Thursday, September 24, 2009

Handling Hand and Wrist Pain

By Karen Litton, L.Ac.

Our hands are such an integral part of our bodies that they are easy to take for granted – that is, until they start hurting or our fine motor control is impaired. It is then that we begin to realize how much we rely on our hands to interact with the world.

It is hard to even imagine all the tasks our hands perform for us. We use them in personal care, to engage in athletic endeavors, to work, and this time of year, to garden. With more than 50 muscles to move the 27 bones in the hand and numerous sensory nerves, we use them to touch others and our environment.

In Chinese medicine, the hands are powerful areas of energy and energy exchange. Six of the 12 Primary Meridians either begin or end at the fingertips and connect us to other areas and systems in our body. “Dis-ease” elsewhere in our body can show up in our hands. Thus, our hands can be used to treat other areas of our body.

Hand or wrist pain can occur from a variety of sources and be felt in many ways. There can be pain after local trauma or injury, as a result from straining while lifting, or in exercise, or even while lying in bed with the hands curled awkwardly. There can be pain following over-use or repetitive movements. For many of us, long hours working on the computer can also result in painful wrists or fingers. For others, it can arise after prolonged exposure to cold, heat or dampness.

The quality of the pain can vary. It can be dull and aching or sharp and uncomfortable. It can radiate to or from other areas, such as the forearm or shoulder. There can be a feeling of stiffness and tightness in the ligaments/tendons, or even seem as if there are nodules on the fingers.

Western medicine has various names for these conditions: arthritis, carpal tunnel syndrome, neuropathy, trigger finger, joint inflammation or degeneration, etc. Drugs are often prescribed for the pain. The difficulty is that they do not address the root cause of the difficulty and therefore do not last. In other words, the benefits of pain medication are only felt as long as the drug is in the system.

From a Chinese medical perspective, most hand pain falls under a general heading of Painful Obstruction Syndrome of the hand channels, which results from the blockage of qi or blood in these channels. As with any syndrome, Chinese medicine seeks to diagnose the probable root cause of the problem and thereby determine the best way to address the symptoms.

Most pain patterns stem from a variety of factors.

An extremely common cause of finger, hand and wrist problems is the contraction of the muscles in the hands or forearms due to overwork or trauma. These sensitive areas in the muscles can be considered “trigger points.” This is simply another way of describing an area in which the qi and blood have stagnated and caused a muscle “knot” or area of contraction and soreness.

An important part of self-care is to figure out what is stressing these sore spots and then to modify or remove those stressors. Repetitive strain injuries are common whatever the activity – even if we are having fun! Whenever we do a motion over and over, without a break, the tension gradually increases in the joints and muscles, and they contract. Unless we do something during or after the activity, such as stretching, these areas remain contracted.

Stretches for Your Hands & Arms:

There are a few simple stretches that you can do for your hands to help ensure that the qi and blood are flowing and the area does not get blocked. This can make a big difference to your hands, especially if you use them a lot.

Take a moment and stretch your arms out in front of you. While the arms are outstretched, pull the hand back toward your body with the other hand. Hold for five seconds. Then do the same motion bending the fingers and hand toward the ground.

Then make circles with first your hands, and then your arms, to get the blood flowing in those areas. Take each finger and gently bend it to the side and backwards as you stretch the finger tendons.

Simply flexing and extending the fingers with an open then closed fist can be helpful to getting blood to flow into the area.

Since pain in the hands can be referred pain from the shoulders or neck, it is good to stretch these areas, too. That can be done by rolling the shoulders up toward the ears and letting them drop down, as well as by making windmills with your arms.

Herbal Liniments for Pain Relief:

There are some wonderful liniments at the Clinic, which you can rub on your hands. Zheng Gu Shui will feel warming to use. Two with more cooling qualities are White Flower Oil and Po Sum On. Be careful not to get these oils into your eyes. We also have a tendon soak made with raw herbs, which have been boiled to make a soak for your hands. For arthritis, you can also soak your hand in hot apple cider every night.

