Dr Maggie Ju uses pain-free acupuncture techniques to release your pain quickly and efficiently. She helps many people get rid of their pain and improve their quality of life greatly.
If you don't have pain, you can never imagine how terrible to live with a pain. Chronic pain is a common condition in adults and almost everyone has experienced chronic pain at some points of their life. Pain can happen anywhere of the body from the head to the toes.
The pain cycle, what is involved?
Pain is a general term that describes uncomfortable sensations in the body and can be described as sharp stabbing, dull ache, throbbing, stinging, sore, and pinching. It can range from annoying to debilitating and can be consistent or on and off. Pain is highly subjective. People respond to pain differently. Some people have a high tolerance for pain, while others have a low tolerance.
Pain starts from activation of the nervous system. There are 9 steps of the pain circle:
Step 1: Local inflammation. There are injury, surgery, infection causing local inflammation.
Step2: Peripheral sensitization. Local inflammation irritates the nerves lowering the pain threshold causing peripheral sensitization.
Step3: Central sensitization. Nerve signals are transmitted to the brain causing central sensitization.
Step4: Pain sensation. The brain tells you that there is pain in the body somewhere.
Step5: Pain cognitive processes. The brain where is sensing the pain connects other part of the brain where controls emotion causing emotional and behaviour changes.
Step6: Depression and anxiety. The brain where controls emotions is affected by the pain signals and alters its function causing depression and anxiety
Step7: Cortical reorganization. The brain reallocates its task to different parts of the body to reduce pain sensation and help replace the lost function.
Step8: Avoidance and disability. The body will respond the brain demands to redistribute the work causing avoidance and disability.
Step9: Muscle spasm deconditioning. Injured and related muscles become spasmed to protect the body from moving and feeling the pain causing muscle waste.
Pain relief with acupuncture:
Acupuncture is a therapy in which thin needles are inserted into the body to relieve the pain.
Acupuncture is a valuable treatment for chronic pain conditions such as tension headaches, migraines, facial pain, neck pain, back pain, chronic pelvic pain, bladder pain, chronic abdominal pain, shoulder pain, arm pain elbow pain, wrist pain, hip pain, thigh pain knee pain, leg pain, ankle pain, kidney stone, and others etc, you name it. Acupuncture needles creates micro-injury and stimulates nerve endings located in muscles and other tissues leading to the production of endorphins and other neuro-hormonal factors and anti-inflammatory substances and releasing vascular and immunomodulatory factors. Acupuncture increases local blood circulation and improves muscle stiffness, joint mobility and swelling. Also brain and spinal cord processing pain has been altered.
Clinical investigators have found that patients with chronic pain often have lower-than-normal levels of endorphins in their spinal fluid. Acupuncture activates endorphin systems and there are higher levels of endorphins in cerebrospinal fluid following acupuncture.
Headaches are one of the most common chronic pain conditions; most people experience them at some point in their life.
Tension headaches are the most common form of headaches. Tension-type headaches can be either episodic or constant. In most cases, they are mild to moderate in severity and occur infrequently. But a few people get severe tension headaches. The typical tension headache produces a dull, squeezing pain on both sides of the head. People with strong tension headaches may feel have a tight band around the head. The shoulders and neck can also ache. Pain spread to or from the neck. Fatigue, emotional stress, or problems involving the muscles or joints of the neck or jaw can be a trigger of tension headaches.
Migraines occur less often than tension headaches, but they are usually much more severe. In typical cases, the pain is on one side of the head, often beginning around the eye and temple before spreading to the back of the head. The pain is a pulsating, throbbing pain and it may be accompanied by blurred vision, light-headedness and nausea. A migraine can come on without warning, but about 20% of migraines begin with one or more neurological symptoms called an aura. Without effective treatment, migraine attacks usually last for a few hours to a few days.
