Treating back pain: an acupuncturist's approach

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Back pain is one of the most common reasons that people seek out complementary therapies like acupuncture, massage, and chiropractic. Thankfully, acupuncture can help big time! Research shows that acupuncture helps relieve many types of pain, especially back pain. Acupuncture may even be more effective for acute low back pain than NSAID medications like Ibuprofen

But how does acupuncture work for back pain? Or, more accurately, how does Chinese medicine work?

Relief is not as simple as putting needles where it hurts. There are numerous causes of back pain according to Chinese medicine. We call the pain the “branch” symptom, and your deeper state of overall health the “root” of the symptom. For lasting pain relief, we must treat both the branch and the root. All pain is due to a blockage of Qi, or energy, flow - which means that things like oxygen exchange and blood flow may not be as they should be. In the early stages of pain this is usually due to tense, inflamed or strained muscles. In later stages, deeper structures like nerves, vertebral discs, or the vertebrae themselves, may be involved. Following is a peek inside the way my Chinese medicine mind works when it comes to treating back pain. 

To promote circulation, induce muscle vacillations (little twitches which help the muscles relax) and stimulate tissue repair, I use various needling techniques near the site of pain. These techniques depend on which muscle groups are involved and how much disc space there is between the vertebrae. I also look for visual clues such as scars or varicosities (enlarged, twisted veins at the skin surface), which indicate places of impaired circulation. It’s also important to assess the overall quality of the soft tissue. For example, how elastic and hydrated, warm or cold it might be, both at the sight of the pain and beyond, especially in the legs and ankles. This is often where the cause of what we call channel obstruction - a type of pain syndrome - begins. 

In addition to acupuncture, I may also use other modalities to help promote circulation and reduce pain and tension. Acupuncture combines beautifully with tui na (Chinese medical massage), cupping therapy, gua sha (a type of skin friction), and moxibustion, a practice of burning the herb mugwort over the skin's surface. We Chinese medicine practitioners have a lot of tools on our toolbox.

Chinese medicine relates the entire length of the back side, literally from head to toe, to two primary channels. Helping people understand the connection between body parts they’ve been conditioned to sense as separate from each other, and how to care for these related body parts to take stress off the back, is often very helpful. Being conscious of this broad connection while walking and breathing can help relax chronically tense muscles while strengthening forgotten ones.

Symptoms are just part of the story - we want to find the cause.

In addition to addressing the local area of pain, we Chinese medicine practitioners are obsessed with figuring out the underlying cause of your pain pattern. For instance, maybe you always get a low back/sciatic flare up in the spring. The seasonal timing of this flare is no coincidence in Chinese medicine. We know that the channel associated with sciatic pain holds the body’s energetic potential for change, transition, and transformation, which is what spring is all about. We may diagnose and treat stagnation in this channel, but we will also work on warming, nourishing and supporting the other systems in your body that provide the push you need to get the deeply recessed energy of winter awakened and flowing throughout your whole body.

Or maybe you’re a person who always gets low back pain before, during or after your period. The timing of your back pain in relation to your menstrual flow is very important, as it tells us whether your energy, as it relates to your blood, is more full and stuck or more depleted and stuck. This will also relate to your emotional state around your period, which we can help keep in balance, even if we’re focusing primarily on your back pain.

Your emotions play a role too!

Lastly, there’s another very common but complex cause of back pain: emotional stress. Most people tell me that when they feel stressed their neck and upper back muscles tense up. But did you know there’s another set of muscles in the groin closely linked to the “fight or flight” stress response that can also tense up? The muscle pair known as the iliopsoas connects the 12th rib to the hip bone from top to bottom and front to back. One theory suggests that during times of high stress, which might unconsciously threaten our sense of safety, the ilopsoas goes into chronic spasm in an effort to return us to a more protected, fetal-like position. This tilts the pelvis, causing low back pain.

I suspect involvement of the iliopsoas when low back pain is one-sided, or worse when lying down or going from sitting to standing. In this case, acupuncture can not only treat the structural causes of back pain, but also the apparent (or unapparent) emotional factors as we help regulate the nervous system. 

I know, you’re still wondering, “But how does the needle work?”

That’s what everyone wants to know. Basically, each acupoint is a tiny gateway that allows us to access and modulate the two most basic life forces — expansion and contraction. Everything is effected by those forces via unseen energy networks, soft tissues, and peripheral nerves. By helping your body regulate these forces, acupuncture helps you experience a decrease in symptoms and improved wellbeing! 

That’s all I’ve got for now. If you want to know more, come in for a treatment!

Are you ready to use acupuncture to reduce pain and promote healing?

*The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.

*Heads up! This post may contain some affiliate links. If you buy something through one of those links you won't pay a single cent more, but we'll get a small commission that helps keep the content flowing. P.S. We only recommend products we use in our own daily life!

