Treating Pain: Chinese Herbs for Pain

By Ann Wolman, L.Ac.

Patients commonly seek Chinese medical care because they are in pain. Acupuncture is becoming well known for its ability to resolve pain. A growing number of studies are demonstrating its use in the treatment of painful conditions such as low back pain and sciatica.

In Chinese medical terms it is said, "where there is pain, there is stagnation." This means that pain is indicative of some kind of blockage in the Meridian or Channel System. Acupuncture has the ability to "move qi and blood" and is therefore a treatment of choice for pain relief.

What is not as well known is that there is a long tradition of using Chinese herbs internally, meaning taken by mouth, for the treatment of pain disorders. For example, some of the most useful Chinese herbal formulas fall into the category of "Tieh Tah," or "Hit Medicine." These are formulas that come from the martial arts tradition and historically have been an important branch of Chinese medical study. Many herbal formulas have pain relieving functions.

Chinese herbs have advantages over pharmaceuticals for resolving pain. While Western medications may be more quick acting, they have numerous side effects, and many patients have difficulty tolerating them. All substances that are ingested must some how be detoxified and expelled by the body. Drugs are processed through the liver or the kidneys, and some may irritate the stomach. The use of pain relievers daily can be problematic. For example Acetaminophen, also known as Tylenol, is toxic to the liver, and in high doses, taken over a period of time or in combination with alcohol, can lead to liver damage. Other NSAIDS (non-steroidal anti-inflammatory drugs) like ibuprofen (Advil) can irritate the stomach and cause ulcers. Advil has also been linked to renal damage. Narcotic pain relievers like Vicodin are extremely habit forming, may be very sedating and cause symptoms like nausea and constipation.

The beauty of Chinese medicine is that by treating the "pattern of disharmony," presenting symptoms are alleviated. This means that if pain is caused by stagnation, pain will be relieved by herbs that regulate or move qi and/or blood. We can treat the "root and the branch" simultaneously, relieving pain and resolving the underlying disharmony.

Chinese herbs are easily administered at home. Herbs can be taken in the form of teas that are cooked at home, pills, granules or tinctures. Herbs can also be targeted to treat pain in a specific area of the body. For example, for tight muscles in the upper back and shoulder blades Ge Gen (Kudzu) will guide an herbal formula to that area. It can be combined with herbs that specifically relax spasms like Bai Shao and Zhi Gan Cao (White Peony and Baked Licorice) and medicinals like Ji Xue Teng (Milletia) that open the channels and invigorate and nourish the blood. Pharmaceuticals are broad-acting and often do not target specific areas of the body.

As an adjunct to the use of internal herbs, liniments, plasters, or soaks can be used in the management of pain. Self-massage, epsom salts baths, stretching exercises, relaxation techniques and the application of caster oil packs can also be helpful. If you are dealing with pain, feel free to talk with your practitioner about your treatment plan, home care suggestions and herbal formulas that may be helpful to resolve your condition and support your healing.

Qigong Basics: The Breath & Calming the Mind

By Eric Aufdencamp, D.O.M.

Qi is the vital life force that animates all living things. In Chinese medicine, the breath is one aspect that allows us to create Qi.

Qi from a Chinese Medicine perspective:

1. Provides warmth
2. Keeps blood in the vessels and organs in their proper place
3. Acts as the catalyst for the production of blood
4. Protects the body from external influences (i.e. bacterial and viral influences)
5. Provides movement for the fluids in the body

Qigong means to acquire benefit through being in harmony with one's life energy, or Qi. Exercise and relaxation techniques are ways you can regulate the flow of Qi in your body. If you tend to be tense and always on the go, then relaxation practices are very important. If you tend to have a sedentary lifestyle, movement practices such as tai chi, yoga, swimming, and other low-impact exercises, are important.

Regardless of your activity level, quieting the mind is an essential practice for better health.

• To begin your practice, first sit and simply observe your breath. Is it shallow, rapid, slow, or constricted? Do you breathe only in your chest or do you breathe deeply into both your chest and abdomen?

