Treatment of Anxiety with Acupuncture & TCM

What is Anxiety?

Anxiety is a normal human emotion that most people will experience in their lives in response to stress. It becomes pathological when anxiety interferes with daily life and is irrational, or excessively prolonged, or disproportionate to the cause. Panic attacks are episodes of intense panic or fear. Anxiety attacks usually peak within ten minutes, and they rarely last more than a half hour.

Common Symptoms:
  • Feelings of apprehension or dread
  • Trouble concentrating
  • Feeling tense and jumpy
  • Anticipating the worst
  • Irritability
  • Restlessness
  • Watching for signs of danger
  • Feeling like your mind’s gone blank

Additional physical symptoms can include the following and more:

  • Pounding heart
  • Sweating
  • Stomach upset or dizziness
  • Frequent urination or diarrhea
  • Shortness of breath

Anxiety Attack Symptoms:

  • Surge of overwhelming panic
  • Feeling of losing control or going crazy
  • Heart palpitations or chest pain
  • Feeling like you’re going to pass out
  • Trouble breathing or choking sensation
  • Hyperventilation
  • Hot flashes or chills
  • Trembling or shaking
  • Nausea or stomach cramps
  • Feeling detached or unreal
Western Medical Treatment

Medication in conjunction with cognitive-behavioral therapy is the general treatment. Anxiety is often treated with benzodiazepines such as Ativan, Xanax, and Valium. Antidepressants can also be used such as Paxil, Prozac, Effexor, Zoloft, and Lexipro.

Traditional Chinese Medicine (TCM) Treatment

Anxiety almost always involves some dysfunction of the Heart. Excessive sadness, depression, or grief can actually damage the Heart qi and/or blood. Inadequate nutrition and excessive intake of stimulants can also deplete the Heart and cause anxiety disorders. Anxiety can also be associated with hormonal imbalances such as can occur during menopause, the menstrual cycle, or postpartum, withdrawal from cigarettes, drugs, or alcohol, and as a side effect of medication or complication of other disease. In these cases the anxiety would be treated in conjunction with the other concerns. The following are the predominant patterns for anxiety:

Heart Qi Deficiency: Patients feel easily vulnerable. disoriented, and unstable. There is often fatigue, palpitations, poor concentration, and fitful sleep. The treatment principle to tonify Heart qi and calm the spirit. Acupuncture can provide almost instant relief that will last longer after each consecutive treatment until the patient no longer needs to come in often. Herbs are very important in the treatment of anxiety.

Heart Blood and Spleen Deficiency: Phobias, panic attacks, difficulty falling asleep, blurred vision, abdominal bloating after eating, and poor appetite. Treatment principle is to tonify Heart blood and Spleen qi and calm the spirit. Acupuncture can provide almost instant relief that will last longer after each consecutive treatment until the patient no longer needs to come in often. Herbs are very important in the treatment of anxiety.

Heart and Kidney Yin Deficiency:  Palpitations, panic attacks, insomnia, nightmares, heat in palms and soles of the feet at night, and night sweats. Treatment plan in to nourish Heart and Kidney Yin and clear heat. This case is a little more involved so treatments will take longer than in the case of Heart Qi deficiency.

Heart and Gall Bladder Deficiency: People with this pattern often describe their anxiety as a personality trait or it arises after a significant shock or trauma. Acute anxiety and frequent panic attacks, nightmares and waking up terrified, restlessness, timidity, and phobias. Treatment principle is to calm the spirit and tranquilize the Heart. This case is a little more involved so treatments will take longer than in the case of Heart Qi deficiency. Regular treatment with acupuncture and herbs is crucial.

Phlegm Heat: This is a result of longterm inappropriate diet or febrile disease. waking up around 4 am and not able to fall back asleep, irritability, nausea, abdominal bloating, bitter taste in the mouth, nervousness, and poor appetite are common symptoms. This case is a little more involved so treatments will take longer than in the case of Heart Qi deficiency.

We recommend that with emotional disorders that TCM be used in conjunction with either traditional or nontraditional counseling. Feelings of anxiety, stress, and depression are often signs that something is legitimately out of balance in our lives and can be a call for positive changes.

Lifestyle

Stabilizing blood sugar, treating anemia, getting rest and regular meals are often key to treating anxiety.