How often should you come in for acupuncture treatments?

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A common question I hear from patients at their first appointment is: How often do I need to come in for treatments?

Well, of course there's no one-size-fits all answer to anything when it comes to health - and each patient gets a treatment plant for their exact needs - but I can give you a general overview of what I've seen work best for my patients.

There are three common levels of care in acupuncture - each with their own treatment frequency. Your acupuncturist will first figure out where you are on this spectrum, and then come up with a treatment plan customized specifically for you.

Wondering how often you need acupuncture? First, find out what stage of care you're in.

Acute care

Acute care focuses on the here and now - mainly dealing with more recent conditions or shorter term care. Here's a few examples where you would need acute care treatment:

  1. You've suffered a recent injury or are dealing with a short term ailment. Maybe you sprained your ankle in the last few days, came down with travelers diarrhea, or recently got pregnant and are dealing with morning sickness.
  2. You're having an acute flare-up of a chronic condition or a condition that was previously in remission.
  3. You've been dealing with your symptoms for a long time, but you're new to acupuncture.

In the acute care phase your treatment plan will be a little more aggressive. You can expect to come in for acupuncture at least once or twice weekly for the first two weeks. (This is exactly why we offer acute care packages in our clinic.)

Your course of treatment will depend on how your symptoms react to the acupuncture. Someone with an acute injury will need more frequent treatments for a shorter period of time. Whereas someone working on a chronic condition might have their treatments spaced further apart, but can expect to commit to a longer process.

Don't forget, it's usually taken years for our symptoms to manifest in the way they do now. We can't expect them to disappear in one or two treatments.

Something people don't know about acupuncture, is that the effects are cumulative. It's better to build the positive effects of each treatment on top of each other instead of playing a constant game of catch-up between further and further spaced out appointments.

The acute care phase lasts until your symptoms are relieved or your health goals are met. Then we move on to the transitional care phase.

Transitional care

So at this point your symptoms have improved to the point that you've met your health goals.

Now what? You can't just quit cold turkey, right? Right.

In the transitional care phase, we start to spread the appointments further out - but not so far that the symptoms start to come back! If that happens, it means that your body can't go that long between treatments right now.

We'll keep pushing your appointments out further and further until we find your sweet spot. Then you've move on to the third level - maintenance care.

Maintenance care

Maintenance care is continued care within your specific sweet spot. What's your sweet spot? It's the time that you can go between appointments before your body gets out of balance and trouble arises.

Everyone's sweet spot is going to be different. A lot of my patients' do best when they come in for monthly treatments, others can go 6-8 weeks between treatments, and for a few folks only need to come in once every 3 months in order to feel great!

I use this analogy a lot in clinic: Most of us take better care of our cars and bikes than we do ourselves. We're conditioned to remember to get oil changes every 3,000 miles on our cars and tune-ups on our bikes at the change of every season.

But when do we get our own tune-ups?

Acupuncture is a great tool to treat so many various conditions. But where it really excels is in keeping you healthy! Using acupuncture as preventative medicine and self care can save you lots of time, money, energy, and pain in the long run.

Using acupuncture as preventative medicine can save you lots of time, money, energy, and pain in the long run.

More of a visual learner? Here's a video where I explain the cumulative effects of acupuncture:

Ready to try acupuncture for yourself?

Book an appointment today and see how acupuncture can benefit your health!

*The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.

 

*Heads up! This post may contain some affiliate links. If you buy something through one of those links you won't pay a single cent more, but we'll get a small commission that helps keep the content flowing. P.S. We only recommend products we use in our own daily life!

Leah's story: Community Acupuncture in action

Leah's community acupuncture story

It was March 2001, and I had recently moved from NYC back to the small town of Amherst, MA in the hopes of finishing up my undergraduate degree at UMass/Amherst. Before summer classes started in June, my dad, an avid cyclist, invited my sister and me to join him on a Cuban cultural exchange program that seemed right up my alley: 13 days of biking all over the island, with the ultimate goal of delivering much needed school supplies to small schools located in the Cuban mountains. A chance to experience a different culture, do some good, AND ride my bike. Perfect!

And oh, what a trip it was! From biking through the yearly crab migration to the ocean (crabs absolutely COVERED the road, claws at the ready to attack our bike tires), to sleeping in a beautiful open air house with the family pigs just outside my bedroom door, there was color, life and beauty everywhere. But what truly surprised me is that this trip opened my heart and my mind to something I had rarely thought about previously: acupuncture and cooperative therapies.

Community medicine in action

On day 11, we stopped in the town of Matanzas on the northern coast of Cuba and spent some time visiting local artisans and a farmer’s market. From there we were told we could visit a nearby medical clinic. My dad is a pediatrician who worked his entire career at hospitals in Minneapolis. Subsequently, I had spent a fair amount of time visiting him at work and was familiar with medical settings. “Well this might not be the most interesting place we visit in Cuba,” I confided to my sister, “but let’s go along because Dad seems interested.”  