• Next, breathe through your nose with your mouth closed and the tip of your tongue gently resting on the border of your upper teeth and palate. This creates a circuit in the body that assists the movement of Qi. Breathe from your diaphragm, or from the area around the middle of your torso. As you fill up the area of the diaphragm, your chest may slowly rise as a natural consequence.

• It is best to breathe from deep in the belly, because chest breathing may cause you to feel anxious or lightheaded. When inhaling, breathe deep in order to fill up the entire cavity in a 360-degree radius. Feel as if there were a balloon in the center that is being filled up in all directions. Remember that breathing should always be gentle and not forced.

Over time, your breathing will become slower and deeper without effort. Eventually, you can let go of the focus on your breath and just notice the sensations in your body and the sounds surrounding you.

It is ideal to not shut out sounds, but instead make them a part of your practice. It is a practice of accepting or surrendering to what is both in our bodies and our minds. This practice is excellent for reducing anxiety, promoting restful sleep and slowing down our thoughts.

Reading The Research Regarding Supplements

By Mary Cissy Majebe, OMD

Each month I receive a newspaper entitled, Family Practice News. It refers to itself as “The Leading Independent Newspaper for the Family Physician.” I look through it as a way of keeping myself up to date with Western medicine, as well as with what the Western medical press may be reporting about alternative or complementary medicine. During the week of December 1, 2008, on page 32, the headline at the top of the page read:

“Prescribed Drugs, Supplements Tied To Liver Injury”

It went on to state: "Single prescription medication was the likely cause of the liver injury in 73% of cases. Multiple prescription medications or a combination of prescription medicine and dietary supplements were the cause in 18%. Single or multiple dietary supplements were the cause in the remaining 9%.”

Needless to say, I was distressed, so I sought out the research citation: “Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United States.” Gastroenterology 2008: 136: 1924-1934. After reading this article, I had a much different picture.

The article’s headline listed both pharmaceuticals and supplements. However, of the total 300 patients in this study, 270 of these liver injuries were linked to either one or multiple pharmaceuticals. Only 30 of these liver injuries were linked to a supplement, and 2 of these 30 were linked to a pharmaceutical and a supplement. In other words, 90% of the liver injuries in this study are associated with pharmaceuticals and 10% to supplement usage. Of the 10% with liver injuries due to supplement usage, 65% of these were using supplements for weight loss and muscle building.

Furthermore, 73% (217 patients) of the liver injuries were due to pharmaceuticals, while 18% (55 patients) were linked to multiple pharmaceutical and supplement usage. Of these 55 patients, 2 of them used a supplement that was also listed as a probable causative agent, including Cell Tech, which is a muscle-building agent for body builders, and a Source of Life multivitamin supplement. For 53% of the 55 patients, they were using multiple pharmaceuticals. For 9% (28 patients), they were linked to supplements. Of these 28 patients, 19 were using supplements geared towards body building or weight loss.

All of the liver injuries that resulted in death (11% or 18 patients) were attributed to pharmaceuticals. No liver injuries in these 18 patients were attributed to supplements. Eight of the patients who were in this study received a transplant. One of these was attributed to an over-the-counter weight loss supplement, CVS Spectravite.

My concern with this type of reporting is that often, I, like many other health care professionals, only read the titles and highlights. Of the total 30 patients who were taking supplements, there were also no indications whether they had been prescribed to them by a Licensed Health Care Practitioner or a Trained and Educated Health Care Practitioner.

I find the article in Family Practice News to be reflective of the bias in the media and in allopathic research, which often highlights aspects of wholistic medicine, rather than focusing on the consequences of an over-medicated society. A point of interest is that all liver injuries due to Acetamenaphin were excluded from this study. I wonder how much smaller would the percentage have been for supplements, if all Liver injuries were included in this report.

Cooking With Chinese Herbs To Stay Healthy During The Winter Months

By Ann Wolman, L.Ac.