Take care of your valuable hands and fingers, and come see us if you have difficulties.

Saturday, September 19, 2009

Chinese Medicine for Autism: Exploring an Eastern Approach for Helping Children

By Dr. M. Cissy Majebe, O.M.D.

The treatment of Autism with Chinese Medicine (CM) first began to interest me in 1993 when a parent brought a three-year-old, non-verbal child into the clinic. I acquired a special interest in the treatment of children diagnosed with Autism Spectrum Disorders from working with this child.

Currently, Autism is recognized as a developmental disability with primary symptomology affecting social interaction and communication skills. Autism is a behaviorally-defined syndrome.

Within a Western framework, there are no clear causes of Autism, although it is believed to be a biological neurological disorder affecting brain function. There are strong indicators for a genetic basis, and there is also a growing concern that environmental toxins and pollutions may be contributing factors, as well as viral infections.

Currently, there are no medical tests for the diagnosis of Autism. In regard to treatment, the only real option Western Medicine offers is intervention with early educational programs.

For those of you who may have little experience with Chinese Medicine, let me begin by saving that Chinese Medicine is a comprehensive health care system that has its own system of diagnostics. It includes not only acupuncture, but also herbal medicine, nutritional therapies, Tui Na (massage techniques), aromatherapy, spinal manipulations and lifestyle counseling. CM, as a system, allows the practitioner to utilize different combinations of techniques, based on the constitution and specific needs of the individual.

The World Health Organization recognizes Chinese Medicine's ability to treat many common disorders, including disorders of the bones, muscles and joints, respiratory, gastrointestinal, circulatory and urogenital disorders, addictions, eye, ear, nose and throat disorders and emotional and psychological disorders. It is this history of the effectiveness of CM with psychological and neurological disorders that provides a basis for the effective treatment of Autism.

In CM, Zang-Fu is a term for the organs of the human body. Many of the organ names are familiar terms. These terms refer not only to a physical organ but to the energetic functions of the organ as well. Each organ relates to an emotional response, sensory organ, and soft tissue. Autistic children often experience difficulties with sensory integration. In the treatment of Autism, the three primary organ systems of concern are the Heart, Spleen, and Kidneys; these organ systems are associated with speech, hearing, and taste, respectively.

"On an emotional level, the state of the Heart determines a person's capacity to form meaningful relationships." This quote from The Foundations of Chinese Medicine, by Giovanni Maciocia, is paramount to the understanding of Autism within the framework of CM.

According to Chinese Medical theory, autistic individuals suffer from a Heart imbalance that inhibits connecting on an emotional level with other people, including their immediate families. A person with Heart imbalances might manifest a lack of joy in life, anxiety or inappropriate laughter and talking. A person with a Heart Qi disorder could either manifest with excessive talking or aphasia (problems with speaking or an inability to speak).

Children diagnosed with Autism may present with digestive anomalies that may be deemed irrelevant by Western Medicine Physicians. In CM these children exhibit signs and symptoms associated with Spleen Qi Deficiency. On an emotional level, persons with extreme Spleen Qi imbalances often manifest obsessive-compulsive behaviors.

Autism is usually diagnosed before the age of three. CM sees this disorder as having a Pre-natal origin, compounded by a Post-natal weakness. The Pre-natal component would translate as genetic influence, whereas the Post-natal aspect would relate to all that has occurred since birth. Pre-natal factors in Autism indicate Kidney involvement. Kidney Qi is important for brain development, along with Heart and Spleen, according to Chinese Medical theory.

Basic methods of diagnosis include observation of the patient, such as listening, smelling, examination by questioning and physical examination by palpation. Observation includes CM specific skills such as tongue, pulse and facial diagnosis. It also includes close attention to how the patient relates to and moves in the world.

In CM, imbalances arise from three different sources: external factors, internal factors and miscellaneous factors.

