesirable side-effects and may offer only limited effectiveness for dealing with the pain. Other treatments may include physiotherapy, massage, chiropractic, counseling, and acupuncture, therapies which aim more at resolving the pain. Often, a combination of approaches is needed to effectively treat this problem.

Acupuncture is an excellent option for chronic pain. Although Western medicine has not yet uncovered the mechanisms of acupuncture, it is clear that acupuncture is very effective for treating all kinds of pain, both acute and chronic. This goes beyond the “placebo effect”, as acupuncture works just as well on animals (who bring no expectation to the treatment table). One of the reasons that acupuncture is good for pain is the way in which it stimulates the production of endorphins, the body’s natural pain relievers.

In addition, acupuncture focuses on correcting imbalances in the body and encouraging normal, healthy functioning of the body’s various systems, which may help the body to correct the sensitization process as described above, or changes or disruptions to the body as a result of injury or illness. In this way, it can help both to manage and relieve the pain in the short term, and help to address the underlying causes of the pain to help to resolve chronic pain over time.

I have seen patients with chronic pain respond very positively to acupuncture, with a reduction in pain symptoms and the overall level of pain. As pain diminishes, acupuncture helps open the door for healing, allowing a person to regain aspects of their former lifestyle and quality of life. It is very rewarding to see patients who have lived with debilitating pain on a daily basis for many years begin to see improvements in their pain and to see their pain slowly resolve, as is often the case with acupuncture treatment. Although chronic pain is a complex problem, acupuncture is a treatment option certainly worth considering

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing a painful swelling that can eventually lead to bone erosion and joint deformity. This condition is an autoimmune disorder where the immune system mistakenly attacks the body's own tissues.

Rheumatoid arthritis can cause symptoms of joint pain, swelling and tenderness, as well as red and puffy hands, firm bumps of tissue under the skin on the arms (rheumatoid nodules), and morning stiffness that may last throughout the day. It can also affect the whole body with fevers, fatigue, and weight loss.

Rheumatoid arthritis tends to affect the smaller joints first, such as the wrists, hands, ankles and feet, but as the disease progresses, the shoulders, elbows, knees, hips, jaw and neck can also become involved. Symptoms may vary in severity and may come and go. Flare-ups of disease activity alternate with periods of relative remission, during which the swelling, pain, difficulty sleeping and weakness lessen or disappear.

Doctors don’t know what causes rheumatoid arthritis, though it may have a genetic factor that is triggered by environmental factors such as a bacterial or viral infection. There is no cure for rheumatoid arthritis, and treatment involves managing symptoms to prevent flare-ups and further progression of the disease. Western medical treatment may involve medications to reduce joint inflammation, relieve pain and prevent or slow joint damage; physiotherapy to teach better movements to protect the joints; and in severe cases, surgery.

In Chinese medicine, rheumatoid arthritis is considered a “bi syndrome”. “Bi” means obstruction or blockage, and bi syndromes are characterized by an obstruction of qi-energy and blood by wind, cold, dampness, or heat. This causes symptoms of aching, pain, heaviness, numbness, stiffness, redness, and swelling. Bi syndromes usually arise because of an underlying weakness or imbalance in the body that makes us vulnerable to injury or disease.

Bi syndromes that lead to rheumatoid arthritis typically arises from an imbalance of the kidneys, because of their role in the functioning of the bones and marrow, and the spleen, because problems with the spleen can lead to internal dampness in the body, as with joint swelling during a flare-up. The liver is also often involved with rheumatoid arthritis, because liver dysfunction can lead to blockages of qi-energy and shortage of blood, and the liver is also closely tied into the health of the tendons and ligaments.

However, rheumatic arthritis may have different causes depending on the person, and determining the organs involved is done by looking at the specific symptoms for each person. In this way, treatment is tailored to the individual’s symptoms and constitution, to better target the causes and relieve the symptoms.

Acupuncture has a lot to offer those suffering from rheumatoid arthritis. It offers a healthy way to manage the symptoms of the condition, helping to reduce pain and inflammation and prevent flare-ups from occurring. Acupuncture improves the body’s healthy functioning, including the immune system. It is also very effective for the relief of pain and inflammation- in the case of rheumatoid arthritis, relieving joint pain and stiffness and helping the joints to function more healthily.

For those who suffer from rheumatoid arthritis, acupuncture offers a safe and healthy option to help manage the condition, prevent further progression, and enjoy life symptom-free.

Sports Injuries

Sports injuries are injuries that occur in athletic activities. Some sports injuries result from accidents; others are due to poor training practices, improper equipment, lack of conditioning, or insufficient warm up and stretching. Many sports injuries can be due to overuse of a part of the body when participating in an activity. Other types of injuries can be caused by hard contact with something. Sports injuries typically involve the musculoskeletal system, which includes the muscles, bones, and associated tissues like cartilage.  

Acupuncture can be of benefit to all types of sports injuries. It is of course always best to treat an injury in the acute stage or as soon after an injury occurs as possible, in order to assist the body in healing quickly and fully. Early treatment also helps to prevent the possibility of long-term or chronic problems with the injury down the road due to improper healing. However, acupuncture is also very beneficial in any stage of healing and can also be of great help to old, lingering injuries or injuries that did not properly heal. Acupuncture taps into the body’s own resources to encourage the healing process and the body’s optimal functioning. With sports injuries this can mean reduced inflammation, increased circulation, reduced muscle tension, and of course, pain relief. Treating sports injuries, whether old or new, can help the body to regain former functioning and health levels and prevent more long-term consequences such as reduced mobility, stiffness, weakness, or arthritis.