Some things you can do at home:

1. Are you breathing? This may seem like a silly question but if you are chest breathing most of the time it will make you feel panicked and uneasy. Consciously start to expand your lower ribs when you breath. Though meditation is wonderful, it is particularly difficult for the anxiety-prone. Gentle activities such as tai chi, relaxing yoga, walking, and relaxed swimming can be very helpful.

2. Are you blood deficient? Blood deficiency (anemia) can make you feel tired, weak, and emotionally fragile. Eating dark leafy greens, beets, beef, and liver are very helpful as are iron-rich vitamins. In less severe cases this can be enough to correct it.

3. Are you running on sugar and caffeine? Your body needs real food and actual rest on a daily basis to function optimally. You can’t cheat this on a longterm basis by using sugar, caffeine or other uppers.

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Treatment of Rhinitis with Acupuncture & TCM

What is Rhinitis?

Rhinitis is a runny nose caused by an increase in histamine, and is most often the result of airborne allergens. This results in an increase in fluid production in the eyes nose and throat. There are 3 subtypes of rhinitis: 1)allergic rhinitis due to exposure to pollen, dust, etc., (2)nonallergic rhinitis associated with hormonal issues or medications, and (3) infectious rhinitis caused by acute or chronic bacterial infection.

Common Symptoms:

  • Runny Nose
  • Sneezing
  • Itchy Watery Eyes
  • Itchy Nose

Western Medical Treatment

Depending on the cause treatment can include over the counter nasal decongestants, nasal sprays, and antibiotics (in cases of bacterial infection).

Traditional Chinese Medicine (TCM) Treatment

Rhinitis always involves a weakness in the wei qi, Wei (or protective) qi runs on the surface of the body, including skin and mucous membranes and controls the opening and closing of the pores. Wei qi responsible for defending the body against external pathogenic invasion. Wei qi is supported by the Kidney Yang and distributed by the Lungs so that a dysfunction  is associated with one of the following 3 patterns:

External Wind: Acute and copious runny nose due to an allergic response or infection. Treatment principle is to expel exterior wind, transform phlegm,  and redirect Lung qi downwards. When an acute condition is caught early with treatment it tends to resolve as quickly as it came.

Lung and Spleen Qi Deficiency: Chronic rhinitis, frequent colds, fatigue, wooly headedness, picky eater. Treatment principle is to tonify Lung and Spleen qi, and expel wind.  Treatment includes acupuncture, herbs, and cupping along with dietary changes. Weekly acupuncture is indicated for several weeks.

Kidney Deficiency: Chronic rhinitis for several years, reduced sense of smell, symptoms worse with fatigue and exertion. Treatment principle is to tonify the kidneys. Treatment includes acupuncture, moxibustion, and herbs along with dietary changes. This pattern takes the longest to treat.

Lifestyle

Nasal irrigation as with a Neti pot is very helpful for symptomatic relief and can be performed 1-2 times a day away from meals. Dietary guidelines vary from individual to individual, but as a  general rule, phlegm-producing foods should be reduced or avoided such as cold temperature food and drinks, highly sugary foods, greasy foods, and excessive dairy. Adequate rest and avoidance of exposure to cold (including walking around with wet hair) are key.

Treatment of Sinusitis with Acupuncture & TCM

What is Sinusitis?

Sinusitis is  inflammation of the sinuses and is a very common condition. Cases are divided into Acute Sinusitis (lasting 4 weeks or less) and Chronic Sinusitis (lasting more than 12 weeks). Sinusitis is differentiated from rhinitis in that rhinitis is characterized by additional symptoms like red, itchy eyes and nose.

Common Symptoms

  • nasal discharge
  • nasal congestion
  • sinus pain
  • frontal headache

Western Medical Treatment

Acute sinusitis is often caused by viral, though also bacterial and sometimes fungal, infections. In cases of bacterial infection, the  treatment is antibiotics. For chronic cases nasal irrigation, occasional use of nasal sprays, and in severe cases, surgery is used.

Traditional Chinese Medicine Treatment (TCM)

Treatment for sinusitis is based upon diagnosis of  one of the following TCM patterns:

Wind Heat– This is a case of an external pathogen invasion that has progressed. The treatment principle is to release the exterior and open the orifices. These cases are acute and quick to resolve with acupuncture, herbs taken three times a day and cupping.