In Chinese Medicine, the winter is associated with the water element and with the energetic organ system of the Kidneys. It is the time of maximum yin. These are the cold, quiet, contemplative months. Kidney energy holds our deepest reserves and provides the basis for our constitutional strength. This is a perfect time of year to incorporate nourishing and warming medicinal herbs into your cooking.

Foods and herbs have flavors, temperatures and energetic qualities. The Kidneys are nourished by the flavor of salt and other astringents. The Kidneys benefit from cooling or warming foods depending upon an individual’s constitution, but generally speaking, the Kidneys prefer warm natured herbs and foods. Some foods that nourish Kidney Qi are root vegetables like potatoes, yams, parsnips, and small beans like kidney, aduki and black beans and seeds.

One of the best ways to utilize Chinese dietary and herbal therapy is to cook with Chinese herbs. You can put raw herbs into soups and stews. This is often done with herbs like gou qi zi (lycuim fruit), dang shen (codonopsis), fu Ling (Poria), ren shen (Ginseng) and da zao (Chinese Dates).

It is also traditional to make congee, a kind of grain soup, with herbs. These congees are tasty, nutritious, and cost effective. They are particularly comforting on a cold winter morning. All of the herbal ingredients mentioned are available at the clinic and your practitioner can make more specific recommendations regarding those, which would be most beneficial for you.

Below are a couple of simple congee recipes.

Both of these congees can be varied based upon your taste, and as your practitioner recommends. You can use rice, millet, barley quinoa or amaranth as the base. Spices include cinnamon, bay leaf allspice, rosemary, ginger, nutmeg, cloves and fennel. Try walnuts, almonds or pumpkin seeds, and include different vegetables like sweet potato, pumpkin and squash. Experiment a little and enjoy.

If your practitioner suggests a more Kidney yin nourishing recipe, try the Mulberry Congee Recipe.

Basic Herbal Congee Recipe (warming)

½ cup white rice
8 cups vegetable or chicken stock (5 cups stock to 1 part grain if using a crock-pot)
10 grams astragalus root (huang qi)
6 grams codonopsis root (dang shen)
5 grams pueraria root (ge gen)
5 grams lotus seeds (lian zi)
8 shitake or black mushrooms, slivered
1 carrot, diced
1 strip seaweed

Place the astragalus in a bag or tie with string. Cover the codonopsis and pueraria with boiling water for 20 minutes, and then cut into ¼ inch lengths. Simmer all ingredients except carrot for 60 – 90 minutes, or cook overnight in a crock-pot on a low temperature setting. Add the carrot for the last 12 minutes. When done, remove astragalus and serve. This recipe can be varied using other grains like barley and warming herbs like fennel seed and dried ginger.

Mulberry Congee Recipe (cooling)

30 grams fresh mulberries
20 grams dry mulberries
20 grams dried lycium fruit (gou qi zi)
1 /2 cup walnuts
1 cup rice
4 – 7 cups water (7 cups water if using a crock-pot)

Cook mulberries and rice in water preferably overnight in a crock-pot on low setting. Add lycium fruit and walnuts. Serve warm each morning on an empty stomach.

It is even more important in the winter months to follow the basic principles of Chinese dietary therapy, as this will help to protect us from the bad effects of cold natured foods that tend to predominate the American diet. It is suggested that one avoid raw fruits and vegetables and cold or chilled foods and beverages (especially ice cream). Bon Appetit!

DAO YIN Exercises for Health

By Junie Norfleet, L.Ac.

In the book Daoist Health Preservation Exercises, it is reported that Dr. Tissot, a famous French doctor from the 18th century, said, "As far as the role of movement is concerned, it can almost replace any kind of medicine. But no medicine in the world can replace the role of movement."

For many years the Chinese culture has recognized the importance of using movement to maintain and support the health of the body. The type of movement that the Chinese culture uses is not the aerobic and weight lifting types of movement that are so much a part of the culture in the United States.

