Healthy Snacks and Lunches for Back to School

By Junie Norfleet, L.Ac.

The start of school brings the challenge of a healthy snack or lunch that is easily packed. Below you will find some suggestions, but first some information on the systems of the Spleen and Stomach.

The Spleen and Stomach systems are an integral part of digestion in Chinese medicine. The Stomach system must have some "heat" to begin the digestive process. Too many hot, spicy foods can create too much "heat" and disrupt the digestive process. The Spleen system can become depleted if we consume too many "cold" items. "Cold" can be temperature cold, or energetically cold. For example, raw foods and soy products are energetically cold.

The Spleen system is strengthened by the taste of sweet. Sweet from a Chinese medicine perspective is the sweetness of rice. In our culture, many people would not recognize that rice is sweet, because we are so accustomed to the sweetness of refined sugar. Eating rice, sweet potatoes, beets, and carrots will strengthen the spleen.

From a Chinese medicine perspective, it is strengthening to the digestive system for foods to be lightly cooked. A weak digestive system will not be able to absorb nutrients adequately, so it aids the digestive process to begin the break down of foods by lightly cooking them.

Preparing a bento box can be a fun way of introducing less "traditional" foods into the lunch. Bento boxes were designed in Japan and are becoming more popular in North America recently. A bento lunch is a compact, balanced, visually appealing meal packed in a box. There are many websites that discuss bento boxes. They include ideas for taking advantage of leftovers when preparing a bento box and elaborate or simple meals that can be prepared ahead of time. This website has a lot of great ideas that can give you inspiration for lunches: click here

Fresh vegetables are great fillers for bento boxes. Cutting them into special shapes can make the food more attractive to a picky eater. Carrots, celery, broccoli, cauliflower, and green peppers are easy to add to bento boxes. Add a small container of almond butter (less oil than using peanut butter), hummus, or Lemon Tahini dressing (quarter cup tahini, 2 Tbs extra virgin olive oil, 1 clove garlic, juice of 1 lemon, half tsp tamari, third cup water), as a dipping sauce. (This recipe and the recipe for Apricot Kudzu Custard below are from Feeding the Whole Family, Recipes for Babies, Young Children, and Their Parents by Cynthia Lair.)

Healthy snacks can be made from leftovers: just mix cooked rice with leftover vegetables. For small children, a fun snack (or breakfast) can be made by warming cooked rice and sweet potatoes (or winter squash in the winter) in some rice milk and adding some walnuts or seeds to add texture. Below is a recipe for a seed mixture that is great to add as a topping for vegetables or just to eat as a snack.

Take the seeds that are the same physical sizes and dry fry or toast them. (To dry fry, just put the seeds in a frying pan without oil and heat until the seeds pop.)

Seed Mixture

Quarter cup of each of the following:
black sesame
white sesame
gold flax
brown flax
pumpkin seeds
unsalted sunflower seeds

Mix all these together after dry frying.

You can learn to use your left over rice to make sushi rolls. Cucumber, carrot, asparagus, and avocado can be added to make sushi interesting. Sushi rolls make a great addition to a bento box.

Nuts are healthy snacks. Walnuts and almonds are better choices, because they are not as oily as peanuts and cashews. Overeating oily nuts can congest the liver.

According to Paul Pitchford in Healing With Whole Foods, goat milk is more easily digested than dairy products, because the curd is softer and the fat globules are smaller. Add rosemary and/or basil (or spices of your choosing) to goat cheese and spread it on rice crackers. Berries and other fruits can be easily added to goat yogurt for a sweet snack. The darker the berry, the more it nourishes blood, so blue and black berries are excellent choices.

Fruits are also good snacks, with local fruits being better choices. Remember that fruit sugar is still sugar, and that too much sugar can deplete the Spleen system.

Another sweet snack is Apricot Kudzu Custard:
Prep time 5-10 minutes
Makes 4 servings
2 Tbs Kudzu
2 cups apricot juice (or any juice of your choice)
2 tsp tahini
1 tsp vanilla extract

Dissolve the kudzu in cold or room temperature apricot juice. Put mixture in a small pan over medium heat, stirring constantly. As mixture simmers, it becomes clear and thick. Once this happens, remove from heat. Add tahini and vanilla; mix well. Serve immediately, custard will get rubbery if allowed to cool to room temperature.

Have fun with these suggestions and invite your child to learn how to make some of these snacks, too.

Lifestyle Changes Can Cut Breast Cancer Rates

Mary Cissy Majebe, O.M.D.

