Monday, June 20, 2011

Acupuncture and Herbs for Burning Foot Pain

Chief Complaint: Severe burning foot pain
Western Diagnosis: Sciatica
Medical History: Patient suffered traumatic fall and damaged sciatic nerve resulting in burning foot pain
Pulse exam: slightly rapid and wiry
Tongue exam: pale pink body, thin white coat
OM Diagnosis: Decided not to treat root. Only treating branch, so diagnosis was channel obstruction or “blood stagnation”.
Treatment Principle: Stop pain, Remove obstruction, Move blood
Point Prescription: Ear points: shen men, occiput, brain. E-stim on shen men and occiput. GB31 opposite side
Herbal Formula: Yan Hu Suo Zhi Tong Wan
Results: After 10 treatments two times a week, patient could put weight on the foot and pain was 90% reduced.

The Treatment of Sciatica Pain with Acupuncture

Chief Complaint: sciatica
Medical History: The patient’s history included having his right femur crushed in a car accident 50 years before, and right knee replaced 3 1/2 years before.
Questioning exam: A seventy-nine year old man presented with sciatic pain which had begun 6 weeks before, in the early winter. The pain began in the lumbar area and traversed down the posterior aspect of the right thigh, calf, and into the 4th and 5th toes, following the Urinary Bladder channel. In addition, pain also went into the right inguinal area and down the medial aspect of the right thing, following the Liver and Kidney meridians.
OM Diagnosis: Wind cold and damp in the channels
Treatment Principle: Eliminate wind, warm the channels, dry damp
Point Prescription: Using Dr. Richard Tan’s Balance Method of mirroring, points on the left and right shoulder were unsuccessful in alleviating pain rapidly. So, per Tan protocol, other locations were tried, until success was found by treating the left wrist. In this mirror image, the leg was mirrored onto the arm in an inverted fashion. Therefore, the hip was at the wrist, and the toes at the shoulder. Following Balance Method protocol, ashi points were located on the meridians related to the areas of pain previously mentioned. Since the UB, K, and Lv meridians exhibited pain, SI, H, and P meridians were needled, and the area was warmed with a TDP lamp.
Results: The patient was treated three times per week for a total of 10 treatments The patient got significant relief from his pain. There was some residual lumbar pain, but all pain down the leg, both medial and posterior was gone.
Synopsis: The most interesting aspect of this case was an unexpected benefit. The patient reported before the 8th treatment that he had been a soldier in the War in the Pacific, and had had malaria 60 years prior. The illness had left a rash on his posterior right shoulder which had been continuous ever since. It was now completely gone. The practitioner had been unaware of the condition and had made no attempt to address the problem. Possible reasons the condition cleared up are pure conjecture, but could be the PC and SI points used to address the sciatica did double duty on the shoulder. However, upon close inspection, it was discovered that one of the SI channel ashi points used to treat the patient’s pain radiating down the leg, was in fact Gan Men, one of the points described in Dr. Tan’s Twelve and Twelve in Acupuncture (copyright 1991). Gan Men is used to treat disease and dysfunction of the liver, which of course is exactly what malaria is.