Liver Qi Stagnation– Patient tends to be irritable and stressed with shoulder tension. It is characterized by swelling and congestion rather than discharge. The treatment principle is to smooth the Liver Qi and open up the orifices. These cases can experience fast relief but continued relief depends on management of stress.

Phlegm Heat– In these cases there is often digestive weakness, food intolerances, or a prolonged overconsumption of rich, greasy foods, and alcohol. Characterized by sticky yellow discharge, severe nasal congestion, a heavy sensation in the body, and dizziness. Treatment principle is to clear and transform Phlegm Heat and open the orifices. Treatment tends to be more prolonged and includes acupuncture, herbs, and dietary modifications.

Lung and Spleen Qi Deficiency– This is a chronic pattern characterized by congestion and loss of sense of smell along with fatigue, dizziness, and poor appetite. Treatment principle is to strengthen the Spleen Qi and raise the clear yang. Treatment involves weekly treatments of acupuncture and herbs, along with lifestyle changes that can take a few months to resolve.

Kidney Deficiency– Is characterized by incessant, chronic mucus discharge and is often accompanied by poor memory, soreness and weakness in the back, and loss of hearing. This is often a lifelong issue or occurs after extreme overwork or stress. Treatment principle is to tonify the Kidneys and stop discharge. This case takes the longest to treat. Weekly treatments of acupuncture and herbs for a period of a few months is often necessary.

A common patent formula used to provide immediate symptom relief is Bi Ming Gan, however other herbs targeting the underlying pattern should also be used. Points commonly used in all cases of sinusitis are Bi Tong and Yin Tang and can be seen needled in our November special.

Lifestyle

Nasal irrigation as with a Neti pot is very helpful for symptomatic relief and can be performed 1-2 times a day away from meals. Dietary guidelines vary from individual to individual, but as a  general rule, phlegm-producing foods should be reduced or avoided such as cold temperature food and drinks, highly sugary foods, greasy foods, and excessive dairy.

TCM Tongue Diagnosis

Tongue Diagnosis is a primary diagnostic tool in Traditional Chinese Medicine. The tongue can tell a great deal about the internal condition of the body. The image on the left shows the correlation between the organs and area of the tongue. Tongue diagnosis requires a great deal of knowledge of TCM theory and experience with patients but here is a simplified guide that you can use to observe your own health.

Diagnosing the Tongue Body

This refers to qualities of the tongue related to size, shape, and color independent of the tongue coating. A “normal” tongue body is a nice healthy pink and fits nicely in the mouth, being neither too puffy nor too thin. A puffy tongue body indicates excess fluids or a build up of phlegm. A thin, small tongue indicates yin or fluid deficiency. A pale tongue body indicates yang or blood deficiency. A red tongue indicates excess heat or yin deficiency heat. A purple body indicates blood stagnation. Scallops of the sides of the tongue (indentations left by the teeth) show Spleen Qi deficiency.

Diagnosing the Tongue Coating

A “normal” tongue coating is thin and white.  A thick tongue coating indicates an excess condition and a lack of tongue coating (the tongue looks shiny) indicates deficiency. A white coating shows the presence of cold while a yellow coating indicates heat.

The chart below shows some common tongues:


TCM Pulse Diagnosis

Pulse diagnosis is one of the main diagnostic tools used by acupuncturists and Chinese herbalists. The pulse was originally taken in three parts of the body: the carotid artery besides the Adam’s apple (ST9 area), the radial artery close to the wrist (Lung 9 area), and the dorsalis pedis artery on the top of foot (St42 area). Presently, only the radial pulse is taken for diagnosis.  Pulse Demo Video.

In TCM, we take the pulse on both sides and feel for three distinct positions. See diagram on the left. Pulse diagnosis takes years to master and can get very complicated, but even the lay person can begin to feel certain qualities.

Firstly, how deep do you need to press to feel the pulse? The “normal” pulse should be felt best when you apply a little bit of pressure. If you can feel the pulse without putting any pressure it is a Superficial pulse and likely indicates the patient is battling a cold or some other external pathogen. If you have to press deeply to feel the pulse well it is a Deep pulse and likely indicates deficiency (weakness) or excess cold in the body. How much pressure constitutes a Superficial or Deep pulse will take a little practice to feel.