Cluster headaches are uncommon but very severe headaches. The pain always strikes one side of the head typically located in or around one eye and is very severe burning or sharp pain. The affected area may become red and swollen, the eyelid may droop, and the nasal passage on the affected side may become stuffy and runny. The attack starts abruptly and lasts for 30 to 60 minutes. This type of headaches tends to come in clusters, with one to eight headaches a day during a period of weeks, months or a couple of years. In between clusters, there may be no headache symptoms, and this headache-free period can last months to years.
Temporomandibular disorder (TMD) is a condition affecting the movement of the jaw. Signs of TMD include: pain around the jaw, ear and temple; clicking noises when moving the jaw; a headache around the temples; difficulty opening the mouth fully; jaw locking when opening the mouth. The pain may be worse when chewing and stressed. TMD can affect sleep.
One review analysed the data to study the effectiveness of acupuncture in treating pain from TMD. The data is for 25 years from 1990 t2015. The result has shown that acupuncture treatment appears to relieve the signs and symptoms of pain in myofascial TMD. Another study was from 8 publications involved in 231 patients with TMD. The result indicates that conventional acupuncture therapy is effective in reducing the degree of pain in patients with TMD, especially those with myofascial pain symptoms.
Acute dental pain is the main reason for seeking dental services. Have you tried acupuncture for reduce your dental pain? There is a study investigated the use of acupuncture in reducing the intensity of acute dental pain in pre-dental care in patients waiting for emergency dental care, and was conducted in Piracicaba, São Paulo, Brazil. 120 patients participated the study. All patients underwent one session of acupuncture. Reduction in pain was observed in all 120 patients. The results of this study indicate that acupuncture analgesia could be a technical adjunct to pain control in patients with acute dental pain.
Chronic neck pain
Chronic neck pain is a long-lasting pain on the neck or back. This pain commonly started from improperly healed acute injury. Scar tissues formed during the healing process. These scar tissues are called fibrosis. They can develop inside of the body, under the skin, muscles, tendons or inside of a joint capsule. Fibrosis always occurs at the end stage of inflammation and it causes adhesion which grabs the connective tissue and surrounding muscles together causing pain and tension, limiting the function. There are more pain receptors in the fibrosis tissue making the area more sensitive to protect the area by the body automatically.
Acute neck pain
Acute neck pain is a sudden-onset pain in the neck. It is often due to neck muscles strain and muscle spasm. This can be caused by poor posture, sleep in an awkward position, carrying heavy loads, stay in one position for a prolonged period of time etc. One might not find exactly causes. The pain is sudden and can be very severe. This makes the person with the pain panicking. Movement of the neck is restricted because of the pain. The recovery can take a few days or a week. Acupuncture can help release muscle spasm and the pain and speed up the recovery.
A large German study with more than 14,000 participants evaluated adding acupuncture to usual care for neck pain which is a large sample size. The researchers found that participants reported greater pain relief than those who didn’t receive it.
Shoulder joint is the most mobile one in the body. It moves the shoulder forward and backward, up and away from the body and also moves the arm circularly. Shoulder consists of bones, joint, cartilage, muscles, tendons and ligaments. If something goes wrong with the shoulder, it will cause pain and reduce the movement. With aging the soft tissues surrounding the shoulder tend to degenerate, and older people are likely to get shoulder problem. Soft tissues injury around the shoulder is very common and this will cause shoulder pain. The pain can come on gradually or abruptly, and it may range from mild to severe often accompanied with limited motion. The common causes of shoulder pain include
no 1: rotator cuff injuries and irritations: due to tears and inflammation of rotator cuff, the symptoms include pain or stiffness in the shoulder when you lift your arm above your head to brush your hair or when you reach behind your back.
No2: Calcific tendinitis. Calcium deposits embedded within the rotator cuff tendons and this caused the pain.