We biked up to a slightly crumbling, faded two story concrete building and walked inside. There, we were welcomed by the clinic director, a friendly gentleman with graying hair. He offered a tour of his quiet clinic, as fresh breeze blew in through the open windows. I was expecting what I had seen in my dad’s hospitals: patients lying lethargically in their beds, hooked up to machines and dazed from medication.  

East meets west in the clinic rooms

First he brought us into a large room right off the entrance. Instead of listless patients in hospital gowns, I was shocked to see to several fresh faced young people who were practicing tai chi. “This is preventative medicine in action,” the director informed us. We climbed the stone stairs to the second floor to witness patients being treated with homeopathic preparations and chiropractic adjustments. In the last room at the end of the hallway six women sat very quietly in chairs. I cautiously peered into the room as the director explained to us, “These patients are receiving acupuncture. If you look closely they have needles in their arms, legs, and heads.” Some women dozed quietly with their needles in, while others looked at us and gently smiled. This was the first time I had seen what an acupuncture treatment looked like.

I turned to the director to comment, “Wow! I didn’t know you could use acupuncture in a medical setting like this,” and he replied, “Of course you can! Not only does acupuncture work well, it’s also much less expensive than ‘standard’ medical interventions. We can accommodate many people in this room, and they can all be treated simultaneously. In Cuba we use whatever works.”

Bringing it all back home

Fast forward to 2007. After graduating from college and practicing massage for a few years, I found myself drawn back to acupuncture and moved (once again!) to Minneapolis to begin my Master’s degree in Asian medicine.

During my education I trained for a few weeks in Tianjin, China at a teaching hospital. This medical setting could not have been more different from Cuba; the shiny halls of the hospital were long, crowded, noisy, and there was a noticeable lack of cooling ocean breeze. BUT, if you peered into one of the many treatment rooms you’d see a remarkably similar scene: many patients quietly sitting or lying on cots, receiving acupuncture together in the same space. Just like in Cuba, these patients and practitioners were participating what has come to be known in the U.S. as community acupuncture (or CA).  

Community Acupuncture here at Constellation clinic

Constellation Acupuncture & Healing Arts is integrating this time-tested model of treatment into our practice, and we are happy to announce we will be hosting CA events once or twice a month on Sundays. Treatments will be provided on a sliding scale of $10-$50, pay what you can, no questions asked (cards, checks, and cash accepted). All proceeds from each CA event will go to a different organization that benefits social, environmental, physical, and/or emotional well-being.

Pokes for Planned Parenthood is Sunday, October 1st from 12-4pm

We're excited to host our very first event at the beginning of October, with 100% of proceeds being donated to Planned Parenthood Minnesota, North Dakota, South Dakota. Appointment times are every 15 minutes and start at noon, and we encourage you to book a time in advance! Come dressed in your most comfy, loose clothes that can be rolled up over your knees and elbows. Come with whatever ails you - we can treat it all, from back pain to allergies to headaches. You will be treated alongside others while lying back in a zero gravity recliner in our serene new clinic space.

If you like how that sounds, you'll love that we have even more CA fundraising events scheduled! On October 29 from 12-4pm we will host Pokes for Harvey, fundraising for Organize Texas, a direct relief agency helping victims of Hurricane Harvey. On November 12 from 12-4pm, you can help increase access to mental health support for queer and trans youth through Pokes for RECLAIM. We're adding new events all the time, so stay tuned! 

Click below to sign up now - these events are sure to be popular.

I look forward to seeing you there! 

-Leah

*The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.

*Heads up! This post may contain some affiliate links. If you buy something through one of those links you won't pay a single cent more, but we'll get a small commission that helps keep the content flowing. P.S. We only recommend products we use in our own daily life!

What happens during an acupuncture treatment?

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"Am I going to look like the guy from Hellraiser?"

"I don’t know about acupuncture - What if I’m afraid of needles?!"

"Do I have to lie as still as a board when the needles are in?"

These are just some of the common questions people ask me when they’re in my office for their first acupuncture treatment.

Yeah, acupuncture is getting more and more commonplace nowadays (even my Grandpa had acupuncture for a painful hip almost 10 years ago), but it’s still a pretty bizarre thing for many, many people.

Today I’m going to demystify an acupuncture treatment for all y’all. Help you to see what my devoted patients see. Understand why I can have a new patient going from being a nervous wreck about the thought of needles in their body one second, to blissfully snoozing away on the table 30 minutes later.

So, what really happens during an acupuncture appointment?

