Acupuncture Helpful for Maternal Separation Anxiety

Maternal separation anxiety involves a mother experiencing emotions of worry, sadness and/or guilt during temporary separations from their child. No study has shown precise numbers but it seems to be a somewhat common phenomena, if not under diagnosed, which according to some studies is more likely in first time mothers. While a fairly extensive study didn’t find a correlation with maternal anxiety leading to separation anxiety in children, considered within the context of the psychological changes prevalent post-partum and other anxieties of child rearing any help in limiting anxiety from any cause is very likely a positive offering.

Acupuncture and Chinese Medicine more broadly is used for the entire range of psychiatric conditions including anxiety disorders, insomnia, depression and other more complicated conditions. There are any number of studies supporting the use of acupuncture and Chinese herbal medicine in the treatment of this range of conditions and postpartum depression issues fall well within this scope.

In very general Chinese Medicine terms the weaknesses that can arise from pregnancy, labor and delivery, and postpartum activities in both qi (your bodies energy) and blood (your blood and other facets of tissue nourishment) are often linked to psychiatric issues postpartum. Some of these deficiencies may have been prevalent before pregnancy and then only made more significant through the process, for others it may arise at anytime through the process. An example of some possibly underlying Chinese Medicine diagnoses for anxiety may be seen on our acupuncture for anxiety page. For more on how Chinese Medicine treats causal patterns and not symptoms/conditions – see “What Does Acupuncture Treat?“.

Treatment is centered around strengthening these deficiencies in Chinese Medicine terms, not in simply calming the person as a western psychiatric drug might be used for example. Due to the complexity of the diagnostic process in Chinese Medicine, the best outcomes will come by consulting with an acupuncturist in your local area to receive treatment tailored to your unique situation. What I am going to discuss today, however, is a fairly simple study using a single acupuncture point that changes some of the chemistry thought to be involved with maternal separation anxiety, thus relieving symptoms. This isn’t as much a recommendation to use this single point, although it can be used with acupressure, but to understand more of how it works in biochemical terms.

The point used in the study was HT 7. HT 7 is an important point in Chinese Medicine for what we term “calming the shen” and what in western terms would be for alleviating stress and anxiety. It is easily found with your palm facing up at the wrist crease on the pinky finger side just towards the inside of the tendon you feel there (flexor carpi ulnaris). Indications include strengthening deficiencies of the heart qi and blood, emotional issues particularly related to thinking, strong physical responses to emotional stimulation, etc.

In this study they utilized rat pups and divided them into 3 groups – a control, a HT 7 treatment group and then a group with a random acupuncture point – in this case UB 57 which is often used for hemorrhoids. They were treated for 7 days and various blood and biochemical samples were taken along with other stress related tests.

The researchers concluded that “acupuncture stimulation at HT 7 can alleviate the behavioral impairment and changes of the cytokines by MS, indicating that acupuncture can help to relieve MS-induced depression”.

In more biochemical terms the researchers found that compared with the other groups, those in the HT 7 treatment group had significantly lower levels of IL-1β and IL-6 (which when elevated indicate stress and anxiety), as well as reductions in GDNF (again, higher in stress responses) and lower overall cortisol levels.

While treatment is generally more directly tailored when applied by an acupuncturist, it is interesting to note that very simple approaches may also yield very productive results.

Need Focus and Impulse Control? – Practice Tai Chi

Without getting into an incredibly detailed discussion of your brain and nervous system, you have two modes of being; your sympathetic (“fight or flight”) mode and your parasympathetic (“rest and digest”) mode. Technically you need both, but many of our psychological and physical health issues come from over-activation of our sympathetic system – i.e. living in fight or flight. While that is bad enough, over time aspects of our brain will change to essentially facilitate operating in that undesirable mode making true emotional and physical wellness more difficult than just changing habits, diet or other aspects.

One of the principle reasons why people have a hard time changing their diet, lifestyle and emotional behaviors is that without the activation, growth, and development of certain parts of the brain the changes we wanted to do become a correction after we act (a response), rather than the consistent act of balance and choice without choosing (see “wu wei“) that we desire. In essence we want our initial, thoughtful intent to be what drives our behavior, not to always act by reacting to internal or external stimuli.