No3: Adhesive capsulitis. Known as frozen shoulder. Adhesive capsulitis is caused by a thickening and stiffening of the tissues around the shoulder joint. This is is a painful condition in the shoulder. Typical symptoms are shoulder pain and restricted shoulder movement. It presents a painful persistent stiffness of the shoulder joint that it is difficult to carry out everyday tasks such as dressing, driving and sleeping comfortably. Some people are unable to move their shoulder at all. This is caused when the capsule surrounds the shoulder joint becomes inflamed. The capsule that surrounds the shoulder joint becomes swollen, thickened and tightened This leaves less space for the upper arm bone in the shoulder joint, and makes the movement stiff and painful. The symptoms of frozen shoulder can vary greatly, but tend to get worse slowly over the time. They are usually felt in three stages spread over a number of months or years. This is a common condition affecting about 2% of adults.
No4: Osteoarthritis can affect shoulder as well thigh less common than knee and hip.
Treatment for shoulder pain is aimed at relieving pain and preserving range of motion of the shoulder. Acupuncture is a valuable treatment for shoulder pain.
If you have had acupuncture for this, do you know the effect of acupuncture for shoulder pain is closely related to the acupuncture points chosen? Some clinical trials showed that the most effective acupuncture points for shoulder pain are Ashi points with a significantly greater recovery rate.
Upper back pain
Upper back is the region between the shoulder blades, or between the neck and the waist. This is so called thoracic back pain. The pain is this region is very common. Symptoms can vary from person to person. The pain can be mild or more severe which might affect daily activities and sleep. It could be a sharp pain in one spot or a general achiness that comes and goes. The pain can be referred up to the neck, shoulder, down to the low back and around to the abdomen. There may be other symptoms associated with the pain such as acid reflex, bloating, stomach-ache, tight chest etc. In most of cases, the pain is nonspecific which means the cause is not clear or unknown. Pain in the upper back is usually the result of poor posture, muscle overuse, or injury.
Stooping in a chair over a desk is a good example. This may cause a loss of strength in the muscles. Over time, the weakening of muscles may lead to pain in the area as they experience strains or irritation; the pressure from gravity and the body itself pushes on the spine, neck, discs, and ligaments and can lead to pain and other complications. Overusing back muscles is another common cause of upper back pain. repeating the same motions over time may cause muscle strain, tightness and irritation. A traumatic injury at the upper back can also lead to back pain after the injury is healed.
Low back pain
95% of back pain occurs in the lower back. About 80 percent of adults experience low back pain at some point in their lifetimes. It is defined as non-specific low back pain, if there is no cause found. Non specific low back pain is from mild to severe, from a dull, burning, constant ache to a sudden, sharp or stabbing pain in the lower back region. The pain can be also shooting pain to the legs or up to the back or forward to the abdomen.
Acupuncture is very effective for non specific low back pain and it helps patients with low back pain reducing lumber surgery rate. . There is a research investigated the association between acupuncture treatment and lumbar surgery rate in patients with LBP. The participants in this study were all newly diagnosed LBP in Korea between 2004 and 2010 and they were allocated into two groups: acupuncture group and control group. The lumbar surgery rate in the two years following the first visit (control group) or the first acupuncture session (acupuncture group) was calculated. 130,089 patients were included in each study group which is not a small sample study. The result has shown that the lumbar surgery rate was significantly lower in the acupuncture group than in the control group.
In the US, the National Institute of Clinical Excellence (NICE) recommends acupuncture therapy for persistent, non-specific lower back pain. A 2017 clinical practice guideline (guidance for health care providers) from the American College of Physicians (ACP) included acupuncture among the nondrug treatment options for management of both acute and chronic low-back pain.
In the UK, with 2.3 million acupuncture treatments carried out each year, acupuncture is one of the most popular complementary therapies practiced today. Acupuncture can be extremely beneficial for back pain, providing long term pain relief and reducing inflammation.
