ACUPUNTURE

The Acupuncture Treatment

Acupuncture treatments consist of a short intake interview, pulse taking and tongue inspection. If necessary, we will do orthopedic testing, which may include range of motion, sensory and muscle testing. This information is used to make a diagnosis after which acupuncture is administered. Needles are typically retained for 15 minutes, making the total treatment time approximately 45 minutes to 60 minutes. Depending on the complexity of symptoms, your treatment may be slightly longer or shorter because it is tailored to your specific needs.

The course of treatment depends on the severity of symptoms but in general, the more chronic the problem is, the longer it will take to treat. Four to eight weeks is typical for chronic conditions, with one or more visits per week. For acute conditions, you may experience profound results within the first visit and need no additional treatment, while others may require several treatments in a short time span to have a similar reaction.

The Acupuncture Experience

Acupuncture needles are much thinner than those needles use for injections and so are less painful. Needles are always pre-packaged, pre-sterilized and are disposed of after each use. You may not even know when they have been inserted. When the needle contacts Qi, or energy, you may feel a variety of sensations, including heat, tingling, numbness, swelling, a sensation in another part of your body, etc. Many patients feel so relaxed during treatment that they fall asleep on the treatment table.

Your Individualized Treatment

Although the use of needles is the main mode of treatment, our clinic will customize your treatment program to care for your specific health needs. Based on the diagnosis and treatment principle, your treatment may combine: Chinese Herbal Medicine, Cupping, Scraping, Moxibustion, Electrical point stimulation, Microsystems or TuiNa (traditional Chinese massage done through clothing that incorporates kneading manipulations of western massage with acupressure).

The Researches of The Meridian Theory and Mechanisms of Acupuncture

For thousands of years, acupuncture has been based on the premise that specific points along the meridians correspond to specific organs, such as liver, and functions, such as the motor control. From the 1970’s and 90’, the relationship between acupoints and their related organs was a key focus of acupuncture research.

The meridians depicted in Chinese medical charts have no obvious anatomical basis-though diagrams of them do bring the nervous system to mind.

Meridians and acupoints might also correspond to areas of the body with physiologically distinct properties. In a study published in the scientific journal anatomical record in 2002, dr Helene langevin, an associate professor of neurology at the University of Vermont College of Medicine, showed that about 80% of the acupoints o the arm correspond to areas of connective tissue between muscles.

Langevin is now examining what implications this might have for how acupuncture sends messages to the brain. She has published data showing that when needles are inserted into acupoints, the underlying connective tissue winds around the needle “like spaghetti around a fork,”she says. This doesn’t happen when a needle goes into a non-acupuncture points.

Langevin has also shown that the winding action causes the cells in the area to change shape, a process that she theorizes might signal the central nervous system. She is testing the theory in a series of animal experiments.

Other, older studies conducted and published in Asia and Europe during the 1970’s and ‘80s produced evidence suggesting that acupoints might be areas of very low electrical resistance, might be slightly more sensitive to touch or might lie near major nerve pathways. But scientists don’t know the significance of these characteristics.

Evidence from Neuroimaging Studies

In more recent years, brain imaging has been used to clarify the relationship between acupoints and the functions they represent. The practice way pioneered by Dr. Zhang-hee Cho, UC Irvine professor of radiological sciences.

Dr. Cho showed in a series of imaging experiments, published in 1998 in the proceedings of the national academics of sciences, that needling several acupoints for eye problems-located near the little toe-in a group of 12 volunteers increased activity in the visual cortex, the part of the brain governing vision.

sagewinterpark

 

Figure 8. Side-by-side comparison of 2 cortical activations seen at the mid-line sagittal view due to: (a) pain vs meridian acupuncture (LI 3) + pain stimulation and (b) pain vs sham acupuncture + pain stimulation, respectively. Decreases in activation of the 2 appear similar, suggesting that they are based on similar neural mechanisms.

Yet when Cho and his colleagues stimulated random points, located a few centimeters away from each point, no activity occurred in the visual cortex.
Dr. Randy Gollub, assistant director of psychiatric neuro-imaging at Massachusetts General Hospital, is also investigating the differences in brain activity generated by needling at real and fake acupoints. In an ongoing study, healthy volunteers are subjected to pain and then given either real or sham acupuncture. So far, both treatments appear to activate or deactivate various regions of the brain involved in controlling the body’s reaction to pain: “they’re a lot more alike than they are different,” Gollub says.

But, she adds, it looks as if the brain’s response is stronger for true acupoints than for sham ones. “think of it as a mountain range, with the acupuncture points as peaks,” “as long as you’re not in the valley, the acupuncture is probably going to have some effect.”

Dr. Cho, for one, has found in recent studies that inserting needles in real or sham sites produces similar changes in parts of the brain perceiving pain.