If it’s your first time (Ooh, you acu-virgin you!), you’ll take a seat in a comfy chair, I’ll get you a glass of water or tea, and then we’ll start out with your typical doctor’s office boredom. Yep, paperwork. Acupuncturists in Minnesota are licensed by the MN Board of Medical Practice, which means I follow many of the same rules and regulations as any other doctor’s office. I’ll go over your privacy rights and the acupuncture consent form with you and then we’ll be past the boring stuff and onto the reason you’re here!

One of the reasons people love getting acupuncture is that they’re not used to a medical practitioner actually taking the time to really get to know them and their health story. During your first treatment we’ll easily spend up to 40 minutes chatting about your medical history, your current symptoms - I’ll even want to hear about your diet, sleep, stress, and anything else that might be affecting your health.

After I get to know you better than a first tinder-date, I’ll take a look at your tongue and feel your pulse. No, I’m not counting your pulse rate - although I will make note if it’s especially fast or slow. When I’m feeling your pulse I’m actually feeling for the quality of your pulse. Does it feel taut like a guitar string? Or soft and squishy like a sponge. There are tons of variables that I’m feeling for when I take your pulse - all of which give me even more diagnostic information.

Same goes for looking at your tongue. (And no, please don’t scrape your tongue before an acupuncture treatment! That coat means something to me! And seriously, I look at tongues all day long - no need for embarrassment here.) The shape, color, and texture all tell me things! Just from looking at your tongue, I can tell how you’re pooping, how you’re sleeping, or how stressed out you’ve been feeling!

After the interrogation (oops, I mean interview and tongue/pulse diagnosis), it’s #needlenap time!

I generally ask patients to either wear loose clothing or to bring a change of shorts/t-shirt with them so I can have easy access to elbows and knees. (Lots of great acupoints around those elbows and knees!) Then you’ll lie down on my super comfy, heated massage table (yep, you read that right, this is the ultimate adult nap-time) and I’ll get started.

The treatment itself consists of ultra-thin, sterile, disposable needles inserted gently by yours truly into specific areas of the body. I generally explain to people that the insertion feels like a tiny mosquito bite - nothing like a shot from a doctor! The needles I use are crazy thin (thinner than a dog’s whisker) and incredibly comfortable.

Once the needles are in, there are a range of sensations you might feel. I’ve heard everything from “I feel light - like I’m floating,” to “My arms are like a ton of bricks right now.” My favorite was when a patient told me that it felt like “water bubbling from a stream.” Seriously! How freaking awesome is that? I always make sure to tell people that if any of the needles feel painful or uncomfortable, to let me know right away and I’ll take it out and re-do it. There’s no reason that you should feel any discomfort in one of my treatments (that’s just not my style).

Once you’re all set, you can lie back and relax. And don’t worry - even though you have needles in, you don’t have to be perfectly still. If you have an itch - scratch it! I don’t want you hopping off the table with a bunch of needles in you, but shifting your weight around to get more comfortable or scratching an itch on your nose is really no big deal. Your comfort is key. You may even doze off a bit! This deep sense of relaxation really helps stimulate the body's innate ability to heal.

What happens after an acupuncture treatment?

After you’ve been resting (or napping/meditating/counting the slats in the ceiling) for about 25 minutes I’ll gently wake you up and take all your needles out. Everyone always proclaims how much more relaxed they feel right away.

After you’re up and back to reality, I’ll have you drink a glass of water (and remind you to keep drinking more after you’ve left) and go over your treatment plan with you. The frequency of your appointments is totally dependent upon your specific situation. In some acute cases more treatments in a shorter amount of time is necessary, while in more chronic conditions, a longer treatment plan that includes herbs might be recommended. In general it’s good to plan on coming once a week for a month to “build up your dosage” and to help the treatments last longer. As your symptoms become less noticeable I’ll scale back the frequency to fit your body’s needs.

As for how you’ll feel later in the day - everyone reacts differently to their first acupuncture treatment. Some people feel a bit zoned out (almost as if you've had a couple at happy hour!) while others get a boost of energy. How you personally react will tell me a lot about your constitution and how I’ll proceed in future treatments. So always feel free to email me the next day and update me on how you’re feeling.

Either way, whether you feel relaxed or energized, I recommend you avoid vigorous exercise after treatment. Even though you might be thinking, "All I did was lay on a massage table and take a nap!" your body was working hard that whole time - moving a lot of energy and doing a lot of healing - all of which can be a little tiring. If you're determined to get in some exercise after your appointment, I suggest something gentle such as restorative yoga, tai chi, or a nice walk.

So there you go! An acupuncture appointment deconstructed. That’s not so scary after-all, right?

Do you feel like you have a better idea now of what goes on in a session? Do you still have more questions? I’d love to hear them (and answer them)!

Tell me in the comments what other questions you have about acupuncture!

*The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.

*Heads up! This post may contain some affiliate links. If you buy something through one of those links you won't pay a single cent more, but we'll get a small commission that helps keep the content flowing. P.S. We only recommend products we use in our own daily life!