The Sacroiliac Joint pain
The Sacroiliac Joints (SI joints) are located at the low back where the sacrum and ilium meet. The sacrum is the triangle-shaped bone near the bottom of the spine, just above the coccyx, or tailbone. The ilium, one of the three bones that make up the hip bones, is the uppermost point of the pelvis. The Sacroiliac Joints connect the spine to the hips. All the bones in the SI joints are connected by muscles and the joints are reinforced by strong ligaments. This network of soft tissues provides support and stability, limits movement at the joint, and assists with absorbing pressure. Small movements at the joint help with shock absorption when walking and lifting and forward/backward bending. The bones of the SI joints are jagged which help them stay in alignment. Spaces between the bones of the SI joints are filled with fluid providing lubrication. These spaces are also filled with free nerve endings, which send pain signals to the brain.
SI joint pain can occur. Other terms for SI joint pain include: SI joint dysfunction, SI joint syndrome, SI joint strain and SI joint inflammation. The SI joint is to account for 15-30% chronic lower back pain. Chronic SI joint pain persists for more than three months. Common symptoms include: pain in the lower back, pain in the buttocks, hips, and pelvis, pain in the groin, pain limited to just one of the SI joints, increased pain when standing up from a sitting position, stiffness or a burning sensation in the pelvis, numbness, weakness, pain radiating down into the thighs and upper legs.
Typically, it is dull, aching, lower back pain and can range from mild to severe. It may be felt all the time or worsen with certain activities. Lower back pain is typically felt only on one side, but in some cases may be felt on both sides. It can be a sharp, stabbing pain that radiates from the hips, buttocks, and/or groin and pelvis, up to the lower back, and down to the thighs. The pain is worsened when putting added pressure on the sacroiliac joint, such as climbing stairs, running, or jogging, and lying or putting weight on one side. Stiffness and reduced range-of-motion in the lower back, hips, pelvis, and groin may cause difficulty with movements such as walking upstairs or bending at the waist.
The hip joint is a ball and socket synovial joint. It is one of the most flexible joints in the body which allows a great range of movement. Because of hip joint, walking, running and jumping become possible. It supports the body’s weight and bears the force of the strong muscles of the hip and leg when standing, walking, running etc. The hip joints have very important roles in retaining balance, and for maintaining the pelvic inclination angle. Surrounding the hip joint are many tough ligaments that prevent the dislocation of the joint. The strong muscles and tendons of the hip region also help to hold the hip joint together and prevent dislocation. Hip pain is a common condition that can be caused by a wide range of problems. The precise location of the hip pain can help to find out the underlying cause. Hip pain on the outside of the hip referred to the upper thigh or outer buttock is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround the hip joint. Injury of ligaments, muscles and tendons and fasicas around the hip joints is a common cause of hip pain. Hip bursitis is a common condition for hip pain. Hip bursitis is an inflammation between the thighbone and nearby tendons. The pain is from outer side of the hip. Tendinitis: there are many tendons around the hip connecting buttocks to the hip bone. These tendons can get inflamed causing outer side of hip pain. IT band syndrome: IT band is a long band f connective tissue that runs from the hip to the knee on the outer side of the thigh. If IT band is injured and inflamed, it causes our side of hip pain. Tight gluteal muscles and IT band and they pull the bone that they attached causing pain on the hip. Hip pain can also a referred pain from low back.
The sciatic nerve is the longest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and runs through the buttock area down to the lower limb ending at the feet. The pain of sciatica is sometimes referred to as sciatic nerve pain. Sciatica is pain caused by irritating sciatic nerve. It is a syndrome involving nerve root impingement or inflammation that causes neurological symptoms in the areas that are supplied by the affected nerve roots. The pain of sciatica radiates out from the lower back, down the buttocks and into one or both of the legs, right down to the calf. The most prominent symptoms include unilateral leg pain radiating to the foot or toes that is greater than low back pain. The accompanied symptoms can include numbness, tingling, muscle weakness, loss of tendon reflexes. It may involve increased pain on straight leg raising and neurological symptoms limited to one nerve root. Sciatic pain can range from being mild to very painful and may last just a few days or for months or years. The pain often gets worse over time and may also be made worse by: sneezing, coughing or laughing, standing or sitting for a long period of time, bending backwards. Acupuncture is clinically effective, reduces pain intensity.