This was the headline in the March 26, 2010 USA Today. As Western science evolves, it confirms knowledge handed down for centuries in Chinese medicine (CM). Western science continues to affirm CM knowledge, rather than refuting its wisdom. For example, CM linked the Kidney Qi to the bones long before Western science taught us that the kidneys secrete the hormone erythropoietin, which stimulates bone marrow to produce red blood cells, long before we knew the connection between calcium and kidney function.

These headlines lead me to reflect on the causes of disease from a Chinese medicine perspective. In Chinese medicine, diseases are generally attributed to three primary causes:
1) Internal Pathogenic Factors
2) External Pathogenic Factors
3) Miscellaneous Factors.

External Pathogenic Factors are the six environmental factors: cold, heat, wind, damp,dryness and summer heat. Bacterial conditions can be transmitted via the wind, and this wind was the "cause of 100's of diseases" based on the oldest Chinese medicine text, the Nei Jing, written in 220 BCE. I am always amazed that the Chinese knew of air-borne conditions long before access to the "scientific tools" that now confirm their knowledge.

Internal Pathogenic Factors relate to those things that we are consuming on a daily basis. This has to do with not only the foods that we are consuming, but also the emotions that we are consuming. These are the lifestyle factors that are becoming more of a focus in many of our lives.

Miscellaneous Factors include genetics and also the toxic influences that are now proliferating in our world. We know that there are onco-genes that are associated with a greater likelihood of a cancer diagnosis. I believe that we are just beginning to scratch the surface of understanding the toxicity of chemicals, pesticides and other noxious substances in our environment.

SO, HOW DO WE PROTECT OURSELVES FROM CANCER??? This question could be assigned the same answer as the question of, HOW DO WE PROTECT OUR CHILDREN FROM HURT AND PAIN? We do the best we can with what we have.

We exercise, pray, do progressive relaxation or meditate.
We eat as organically and clean as possible. Yet, we are still subjected to chemical and toxic influences daily. So, how do we negotiate this journey of life amidst all of the perils that lie ahead?

We wake each morning, knowing that it is a gift to be alive and walking and sharing this journey with each other. We acknowledge that our time here is limited, and we embrace each precious moment. We meet each other with love and hopefully learn to meet ourselves with love and acceptance.

Herbal Medicine: The Mulberry Tree In Chinese Herbology

David Treviño, L.Ac.

One of the most useful plants in Chinese herbal medicine is the white mulberry plant, Morus alba. Since ancient times, the Chinese have used this plant for raising silkworms, which utilize the tree's leaves as their main source of food. Chinese medical practitioners have used several parts of this plant for centuries to treat various health conditions. The Chinese term for the mulberry plant is sang. The plant parts used in Chinese herbology include the fruit (sang shen), leaves (sang ye), and the root bark (sang bai pi).

Additionally, the silkworm fecal matter (can sha) created after the worms have eaten the leaves is an important medicinal derived from this plant. Each of the plant parts has unique characteristics and diverse therapeutic uses.

Mulberry fruit is a sweet, gentle, and cooling blood tonic that enhances the nourishing, cooling, and moistening (Yin) aspects of the Liver and Kidneys. Chinese medicine utilizes this herb to treat deficient conditions such as anemia, dry constipation, and the premature graying of hair. The ability for this fruit to treat deficient conditions may be due to the fact that it contains significant amounts of vitamin A, B1, B2, C, protein, lipids, and anthocyanins.

According to Subhuti Dharmananda, president of the Institute for Traditional Medicine (ITM), the high levels of anthocyanins found in mulberry fruit, "may improve blood circulation and other body functions to alleviate many symptoms that arise under deficiency conditions." In China today, Morus fruit is bottled as a beverage and marketed to improve the immune system, enhance general health, and promote longevity.

Morus leaves are sweet and cooling like the fruit, but also have a bitter flavor. The leaves enter the Liver and Lung meridians, where the cooling and bitter properties remove externally contracted heat conditions (as occurring with a cold or the flu) with symptoms such as fever, sore throat, headache, sore-watery eyes and cough.

Mulberry leaves are also used to stop bleeding in patients who are vomiting blood. Western studies have shown that decoctions made from fresh mulberry leaf can inhibit several bacteria including Staphyloccocus aureus, Escherichi coli, and hemolytic streptococcus. New research shows that mulberry leaf extracts may play a role in the management and treatment of diabetes.

