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Success in 3 Cases of Knee Pain

In the last week, 2 different patients came in presenting with knee pain.  The first patient had pain on the medial side (inside of the leg) of their right knee. The pain was related to slipping on a hike.

In this first case, the knee pain was aggravated by both pressing on the area with even mild pressure, and also by going from a sitting to a standing position.  Acupuncture was given by using points in the lower leg as well as placing needles in points on the opposite arm near the elbow. After the needles were removed, there was still some soreness when the knee was pressed. At this point, I then employed a manual technique called PNT. This technique utilizes a very gentle pressing perpendicular to the muscles which run through the knee area. Immediately after, the patient tested the knee by sitting and moving to a standing position. She reported that all pain was completely gone, and the remaining soreness that occurred with pressure was also gone.

In the second patient with knee pain, there was significant soreness and pain just above the knee. Acupuncture needles were gently inserted into the opposite elbow area at points P3, Lu5, and LI11. The patient was then instructed to move the leg, flexing and extending the knee. She immediately reported that there was no longer any pain. Next she tested the knee by walking, and still no pain returned at all!

In both cases, I Ching/Balance Method style of acupuncture was used with good effect.  This is a particular type of acupuncture which typically gives instant pain relief for many types of pain.  As we mentioned, the first patient also needed some manual therapy. PNT is a simple manual technique which is very gentle, and utilizes the body’s own neurologic reflexes to ‘reset’ the muscles.

In many simple cases of knee pain, quick relief can be gained. When a patient has very advanced arthritis, such as when cartilage is completely worn away, and bone is rubbing on bone, then these techniques typically do not provide real relief. However, for mild to moderate arthritis, tendonitis, or bursitis, these techniques have been extremely effective in many patients who have come to New England Acupuncture.

For some people, simple nutritional therapies may also be helpful for joint pain, such as knee pain.  In a third patient who came in for bilateral knee pain (pain in both knees), and had a prior diagnosis of osteoarthritis from her doctor,  we have been able to almost completely eradicate her knee pain, even though she had been suffering pain for years before coming to the clinic.

In her case, we did a course of acupuncture treatment with excellent results. Still, there was a small flare up many months later. Along with a few more acupuncture treatments, it was suggested that she purchase some beef gelatin powder and take some daily. Recently, when the patient came in for a general ‘tune up’ treatment, she reported that the gelatin has been highly beneficial, and she is able to be active without pain in either knee, and also reported that the gelatin has improved her skin, hair, and nails.

These 3 cases of recent patients exemplify how simple and gentle treatments can significantly erase pain and return individuals to a more active lifestyle.

Natural Remedies for Seasonal Allergies (Allergic Rhinitis)

If you are a sufferer of seasonal allergies, then you are familiar with itchy red eyes, stuffy nose, sneezing, and the fatigue that often goes with it. Fortunately, there are a great number of natural remedies available that can help manage. Once allergy symptoms have kicked in during a given season, treatment will focus first on getting immediate relief. However, during periods of ‘remission’, ie outside of allergy season, treatment can aim directly at treating some of the potential underlying causes of allergies. There is significant evidence to connect digestive issues with respiratory allergies (1)(2)(3) This is not surprising since the majority of our immune system is found within the gut, and seasonal allergies are generally an over reaction by the immune system. Therefore, in patients with poor digestive health such as IBS, bloating, gas, constipation, addressing these issues may also  help reduce and prevent allergy symptoms. Possible interventions for this could include herbal therapies, probiotics, supplementation with zinc, glutamine, or other supplements beneficial to the lining of the gut.

Other factors may also play a contributing  role in the development or worsening of allergies. According to research published by the Mayo Clinic,  individuals with chronic sinusitis are likely to have fungal infections in the sinuses (4). So, treatment to resolve this  issue could certainly play an integral role in improving sinus health for some patients.  Of course, there may be a wide variety of other factors contributing to a person’s seasonal allergies.  This can be determined more precisely during a patient visit.

Whether a person chooses to address these underlying issues or not, symptom relief during allergy season is something our patients always appreciate.  There are a number of herbal formulas which effectively reduce symptoms such as stuffy nose, sneezing, itchy eyes and fatigue. Which herbal product is best depends on the specifics of each individual. Some people may have significant itching and redness of the eyes, while another person may suffer more from sneezing and sinus pressure.