Put more simply, we want a brain to tell us we are calm and our reactions to be as they would be from a calm, thoughtful person, not to have to consistently tell ourselves that we “should” be calm after we behave poorly.

Much of this is laid out in detail in the text “Buddha’s Brain: The Practical Neuroscience of Happiness, Love, and Wisdom.” The text itself doesn’t have much to do with Buddhism, if anything really, but it discusses in practical terms the outcomes of some very extensive studies on a group of Tibetan meditation practitioners. Long story short, their brains facilitate the primary responses of calm, thoughtfulness and attention that we desire. And their brains do that because they are conditioned and developed, not unlike a muscle in our physical body, to perform that function. Essentially, if we live in fight or flight we focus poorly, we behave aggressively, we react – if we don’t, we don’t.

So how do we accomplish this?

Well there are any number of studies discussing the developmental changes that happen with the regular practice of meditation, and other internal arts such as yoga, tai chi, qigong and others. If you are not interested in the science, you can probably stop reading here and just start a basic meditation program or start taking tai chi, and over just a few months you will experience these positive changes.

For those who would like to better understand some of what is happening on a scientific level to better facilitate their mood and behavior researchers from the Massachusetts General Hospital and Harvard Medical School as well those from the Fujian University of Traditional Chinese Medicine among other institutions, recently conducted a brain imaging study to explore more deeply.

Researchers led participants through a 12 week program of tai chi and ba duan jin qigong exercise. Ba Duan Jin, also known as the “eight brocades” is a very common form of qi gong practice that has a few variations. We practice it regularly as part of our tai chi classes in my clinic in Chattanooga – there is a video of our version of it midway through a recorded live broadcast of our free weekly meditation, qi gong and tong ren class.

The participants were older adults and while the researchers were looking at all aspects of the brain scans, they were primarily interested in reducing memory deficiencies. They used various brain scans at the beginning and the end of the 12 week study and found that both Tai Chi and Qi Gong significantly increased grey matter volume (i.e. made them more active) in the following areas:

  • Insula – involved with perception, self-awareness, interpersonal communication, and cognitive/sensoral processcing.
  • Medial Temporal Lobe – important area for declarative memory (facts and events).
  • Putamen – involved in all aspects of physical movement.

There were no significant differences between a group that practiced only qi gong and a tai chi only group. Essentially the participants in such a short time experienced “improved mental control, recognition, touch and comprehension memory scores” – the researcher concluded that the results demonstrate the potential of tai chi and qi gong practice for preventing memory deficiencies in older adults.

While researchers here were looking at older adults and memory any exploration of those brain areas make it fairly clear that these benefits would be applicable to improvements in focus, impulse control, emotional control, and other related aspects in all ages. While your “fight or flight” system is telling you to just maintain the status quo and keep on doing what you are doing, now would be the time to start making changes – avoiding problems rather than managing them after the fact, that is “wu wei“.

Awakening a Child From a Vegetative State with Xing Nao Kai Qiao Acupuncture

Persistent vegetative states (or “unresponsive wakefulness syndrome”) arise following brain damage leaving the patients in a state of partial arousal. While potential outcomes will vary depending on the causal factors, after 3-6 months chances for a complete recovery are considered low and generally get lower as time progresses ( 1 ). For children under western medical care, one study, described potential outcomes as follows: “The long-term outcome for children discharged from the hospital in a persistent vegetative state was poor. Forty percent of the patients died and, at best, children showed only minimal awareness after an average of 4.5 yrs. Care costs were > $90,000/yr per patient.” ( 2 ).

Stroke recovery and the treatment of related neurological conditions are often treated by Chinese Medicine. A few years ago I wrote a brief review of a documentary entitled 9000 Needles. This documentary follows a Kentucky man’s struggle towards recovery following a brain stem stroke. After exhausting all western options and much of their insurance coverage and finances he heads to a famous Traditional Chinese Medicine hospital in China, the “First Teaching Hospital of Tianjin University“. Within their stroke center which utilizes the work of Dr. Shi Xuemin and his Xing Nao Kai Qiao (“activating the brain and opening the orifices”) treatment methods he exits a few months later walking nearly unaided and able to communicate fairly clearly.