Similar to the leaves of this plant, Morus root bark is sweet and cold in nature and enters the Lung meridian. The difference between Morus leaves and the root bark is that the latter is indicated for coughs that have hot phlegm. In Chinese medicine, hot phlegm occurs when the body's physiological fluids in the Lung are heated and congealed in reaction to a pathogen. The phlegm can then turn white, yellow, green, or even gray depending on the severity of the heat.

Morus root bark has the ability to help the body transform the pathological phlegm with a downward directing function, which settles coughs and wheezing and facilitates urination to eliminate excess fluid. In fact, this herb is commonly used for the treatment of edema, especially when it is around the eyes.

According to John Chen, author of Chinese Medical Herbology and Pharmacology, the water and alcohol extracts of Morus root bark "have a marked diuretic effect by increasing the excretion of water, sodium chloride, and potassium." Other pharmacological effects of this herb include inhibiting bacteria such as Staphylococcus aureus, Salmonella typhi, and Baccillus dysenteriae.

Because of its sweet, acrid and warm qualities, the silkworm fecal matter is effective for the treatment of pain in the extremities and abdomen caused by Wind and Dampness. Chinese medicine considers this type of pain in the extremities as Wind-Damp Painful Obstructive Syndrome. Wind refers to the tight or pulling nature of the pain (like a spasm) and the dampness to the swelling in the joints, which is often exacerbated by damp environments or damp weather. The silkworm's fecal matter has a warm quality, is able to dry the damp obstruction and the acrid quality helps increase the blood flow to eliminate muscle aches and pain.

Believe it or not, silkworm fecal matter is also used in Chinese medicine to harmonize the stomach. Its sweet flavor harmonizes the stomach, and the warm and pungent properties help eliminate any fluids that may be obstructing the normal flow and function of the stomach. For these reasons, this herb can stop abdominal cramping and transform the dampness that is inherent in diarrhea and vomiting. Finally, this herb is commonly used to treat itchy skin and eczema. The acrid and warm properties help bring blood to the skin, dry the secretions and promote healing.

Morus albae is a unique plant in Chinese herbal medicine. This plant's fruit, leaves, root bark, and the silkworm fecal matter created from the leaves, all have unique characteristics. They have been used effectively for centuries and currently are important herbs in Chinese medicine. Morus albae's diverse therapeutic ability to treat a range of conditions make this a remarkable plant in the Chinese pharmacopeia.

References:

Chen J., Chen, T. Chinese Herbal Medicine and Pharmacology. City of Industry, CA: Art of Medicine Press, 2001.

Bensky, D., Clavey,S., Stöger,E. Chinese Herbal Medicine Materia Medica. Seattle, Washington: Eastland Press, 2004.

Dharmananda, Subhuti, Ph.D., Fruit as Medicine. Director, Institute for Traditional Medicine, 2004.

Murata K, Yatsunami K, Fukuda E, et al. "Antihyperglycemic effects of propolis mixed with mulberry leaf extract on patients with type 2 diabetes." Altern Ther Health Med, May-June 2004;10(3):78-9.

Treating Pain: Fibromyalgia

Karen Litton, L.Ac.

Various rheumatology studies have estimated that 3 to 6 million Americans suffer from fibromyalgia. That is one in every 50 Americans. Over 80% of sufferers are women over 50 years of age. The prevalence of fibromyalgia is second only to osteoarthritis among rheumatic ailments. The pervasive pain of fibromyalgia is challenging to both the patient and doctor.

Western medicine does not know exactly what causes it. There are no diagnostic tests such as x-rays or blood tests to detect it. The symptoms of it may overlap with the symptoms of other conditions. These are some of the reasons it is difficult to diagnose from a Western standpoint.

Fibromyalgia is characterized by wide-spread muscle pain and stiffness. This pain can be accompanied by fatigue, non-restorative sleep, balance issues, dizziness, and pain that is worse with stress/physical activity/and weather changes, especially cold and damp. Some degree of pain is always present. It can be in the hips, low back, shoulders or legs. The condition can be triggered by emotional stress, medical illness and trauma.

Fibromyalgia is also thought to be associated with a variety of other symptoms such as Irritable Bowel Syndrome, dysmenorrhea, and restless leg syndrome. Western medicine treats these conditions with lifestyle modifications, drug therapy and other modalities.

