HEADACHE AND MIGRAINE
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What kind of headaches does acupuncture help with ?
Cluster headaches get their name from the pattern in which they appear, which is typically a cyclical cluster of a few headaches in succession with a period without headaches. Clusters may last from weeks to months. Cluster headaches have been known to awaken sufferers from sleep in the middle of the night. Cluster headache pain is typically intense, and the pain focuses in and around the eye on one side only. Fortunately for most, cluster headaches are not very common. The cause of cluster headaches is unknown, but doctors believe they are caused by an irregularity in the hypothalamus, a part of the brain. Unlike migraines, cluster headaches are not associated with triggers, like certain foods, hormonal changes or stress.
Tension headaches are the most common kind of headache. Tension headache pain is usually generalised (you can’t point to one area of pain), dull and achy. The pain is often mild to moderate. The most common feeling is that there’s a tight band around your head. The cause of tension headaches are not understood. Tension headache pain often involves neck tension, and relieving tension in the neck will often improve headache pain. Tension headaches can also be related to eye strain. Tension headaches, unlike migraines, do not have any associated sensitivity to light, nausea, vomiting, one-sided weakness or numbness, or slurred speech.
A migraine is usually a one-sided headache with intense throbbing pain. Migraines are accompanied by nausea, vomiting, photophobia (sensitivity to light) and sensitivity to sound. Migraine pain is often severe and significantly impacts a person’s quality of life for hours, even days, at a time. Migraines often have tell-tale warning signs that signal their onset, like visual disturbances (flashes of light), blind spots or tingling in the extremities. Migraines typically have triggers, like certain foods, hormonal changes and stress. A diet avoiding tyramine-containing foods is often prescribed.
Sinus headache are headaches felt mostly around the eyes, in the cheeks and forehead. They are generally caused by sinusitis, which is the inflammation of the membranes lining your sinuses. These headaches sometimes feel like having a heavy towel on the head and may be throbbing or squeezing in nature. They may also be related to changes in weather. Sinus headaches are often chronic, especially in allergy sufferers or people with structural abnormalities in the nose and sinuses.
Fibromyalgia and headache
People with fibromyalgia experience aches and pains all over their bodies, including head pain. Some people with fibromyalgia also have migraines. For more on fibromyalgia, please visit the Fibromyalgia pain page.
When do I need to see a doctor about my headaches?
You should always mention your headaches to your doctor if they occur more than occasionally because headaches can be a sign of a more serious condition. If you’ve already discussed your headaches with your doctor, but the pattern or nature of the headaches have changed, you should discuss this with your doctor again. If you have a severe headache with abrupt onset, headache accompanied by a high fever, stiff neck, and nausea and/or vomiting, or headache following a head injury, you should contact your doctor immediately.
How does a doctor diagnose and treat headache?
A doctor will conduct a physical exam, medical history (including family history), and neurological exam. Your doctor may also order an MRI or CT scan. From there a pharmaceutical prescription is likely.
How does acupuncture help to treat headache pain?
I’ve mentioned on other pages that acupuncturists do a lot of talking with their patients. When treating for headaches, this conversation is of the utmost importance. It’s very important to determine when the headaches started, where you feel the pain, when you feel the pain, what the pain itself feels like. It’s also important to get a general picture of a person’s overall health and wellness. This information allows me to determine what acupuncturists call the pattern of disharmony. A patient may have multiple patterns, so I always start with the predominant one. It’s kind of like peeling an onion - balancing subsequent imbalances as the predominant ones resolve.
Acupuncture helps restore the natural balance of energy in the body and improve circulation. This is how acupuncture may help to stop pain. I use herbal medicine to do the same thing from the inside out. The channels that run through the head have strong ties to the digestive system and I have observed that some headache patients also have a digestive system pain connection. Herbs designed to help treat the digestion may also help the symptom of head pain.