The buttocks are made up of three muscles: the gluteus maximus, gluteus medius, and gluteus minimus. Buttocks can become painful due to some conditions.
Buttocks muscle strain is a very common condition causing buttocks pain. If buttocks muscles are strained, it can cause muscle spasm and tendon injury and causes pain, swelling, tenderness and stiffness. Trigger points can be found in these muscles.
Many other conditions can also cause pain in the buttock. For example
Piriformis syndrome: Piriformis is a small muscle that is located deep in the buttock region. If this muscle is tense and inflamed, it can irritate and compress the sciatic nerve causing pain and tingling at the buttocks ot numbness.
Sciatica: The sciatic nerve is the longest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and runs through the buttock area down to the lower limb ending at the feet. The pain of sciatica is sometimes referred to as sciatic nerve pain. Sciatica is pain caused by irritating sciatic nerve.
Slipped disk: A slipped disc or prolapsed or herniated disc is a condition in which the disc in the spine is torn and the central part inside comes out. This can cause pain at the buttocks.
Sacroiliac joint pain: sacroiliac joint is the joint between the triangular sacral bone at the base of the spine and the iliac or pelvic bone. If the area becomes inflamed, it causes pain at the buttocks.
Buttocks pain can be distressing especially no causes are found and nothing is shown on tests: the MRI show no problems, no tumor, no slipped disk, no nerve damage, no nothing. Blood test is normal: no sign of infection.
Osteoarthritis: Osteoarthritis in the low back, sacroiliac joint and the hip can cause buttock pain. The pain, when spreading from an arthritic joint, is often non specific.
Ligament and tendon inflammation: There are many ligament s and tendon at the buttocks. If these ligaments and tendons get strained and stretched, it will cause inflammation. A common way of stretching the ligament is by sitting with the low back unsupported in a slumped position. Coccydynia known as tail bone pain can also be caused by ligament and tendon inflammation around the tail bone.
Bursitis: There two main bursa in the buttock area_ the trocanteric bursa and the ischial bursa. If these bursa is inflamed, it can cause pain at the buttocks especially when sitting down.
Hamstring tendonitis: Hamstring tendon is inflamed in this circumstance causing pain at the buttocks which is noticeably when sitting down.
The groin is the area of the hip between the inner, upper thigh and lower abdomen. Five muscles (adductor brevis, adductor longus, adductor magnus, gracilis and pectineus) from the thigh originated here. Four abdominal muscle including transverses abdominis, rectus abdominis, external oblique and internal oblique muscles end there. Pain can develop in groin. Groin pain can be mild discomfort to severe pain. The most common cause of groin pain is muscle, tendon or ligament strain during exercise such as running, skating, kicking in soccer, or playing basketball or during doing work such as lifting, pushing, or pulling heavy objects. Groin pain may occur soon after an injury and it can also have swelling and bruising. The pain may come on gradually over a period of time: weeks or even months. The pain may be worsened by continued use of the injured area. Overuse is another common cause for groin pain. This often happens when you do too much an activity or repeat the same activity day after day. It put too much stress on the area and can lead to muscle strains or tears or may cause swelling.
There are many other conditions which can cause groin pain, such as a bone fracture, a hernia, kidney stones, bladder infections, prostatitis or a testicle condition.
Groin pain not caused by an injury to the groin may be coming from other parts of the body such as leg muscles, ligments and tendons injury.
If you have groin pain, you need to see doctor and get it checked out. If the groin pain is caused by muscle, tendon and ligament strain, acupuncture is very effective to reduce the pain.