Dao Yin movements are gentle and yet very effective for moving the energy (qi) of the body to help maintain health or to help cure illness. Following are some Dao Yin exercises that will help to maintain a supple, energized body. (As with all exercise, do only what your body feels comfortable doing.)

1. Lie on your back. Relax. Notice where your breath is in your body. Put your hands on that area. Relax. Gently guide your breath to the lower body. Breathe into the lower body several times. Place one hand on the upper body and one hand on the lower body. Inhale into the lower body and hold the breath. While holding the breath, force the breath into the upper body and then back down to the lower body. "Pump" the breath between these two places until you can no longer hold your breath. Release the breath through the mouth. Repeat several times. Relax and notice where the breath is now.

2. Stretch both hands over your head and spread your legs so that your body looks like an "X." Relax. Now you are going to "crawl on your back." Stretch the right hand higher over your head, then stretch the left leg out; then the left hand higher and the right leg out. By letting the hips shift as you reach, a "crawling" motion will be created when you do it at a fairly rapid pace. Once you have done it several times, relax and notice what feels different in your body. Where is the breath?

3. Lie on your back with your arms out to the sides as if the body is a cross. Pull the knees up and place the feet on the floor. Cross the right leg over the left leg so the knees cross. Inhale and let the weight of the right leg push the left leg to the left as far as it will go and release the breath. The head should naturally turn to the right. Let the left leg do the work of bringing both legs back up. Repeat this several times. As you repeat the exercise again, this time let the legs flop over to the left and release the breath rapidly. Repeat several times. Now lie on your back again. Notice what feels different in the body. Which leg feels longer, heavier? Where is the breath?

4. Repeat exercise 3, but cross the left leg over the right.

Doing these gentle exercises helps to lubricate the joints, stretch the sinews, move the qi, and relax the body. As you do these exercises more and more, you will begin to notice that you feel more centered and comfortable in your body, and that your body can stretch more each week. And remember, there is no medicine that can take the place of movement!

Setting a Good Example through Healthy Eating

By Rachel Nowakowski, L.Ac.

At Thanksgiving dinner, I noticed how some kids are willing to try new foods while others reject anything unfamiliar. Like adults, children develop a natural preference for what they eat most often and enjoy. One way to get kids to make healthy choices is by setting a good example. Because the childhood impulse to imitate is strong, you can encourage your child to eat nutritious foods by being a role model.

Spleen qi is responsible for transforming and transporting food essences and absorbing nutrients. In Chinese medicine theory, children are born with underdeveloped Spleen energy. Considering this theory, we must carefully introduce new foods to children. Overindulging in sweet foods will only lead to further Spleen qi deficiency. Because Spleen qi is associated with the sweet flavor, when it is out of balance, we usually crave sweet foods. (Perhaps this is why so many kids seem to be born with a sweet tooth!)

When your kids ask to taste what you're eating, it helps to have your plate filled with nutritious selections. But healthy eating is not just about what we eat, but also how we eat. Eating while under physical or emotional stress can be harmful to the digestion, even if we are eating a perfect diet. Do you eat while in a hurry? While standing up? While under stress? Stress negatively impacts Liver qi. When this excess energy overacts onto the Spleen, digestion will suffer.

We can teach our children healthy eating habits and take special care to protect Spleen qi if we:

Sit down to eat together. Studies show that children and teens, who eat frequent meals with their families, eat more fruits and vegetables (even dark green ones) and drink fewer soft drinks.

Knowing that dinner is served at about the same time every night and that the family will be sitting down together is comforting, which also enhances appetite and digestion.

Relax. Sitting and taking the time to eat slowly and digest helps Spleen qi to break down food properly. When we eat on the run or rush from the table after eating, it sends qi to other parts of the body when we need the qi in our stomachs for digesting. Taking time to give thanks and enjoy the company of your family and friends during meals also sets a good example for children.

Limit mealtime conversation to pleasant topics. Eating together provides time for your child to share what's on his/her mind. Make mealtime an enjoyable experience by avoiding upsetting topics while at the table.