A lot of the headache sufferers I talk to are concerned about having acupuncture done on their head because the pain is often severe. Acupuncture is rarely applied to the head when you’re in pain. Instead we use points around the hands and feet whose channels reach up to the head. Back to Pain Types Menu
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Acupuncture addresses shoulder pain
The shoulder is a marvellous joint ... and a pain in the butt. Fortunately for us, the complex structure of the shoulder joint allows for an incredible range of motion. We are able to move arms the way we do largely due to this flexibility. Unfortunately, the shoulder joint has relatively poor blood supply, so it is slow to heal when it is injured. Prevention is the best medicine for shoulder injuries.
Another tick-mark in the “fortunately” column is that acupuncture is really good at improving circulation wherever it is applied. In Chinese medicine speak, we say acupuncture promotes the circulation of Qi and Blood. Qi and Blood are the healing regenerative forces of the body. Free-moving Qi and Blood also stops pain. Regardless of how you phrase it, acupuncture treats shoulder pain by invigorating the area, relaxing muscles and promoting healing.
What are the different types of shoulder pain that acupuncture can address?
Shoulder bursitis is inflammation of the bursa in the shoulder joint. Bursa are small sacs filled with fluid that cushion the joint and allow for smooth movement of the bone, tendons, and muscles. vThe causes of shoulder bursitis include injury, repetitive motion (athletics or manual labor), and impingement syndrome leading to inflammation. vThe symptoms of shoulder bursitis include pain with overhead activities, pain while sleeping at night, joint stiffness, swelling and redness. vPain from shoulder bursitis is often felt over the outside of the shoulder/upper arm.
Rotator cuff tendinitis
The rotator cuff refers to all the muscles and tendons in and around the shoulder that work to stabilize the shoulder joint (glenohumeral joint). vThe four muscles of the rotator cuff are the supraspinatus, infraspinatus, teres minor and subscapularis muscles keep the bone of the upper arm (humerus) in the shoulder socket (glenoid fossa). Rotator cuff tendinitis is the swelling and inflammation of the tendons of these muscles. Some of the causes of rotator cuff tendinitis include overuse, especially through athletic (throwing sports, tennis) or other physical (overhead lifting) activities. The symptoms of a rotator cuff injury are pain at rest or at night, especially upon lying on the affected shoulder, pain when raising and lowering your arm in specific ways, weakness when lifting and turning your arm, noises in the shoulder joint when moving in certain ways.
Shoulder impingement syndrome
Shoulder impingement syndrome is the combination of shoulder bursitis and rotator cuff tendinitis. Typically, both causes of shoulder pain are present, but the degree of one versus the other may vary. Regardless, the swelling and inflammation of the tendons and bursa cause a narrowing of the space of the shoulder joint. This leads to pain and restricted movement. Supraspinatus tendonitis is another part of shoulder impingement syndrome.
Frozen shoulder (adhesive capsulitis)
Connective tissue forms a “capsule” around the bones, ligaments, and tendons of the shoulder. If this capsule thickens or tightens, frozen shoulder can occur. The inflammation associated with frozen shoulder causes severe pain and restricted range of motion. Most of the time, there isn’t a cause of frozen shoulder, but it has been noticed that people with cervical spine (neck) injuries, diabetes, those who have had shoulder or open heart surgery, and hyperthyroidism are at an increased risk for frozen shoulder. The symptoms of frozen shoulder are ranged by stage:
Stage One (painful stage): pain with movement, decreased range of motion
Stage Two (frozen stage): less pain but more stiffness, further decrease in range of motion
Stage Three (thawing stage): improved range of motion
If the ligaments and tendons that hold the shoulder together become stretched out or weakened in any way, the shoulder may easily separate or dislocate. This is called shoulder instability, and the shoulder can be partially (subluxated) or fully dislocated forward or backward. The causes of shoulder instability include direct injury, post-traumatic instability, joint laxity (hypermobility, as seen in the very flexible and pregnant women), and overuse, especially through swimming or throwing. The symptoms of shoulder instability include frequent dislocations or separations without direct trauma.
