Scleroderma reynauds syndrome

Comment by Chad J. Dupuis, L.Ac.

There are various types of scleroderma, essentially from localized to systemic, and Raynaud's Disease can exist with scleroderma (less common) or without (80%+). Raynaud's can also co-exist with other auto-immune conditions such as lupus. Generally Raynaud's disease is when it is stand-alone and Raynaud's phenomena when it co-exists with an auto-immune condition.

I'll offer the areas we focus on below for both conditions and you can choose what you think it best based on your knowledge of the patient.

I would like to comment on something you said first. You mention, "Myofascial release has helped with softening of tissue externally but am looking for anything that would benefit internally." I think I know what you were basically asking - but don't discount your work in any way. From a Chinese perspective there isn't really an internal/external divide. Your work on the surface sends information through the nerves into the body and will create internal changes - in addition to loosening the external/surface aspects of the body. Tuina (similar to aspects of myofascial release) is actually a crucial part of our system generally and particularly for auto-immune conditions.

For Scleroderma we focus on the following (for acupuncture this would be in addition to general points related to their condition overall):

Huatuo of T1 (bone marrow), T2 (thymus gland), T3 (lung/lymph) - collectively used to balance the immune system in auto-immune conditions. GV 22, KD 26, Huatuo of T4 (any skin/sweat, connective tissue, issues), SI 16, GV 20, ST 36, LI 11, TH 16.

For Raynaud's we focus on the following (again with the same adjustments for acupuncture):

Huatuo of T4 (skin/sweat, connective tissue), T5 (heart, pericardium - circulation) and T7 (spleen, abdominal blood vessels, circulation), UB 9 (medulla area, respiration, circulation), LI 18, Tiandong, SP 10, LI 11, GV 17.

What I would recommend as a bodyworker would be to focus on the following. First, add in work to the sky window area in Chinese Medicine (effects the circulation in the neck to help nourish the brain) - work in SI 16, TH 16, LI 18, Tiandong area on whichever side is most sore to the patient (or both). Then, focus deeply on the thoracic vertebrae areas of T1, 2, 3, 4, 5 and 7 to help balance the immune system and promote circulation. Finally some acupressure in UB 9 and GV 22.

Comment by Archived User

thanks chad, appreciate the help. Client has a hard time with the hands being taught, MFR has helped with that but client gets small ulcerated nodules on index fingers. They seem to get better but never quite go away. Any suggestions? Great website by the way, i spend alot of time here. Just a question Tiandong is the same as tian den?

Again many thanks, but might have more questions.

Dennis

Comment by Chad J. Dupuis, L.Ac.

The work in the neck should begin to open circulation through the arms and into the hands and the nodules should improve or disappear entirely. And for Tiandong (which is an important point for this condition) if you click the link above it will describe the location and usage of the point. It's a point we use between two other points to effect the circulation in the vertebral artery.

Comment by Archived User

What both of you don't seem to realize is that the selection of acupuncture points is based on a traditional Chinese medical diagnosis. If you don't understand how to diagnose to select the appropriate acupuncture points or herbs, why not just refer them to someone who does?

Chad, based on your response, I think you're encouraging this type of interaction and thereby devaluing the methodology of TCM. Would you go to an MD and ask them what medications to use for a patient who appears to have a lung infection and expect the MD to recommend a drug without even diagnosing the problem?

Dennis, as for the ulcerated nodules on the index finger, one would have to determine whether it was yin or yang in type, excess or deficient in nature, internally or externally caused, if there were any pathogenic factors involved, if it lay on the hand yangming meridian, etc, etc. in order to make a proper diagnosis which would then help the practitioner determine the appropriate treatment.

Comment by Chad J. Dupuis, L.Ac.