Thigh pain is one of the common chronic pain conditions. Pain can be at the front of the thigh. If the pain at the front of the thigh, this can be caused by hip flexor muscles strain, injury and overuse. Pain or muscle spasms at the front of the thighs can be present. This may be accompanied with increasing pain when lifting the thigh toward the chest; pain when stretching the hip muscles; tenderness to the touch; swelling or bruising. Pain can also be in the outside of the thigh. Greater trochanteric pain syndrome can cause pain in the outside of the upper thighs. It’s typically caused by injury, pressure, or repetitive movements. Symptoms include that pain is worse when lying on the affected side; pain is worsening over time; pain is increasing when walking or running; hip muscle spasm and weakness. IT band syndrome is a common cause of the pain at the outside of the thigh. IT band runs down the outside of the thigh from the hip to the knee. It can become tight and inflamed causing pain at the outside of the thigh. Pain and swelling can be felt around the knees, but it can also be felt sometimes in the thigh. Pain can be at the back of the thigh. Hamstring muscle strains are very common causing pain at the back of the thigh. Symptoms include sudden onset of pain, soreness, limited movement, bruising, swelling, muscle spasm, stiffness and weakness.
Chronic pelvic pain which is continuous or episodic pain in the lower abdomen or pelvis lasting at least three to six months is one of the most common pain conditions experienced by women. It has great negative impact on women’s quality of life including constant physical and psychological aspects. Recently a study from the US has shown that most women who used acupuncture (91%) had at least some improvement in symptoms based on self-report.
Chao et al Pain Med (2015) 16:328-40
Acupuncture is effective for chronic prostatitis/chronic pelvic pain syndrome
chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) presents as chronic pain in the region of the pelvis, and often associated to ejaculatory pain, urination pain lasting for at least 3 to 6 months. The benefits of acupuncture on CP/CPPS have been well established. How many sessions of treatments were required for this condition? A paper analysed existing data involved in ten studies of 329 participants. Overall, more acupuncture sessions received for CP/CPPS patients is associated with increased symptom relieving. After 6 sessions of treatments, the pain started to decrease; after 18 sessions of treatment significant improvement of pain was observed. The conclusion is that there is dose-response relationship between acupuncture sessions and CP/CPPS outcome. Prolonged acupuncture sessions were associated with less NIH-CPSI score. Six acupuncture sessions might be the minimal required 'dose' to reach its clinical effects.
Qin Z et al Ann Transl Med. 2019 Mar;7(6):116. doi: 10.21037/atm.2018.11.45.
Vulvodynia is a medical condition characterized by nonspecific vulval pain.With up to 15% of women suffering from this condition, you can be sure that you’re not alone if you have vulval pain. It is a persistent burning or stinging pain of the vulva. It could be a constant pain and get worse when under pressure or it could be only painful under pressure such as using tampon or sex. The pain can be only in the vulval area. It can also spread to the thigh, tummy or back. Women with vulvodynia could have severe period pain, heavy periods, frequent urination and pain and changed bowel habit. Before vulvodynia is diagnosed, other causes of vulvar burning must be excluded. These include fungal, bacterial and viral infections, inflammatory dermatoses such as lichen sclerosus and lichen planus, contact sensitivity and eczema, and lesions such as surgical scars and recurrent fissuring. Vulvodynia can affect women of all ages. The possible causes of vulvodynia may include nerve irritation, abnormal response in vulvar cells to an infection or trauma, genetic factors that make the vulva respond poorly to chronic inflammation, hypersensitivity to yeast infections, muscle spasms, allergies or irritation to chemicals or other substances, hormonal changes, history of sexual abuse, frequent antibiotic use. This condition is not life threatening, but it has great impact on a women’s life physically and emotionally. It could affect their daily activity and relationships. Some of them can only stay in bed all the time when the pain is severe. Some women with severe vulval pain feel that it is so difficult to cope with this pain every day especially when they are told that there is no effective treatment and they have to live with the pain all of their lives.