Wind, Heat, Fire, Cold, Dryness and Dampness are external pathogenic factors in CM. These factors create imbalances that lead to disease.

In CM, Internal Pathological Factors are the Seven Emotions. Each of these emotions is associated with an organ system. Those that relate to Autism include: fear or shock that weakens the Kidney, over-pensiveness that weakens the Spleen and shock and anxiety that weakens the Heart. The over-pensiveness that is discussed in classical Chinese writings is related to the obsessive behaviors or obsessive thought patterns that often manifest in Autism.

Miscellaneous factors include genetic influences, poor nutrition, lack of exercise and excessive mental stimulation, such as an inordinate amount of television viewing. Air pollutants, food additives and preservatives are other miscellaneous factors. Antibiotics and Immunizations are also considered miscellaneous factors.

Phlegm is the primary pathological factor related to the development of Autism in CM. In regard to Autism, Phlegm is generally an External Pathogenic Factor, but it can also manifest from Internal and miscellaneous causes. Phlegm is said to be either substantial or insubstantial, meaning that it can either be the mucous we expectorate and drool or a kind of "fog" that blocks the sensory organs. This "fog" would present itself as poor concentration or hearing, a lack of response to external stimuli, etc. In CM, the diagnosis of Autism generally can be classified as either Phlegm Misting the Heart or Phlegm Fire Harassing the Heart.

The Autistic child will have symptoms that are linked to Heart, Spleen and Kidney imbalances. The Heart imbalance relates to the difficulties the child has in establishing meaningful emotional relationships with others, and communication and speech difficulties. The Spleen deficiency is linked to digestive anomalies that contribute to the development of Phlegm. Kidney involvement is related to the young age at which this condition develops.

The development of Autism is a multi-faceted pathway. There is no single direct cause and effect for Autism Spectrum Disorders in Chinese medicine, although there are a set of co-factors that must be present. Recall that in CM imbalances are related to External, Internal and Miscellaneous factors. The External and Internal factors can be a source of difficulty, but a major focus in Autism is on the Miscellaneous factors. Genetic factors can set the stage, but there must be other co-factors in order for Autism to develop. Nutritional and lifestyle factors must be addressed in the treatment plan. The manifestations of Phlegm and the root cause of Phlegm must be addressed. It is due to the very different pathways in the development of Autism that makes it difficult to assign causality.

As I stated previously, Chinese Medicine treats the constitution and specific needs of the individual, not the disease. With a behaviorally-defined syndrome, such as Autism, such treatment is especially appropriate, because the practitioner is able to accurately diagnosis and treat a patient who may be manifesting any number of diverse and seemingly unrelated symptoms. The foundation for effective treatment in CM would use a multi-tiered approach that includes synergistic CM modalities, such as herbal medicine, acupuncture, Tui Na (massage), nutrition, aromatherapy, and manipulative therapies. This multi-tiered approach should include the intervention with early education treatment that Western medicine recommends.

Originally published as an article in various publications in 2002.

Monday, September 14, 2009

Native Plant Turns Fate of Breech Pregnancy

By Joshua Herr, L.Ac.

The cesarean rate for diagnosed breech presentations rose from 12% in 1970 to more than 95% today. A fetus that is in a breech position has its head at the top of the uterus instead of down against the cervix. This can create complications during delivery. For women who are planning on having a vaginal birth, this is a shocking statistic.

The trend began in 1959 when Dr. Ralph Wright called for mandatory cesareans for women with a baby in the breech position. The move towards mandatory cesareans for breech babies is affecting the clinical training of obstetricians and midwives, as fewer are having the chance to witness a vaginal breech birth. Coupled with the threat from malpractice insurance companies to not provide coverage for hospitals that permit planned vaginal breech births, the clinical skill is in jeopardy.

Acupuncturists are turning fate around for women with a breech presentation. A common plant found in the mountains and abandoned plots around North Carolina is the method of choice. The plant is called Artemisia vulgaris and has been used in Chinese medicine for thousands of years to stimulate acupuncture points with heat. The plant is dried and repeatedly ground and sifted until it forms into a soft, golden fluff called moxa.