Publishing in the frontiers in medicine journal a team using Dr. Shi’s system recently submitted a case report of the return of a 5 year old, 3 months into a persistent vegetative state, to a nearly completely recovered state after 50 days of treatment. The treatment was offered within the Xi’an Encephalopathy Hospital of Traditional Chinese Medicine in Xi’an, China.

The treatment offered was a combination therapy including Dr. Shi’s “Xing Nao Kai Qiao” acupuncture method, oral “An Gong Niu Huang Wan” Chinese herbal formula, and “Xing Nao Jing” herbal formula via IV drip. After the 50 day treatment the team reported that the child had “his health significantly improved and is nearly similar to that of a healthy child“. In this article, I’m going to explore the basics of their treatment – note, however, that I am only marginally familiar with the approaches of Dr. Shi and do not have a relationship with these particular researchers.

Dr. Shi’s “Xing Nao Kai Qiao”, “activate the brain and open the orifices”, method is drawn from his many years of clinical experience, particularly with stroke and other neurological conditions. The general points used are as follows. The primary points are always used and then some additional points would be used for each individual case.

  • Main Points:
  • PC 6 “inner pass” – influences the median nerve, used in TCM for a range of psychological issues, nausea, and opening and relaxing the chest.
  • SP 6 “three yin intersection” – influences the tibial nerve, used in TCM to tonify the yin and the blood for a range of psychological and menstrual conditions, clearing what we call “heat” in the blood.
  • GV 26 “water through” – with PC 6 forms a set of “command points” for the chest, heart and epigastrium areas, a very useful point for recovering from shock and/or fainting, as well as other psychological and neurological conditions such as epilepsy.
  • Secondary Points:
  • HT 1 “highest spring” – used for a range of shoulder and arm issues, but also tension in the chest and anxiety issues.
  • LU 5 “cubit marsh” – useful for a range of shoulder/arm/elbow issues, but of more relevance here for removing what we would call phlegm heat in Chinese Medicine.
  • UB 40 “bend middle” – another “command” point, this one for the lumbar region, but of more relevance here, used for clearing heat in cases of heatstroke and related issues.
  • Dysphasia Points:
  • GB 20 “wind pool” – an important point for dispelling “wind” in Chinese Medicine terms, symptoms such as vertigo, dizziness, numbness, etc., a “cva” in Chinese Medicine terms may be called a “wind stroke” alluding to the damage a strong “wind” can do.
  • GB 12 “completion bone” – another point for dispelling “wind” in the head,
    tinnitus, tremors, also some cases of insomnia and/or anxiety.
  • SI 17 “celestial countenance” – a “window of the sky” point, used to open the throat but also has a role in improving circulation to the brain.
  • Asphasia Points:
  • CV 23 “ridge spring” – commonly used in stroke patients to aid speech and swallowing.
  • Jinjin and Yuye “golden fluid and jade fluid” – a pair of “extra points” used for post stroke asphasia, but also other issues with the tongue and/or speech, or swelling of the tongue that restricts breathing.
  • Hand and Finger Paralysis:
  • LI 4 “union valley” – a commonly used point to release wind-heat or wind-cold in Chinese Medicine terms, strengthens immunity, used for many facial issues involving pain or mobility.
  • Bafeng and Sifeng “eight winds and four cracks” – “extra points” between the toes (bafeng) and the finger joints (sifeng) clinically noted for issues such as malaria and deep digestive issues, but used as strong local stimulators for stroke and other conditions.

Treatment is, if possible, offered twice daily for 10 days per course. Often 3-5 courses of treatment are required. The case report here, as an example, was 50 days of consecutive treatment.

Further exploration of Dr. Shi’s work can be started by reading “Shi Xuemin’s Comprehensive Textbook Of Acupuncture And Moxibustion, Volumes 1& 2“. Which is not a text exclusively related to stroke, but it provides a good framework and case studies from which a practitioner can begin to understand some of Dr. Shi’s methodology.