Chew well. How many times have we heard this? Yet many of us tend to speed through meals, barely chewing our food. Digestion begins with chewing. Chinese medicine says the digestive qi works to break down food into a "100 degree soup". If we chew well, food gets broken down before it reaches the stomach and leaves less work for the digestive qi.

Avoid excess fluids while eating. Don't put out the digestive fire by drinking too many fluids. It is best to drink a little at the beginning and at the end of the meal. Not between each bite. Limiting drinks for kids will also keep them from getting full before they've eaten their vegetables!

Other tips to encourage healthy eating:

Get kids involved. Let them help with the grocery shopping. It's a great time for you to teach them about the nutritional values of different foods, and how to read food labels. Let your child help with dinner by washing or peeling the vegetables. Start a vegetable garden at home so your kids can eat what they grow!

Keep only healthy snacks around. Kids are bombarded by messages that counteract your best efforts. Between peer pressure and junk food advertisements, getting your child to eat well might seem like a lost cause. They may choose poorly when they are out of the house, but you can decide what is available to them at home.

Your children are looking to you for direction on how to eat well. Show them how and help your own health at the same time. Research shows that it takes the average child 8-10 presentations of a new food before he/she willingly accepts it. So don't give up.

Have the kids help with this fun and yummy recipe:

Butternut Squash Fries. Peel and remove seeds from squash. Cut into long, 1/2-inch wide strips. Drizzle with olive oil. Sprinkle with sea salt. Toss the fries to make sure they are evenly coated. Spread fries on a baking sheet. Bake 30-45 minutes, turning to ensure they are crispy on all sides. Enjoy!

Ensuring the Safety of Chinese Herbs

By Mary Cissy Majebe, L.Ac.

Due to the arrival of toxic toys and foods from China into the United States, I would like to address the safety of Chinese herbal medicines for our patients. I will share information with you about how herb producers and manufacturers in the United States have been working to ensure the safety of Chinese herbal products.

First of all, for more than ten years, herbal manufacturers and Chinese medicine practitioners have taken steps towards ensuring a safe supply of Chinese herbal products. Aware of potential issues, Licensed Acupuncturists and herbal companies in the U.S. had already begun instituting procedures to ensure that herbal medicines were safe. This was done well before the recent crisis involving toys and foods from China, and the FDA’s new regulations for dietary ingredients, nutritional supplements and herbal medications.

Secondly, herbal companies in the U.S. carry product liability, which means they must have Certificates of Analysis for each herb product they offer for purchase. This verifies the identity of the herbs in order to prevent misidentification. This process also involves testing to assess any heavy metal toxicity or bacterial contamination.

Asia Natural is the primary company that supplies the Chinese Acupuncture Clinic with the herbs used for making teas. We have worked with this company for more than 20 years, and I have personally visited them in Berkley, California, where I was given a tour of their facilities. I left the factory reassured that the company was doing an excellent job supervising the growing of the herbs in China and following the testing guidelines for herbal products.

In June of 2007, the FDA published its final regulations. Called FDA cGMP, these standards require that each herb importer and manufacturer have documentation attesting to the identity and purity of the herbs it has imported into the U.S. from China. All raw herbs entering the U.S. must meet specifications, which include testing for active ingredients, heavy metals and bacterial contamination. These regulations are to be implemented June 25, 2009 or June 25, 2010.

Likewise, regulations have been published in China requiring cultivators to follow certain practices that minimize pesticide use and residues. In July 2001, China adopted the "Green Trade Standards of Importing and Exporting Medicinal Plants and Preparations." These standards provide for testing of organochloride pesticides, as well as heavy metals, bacteria and aflatoxin. Although pesticides of various types are used in growing some portion of Chinese herbs, detectable levels of pesticide contamination cannot be found.

In conclusion, thanks to a safety net of regulations from the U.S. and China, as well as the conscientious oversight and testing of American herbal companies, I feel comfortable trusting the herbal products available to our patients at the Chinese Acupuncture Clinic.