In simplified terms, he thinks that inserting a needle at almost any point on the body triggers a series of biochemical messages between the brain’s hypothalamus and the hormone-producing pituitary and adrenal glands. The signals tell the body to alter its production of, for example, certain stress with stressors-such as bacteria, viruses, emotional trauma or pain.

In fact, Dr. Cho believes that acupuncture might someday be refined to the point where the use of a dozen or more needles could be traded in for a single well-placed needle. “one good stimulation may be enough” for lasting pain relief, he says.

Gate-control Theory of Pain

The “gate control theory of pain” proposed that pain perception is not simply a direct result of activating pain fibers, but modulated by interplay between excitation and inhibition of the pain pathways. According to the theory, the “gating of pain” is controlled by the inhibitory action on the pain pathways. That is, the perception of pain can be altered (gated on or off) by a number of means physiologically, psychologically and pharmacologically. The gate-control theory was developed in neuroscience independent of acupuncture, which later was proposed as a mechanism to account for the hypothesized analgesic action of acupuncture in the brainstem reticular formation in 1976.

This leads to the theory of central control of pain gating, i.e., pain blockade at the brain (i.e., central to the brain rather than at the spinal cord or periphery) via the release of endogenous opioid (natural pain killers in the brain) neurohormones, such as endorphins and enkephalins (naturally occurring morphines).

Neurohormonal Theory

Pain transmission can also be modulated at many other levels in the brain along the pain pathways, including the periaqueductal gray, thalamus, and the feedback pathways from the cerebral cortex back to the thalamus. Pain blockade at these brain locations is often mediated by neurohormones, especially those that bind to the opioid receptors (pain-blockade site).

Some studies suggest that the analgesic (pain-killing) action of acupuncture is associated with the release of natural endorphins in the brain. This effect can be inferred by blocking the action of endorphins (or morphine) using a drug called naloxone. When naloxone is administered to the patient, the analgesic effects of morphine can be reversed, causing the patient to feel pain again. When naloxone is administered to an acupunctured patient, the analgesic effect of acupuncture can also be reversed, causing the patient to report an increased level of pain. It should be noted, however, that studies using similar procedures, including the administration of naloxone, have suggested a role of endogenous opioids in the placebo response, demonstrating that this response is not unique to acupuncture.

One study performed on monkeys by recording the neural activity directly in the thalamus of the brain indicated that acupuncture’s analgesic effect lasted more than an hour. Furthermore, there is a large overlap between the nervous system and acupuncture trigger points (points of maximum tenderness) in myofascial pain syndrome.

Evidence suggests that the sites of action of analgesia associated with acupuncture include the thalamus using fMRI (functional magnetic resonance imaging) and PET (positron emission tomography) brain imaging techniques, and via the feedback pathway from the cerebral cortex using electrophysiological recording of the nerve impulses of neurons directly in the cortex, which shows inhibitory action when acupuncture stimulus is applied. Similar effects have been observed in association with the placebo response. One study using fMRI found that placebo analgesia was associated with decreased activity in the thalamus, insula and anterior cingulate cortex.

The Study with Thermography using the infrared images by Yin Lo, Ph.D.

thermograpgysage

 

The above picture is the before acupunctuer, the red color region means the pain or inflammed, the picture 9 doesn’t show the red region, pain or inflammation significanlty decreased after acupuncture treatment.

Recently, acupuncture has been shown to increase the nitric oxide levels in treated regions, resulting in increased local blood circulation. Effects on local inflammation and ischemia have also been reported.

Acupuncture appears to have effects on cortical activity, as demonstrated by magnetic resonance imaging and positron emission tomography.

Theoretical Background for Specific Duration Times:

1. 15-20 minutes : The Nan Jing-The Classic of Difficulties, Chapter 23 According to ?The Nan Jing , Qi and Blood move through the meridians at the rate of six *Cun for each complete inhalation and exhalation.? The total length of the Meridians and Collaterals equals 1620 cun.?1620 divided by 6 equals 270, so it is said that 270 breaths are required for Qi to make one complete cycle through the body.? However, this number could vary based on a person’s breath rate.? If a person breathes 14 times/minute, it will take 20 minutes (270/14) for Qi to make a complete cycle.? If a person breathes 18 times/minute, only 15 minutes (270/18) will be needed for Qi to make the complete cycle.? Therefore needle retention time can be calculated around 15-20 minutes.

*Cun is a Chinese proportional unit of length

2. 30 minutes : The Ling Shu-Spiritual Pivot, Chapters 15 & 18 the Qi and Blood circulated through the channels 50 times per day. Since 24 hours equals 1440 minutes, dividing 1440 by 50, we get the 28 minutes and 48 seconds. This is where we get the guideline for approximately 30 minutes of needle retention time.

Resources:

Acupuncture Mechanism Studied by fMRI
Acupuncture Today
Colon Cleansing Products