Now onto the Chinese herbal formula “An Gong Niu Huang” or “Calm the Palace Pill with Cattle Gallstone”. This formula is a strong herbal formula primarily used in patients who are unconscious and/or have had a stroke. The herbal ingredients are generally as follows:
Cattle Gallstone (Niu Huang), Rhinoceros Horn (Xi Jiao) * substituted with Water Buffalo Horn (Shui Niu Jiao), Navel Gland Secretions of Musk Deer (She Xiang), Coptis Rhizome (Huang Lian), Baical Skullcap Root, Scutellaria (Huang Qin), Cape Jasmine Fruit, Gardenia (Zhi Zi), Realgar (Xiong Huang), Borneol (Bing Pian), Tumeric Tuber (Yu Jin), Cinnabar (Zhu Sha), Pearl (Zhen Zhu).

This particular formula has been used for hundreds of years for a range of central nervous system issues and for resuscitation. A fairly lengthy clinical exploration of this formula, case studies and clinical applications may be read here.

The other formula that was given via IV, Xing Nao Jing, is used for stroke and other neurological conditions. A study exploring how it helps may be read here.

Exploring this case study is a useful enterprise for practitioners of Chinese Medicine as well as neurologists and other specialists from the western medical side. In many of these types of cases a combination approach of western and eastern medicine would in most cases be best. It is nice to see that type of integration happening in Chinese hospitals and perhaps with more studies of this nature that interest in integration will continue in western countries as well.

Acupuncture for Insomnia – Mechanisms Explored

A range of research puts chronic insomnia rates around 30% and those with at least one bad night per week much higher, around 65%. Now the one off night of sleeplessness is probably just annoying and part of life. We all have times where we may have too much on our mind or a period of time with unresolved emotions towards events in our lives.
More chronic experiences however begin to contribute to more significant health effects.

Research shows relationships between any number of health issues and poor sleep. Possible health effects include obesity, diabetes, hypertension, anxiety, depression, alcohol abuse, and more ( 1 ). Chinese Medicine, both Chinese herbal medicine and acupuncture, has long been used to treat a range of sleep disorders, including generalized insomnia. When insomnia is properly diagnosed in the Chinese Medicine context (see “treating the cause and not the symptoms“) and the treatments are properly tailored to the individual, it generally responds quite well. Our acupuncture for insomnia page has some of the possible patterns and basic treatment protocols.

Approximately 7 years ago a team of researchers from Changchun University of TCM in China conducted a study exploring the effects of a certain point protocol and needling method on insomnia and the flow of blood in the brain ( 2 ).

In their study they divided 60 patients with insomnia into a treatment group and a control group. Within the treatment group they utilized the following acupuncture points:

  • Sishencong (God’s Cleverness) – a set of 4 “extra points” at the top of the head surrounding GV 20. Can be used as a calming point for issues such as insomnia and adhd, for example, but also as a nourishing function for conditions such as stroke or epilepsy.
  • HT 7 (Spirit Gate) – a calming point that strengthens the “blood” in Chinese Medicine terms – among other functions. Generally useful for anxiety, insomnia, panic attacks, palpitations and more.
  • SP 6 (Three Yin Intersection) – a broadly useful point in Chinese Medicine that strengthens the yin (the cooling/calming aspect of the body) and the blood – for a range of “spleen” disorders (see “My Spleen is What?” for more), and issues such as insomnia, anxiety, hypertension as well as a range of menstrual issues.

In the control group they used UB 62 and KD 6 – which can be calming and in some cases useful for insomnia, but are fairly different in function from the main treatment points.

In their study they concluded finding a 93.3% total effective rate in the treatment group and that peak velocity of systolic and diastolic blood flow velocity within the middle cerebral artery, basilar artery and vertebral artery were increased. There were changes in both groups, but the treatment group noted a stronger therapeutic effect for insomnia and stronger changes in blood flow.

With that study finished, 7 years later, a group from the same university as well as others from the China Academy of Chinese Medicine Sciences and the Shanghai University of Traditional Chinese Medicine conducted a follow up study to look at how these points helped with insomnia.