Moxa is burned at a safe distance from the skin to gently stimulate selected acupuncture points. For women with a breech diagnosis, the point chosen is called Zhi Yin (Reaching Yin) and is found on the outside edge of the little toe.

In 1998, JAMA published a study led by Dr. Cardini, which demonstrated that moxibustion applied to Zhi Yin for 1-2 weeks beginning at the 33rd week of pregnancy resulted in the fetus turning head-first after treatment and at delivery. Cardini's group demonstrated over a 75% chance of success using the moxa technique.

Acupuncture is a safe and effective treatment for women during pregnancy. Acupuncture can resolve muscular pain that occurs during pregnancy and is a treatment of choice for a mother concerned about taking pharmaceuticals.

Women with severe morning sickness are also finding that the holistic approach of acupuncture is the best approach. Incorporating breathing and relaxation exercises along with acupuncture treatment, an expectant mother with morning sickness can keep food down and nourish her body, as well as her baby.

Induction of labor can also be performed with acupuncture. When using acupuncture to induce labor, contractions increase gradually, which gives the mother's body time to safely transition into active labor.

The current age of medicine has brought a tremendous wealth of skills and knowledge, both old and new. As science moves forward with new medical breakthroughs, it is also important to keep old methods of effective procedures alive. A medical community that thoughtfully integrates innovation with antiquity will have the resources available to meet the future's healthcare needs.

Thursday, September 10, 2009

Come Join Us for Our 25th Anniversary Celebration & FREE Open House!

September 19, Saturday

1 pm - 5:30 pm at the

Chinese Acupuncture Clinic

369 Montford Ave, Asheville

ENJOY Healthy FOOD, Live MUSIC, FUN for kids & GREAT Company!

PRIZES Awarded Every 30 Minutes,
Including FREE acupuncture treatments & FREE massages!



1-3 pm
Experience Chinese Medicine
Manual Therapies
Sign up for one demo of
gua sha (spoon massage),
tui na massage, or
auricular (ear) acupuncture

2-2:30 pm
Outdoors Qi Gong with
Junie Norfleet, L.Ac.
A self-cultivation Qi exercise

3-5 pm
LIVE MUSIC by Free Planet Radio
Featuring Musicians…
Eliot Wadopian,
River Guerguerian,
Chris Rosser

3:30-4:30 pm
Balloon Animals for Kids
Voted 3rd for Mountain Xpress's
"Best Children's Entertainer" in WNC for the Year

5 pm
Authentic Chinese Dragon Dance


For more information, please call (828) 258-9016.

Tuesday, September 8, 2009

In Depth: Moxibustion

By Rachel Nowakowski, L.Ac.

As you walk into the Clinic, you often notice the familiar smoky odor of moxa. New patients usually ask, "What's that strange smell?" Some people love it, others do not.

What is moxibustion and what is it used for?

Moxibustion is a method of heating specific acupuncture points on the body by burning an herb material close to the skin. This technique can be used alone or in combination with acupuncture. In fact, the Chinese character for acupuncture literally means "acupuncture-moxibustion." The basic purpose of moxibustion is to warm the meridians to promote circulation of qi and blood.

What is moxa made of?

The herb material used is mugwort (Artemisia vulgaris, Ai Ye) an invasive weed, which grows in many climates, including Western North Carolina. Mugwort has a long history of use in folk medicine. It is believed that the Romans planted mugwort by roadsides to make it available to travelers to put in their shoes to relieve aching feet and protect them from exhaustion. Added to bath water, it is a soothing treatment for relief of muscle and joint aches - perhaps due to its ability to enhance the movement of qi and blood.