One of the ways our body has to protect its joints is to cover the ends of bones in cartilage. This prevents the bones from directly rubbing together. When the protective cartilage breaks down with age, osteoarthritis results. Rheumatoid arthritis is an autoimmune disease that causes inflammation and swollen joints. Direct injury may also be a causative factor in the development of shoulder arthritis. The symptoms of arthritis include pain, tenderness, stiff and inflexible joints and possibly bone spurs.
The biceps muscle connects to the shoulder bones to the arm via tendons. When this tendon become inflamed, irritated, or torn, pain can result. The pain of biceps tendinitis is felt in the front of the shoulder. The causes of biceps tendinitis include overuse (especially due to overhead activities like swimming, tennis, and baseball) and an underlying rotator cuff injury. The symptoms of biceps tendinitis disorders include pain and swelling in the front of the arm.
The labrum of the shoulder lubricates and absorbs shock within the shoulder joint. If it detaches from the tendons and tears, pain will occur. This is also known as a glenoid labrum tear or informally as a shoulder joint tear. The causes of labral tears are overuse, especially in athletes using overhead motion (throwing, swimming), falling on an outstretched arm, direct trauma to the shoulder, and sudden pulling motions (a dog pulling on a leash or lifting a heavy object). The symptoms of labral tears include pain on overhead activities, catching or locking of the shoulder joint, popping or other sounds in the shoulder joint, shoulder instability, decreased range of motion and loss of strength.
How is shoulder pain diagnosed by my doctor?
Your doctor will diagnose your shoulder pain after evaluating your shoulder by:
Taking a medical history
Performing physical exam
Imaging tests, including X-ray, MRI, or computerized tomography (CT)
How does my doctor treat shoulder pain?
Your doctor will likely prescribe some of the following treatments for shoulder pain:
Icing and resting the shoulder
Drugs to ease pain (analgesics and NSAIDs)
Drugs to decrease inflammation
Physical therapy and stretching
Surgery and/or joint replacement
How does an acupuncturist evaluate and assist with your shoulder pain diagnosis?
The body is covered by a network of acupuncture meridians. When a patient is experiencing pain, my first step in evaluating that person is to determine which of the meridians is affected, that is which ones cross over the areas of pain. Pain from an acupuncture perspective, is a blockage in the meridian, so acupuncture is applied to remove those blockages. I can also use herbal medicine to help unblock the meridians from the inside out.
In addition to acupuncture and Chinese herbal medicine, I use Tuina medical massage, cupping, Guasha and other adjunct techniques.
I also take time to evaluate a patient’s overall health. By improving general health, so Chinese medicine theory says, problems like shoulder pain are less likely to arise. From another perspective, you can fix the shoulder, but if the shoulder pain is being caused by something else, the pain will come back when treatments are stopped. So, it’s important to treat the symptoms, but also treat the underlying root cause. This is why we always treat the whole person in Chinese medicine. Back to Pain Types Menu
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Acupuncture addresses elbow pain
Elbow pain is one of the four most common categories of pain conditions I see in the clinic. Needless to say, elbows get a lot of use, which translates into wear and tear. In addition to activities we do at work, a lot of the recreational activities we love so much can lead to elbow pain too.
When offering treatment for pain conditions, I often recommend twice weekly treatments for the first few weeks to encourage speedy resolution of pain symptoms. I then follow up with a few more weeks of weekly treatment to consolidate relief and make sure you stay pain-free. After that, we can discuss maintenance strategies.
What are the different types of elbow you treat with acupuncture?
Golfer’s elbow (medial epicondylitis) and tennis elbow (lateral epicondylitis)
Golfer’s elbow and tennis elbow are caused by irritation of the tendons that connect the forearm muscles to the elbow joint from overusing the wrist and forearm muscles. The causes of golfer’s elbow and tennis elbow include overuse, improper form/technique in athletic activities (golf, tennis, weightlifting, throwing) or other repetitive motions (manual labor). These conditions are common in athletes, workers performing manual labor, and musicians. The symptoms of golfer’s elbow and tennis elbow are pain and inflammation on the inside (golfer’s) or outside (tennis) of the elbow that may spread to the forearm and wrist, stiffness and weakness, and possibly numbness and tingling.