Numerous Western research studies have evaluated the effectiveness of acupuncture in the treatment of fibromyalgia. In June of 2006, a Mayo Clinic study found that acupuncture significantly reduced the symptoms of fibromyalgia. Because Chinese medicine takes an individual approach to diagnosis, there are numerous possibilities as to why a person develops this type of pain syndrome.

Chinese medicine does not treat a specific disease known as "fibromyalgia" per se. What it does treat is the unique expression of fibromyalgia that is particular to each individual based on their own signs and symptoms. Through a detailed analysis, your acupuncturist will consider your combined group of symptoms and how they are expressed in the body.

If an individual's sleep and dizziness issues are accompanied by pervasive pain in the muscles and joints of the body, your practitioner will design a treatment plan focusing on the underlying cause of this set of symptoms. Another individual could have an entirely different set of conditions that are combined together.

A Chinese medicine practitioner will evaluate the energy flow in the different meridians where the imbalances are thought to arise, looking for areas of deficiency and stagnation. This energy flow is known as qi, and it flows through meridians, which correspond to a particular organ or a group of organs. Too much, too little or blocked qi can lead to health problems. Thus Chinese medicine will have a different diagnosis for each individual evaluated, with an individual treatment plan for each.

While adjusting the circulation of qi and blood through an acupuncture treatment, your practitioner may also want you to include herbal medicine, as appropriate. Particular herbs can be chosen, which also help to relieve the pain and address your system's imbalances. Other therapies that might be included are heat, massage and cupping. Cupping is a suction technique used on muscles to move the qi or help to release the muscle groups. All of these additional modalities can help to reduce pain.

There are a number of things which you can do on your own to help with the pain in the body. One activity is to walk. Walking moves the qi in our Liver meridian, which is responsible for overall qi flow in our body. Even though the pain may tell us that moving will aggravate the symptoms, generally an even walking pace and a walk outside will do a lot to move our qi stagnation, which ultimately helps relieve some of the pain symptoms.

Your practitioner will also talk with you about changing what is stressing you in your life. Looking at your stress level and determining how to reduce it in your life is important. When we are stressed, we tighten and decrease the circulation of the qi and blood in our bodies. Stress also uses up the body's resources that could be used for healing. Yoga, Tai Chi, Qi Gong, and stretching are therefore helpful.

Specific stretches can help to relieve painful areas of the body. If your pain is in your shoulders, for example, there is an easy stretch to help keep the shoulders open. Take a rope or a long belt and grasp it in your hands. Act as if you want to pull the rope in two, creating a tension in the rope. Then, with the rope taut, hold your hands in front of your body and slowly raise your arms overhead and back behind your body, continuing to hold the rope in your hands. Make sure that the rope is long enough, so that this is an easy motion to make. Keep your arms completely straight, without bending the elbows. Doing several of these stretches over the head, back behind the body, and to the front again will open up the flow of energy in your arms, thus helping relieve the pain.

In addition, there are a couple of liniments available at the clinic that can be rubbed into the shoulders or hips or knees to provide some pain relief. Two of these are White Flower Oil and Dit Da ointment.

Another area your practitioner may focus upon is your diet. You may be asked to fill out a diet sheet. This is an examination of what foods make up your meals. For example, if we eat a diet, which is more acidic (such as tomatoes, sugar, etc.), then this can add to the heat and stagnation in our joints. Eating a more alkaline diet, with more vegetables and other foods, may be suggested.

All of these different modalities can complement each other in achieving relief from this complex illness.

The Relaxation Response

By David Treviño, L.Ac.

Several years ago, I had the privilege of meeting Herbert Benson M.D., research cardiologist, professor, author, and founder of Harvard's Mind/Body Medical Institute. Dr. Benson coined the term Relaxation Response. It was through his work that I learned about the scientific benefits of relaxation.

According to Dr. Benson, eliciting the Relaxation Response is extremely beneficial as it counteracts the physiological effects of stress and the fight or flight response. In his book The Relaxation Response, Dr. Benson explains that regular elicitation of the Relaxation Response has been shown to be an effective treatment for a wide range of stress related disorders. The Relaxation Response in essence is the opposite response to the fight or flight response.

The "fight or flight" or stress response was originally discovered by the Harvard physiologist Dr. Walter B. Cannon (1871-1945). It occurs naturally when we perceive that we are under excessive pressure, and it is designed to protect us from bodily harm. Our sympathetic nervous system is instantly engaged in creating a number of physiological changes, including increased metabolism, heart rate, blood pressure, breathing rate, dilation of pupils, constriction of our blood vessels, and our blood becomes more viscous and ready to clot, enabling us to fight or flee.