One of the most common products used for seasonal allergies is Pe Min Kan Wan (Nasal Allergy Pills). It contains herbs which are antihistaminic, anti-inflammatory, as well as herbs traditionally used for red irritated eyes. For individuals who experience not only stuffy nose, but also allergy headache, a classic time tested formula, Xin Yi San (Magnolia Flower Powder) often alleviates symptoms very effectively. A common supplement which research indicates can reduce allergy symptoms is quercetin, a commonly occurring bioflavonoid (5). Quercetin is actually plentiful in a healthy diet, as it occurs in foods such as onions, grapes, tea, and many vegetables such as broccoli; one more reason why eating plenty of fruits and vegetables is health promoting. Additionally, quercetin may be beneficial for those who suffer from allergy induced asthma (6). If you, or someone you know, deals with seasonal allergies, there are an abundance of natural therapies which may help. Simply call and set up an appointment here at the clinic to discuss which options will work best for you.

1)EBioMedicine. 2015 Nov 27;3:172-9. doi: 10.1016/j.ebiom.2015.11.038. eCollection 2016

2)Annals Am Thorac Soc. 2016 Mar;13 Suppl 1:S51-4. doi: 10.1513/AnnalsATS.201507-451MG

3)Curr Opin Rheumatol. 2015 Jul;27(4):373-80. doi: 10.1097/BOR.0000000000000191

4)Mayo Clinic. “Mayo Clinic Study Implicates Fungus As Cause Of Chronic Sinusitis.” ScienceDaily. ScienceDaily, 10 September 1999.

5)Molecules. 2016 May 12;21(5). pii: E623. doi: 10.3390/molecules21050623 6)Int Immunopharmacol. 2009 Mar;9(3):261-7. doi: 10.1016/j.intimp.2008.10.021. Epub 2008 Dec 4

6)Int Immunopharmacol. 2009 Mar;9(3):261-7. doi: 10.1016/j.intimp.2008.10.021. Epub 2008 Dec 4

 

Chinese Herbal Medicine: An Overview

OVERVIEW

Traditional Chinese Medicine (TCM) is the indigenous medicine of China, which developed over the last 5000 years.  It employs three main methods/therapies to restore health to patients: herbal medicine, acupuncture, tui na (massage).

While it is acupuncture that has usually grabbed the headlines here in the U.S., it is actually herbal medicine that is considered the primary method of treatment by the Chinese themselves; at least in so far as TCM is concerned.

All three therapies in TCM (herbal medicine, acupuncture, tui na) are based on the same fundamental theories.  It is this sophisticated theory that helps make Chinese herbal medicine so successful.

Pattern Discrimination: What is it?

Most people who want to take an herbal remedy ask a question something like this: What herb can help my X (x being whatever problem they have)? This implies a single remedy for a single problem. For example, if you have gout, get some sour cherry juice. If you have a urinary tract infection, take a cranberry pill.  If you have inflammation take curcumin, for liver problems take milk thistle and artichoke. Its not that this is bad per se. But it could be better.  How so? Ah, that is where pattern discrimination comes in.

Let’s say you go to your doctor because of headaches. It is his/her job to figure out the cause of the headache. If you had neck tension that is severe, maybe a muscle relaxer helps.  If you had migraine, maybe Imitrex helps. But what if the problem is bacterial meningitis? You can’t treat that with a muscle relaxer or migraine medicine; you need antibiotics instead.  The point is that there is not ONLY ONE remedy for headache. Rather, there are many. And finding the right one will depend on getting the correct diagnosis.

A pattern discrimination is a similar thing. When you come into our clinic for a visit, we must determine which ‘pattern of imbalance’ is specifically causing your symptom.  Only after this is done can a Chinese herbal remedy be chosen. Let’s look at an example to make it easy for you to really grasp. Once you have this example stored in your memory, then you will be able to know about Chinese medicine on a deeper level.

Two patients come in complaining of low back pain. Let’s call them Larry and Sally.  Larry has pain that came on suddenly. He thinks it started when he did some extra yard work a couple days ago.  Now it aches and he notes that it improves once he gets moving. But pressing on the area or massaging it aggravate it.  Sally on the other hand has low back pain that came on slowly over time.  It started as a mild little ache, but in the last two years it has slowly gotten worse. It seems better when she rests, and she notices that it is worse by the end of the day.  Sally says that her back ‘feels weak’.

Obviously Larry and Sally are experiencing two very different sets of symptoms. In fact, two patients like this came into the clinic. And, as you might guess, they received two different treatments.

The point is that to treat a patient, we look at more that just the chief complaint.   In fact, the chief complaint is only meaningful when it is seen in the context of all the other signs and symptoms the patient has.  When all this information is woven together, it forms a ‘pattern’, and this pattern will direct the practitioner to the correct herbal formula.