Practitioners of Chinese Medicine are very far beyond the “does it work” stage with many conditions. Due to this we are either happy with the fact that it works and we leave it at that or, for some, we put effort into finding out how it works in western terms to see if we can improve results. Improvement in results would be both in sheer volume of people we can consistently help as well as working towards reducing the number of treatments required to get the desired outcome. For my clinical practice, these western understandings put into the overall context of Chinese Medicine are quite helpful, not exclusively so, but helpful contextually.

To explore the previous study more deeply, this team used rats divided into 3 groups, a control, a sleep deprivation group and an acupuncture treatment group. In the sleep deprivation group they noticed upregulation of the following mRNA contents:

  • BDNF (Brain-derived neurotrophic factor) – a protein found in the brain and periphery that acts on the central nervous system and peripheral nervous system, helping existing neurons to survive and grow new neurons and synapses. When this is downregulated, through stress for example, then it impacts mood and ultimately sleep ( 3 ).
  • SYP – another protein found more broadly through the brain and the spinal cord that plays a role in spatial learning, exploratory behavior and object recognition. When increased in plays a role in fostering overall intelligence ( 4 )
    and when decreased a range of behavioral/intellectual issues may arise.

What the researchers found is that the protocol used in the previous study, what was called “tranquilizing and allaying excitement method”, increased the levels of BDNF and SYP in the hippocampus, thus providing a critical mechanism to improve learning and memory damaged by insomnia. In that previous study, however, there was also a therapeutic effect for insomnia itself so it appears to offer both a treatment of the symptom and a path towards resolution of the effects of sleep deprivation.

Clinically speaking this is generally what we see in the world of Chinese Medicine, particularly for insomnia and related conditions. That is, we see both a symptomatic resolution as well as something deeper shifting/resolving which makes the resolution hold sometimes for months, years, and even permanently with no further treatments of any kind. This in many ways is what we mean by “treating the cause, not the symptoms” and is certainly the goal, if not the entire raison d’être, of Chinese Medicine.

Acupuncture Resolves Menstrual Cramps Regardless of Treatment Frequency and Technique

Acupuncture is used successfully to resolve a wide range of women’s health issues. Menstrual issues such as dysmenorrhea (menstrual cramps) are among those issues that are treated frequently and tend to do quite well with proper treatment.

While a bit technical, our acupuncture for dysmenorrhea section, lists basic point protocols for some of the more common related Chinese diagnoses. (see treating the “cause vs. the symptoms” for general info on treating patterns in Chinese Medicine vs. conditions as in Western Medicine.)

As one might expect in a many thousands of years old system of medicine there are a variety of approaches to the treatment of issues such as dysmenorrhea. Treatments will vary by points chosen, needling style (even needling, strong manipulation, etc.), techniques used (for example, electro-acupuncture and/or needling with moxibustion), and further variations of treatment frequency and duration of needle retention.

For the most part there are no “right” or “wrong” approaches, but ideally treatment is tailored to the individual and their specific circumstances.

Now even though there are technically no “right” or “wrong” approaches – it is a generally accepted idea that choosing the right techniques does matter as far as clinical outcomes go. Certainly what points are used will make a clinical difference. But what about how often you see the patient, or whether you use electroacupuncture or not?

To explore the outcomes of various approaches, a group of researchers from the National Institute of Complementary Medicine and the School of Nursing and Midwifery at Western Sydney University designed a study to look for differences between treatment frequency/timing with menstruation and electro vs. manual acupuncture.

Researchers recruited 74 women with dysmenorrhea and randomly divided them into 4 groups:

  • Low Frequency Manual Acupuncture – treated once per week with regular body acupuncture.
  • High Frequency Mannual Acupuncture – treated 3 times in the week prior to the onset of menstruation with regular body acupuncture.
  • Low Frequency Electro Acupuncture – treated once per week with electroacupuncture.
  • High Frequency Electro Acupuncture – treated 3 times in the week prior to the onset of menstruation with electroacupuncture.

All woman received one acupuncture treatment within 48 hours of their menses and then followed protocol depending on their grouping. Treatment was offered over 3 months (12 treatments total) and evaluated during those 3 months as well as 9 months later at the one year mark.