It is not uncommon for individuals eliciting the fight or flight response to describe such physiological changes as muscle tension, headache, upset stomach, racing heartbeat, deep sighing, or shallow breathing. The fight or flight response becomes harmful when elicited frequently, as high levels of stress hormones are secreted and have been found to contribute to a host of stress related ailments such as cardiovascular disease, inflammatory bowel diseases, and others.

Luckily, the Relaxation Response turns off the fight or flight response, returning the body and its biochemistry back to pre-stress levels. Dr. Benson describes the Relaxation Response as a physical state of deep relaxation, which engages the other part of our nervous system called the parasympathetic nervous system.

Harvard researchers have found that regular elicitation of the Relaxation Response can help any health problem that is caused or exacerbated by chronic stress such as fibromyalgia, gastrointestinal ailments, insomnia, hypertension, and others.

In a 2004 news interview, Dr. Benson explained that when the Relaxation Response is elicited "our brain waves actually change to an alpha state, our blood pressure and metabolism goes down, and any condition made worse by stress will diminish."

There are many methods to elicit the Relaxation Response including visualization, progressive muscle relaxation, acupuncture, massage, breathing techniques, prayer, meditation, tai chi, qi gong, and yoga. True relaxation is commonly cultivated by breaking the train of everyday thought by choosing a word, sound, phrase, prayer, or by focusing on our breath.

It is important to note that the Relaxation Response is a deep state of relaxation and is not equivalent to sitting with our feet up and watching television, listening to music, or reading a book. These forms of distraction are useful, yet they do not induce alpha brain wave activity the way deep relaxation does.

One of the most valuable tools we can learn in our life is to stimulate deep relaxation. The key is making an effort to spend some time every day to learn to calm our minds and create inner peace. Learning to relax is a great skill that may enable us to be better equipped to deal with life's unexpected stressors.

According to Dr. Benson, the best time to practice the Relaxation Response is first thing in the morning for ten to twenty minutes. Practicing once or twice daily is sufficient to counteract the stress response and bring about deep relaxation and inner peace. The following is the Relaxation Response technique reprinted from Dr. Herbert Benson's book The Relaxation Response.

Steps to Elicit the Relaxation Response

1. Sit quietly in a comfortable position.

2. Close your eyes.

3. Deeply relax all your muscles, beginning at your feet and progressing up to your face. Keep them relaxed.

4. Breathe through your nose. Become aware of your breathing. As you breathe out, say the word "one"* silently to yourself. For example, breathe in, and then out, and say "one"*, in and out, and repeat "one."* Breathe easily and naturally.

5. Continue for 10 to 20 minutes. You may open your eyes to check the time, but do not use an alarm. When you finish, sit quietly for several minutes, at first with your eyes closed and later with your eyes opened. Do not stand up for a few minutes.

6. Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to occur at its own pace.

When distracting thoughts occur, try to ignore them by not dwelling upon them and return to repeating "one."*

7. With practice, the response should come with little effort. Practice the technique once or twice daily, but not within two hours after any meal, since the digestive processes seem to interfere with the elicitation of the Relaxation Response.

* Choose any soothing, mellifluous sound, preferably with no meaning or association, in order to avoid stimulation of unnecessary thoughts.

Breathe easy, and feel your body relaxing.

References:

Benson, Herbert. The Relaxation Response, New York, NY: Harper Collins Publishers. 2000.

Treating Headaches with Chinese Medicine

By Joshua Herr, L.Ac.

Headaches affect many Americans. The frequency can vary from daily, weekly or monthly. The intensity varies from a mild nagging headache that interferes with normal tasks to debilitating headaches that can leave an individual bedridden. Medications can sometimes resolve a headache, but don't eliminate the root cause.

A practitioner of Oriental medicine is not only concerned with alleviating the headaches when they occur, but also understanding the root cause of the headaches. Correcting the cause of the headaches can eliminate their occurrence.

Chinese medicine understands the symptom of a headache to be one part of a myriad of symptoms that creates a pattern of disharmony that is present in the patient. Whether the headache is located in the back, top, side or front of the head all point to different clinical significance.

Identifying the headache location is a beginning step in making a differential diagnosis. After collecting further information about the headaches, like medical history, diet and lifestyle, the practitioner determines a diagnosis.