CAN HERBS REALLY BE EFFECTIVE?

Chinese herbs can be VERY effective.  Just like anything else, they will not work 100% of the time, nor can they cure every disease known to man.  But they often can have a significant beneficial impact, sometimes even when other therapies have failed.  And the effects can be quite noticeable to the patient.  A few months ago, a woman came into the clinic because she had a severe yeast infection with vaginal itching, discharge, and was constantly feeling uncomfortable.  She had taken prescription drugs for some time, and they had given no relief.  The herbs we gave her began to give relief within a day, and 3 days later she felt about 75% better.  By the end of one week the yeast infection was eradicated.  Another great example is a patient who came in with significant fatigue.  After one week of herbs the fatigue had vanished.

Not all cases are that simple however.  People with more signifcant problems such as fibromyalgia, CFIDS(chronic fatigue syndrome), or conditions like lupus, may take longer to get reasonable results.

Chinese herbs do not work by magic. They take time and care.  And, in some cases, even the best crafted formula can fail.

RESEARCH

While Traditional Chinese medical theory is sophisticated and beautiful, how about some research.  Can herbs really affect the body? Consider for one moment that 25% of prescription drugs are actually directly derived from natural substances.  AN example is Digitalis, a heart medication which come from the flowering plant foxglove.  How about the antibiotic penicillin? It comes from a common mold.  Therefore it should be no surprise that Chinese herbal medicines can have very real benefits that have been studied and researched.  Here are a few examples:

The Chinese herb jin yin hua (lonicera flower) has shown to be able to inhibit the growth of 73.9% of oral pathogens, and also has a strong ability to inhibit influenza and HIV viruses.  This info is from the following references

Sun Y. et al. Antimicrobial properties of flos lonicera against oral pathogens. China Journal of Materia Medica. 21(4):242-3 Inside Back cover, Apr 1996

Chang W. et al. Antiviral Research. August 1995

The Chinese herb yan hu suo (rhizoma corydalis) exerts strong anti-inflammatory effects and can help with both acute and chronic inflammation.  It also has analgesic(i.e. pain killing) properties. The references are below

Kubo, M. et al. Biol Pharm Bulletin. February 1994

Zhu, XZ. Development of natural products as drugs acting on central nervous system. Memorias do Instituto Oswaldo Cruz. 86 2:173-5, 1991

Suffice it to say, Chinese herbs offer people a multitude of opportunities to improve health and well-being through real mechanisms of action on the body.

Accessory Techniques:The Other Part of Acupuncture

The Chinese word for acupuncture is zhen jiu, and translates as ‘needle and fire’, or as ‘acumoxa therapy‘. Where does the fire come from? Well, there is a technique that has been employed by acupuncturists over the ages, and it is called ‘moxibustion’.  It is a special form of heat therapy. Below, we will describe this and some of the other techniques which, while lesser known here in the U.S., are quite valuable.  They are commonly used by acupuncturists all over the world, and we at New England Acupuncture & Herb Clinic utlizie them whenever they can be of value to the patient, offering another way to move closer to the desired therapeutic outcome and achieve success.

Moxibustion

As alluded to above, moxibustion is a special form of heat therapy commonly used as part of acupuncture. Not every patient will receive moxibustion. But when it is used, its effects can sometimes be remarkable.

Essentially, the practice of moxibustion involves the burning of various substances near the acupuncture points on the body. While there are some forms of direct moxibustion (i.e. burning it right on the skin), we do NOT use the direct method here at the clinic. Instead we use the indirect method, which means the moxa is comfortably held at a distance from the body while the heat gently penetrates the body and benefits the patient.  Patients find this therapy very enjoyable.

The most common substance used for moxibustion is artemisia vulgaris, an herb. Wen it is ground up and prepared for use in the clinic, it can resemble brown cotton, or ground up twigs. Other substances can be used for various therapeutic reason. Indications for the use of moxa include pain worse with cold and better with heat, a tendency to feel cold all the time, fatigue, conditions which in chinese medicine would be termed, ‘damp conditions’, and others. It may even be indicated in breech presentations in pregnant women.

The moxibustion is said to increase the yang energy of the body, dispel cold, promote cirulation of qi and blood, and transform damp. One of the wonderful uses I have found for moxa, is its use in helping older women who experience a feeling of distention and discomfort in their urinary bladder, but who have no infection. They often also have a feeling of  incomplete voiding of urine when they go to the bathroom. Another specific example of the use of moxi is cases of arthritis where the joint pain is worsened by cold weather. For more examples of real life cases treated here at the clinic please go to our case history page. There we have posted some of the cases we have treated, in order to illustrate some of the principles of how Chinese medicine works and the results that can be attained.