The treatment that was offered was tailored by the acupuncturists to their individual tcm diagnoses – for liver qi stagnation or blood deficiency as examples. But in no case were more than 7 acupuncture points used.

The researchers found that all groups received reduction in their menstrual pain with effectively nonexistent differences between the groups and these improvements were sustained at the 12 month follow up between all groups.

Those who received 3 treatments the week before menses recorded more “quality of life” improvements than the low frequency groups and both manual acupuncture groups saw less need for any analgesic usage compared with the EA groups. Of all the groups in this study, the high frequency manual acupuncture group had the strongest reduction in secondary menstrual symptoms compared with all of the other groups.

We walk away from this study with a clear understanding that acupuncture is quite effective for menstrual cramps regardless of treatment frequency or whether you use electroacupuncture or not. This is useful information, particularly in countries where acupuncture is an out of pocket expense in the sense that, as a practitioner, you should feel free to experiment with treatment frequency. Seeing how little you can treat and still get the same response. How little intervention you can do and still get the same response (or even better). Less is often more, particularly in the world of Chinese Medicine.

Abdominal Acupuncture for Neck Pain – Zhiyun Bo Techniques (Study)

Neck pain, statistically speaking, will be experienced by nearly 50% of the global population in their adult lifetime. It can be a very painful condition, which due to how we use our necks for day to day life, can limit social and physical activities for approximately 25% or so of sufferers. Without other interventions, a certain amount of these will obtain surgery which may offer limited value and it may also restrict mobility.

Acupuncture is effective across the board for all types of pain from nearly any cause and neck pain is no exception. What differs in the approach of acupuncture, generally speaking, is the depth of the approach – treating the cause and not the symptoms. So the purpose is not so much to manage pain in a better way than opiates, for example, but to unearth the contributing factors and resolve them. While you can certainly use acupuncture to “manage” pain, and in complex cases this is at times necessary, the overarching goal is to “resolve” it.

Now aspects of the study I’m discussing today will come as no surprise to most acupuncturists, but to the public it may be interesting to see treatments for neck pain being studied that don’t touch the neck at all – or even get close to it.

Rather than trying to show the extensive value of acupuncture in the paragraphs above, my intent was to lead to a different way of thinking of how Chinese Medicine focuses on health issues – approaching the symptoms from a much deeper causative level. And due to this deeper approach, in general terms, you may end up with treatment approaches that to the layperson may seem like you are not understanding what their problem is.

In my clinical practice, patients are at times concerned – sometimes gently, sometimes not so gently – as I begin to insert many needles completely away from where they think they should go. They are concerned that I perhaps simply forgot what they were asking for help with as they cannot understand why I am not just needling around where they hurt. While there is such a thing as what we call “local” or “ashi” (“where it hurts”) needling, that is rarely, if ever, the way to truly resolve a persons condition.

Abdominal acupuncture is one such “sub-system” within acupuncture that may at times seem less intuitive (except for digestive issues, I suppose) than “body” acupuncture. In the study that I am going to explore today, researchers from the Pok Oi Hospital in Hong Kong and the School of Chinese Medicine within the Chinese University of Hong Kong set out to show the value of abdominal acupuncture for neck pain.

The researchers recruited 154 patients with neck pain ranging in age from 18 to 65 years of age and divided them into an abdominal acupuncture group and a sham abdominal acupuncture group. Treatment was provided over 6 weeks and then a 14 week followup was performed.

The treatment group received acupuncture at the following abdominal area points:

  • CV 12 “Central Venter” – used for a range of stomach and spleen patterns in Chinese Medicine terms, which run the gamut of nearly all digestive issues, useful for stress related digestive issues that arise with other symptoms such as insomnia and/or anxiety.
  • CV 4 “Origin Pass” – arguably one of the most important points in the body for strengthen nearly any weakness of what we call the qi, yin, yang, or blood of the body. Useful in cases of deep exhaustion, chronic fatigue, certain fertility issues, back pain, etc.
  • KD 17 “Shang Bend” – generally used for tonifying the weakness involved in a range of digestive issues and/or abdominal pain.
  • ST 24 “Slippery Flesh Gate” – used for what we call “rebellious qi” in Chinese Medicine which can be issues such as vomiting, reflux, etc. – but also has use in resolving what we call phlegm which is a way of describing some of the metabolic and inflammatory relationships in the digestive system to certain psychiatric conditions such as manic depression, for example.