With "What both of you don't seem to realize is that the selection of acupuncture points is based on a traditional Chinese medical diagnosis" Are you honestly writing to me, the person who built every single page on this site, who writes tirelessly on the subject of acupuncture and related aspects, who has an extremely successful practice and who himself and his masters regularly treat all types of cancers, auto-immune disorders, etc. with very good results that I do not understand the proper selection of acupuncture points? Between my masters, our colleagues who use our system of acupuncture and myself we collectively see well over 25,000 patients a year with upwards of 70% of them having serious conditions such as these. Most practitioners don't even see these conditions, let alone have any kind of success rate with them. So while pattern diagnosis is important, it's not the only way to utilize acupuncture and related techniques.

One question for you, have you ever treated a case of scleroderma, first and foremost, and has your treatment ever lead to a good result, how about raynaud's? How many of these cases have you actually seen? If you have them and treated them well why don't you write constructively about what you have done instead of coming off so elitist? The points we list are because they have worked for us. Can you adapt them, can you use them with pattern based points, of course you can do what you want with them. We are simply offering them. And for someone with their hands already on the person, this gives someone with an open mind some very valuable direction.

There are so many problems with your response, but being condescending towards your colleagues is the main problem. I don't believe Dennis was putting himself out there as this persons sole care taker. He was simply asking (and appropriately so) that since my hands are already on this person with such a horrible condition could I do something better. This is noble, an enlightened and outreaching way to work and he should be praised for even thinking of how better to help his patient.

I'm assuming you don't see many patients with serious conditions - you might, but either way you can assume they are already under the care of an MD and probably doing everything else under the sun to help themselves. That said, the question Dennis had wasn't about any of that. It was about what -he- can do...

Along that note, as this is a public forum my responses often include aspects that are not necessary to answer just the individuals questions but more information that can be used by the many people who will come across this discussion in the future.

When I mention our points I do say - "for acupuncture this would be in addition to general points related to their condition overall" So there is an accommodation for pattern diagnosis in our treatments. I will say we rarely use the tongue or the pulse in our treatment and our protocols are somewhat fixed and only vary in general ways such as if the person is yin def or yang def. Personally I've seen my main Chinese master (extremely successful and highly regarded practitioner with real verifiable, daily results) take the pulse less than a hundred times... There are many, many systems of acupuncture and I might be devaluing standard rote TCM, but only to those who think there is only one way.

We rely on palpatory diagnosis as in many systems of Japanese and Chinese acupuncture. We feel it gives us more detailed information that we can use to both choose appropriate points and to monitor the effectiveness of our treatments. I started the same place as anyone else and through arduous efforts, lots of moving around, etc. I've been able to train with some of the best. This has advanced me greatly and how I perform acupuncture is a direct reflection of what I've seen work repeatedly on the hardest of cases. If that's different from what I learned in school, then so be it. Personally, I go with what works the most frequently and in the shortest amount of time.

If you can do it, tell us what you might do and don't judge people trying to help. If you can't, try some of what we recommend and see what happens. Perhaps then we can have a constructive conversation.

And I'm certainly not saying that what we do is the best and everyone should do what we do, far from it. But, I am offering something constructive to the discussion based on direct experience with these conditions....

Comment by Archived User

Chad,

Thank you for your answer to Dennis. It was the most thoughful I have read with regard to acupuncture treatment for scleroderma. I am searching for a friend who is living with chronic systemic and has already lost the tip of his left index and his right index is threatened. He has not researched eastern therapies, so I am. Most of the sites I have come upon are very general with regard to therapies for autoimmune disorders and none that I have found list i as a disease which can be treated at all ... althought Raynaud&#39s is identified. I had not read anywhere previously about the distinction of the treatability of phenomenon when associated with other autoimmune diseases, such as Scleroderma.

In brief, I am hopeful that I may find a practitioner here in Indianapolis with experience in this area. Is there any way I may use your site to locate such a practitioner?

Thank you so much for your work and for sharing it so generously. I hope Mike was able to learn from you also.

Dawn AKA anam cara.