Mugwort gets its botanical name from the Greek moon goddess Artemis, a patron of women, and is a wonderful herb for gynecological conditions. In Chinese Herbal medicine, it is categorized as an emmenagogue, an agent that stops bleeding. Internally, it is used for heavy menstrual bleeding and uterine bleeding. It also increases blood circulation to the pelvic area to treat menstrual pain. Taken internally, it can warm the uterus and is used for threatened miscarriage. Moxibustion has successfully been used to turn breech babies into a normal head-down position prior to childbirth by increasing fetal movements.

Why mugwort and not some other herb?

Some sources say that mugwort is used because of its acrid, spicy odor. This property makes it able to travel through all of the meridians, regulate qi and blood, and expel cold. In addition, its bitter nature helps to resolve dampness. One of mugwort's active components, borneol, is commonly used in topical therapies for its analgesic effects.

Other explanations for the use of mugwort, as opposed to some other herb material, is that it grows easily in many places, is inexpensive, holds its shape when rolled or pressed, and burns slowly.

An additional benefit of moxa is that the smoke may help to prevent transmission of diseases when used in acupuncture clinics. In hospitals in China, incense made of artemisia and other herbal ingredients has been used to inhibit viruses and to reduce the bacterial count in the air.

What is moxibustion used for?
  • To warm meridians and expel cold. Cold slows the flow of qi, resulting in stagnation and pain. Moxa is used for pain that is worse with exposure to cold or damp weather, as with some types of arthritis pain.
  • To promote the smooth flow of qi and blood. Used on the abdomen, moxa helps with digestive problems or menstrual pain due to stagnation. It can be used to promote circulation over areas of chronic pain or muscle tension.
  • To guide qi and blood upward or downward. Energies in the body must flow in the correct direction. Disruption of this movement results in disease. For example, moxibustion at the point Kidney 1 (on the sole of the foot) guides qi downward and is used to treat disorders caused by excess energy in the upper body, like headaches or dizziness.
  • To strengthen yang from collapse. Yang collapse refers to extreme exhaustion, shock and fainting. Moxa can be used to restore the yang and revive the patient.
  • To prevent diseases and maintain health. Moxibustion can be used as a tonification treatment to help strengthen the organs and immune system.
What are the different techniques of moxa?

In the Clinic, we mostly use indirect types of moxa: needle moxa, stick moxa and moxa bowls. With all moxa, the patient feels a mild to moderate heat sensation on the area being treated.
  • Needle moxa: a rolled piece of moxa is placed on the end of an inserted needle and ignited.
  • Stick moxa: a moxa stick (about the shape and size of a cigar) is lit and held close to the skin.
  • Moxa bowls: pieces of moxa are inserted into a small disk that is placed on the skin.
Moxa can also be used with other substances to give different effects. For example, a piece of moxa can be placed on top of a slice of fresh ginger for severe cases of digestive weakness. Moxa can be placed on top of salt applied over the belly button to treat hernia pain or prolonged diarrhea.

Another type of moxa is direct moxa. In direct moxibustion, a small cone of moxa is placed directly on an acupuncture point and burned, but is extinguished or removed before it burns the skin. The patient experiences a heating sensation that penetrates deep into the skin, but should not experience any pain, blistering or scarring.

Traditionally, direct moxa involved scarring moxibustion. The moxa would be placed on a point and left on the point until it burns out completely. This would lead to localized blisters and scarring after healing. The prolonged healing process is thought to increase qi and blood flow to the point, making the treatment stronger. This type of moxa therapy is not done at the Clinic.

Any type heat applied to the body can increase the flow of qi and blood. Heat lamps, heating pads or warming liniments can give a similar effect to moxibustion. But the heat combined with the powerful healing properties of mugwort gives moxibustion a proven advantage.


Chinese Acupuncture and Moxibustion, Beijing: Foreign Language Press, 1987.

Subhuti Dharmananda, Ph.D., 'Moxibustion: Practical Considerations for Modern Use of an Ancient Technique'

Saturday, September 5, 2009

Relieving Menstrual Cramps

By Joshua Herr, L.Ac.