Chief Complaint: Chronic Pelvic Pain
Western Diagnosis: Endometriosis
Medical History: 30y.o. female presents with main complaint of chronic lower pelvic pain. Patient states she got off of Aleese (birth control pill) approximately 6 months ago and began experience pelvic pain around ovulation and menses.
Symptoms: irregular pattern of menses, occasional spotting around ovulation and pre-menses, pain during intercourse, slightly painful bowel movements, a dislike of touch around the area, large clots, thirsty, constipation. Patient has had history of dysmennorea as an adolescent and visited her family physician who began her on birth control at the age of 14. Her current reason for discontinuing is to become pregnant. Patient states that around ovulation she is irritable and frustrated. Post-ovulation and menses she becomes depressed and sad. Her pain is located left lower pelvic region–described as very sharp “as if a knife is piecing me”. This pain will last until menses subsides (usually 5-7 days). Diet: red meat, fruits/veggies, dairy, does have daily caffeine and sugar intake. Exercise habits are moderate at best and states she is too busy to have a steady exercise routine. She is seeking acupuncture/herbal treatment because her doctor simply recommends her returning on the birth control pill.
Questioning exam: Most obvious symptom was her localized chronic pelvic pain, also associated pain symptoms (painful intercourse, bowel movements, etc).
Pulse exam: Pulse: Deep, wiry/choppy, slightly rapid
Complexion is slightly red
Tongue exam: Tongue: body is bluish purple, coat is pinkish/reddish.
OM Diagnosis: Blood stasis with heat. Blood should normally be shedding during the menstrual cycle and not backing up causing the endometriosis. If the blood doesn’t shed, it becomes stagnant, and causes pain. After time, stagnant Qi turns into heat causing this patient to also exhibit heat symptoms.
Treatment Principle: Clear heat, move qi and blood
Point Prescription: Sedate LI11, Four gates, Zigong, TW6, SP6, SP10, LIV5.
Herbal Formula: The developing sequence of the follicular phase is governed by the movement of Liv qi and Blood. Liv qi triggers the transformation of yin into yang to support ovulation. The free flow of liver qi is a must so ovulation can happen. Ovulatory/menstrual pain is indicative of blood stasis and the following herbs should be continuously used for a minimum of six months to promote the free flow of qi/blood and clear heat.
Bai Shao
Yi Mu Cao
Xu Duan
Xiang Fu
Dong Chong Xia Cao
Chaun Xiong
Dang Gui
Chen Pi
Zhi Ke
Shan Zha
Gou Qi Zi
Sha Shen
Hei Zhi Ma
Dan Shen
Da Zao
Lifestyle Prescription: I recommend patient to clean up her diet. Incorporate Vit E (800iu) into her diet-this improves scar tissue caused by the internal endometrial bleeding.
Reduce yeast/sugar. Both are very inflammatory to the body–increasing her pain.
Add a high fiber, vegetarian based diet. Reduce meat/dairy–both contain hormones that may be causing hormonal/endometrial fluctuations and adding unnecessary heat.
Incorporate 30minutes of exercise 4x/week. This to increase endorphins which are our bodies natural painkillers.
Results: Great results. Patient has come to my office 2x/week for first twelve weeks, then lowered to one time a week. It is the forth month and patients symptoms have reduced by over 70%. Acupuncture/herbs are key to pain reduction, but diet and exercise factors also play a key role in gynecological conditions
Synopsis: Patient will continue with treatments. Will adjust acupuncture points and discontinue herbs one month prior to patient wanting to conceive.

Acupuncture Treatment of Ganglion Cyst

Chief Complaint: 1x1x1x inch. right wrist lump
Western Diagnosis: Ganglion cyst
Medical History: Right handed computer/mouse user
Questioning exam: Cosmetic reasons:[/b] looked prominent though painless.
OM Diagnosis: Phlegm accumulation based on local Qi and blood stagnation
Treatment Principle: Local needling
Point Prescription: Looking up medical acupuncture and general acupuncture websites I could not find any particularly relevant information
Herbal Formula: N/A
Lifestyle Prescription: Wrist support, exercise
Results: After one treatment, basically my idea was just to “puncture” the cyst and using direct moxa on site, within 24 hours the cyst fluid leaked out and the prominent, disfiguring lump disappeared.
I had to repeat the very same treatment a couple of times later when the lump was just about showing gain and it has not returned as of today.

Herbs and Acupuncture for Dark Scanty Menstrual Flow

Chief Complaint: dark scanty menstrual blood
Medical History: Patient is a 35 year old pilates instructor.
- very active lifestyle with a 4 year old daughter
- eats irregularly and often on the run
- healthy pregnancy and no surgeries or major illness
Questioning exam: – blood dark in colour, brownish purple and scanty with some clots.
-energy levels very low lately
-some lower abdominal cramping first day of menstruation
-fatigue worse during and just after menstrual cycle
-complexion pale
Pulse exam: thin, choppy, wiry
Tongue exam: pale purple tongue more pale on the sides
OM Diagnosis: Liver blood deficiency and blood stasis
Treatment Principle: Tonify liver blood, dispel blood stagnation
Point Prescription: Sp4, P6, St 36 Liv 3 Li4 Liv 8 Sp10
R4, K3
Herbal Formula: Ba Zhen Tang for the first 2 weeks of cycle and then Tao hong si wu tang for last 2 weeks of cycle
Lifestyle Prescription: Ask patient to follow a spleen qi diet, eating more cooked foods, less dairy and wheat.
- eat on a regular basis and stop eating on the run, sit down to eat, chew food well
-to listen to her body and if she is feeling tires to try to get some rest and miss a day of exercise
Results: After 2 months cycle has improved,abdominal pain is gone, menstrual blood is a much brighter colour and the blood flow is becoming heavier
-overall energy has increased and feeling less stress
Synopsis: Overall patient has learned how to listen to her body, to take the time to slow down when tired and also has stopped eating on the run. These have made a large difference in her health and overall well-being.