Common syndromes that lead to headaches are Liver Yang Rising, Liver and Kidney Yin Deficiency, Liver Blood Deficiency, Stomach Heat, Qi and Blood Stagnation as well as others. Diagnosing the clinical syndrome enables the practitioner to create an acupuncture and herbal medicine plan that best fits the individual.

At the 56th annual meeting of the American Academy of Neurology, a study published in the British Medical Journal (BMJ, 2004;328:744-747) on the use of acupuncture for headaches was highlighted. The study had 401 participants with predominately migraine-type headaches, who received 12 acupuncture treatments over 3 months. At 12 months, headaches were less in the acupuncture group, patients used less medication and made fewer visits to their primary care physicians.

The above study illustrates the usefulness of acupuncture as a therapy for the clinical management of headaches. Often patients experience an immediate elimination or reduction of headaches with acupuncture therapy. The use of food diaries is another useful tool that can help to identify dietary factors that can be contributing to the occurrence of headaches. Wheat, dairy and sugar are common ingredients in an American diet that contribute to an internal imbalance that gives rise to headaches.

Herbal therapy remedies can also correct the internal imbalance that contributes to the reoccurrence of headaches, as well as treating acute episodes of headache. For mild headaches, placing White Flower Oil on the temples can resolve the pain. White Flower Oil is a Chinese medicine liniment that is great to have in the medicine cabinet. As well as treating headaches, it can also be used topically for sinus congestion, arthritic pain, sprains, strains, and bug bites. Use caution when applying White Flower near the eyes, because it can irritate them if placed too close.

If you experience mild, infrequent headaches, explore how dietary factors may be contributing to their occurrence. Try White Flower oil and/or the acupressure described in our Fall 2009 Newsletter. If the problem is more severe, Chinese medicine offers many natural therapeutic resources for you to consider.

Cupping Therapy

By Ann Wolman, L.Ac.

Many patients have experienced cupping as part of their treatment at the Chinese Acupuncture Clinic and have expressed curiosity regarding its origins and uses. Cupping has been widely used in Chinese medicine for thousands of years. In ancient times, it was known as "horn cupping" and/or "bamboo jar therapy." Now cups are almost exclusively made of glass.

Early treatments focused on swellings and purulent swellings; however, over the years, cupping therapy has been expanded to treat a wide variety of complaints including arthritis, muscle tightness, sports injuries, sciatica, the common cold, post-stroke hemiplegia, abdominal and epigastric pain, menstrual cramps, intestinal spasm and even obesity. The use of cupping therapy has spread around the world and is now commonly seen in places as diverse as Cyprus, the Philippines and Turkey.

Cupping is done by creating a vacuum in a cup or jar, usually by means of heat, and applying the cup to the skin to draw up the underlying tissue. The amount of suction can be relatively great or mild depending upon the condition being treated. Usually a cotton ball is held in a pair of hemostats and dipped in alcohol. The cotton is ignited and inserted into the mouth of the cup while it is burning. The cotton ball is withdrawn quickly, and a vacuum is created as the cup is placed firmly against the skin at the desired location.

Cups can be moved (put an oil or liniment on the skin before applying) or left stationary over a particular area, for example, over the lungs to help decongest and ease breathing. Cupping can be combined with the application of liniments and with acupuncture. To remove cups, simply press against the skin at the base of the cup to break the "seal."

There are a few cautionary measures to keep in mind while using cups. Cupping should not be applied where skin is not smooth, or where there is a lot of hair, as it may be difficult to maintain suction under cups. Cupping should also not be applied over any abrasions or cuts. Smaller cups are often used around joints because they have rounded or angular surfaces. Too many cups placed closely together may pull surrounding tissue and cause pain. Cups should not be moved over bony prominences like the spine. Cups should not be left on for long periods of time (more than 15 minutes) to avoid blistering. Cupping should be avoided in areas where it would not be appropriate to have mild discoloration of the skin, like the face. Do not try to pry cups off from the top when removing them.

Cups can create bruising depending on the strength of the cupping process. This is normal and will resolve like any other bruise, disappearing without special treatment. Be careful not to apply a second group of cups until the skin has returned to its normal color.

Cupping has several advantages. It is safe, as long as it is properly administered, simple to perform, cost-effective and can be done at home as part of a self-care program. Cupping feels good, because it warms the area, releases heat and stagnation and relaxes muscles. I have one 5-year-old patient who regularly requests that "we do that cupping thing" on his back. Cups can be inexpensively purchased at the clinic, and your practitioner will happily go over an individualized treatment plan that can include cupping at home. If you have any questions, do not hesitate to ask.