Our bodies have amazing abilities to self-regulate and repair themselves. In any injury the body attempts to minimize, repair and overcome the damage to its normal functions and in many cases, given adequate rest and support, our bodies are able to recover successfully. However, in cases where the body isn’t able to correct a problem on its own, or in cases where long-term damage can occur if left untreated, acupuncture is a promising treatment that helps bolster the body’s healing abilities so that we can return to our normal, healthy selves.

Fibromyalgia

Fibromyalgia is a chronic condition characterized by a constant dull pain throughout the body accompanied by fatigue and sleep disturbances. Symptoms can vary depending on the weather, stress, physical activity, and even time of day. Generally the pain is widespread and occurs in the muscles, tendons, and ligaments, along with especially sore spots called “tender points” on various areas of the body.

Fibromyalgia can be accompanied by many other conditions including chronic fatigue syndrome, depression, headaches, IBS, arthritis, and restless legs syndrome, among others. There is still no clear cause for this condition, though it is believed to be a combination of genetics, stressful events such as car accidents, emotional stress or trauma, repetitive strain on the body, infections and other illnesses- basically everything that drains our immune system.

Fibromyalgia is a complicated condition and Western medicine often finds it difficult to treat. Fortunately, acupuncture has a lot to offer for sufferers of fibromyalgia. 

With fibromyalgia, there are a number of patterns in Chinese medicine (TCM) that can contribute. The first is spleen deficiency, which can be responsible for many of the symptoms of fibromyalgia, including fatigue, digestive problems, muscle weakness, and poor thinking. Liver qi/energy stagnation or blockage can also be a factor, causing emotional symptoms and muscle-joint stiffness. Blood deficiency prevents the body from being properly nourished, causing the constant pain typical of fibromyalgia. Kidney deficiency also plays a role, as all chronic muscle-joint pain tends to include the kidneys, and the kidneys are at the foundation of good health.

Acupuncture can help to reduce tender points, relieve body aching and pain, and improve mood, sleep and digestion, as well as many of the other symptoms associated with fibromyalgia. The key to remember with acupuncture is that it is a healing process, rather than an instant fix, so recovery takes time and each treatment builds on the progress of the last, producing a steady and gradual improvement. We must also factor in the complexity of the condition and consider that conditions that are more complex or that have been developing over a longer period of time take more time to reverse and undo.

Post Operative Recovery

Surgery is a powerful tool in the modern medical tool kit and is used today in a wide range of applications. Surgery for musculoskeletal conditions is called orthopedic surgery, and is used to treat musculoskeletal trauma, degenerative diseases, sports injuries, infections, tumours, and congenital disorders (disorders we are born with). This includes surgeries such as hip or knee replacement, spinal surgery or fusion, carpal tunnel release, or repair of tendons, ligaments, or cartilage. However, there are many, many other surgeries that are performed for a variety of reasons, such as to help relieve or prevent pain, to reduce a symptom, to improve some body function, or to diagnose conditions.

With surgery comes certain post-operative side effects and risks. Some of the major concerns with surgery is dealing with post-surgery pain and the side effects of pain medications, as well as making a complete recovery from surgery and regaining our former mobility and functions.

Doctors rely on powerful medications to relieve pain during and immediately after surgery, including opioids and anesthesia. Opioid pain medications are known to cause side effects such as nausea, vomiting, dizziness, pruritis (itch or a sensation that makes a person want to scratch), constipation, and sleepiness, symptoms which can cause difficulty in the recovery and interfere with our day-to-day life. Use of opioids and their side effects may also delay post-operative recovery.

Acupuncture is an excellent option for post-operative recovery and has been shown to be very effective in the treatment of both post-operative pain and the side effects of opioid medications. Acupuncture is probably best known for the treatment of pain and it is indeed very effective for relieving pain and reducing the need for pain medications. Pain limits your ability to breathe deeply, cough, walk and perform the activities necessary for a speedy recovery, and acupuncture can help to manage the pain so that recovery can happen more quickly.

Acupuncture can also treat the side effects of pain medications including dizziness, upset stomach or nausea, loss of appetite, pruritis (itching sensation), urinary incontinence, and digestive problems, making it an effective option for post-operative recovery.

Acupuncture can also help with the body’s recovery following surgery. While surgical techniques have come a long way, surgery still remains a type of trauma that the body must recover and heal from afterwards. Acupuncture helps to boost the immune system and to restore proper functioning to the body, and in post-operative care can help the body to recover and regain health more quickly.  Acupuncture can also help with inflammation, decrease swelling and improve mobility and range of motion after surgery. This is important to recovery in order for a person to regain their full abilities and have full use of the body in the months down the road from surgery. Acupuncture may also help reduce adhesion formation and reduce scarring and scar tissue as the body heals from surgery.

Research shows that acupuncture can indeed be very effective for post-operative recovery when surgery is followed by a series of acupuncture treatments, and it can also be beneficial to perform acupuncture a day or two before surgery. This ensures that the body is in a healthy state going into surgery in order to ensure a complete and healthy recovery.