Cupping

Cupping is pretty straight forward. It is the application of ‘suction cups’ to specific areas of the body, most often the back and shoulders. This technique can be combined with others, or used by itself. It can be very effective for relieving muscle tension. This is its most common use. Sometimes the cup(s) is placed in a particular spot and left for a few minutes. Other times hypoallergenic massage oil may be rubbed into a broad area and the cup can be moved back and forth over this area. That is termed ‘moving cupping’, or ‘sliding cupping’. There are some people who may be sensitive to the pressure, but most patients seem to find it fine, and even quite pleasant.

Tui Na (no, its not pronounced “tuna”.  It is “tway na” or “twee na”, depending on who you ask).

This translates as ‘pushing and grasping’. While it sounds a bit rough, it is not. Actually, it is a sophisticated and ancient form of massage developed in China. It has been imported to other coutries where it was modified to fit their needs and cultures. The prime example that comes to mind is Shiatsu, which is what tui na became after it was imported to Japan.

Tui Na, sometimes called Anmo, or amma, is based on the same theories and principles as all of Chinese medicine. Thus, it too works to stimulate or relax the acupuncture points and channels that lay on the surface of the body. It also works directly on the muscles, ligaments and tendons. Some patients have described it as a ‘complex form of acupressure’.

In summary, Chinese medicine offers many therapeutic techniques. Each one brings with it a good deal of value and benefit. They are non-invasive, quite safe, and often highly enjoyable.

What is Acupuncture?

Acupuncture is a highly effective therapeutic technique that has been developed and refined over thousands of years.  This was done by the brightest and best scholars of China, during each era, as well as in other countries around the world, and continues even to this day.

Acupuncture therapy works by tapping  directly into the body’s natural innate healing ability.  It does this through the comfortable insertion of  hair thin needles at certain points.  As the needle is gently and safely inserted into your body, healthy signals are conducted which essentially redirect your body’s energy.  This initiates a process by which therapeutic benefits, enhanced higher level functioning of the body and mind, and resolution of health issues can be achieved.

A concrete example will help you to get an even crisper clearer understanding.  To grasp the intriguing concepts behind the acupuncture technique, you can take a look in our case study section.  There you will find real life examples of how patients here at New England Acupuncture & Herb Clinic have gained success through acupuncture.

Swine Flu Prevention (H1N1)

The following message from Dr. Vinay Goyal is sound advice for preventing H1N1 infection as well as avoiding many contagious illnesses.

The only portals of entry are the ears, nostrils, and mouth/throat. In a global epidemic of this nature, it’s almost impossible to avoid coming into contact with H1N1 in spite of all precautions. Contact with H1N1 is not so much of a problem as proliferation is.

While you are still healthy and not showing any symptoms of H1N1 infection, in order to prevent proliferation, aggravation of symptoms and development of secondary infections, some very simple steps, not fully highlighted in most official communications, can be practiced (instead of focusing on how to stock N95 or Tamiflu):

Wash hands with soap1. Frequent hand-washing (well highlighted in all official communications) .

2. “Hands-off-the- face” approach. Resist all temptations to touch any part of face (unless you want to eat, bathe or slap).

3. *Gargle twice a day with warm salt water (use Listerine if you don’t trust salt). *H1N1 takes 2-3 days after initial infection in the throat/ nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation.  In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one.   Don’t underestimate this simple, inexpensive and powerful preventative method.

Neti pot4. Similar to 3 above, *clean your nostrils at least once every day with warm salt water. *Not everybody may be good at Jala Neti or Sutra Neti (very good Yoga asanas to clean nasal cavities), but *blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral populations. *

5. *Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). *If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption.Vitamin rich foods

6. *Drink as much of warm liquids (tea, coffee, etc) as you can. *Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.

I suggest you pass this on to those you love. You never know who might pay attention to it – and STAY ALIVE because of it.

— Dr. Vinay Goyal is an MBBS, DRM, DNB (Intensivist and Thyroid specialist) having clinical experience of over 20 years. He has worked in institutions like Hinduja Hospital , Bombay Hospital , Saifee Hospital , Tata Memorial etc.. Presently, he is heading our Nuclear Medicine Department and Thyroid clinic at Riddhivinayak Cardiac and Critical Centre, Malad (W).