Bursitis is the inflammation of the small fluid-filled bursae that act as cushions between the bone, tendons, and muscles of joints. The most common causes of elbow bursitis are repetitive motion (athletics or manual labor) and leaning on elbows. Symptoms of elbow bursitis include achy and stiff elbow pain, elbow pain upon movement or pressure, and swelling and redness in the elbow.
The ends of bones are covered in protective cartilage, which prevents the bones from rubbing together in the joint. Osteoarthritis results when this cartilage wears down over time, which means the bones rub together. Rheumatoid arthritis is a chronic, inflammatory autoimmune disease that causes joints to swell and bones to become deformed when immune cells attack the joint tissues. The causes of arthritis include advanced age, injury, obesity, inactivity, overuse and immune system disorder in the case of rheumatoid arthritis. The symptoms of elbow arthritis include pain, tenderness, stiffness, loss of flexibility, sound of grating in the joint, and bone spurs.
How is elbow pain diagnosed by my doctor?
Diagnosing the cause of elbow pain involves:
Discussing medical history
Physical exam, including assessing pain in the elbow joint
Imaging tests, such as X-ray, MRI, or electromyography
Fluid or blood tests can detect an infection
What will my doctor suggest as a treatment for elbow pain?
Treatments for elbow pain include:
Icing the affected area
Over-the-counter and/or prescribed pain medications
Physical therapy to increase strength in forearm and wrist muscles and tendons
Surgery and/or joint replacement
More and more orthopedists and other Western medical providers are recommending acupuncture to treat pain. It is not out of the ordinary for your doctor to suggest you get acupuncture treatments before you have a chance to tell him/her you’re going for acupuncture treatment.
How does an acupuncturist diagnose elbow pain
To determine the cause of your elbow pain, I use physical exam techniques, like orthopaedic and neurological tests, and range of motion tests. I will also examine the area for inflammation, redness, or other visible manifestations.
How does acupuncture address your pain?
Acupuncture works with pain by improving circulation, reducing inflammation and relaxing muscles in spasm. I use acupuncture above and below the injured joint, and use what acupuncture calls “mirror points.” Mirror points would include the unaffected elbow and the knees (the elbows of the legs, so to speak).
Herbal medicine can be used too. Herbal medicine works similarly to acupuncture, but does so from the inside out. For smaller joints like those in the hands, feet, and the elbow, I often prescribe an external herbal soak. I also use tui na massage, cupping and gua sha (in certain instances) to help support acupuncture treatments.
According to Chinese medicine theory, applying ice is counter-productive to healing because it hinders circulation in that area. In the case of the inflamed, red joints, we use “herbal ice” plasters to reduce inflammation while also promoting the circulation of blood. Back to Pain Types Menu
WRIST & HAND PAIN
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Acupuncture addresses wrist and hand pain
The hand is one of the marvels of human nature. The precision movements it can make allow us to do a huge number of activities that our nearest primate cousins cannot.
The complexity and dexterity of the hand are wonderful, and they also get us into trouble. Many activities we do daily – typing on a keyboard, using our thumbs on our cell phones, using scissors or tying our shoelaces – can also lead us to develop painful hand problems, like arthritis, carpal tunnel, tendinitis.
The most powerful acupuncture points are those in the hands and feet. These acupuncture have strong pain-stopping abilities. By determining the location and quality of the pain, I use related points to stop the pain you’re experiencing in your hand and wrist.
What are the different types of hand and wrist pain treated by acupuncture?
Carpal tunnel syndrome
Carpal tunnel syndrome is a condition in which the median nerve becomes pinched as it passes through the wrist into the hand. The pain associated with carpal tunnel is said to increase over time, have an electric zinging nature, and is sometimes accompanied with weakness and numbness in the hand. Carpal tunnel syndrome is caused by anatomical abnormalities in the structure of the wrist, pregnancy, and certain patterns of hand movement (ergonomics). The carpal tunnel is a small passageway through the wrist, and a large nerve and nine tendons need to squeeze through that space. When the space is compressed, pain is felt, as well as numbness, tingling and weakness. Acupuncture can help relax and open that space, and reduce inflammation.