How fast is the pulse? Does it feel like its speeding? A Fast pulse is more than 5 beats per practitioner breath and indicates excess heat (inflammation) in the body. A Slow pulse is less than 3 beats per practitioner breath indicates excess cold or deficiency in the body.

Does the pulse feel strong or weak? The general overall quality of the pulse will tell you whether the patient’s condition is one of excess (which will require some form of clearing treatment) or one of deficiency (which will require tonification).

This is TCM pulse diagnosis in a nutshell. For more detail on TCM pulse diagnose please visit: http://www.itmonline.org/arts/pulse.htm or http://www.yinyanghouse.com/theory/chinese/pulse_diagnosis

Treating Sciatica with Acupuncture and Massage

What we call sciatica occurs when either the nerves of the low back or the sciatic nerve is compressed. This causes sharp, radiating pain, tingling, or numbness down the low back, buttocks, leg, and/or heel. At times the pain will be only in one location, such as the heel. At others the whole nerve pathway can be felt. Generally sciatica is felt on one side only, however, clinically it often jumps from side to side.

 

In Traditional Chinese Medical (TCM) terms this can be due to Qi & Blood Stagnation, Wind Cold Damp Bi, Hot Bi, or Kidney Deficiency. When Cold or Damp is present, needle moxa can be very effective to relieve pain and unblock the channels. In these cases having the patient use stick moxa along the entire channel on a daily basis until the pain resolves is also helpful. In cases of Qi & Blood stagnation, needling with eletro-stimulation is very effective at clearing the stagnant qi in the channels.

At Cinnabar Acupuncture Clinic, acupuncture is followed by cupping and massage. Massage can include alternating hot and cold stones, simply hot stones, deep tissue, myofascial release, and/or gentle stretching based on the presentation.

Results can be felt immediately after the treatment, but full results can take up to a day. Depending on the severity and underlying condition (whether it is simply a tight muscle or serious joint deterioration) symptom relief may take anywhere from one treatment to a series of regular visits.

We are featuring a special this month at Cinnabar Acupuncture Clinic called the Sciatica Relief Package that includes the above treatment.

Deconstructing the Chinese Herbal Formula

Chinese herbology developed alongside but independently from acupuncture in many ways. Acupuncture likely emerged out of early Shamanic traditions, qigong and meditation practices, and by cross-cultural influences. Acupuncture’s origins and development  are not documented. By the time the earliest medical texts were written, between 2,500-5,000 years ago, the meridian system and basics of acupuncture had already evolved.

Chinese herbology, however, shows a path of clear development. Medical texts follow a logical path of trial and error on thousands and thousands of subjects, of all ages, classes, ethnic groups, climates, etc. Ship voyages and diplomacy with other nations were fueled not so much by imperialism as a desire for knowledge; herbal knowledge in particular.

The result is a system of herbology that is far more complex than its Western cousin. It is often difficult for those adept at Western herbology to understand Chinese Herbal formulas. For one thing, Chinese herbs are rarely taken alone. With the exception of such herbs as Ren Shen (ginseng) or Gou Qi Zi (gou gi berries), most Chinese are taken in formulas containing anywhere from 3-15 herbs. The formulas follow a very specific reasoning based on a Confucian ideal of harmony. The ideal Chinese herbal formula has no side effects.

First the core disease pattern(s) is chosen for the patient. The underlying constitution, most pronounced symptoms, and other factors are taken into consideration. One or two king herbs are chosen to address the pattern of greatest concern. Herbs that directly support its action are added. Then herbs to to address specific symptoms, additional patterns, neutralize potential side effects, etc. are added.

There are more than 400 herbs in the Chinese pharmacopoeia, originating from all over the world. They are organized in categories of main function, thermal property (hot, cold, neutral, warm), and the channels they affect.

Herbs are taken in various forms: raw herb decoctions, tinctures, honey pills, tablets, and tea pills. Externally they are used as soaks and plasters.

Chinese herbology is part of the training of Licensed Acupuncturists in the state of California. It takes 3600 hours of schooling to be licensed, and a lifetime to master.