After insertion the needles were retained for 30 minutes and a TDP “heat” lamp was applied during that time 30cm above the navel. Patients were treated 3 times each week for 2 weeks (6 total treatments).

This particular selection of points comes from the work of Dr. Zhiyun Bo. His work is explored in the english text “Mastering the Art of Abdominal Acupuncture: A concise guide to treating numerous painful conditions”.

Even for a layperson, aspects of this point protocol would seem somewhat obvious – shutting down systemic inflammatory markers via the digestive system as opposed to working to locally remove inflammation in the neck. Again, treating the root and not the symptoms.

Researchers found that this abdominal acupuncture protocol for neck pain was quite effective, finding that:

“the improvement in NPQ scores in the abdominal acupuncture group was even more significant at 14 weeks from baseline. Patients in the abdominal acupuncture group also exhibited significantly greater improvements in intensity of neck pain and a few quality-of-life measures than those in the sham abdominal acupuncture group, without any serious adverse events.”

Now during this study the patients were asked to refrain from other techniques such as tuina (Chinese medical massage), cupping, and other regular acupuncture treatments – some or all of which would be quite helpful in many circumstances. In most clinical situations you would be combining abdominal points with other body acupuncture points as well as other associated techniques as indicated by the need of the individual patient and your own clinical experience. It is valuable to keep in mind, however, that often less is more and things may not be quite what they seem…

Coffee, Tea, and Acupuncture for Pain – They May Not Mix

Acupuncture is widely used for any number of health issues. Chronic pain, of any nature, is one of the most common reasons for visiting an acupuncturist. The effectiveness of acupuncture on pain generally has been shown clinically as well as within many published studies. What hasn’t been looked at as strongly is what potential influencers may block the positive effects of acupuncture.

I get asked fairly often can I do “x”, “y” and/or “z” after acupuncture. For the most part my answer is always – yes. I generally counsel people against strongly vigorous exercise right after acupuncture (not that most people feel like doing that) and to avoid heavy meals, but other than that I’m of the opinion that there is little that can be done to strongly block the effect of acupuncture.

An interesting study came out from researchers at the Eastman Institute of Oral Health within the University of Rochester in New York. They looked at the effects of having caffeine in the body when having acupuncture for pain. The researchers were following up on a previous study where they were trying to deeply explore how acupuncture helps with pain. This initial study drew the following conclusion:

Although acupuncture has been practiced for over 4,000 years, it has been difficult to establish its biological basis. Our findings indicate that adenosine is central to the mechanistic actions of acupuncture. We found that insertion and manual rotation of acupuncture needles triggered a general increase in the extracellular concentration of purines, including the transmitter adenosine (Fig. 1), which is consistent with the observation that tissue damage is associated with an increase in extracellular nucleotides and adenosine36

This nucleoside adenosine will help slow down nervous system activity, promotes sleep, dilates blood vessels, etc. These functions will effectively limit or block pain signals. The stimulant effect of caffeine is primarily the result of caffeine binding to these molecules and in effect blocking their downregulating functions – thus waking you up ( 1 ).

In effect, then, the pain relieving effect of acupuncture is due to increasing adenosine (among other factors). So as these researchers speculated, caffeine blocks this effect. They concluded in their study that:

a trace amount of caffeine can reversibly block the analgesic effects of acupuncture, and controlling caffeine consumption during acupuncture may improve pain management outcomes

Interestingly they even tried injecting caffeine at the acupuncture point to see if it was only systemic caffeine that created the issue or if it was locally blocking the door of the acupuncture point so to speak. It appears, at least from this study, that caffeine closes the door to certain functions of acupuncture with particular relation to pain – although possibly many others.

More studies will have to be done to further explore this – both to see what other functions caffeine may be blocking and to see if other acupuncture techniques can override the binding of adenosine by caffeine. For now, it may be a good idea to have patients not have caffeine before their treatment, particularly if they are coming with chronic pain issues.