Arthritis is a leading cause of disability in the United States. Osteoarthritis is a “wear and tear” disease in which the cartilage that protects are joints is worn down and eventually disappears. In rheumatoid arthritis, the immune system causes degeneration of the joints. In both cases, smooth pain-free motion is lost. Thumb arthritis is a very common form of arthritis in the hand. Depending on the type of arthritis a person has, different joints (knuckles) in the hand will be affected. Psoriatic arthritis, while less common than the other types of arthritis mentioned above, may affect the hands as well as the finger nails.
There are many tendons in the hand and wrist. Tendinitis is inflammation of a tendon. De Quervain’s is a type of tendinitis. Most commonly, tendinitis in the hand affects the tendons of the wrist. Tendinitis pain is usually described as tightness, aching and burning pain. The pain is often worse during gripping or holding objects. Repetitive motion is likely to aggravate tendonitis.
De Quervain’s tenosynovitis
De Quervain’s tenosynovitis is one of the causes of thumb pain. It is a condition affecting the tendons on the thumb side, which attach to the wrist. De Quervain’s is also known as Blackberry Thumb because it is usually worsened by typing with your thumbs. If you have de Quervain’s tenosynovitis, turning the wrist and grasping will usually elicit pain. De Quervain’s is caused by repetitive motions.
A sprain is a name for damage to the ligaments within a joint. There are many ligaments in the wrist and fingers, making this part of the body particularly susceptible to sprain. This contrasts strains, which refer to the muscle and tendon injuries rather than ligaments. The symptoms of sprain are pain, swelling, tenderness, bruising, stiffness, loss of strength and decreased range of motion. During injury, you may have the sensation of tearing or popping of the ligaments.
Trigger finger (AKA stenosing tenosynovitis)
Trigger finger, also known as stenosing tenosynovitis, causes the finger joint to lock or catch in a curled position due to restricted motion of the tendons responsible for flexing and extending (bending) the finger. Symptoms range from difficulty extending the finger to becoming locked in a bent position. Other symptoms include stiffness, catching, or popping when the finger is extended. Some people notice a small lump and swelling by the base of the finger and pain in the palm and base of the finger. Typically, only one finger is affected, though it is possible for trigger finger to affect more than one finger. Symptoms are generally worse with rest and improve with activity.
How does a doctor treat hand and wrist pain?
Your doctor will perform a physical exam of your hand and conduct a medical history. Electromyography, X-rays and MRIs may also be ordered. Your doctor will likely prescribe physical therapy, rest, icing and anti-inflammatory or painkiller medications for treatment.
How does acupuncture assist with your diagnosis of hand and wrist pain?
In addition to acupuncture, I always prescribe herbal soaks for hand and wrist pain problems. It’s so easy to put the hand and wrist into a bowl of warm herbal medicine soaks – how could I not prescribe that? Herbal soaks allow delivery of medicine directly to the affected tissues to improve circulation, stop pain and encourage the healing of ligaments, tendons, muscle and bone.
Acupuncture treats hand pain and wrist pain by similar actions. Acupuncture improves circulation and relaxes spasms. The improved circulation caused by acupuncture brings fresh blood and oxygen to the area, which promotes healing. Certain acupuncture points help stop pain, too.
As with any acupuncture treatment, it is important to determine a pattern of disharmony before treating. To this end, I always conduct a full medical history to better understand a patient’s overall wellness in addition to gathering information about the hand pain or wrist pain. I will also conduct a physical exam and perform orthopedic and/or neurological tests to help better understand the cause of the pain in the hand or wrist. Coming to the proper diagnosis will inform both the acupuncture treatment and any internal herbal medicine I might prescribe. Back to Pain Types Menu