Many women experience uterine cramping with their menstrual cycle. For some, these are mild cramps that can be alleviated by having an herbal remedy on hand such as the Seven Forest herbal pill called Corydalis 5, which relaxes the uterus and relieves pain. For others, the uterine cramping can be so severe that it limits normal activity. This type of relentless, severe menstrual cramping is a medical condition called dysmenorrhea.

The conventional treatment for dysmenorrhea includes non-steroidal anti-inflammatory drugs (NSAIDS such as aleve or ibuprofen) and hormonal therapies like the birth control pill. These medicines can be effective, but have side effects such as stomach bleeding, nausea, weight gain, and mood changes. Acupuncture can provide effective lasting relief of dysmenorrhea without side effects.

In 1987, Dr. Helms published a study titled Acupuncture for the Management of Primary Dysmenorrhea . The study compared a true acupuncture group, a sham acupuncture group and two control groups of patients who received treatment for three months. Ninety percent of the patients who received true acupuncture showed improvement compared to 10% and 18% in the two control groups. In addition, there was a 41% reduction in analgesic medicine in the women who received real acupuncture compared to no change or an increase use of analgesic medicines in the other treatment groups. Chinese Medicine understands that the symptom of menstrual cramping indicates that the mind, body, spirit is out of balance. There are several different patterns of imbalance that can be identified.

The Chinese Medicine doctor’s role is to simplify the myriad of symptoms and understand them in simple terms such as excess, deficiency, hot or cold. By identifying the pattern the doctor can formulate an acupuncture therapy, differentiate the most beneficial herbs, and most importantly educate the patient on preventative self-care strategies. When the patient understands her Chinese medicine diagnosis, she can make diet and lifestyle choices that create internal harmony and eradicate the symptom of menstrual pain.

Obstetrics and Gynecology. "Acupuncture for the management of primary dysmenorrhea." Helms JM. 1987 Jan;69(1):51-6.

Tuesday, September 1, 2009

Acupuncture & TMJ

By David Trevino, L.Ac.

Temporo Mandibular Joint syndrome (TMJ) is a condition that is related to the muscles and tendons connecting the jaw to the skull. People who suffer from TMJ often experience jaw pain that may radiate to the neck and shoulders, difficulty opening and closing the mouth, popping and clicking of the jaw, facial pain, headaches, ear pain and ringing in the ears.

There are several causes of TMJ, including overstretching the jaw during dental procedures/surgery, injury, repetitive movements, movement and misalignment of teeth and jaw, and clenching and grinding of the teeth.

According to the National Institute of Health (NIH), about 25 million Americans may experience some or all of these symptoms during their lifetime. Women are more likely to experience TMJ than men.

Western medical treatment options include anti-inflammatory medications, mouth guard or oral splints, even surgery.

In 1997 the NIH created a panel of pain specialists, who concluded that, "Acupuncture may be an acceptable alternative to treat TMJ." Today TMJ is treated successfully with acupuncture.

Acupuncture meridian theory provides a good explanation for the treatment of TMJ. For example, the meridians that cross along the jaw area are related to the energy of the Stomach, Gallbladder and Small Intestine. When the energy of these pathways is blocked, pain results.

The pain can be relieved by inserting needles into specific points on the body, which facilitates the flow of energy in the blocked pathways. The trick is to determine which pathways are blocked, so that the acupuncturist can then attempt to open them up to relive the pain. Utilizing pulse diagnosis can help the acupuncturist determine which channels are most likely to be involved in creating the condition.

The approach for the treatment of TMJ with acupuncture varies. Some practitioners prefer to place needles locally in the affected area of pain and focus on placing needles around the ear and along the jaw. Other methods include using points distally along the ankles, big toe, elbows and knees.

Specific points along the body may be included to treat the underlying cause of the problem. In some cases, electrical stimulation of the acupuncture points is used in order to help the jaw relax. Herbal medicines may also be prescribed. If the TMJ has been chronic, several treatments are usually necessary.