Acupuncture can help treating the vulval pain. In 1999, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE published a paper by Powell and Wojnarowska about acupuncture for vulvodynia. They selected twelve patients with vulvodynia aged from 18 to 68 years. All had vulval pain and burning without other abnormalities on examination. All had experienced severe distress and impairment of sexual function. Many had tried suggested treatment without success. These patients were offered weekly acupuncture for ten weeks. As a result of acupuncture, Two patients felt so much improved that they declared themselves 'cured'; three believed their symptoms had improved and wished to continue acupuncture; four felt slightly better and judged acupuncture more effective than any other treatment; and three noted no effect at all. There were no obvious side effects for the treatment. A study from Sweden investigated the effect of acupuncture on vulva vestibulitis. They found that after three month acupuncture treatment patient’s quality of life was improved significantly. More recently Curran et al were using acupuncture for treatment of provoked vestibulodynia which is also a genital pain condition. There were 80 patients involved in this study. After 10 treatments there were significant decreases in pain with manual genital stimulation and helplessness. There were also strong effects for improved ability to have intercourse and sexual desire. Qualitative analyses were overall more positive and showed an improvement in perceived sexual health, reduced pain, and improved mental well-being in the majority of participants. A new research from Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA has shown that acupuncture treatment significantly reduced vulval pain in women with vulvodynia. In this study, thirty-six women with vulvodynia were involved. The women were randomly assigned either to the acupuncture group or to the wait-list control group. 10 sessions of acupuncture were offered to women in acupuncture group. Reports of vulval pain and dyspareunia were significantly reduced, whereas changes in the aggregate FSFI scores suggest significant improvement in sexual functioning in those receiving acupuncture vs. those who did not. Their conclusion is that this was the first randomized controlled pilot study to examine the use of acupuncture for the treatment ofvulvodynia. The acupuncture protocol was feasible and appeared to reduce vulval pain and dyspareunia with an increase in overall sexual function for women with vulvodynia.
These are example cases that were treated with acupuncture successfully
A 34 year old lady had vulval pain for 3 years. The pain is worse when pressure is applied such as having intercourse. She always had very painful periods. There was tightness in her thigh and back. She was treated with antidepressant and physiotherapy, but the pain has not improved. There was no pain when passing water and no change with bowl habit. She decided to try acupuncture. After 8 acupuncture treatments, the pain was reduced significantly and she was able to stop taking antidepressant.
A 29 year old lady had vulval pain for 2 years. There was burning sensation when passing water with frequent urination. The vulva pain was unendurable when having intercourse. It was impossible to use tampon. She also had lower back pain. Her periods were very painful. She was treated with various medications, but the pain was not improved at all. She has heard from a friend that acupuncture can help with her condition and decided to try it. After 3 month treatments, the pain has completely gone. There was no pain when passing water and no intercourse pain.
A 43 year old lady had severe vulvar pain for 1 year accompanied with period pain and intercourse pain. She had irregular periods and she also had frequent urination and urgency. The pain goes to lower abdomen, thigh and lower back. Antidepressant and local injection of steroids did not have any improvement. After 5 treatments the pain was less and another 10 treatments, the pain was completely disappeared.
Powell and Wojnarowska J R Soc Med (1999) 92:579-81
Curran S et al J Sex Med (2010) 7:981-95
Danielsson L et al Acta Obstet Gynecol Scand (2001) 80:437-41
Schlaeger JM et al J Sex Med (2015) 12: 1019-27
Bladder pain/Interstitial cystitis (IC)
The urinary system, also known as the renal system or urinary tract comprises kidneys (two), ureters (two), bladder and urethra. Urine is formed in the kidneys and then passed through the ureters to the bladder where it is stored. When the bladder is not full of urine, the bladder is relaxed. When the bladder is getting full, it will let the brain know the need to pass urine. If the bladder is working normally, one can put off urination for some time. If there is something that goes wrong with the bladder, urination change is a sign of it.
Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic bladder condition. It is a feeling of pain and pressure in the bladder area and the symptoms have lasted for more than 6 weeks, without having an infection or other clear causes. Symptoms range from mild to severe. For some patients the symptoms may come and go, and for others they don't go away. The pain may be worse when the bladder is full and may be temporarily relieved after urination. The pain could be worse during periods or after having certain foods or drinks. IC/BPS is not an infection, but it may feel like a bladder infection. Women with IC/BPS may feel pain when having sex. This condition is poorly understood. Apart from the pain, it is also accompanied with problems of urination, such as sudden, strong urges to urinate, more frequent urination than normal, pain when passing water, waking up quite a few times during the night to urinate. The exact cause of interstitial cystitis isn't clear. Unlike other types of cystitis, there's no obvious infection in the bladder and antibiotics don't help.
Acupuncture helps with interstitial cystitis. A patient said that it was a nice feeling of standing on the beach without rushing to go to toilet.
Tailbone or coccyx is the lowest part of the spine and it is the triangular bony structure and consists of three to five different bones that fused together by joints and ligaments. It is surrounded by many tendons and ligaments. If the tailbone area becomes inflamed, it can cause tailbone pain or coccydynia. Soft tissue injury such as tendons and ligaments surrounding tailbone is the common cause of tailbone pain. The main symptom is pain and tenderness around the tip of the tailbone the area just above the buttocks. It is dull and achy most of the time, with occasional sharp pains. The pain is often worsened by sitting down, moving from sitting tostanding, standing for long periods, having sex and going for a poo. It may affect sleep and other daily activities. The pain can radiate to legs, buttocks and hips. Tailbone pain is often caused by an injury, such as sitting for a long time or bike rides, but it may have unknown causes. Vaginal birth in women sometimes is the cause of tailbone pain.
Case report, knee pain with acupuncture treatment
Though long term effect of acupuncture in treating knee pain is to be confirmed, there are many cases in which long term benefit can be seen clinically. For example Mary was 51, she had knee pain for a few years. Her knee pain was getting worse in winter and getting better in summer. She had difficulty to climb stairs. In last winter, her knees were extremely painful and she hardly walked without pain. She decided to seek help from acupuncture. After first session of acupuncture, she felt less pain. With continuing a few sessions of acupuncture her knee pain was completely gone. A year on another winter arrived, she still did not have any pain on her knees.
The leg is defined as from the knee to the ankle. There two bones the tibia or shinbone together with the smaller fibula bone. Attached to the bones are three groups of muscles in the legs moving the ankle, foot and toes. Leg pain is very common. Most leg pain results from wear and tear, overuse, or injuries in joints or bones or in muscles, ligaments, tendons or other soft tissues. Some types of leg pain can be caused by problems in the lower spine where the nerve to the leg originates and then travels to the legs, such as slipped disk, sciatica. Leg pain can also be caused by blood clots, varicose veins or poor circulation.
Leg pain can be mild that comes and goes, or severe that makes it difficult to sleep and walk. The pain is often described as aching, throbbing or burning and it can be accompanied by numbness, tingling and muscle weakness.
Shin pain is pain on the front of the leg between the knee and the ankle. It can hurt directly over the shinbone all the way or over the muscles that are on the inner or outer side of the tibia. It can be a dull aching, or sharp and severe pain. It could be one or both shin with large area across whole length of the shin bone.
This pain is usually caused by overuse from irritation of the muscles or other tissues in the lower leg. They are common in runners, tennis and basketball players. The cause is not clear, but it is suggested that running and repetitive weight baring on the legs leads to inflammation of the tissue around the shin bone.
The ankle is a large joint made up with three bones: two are from the leg tibia known as shin bone and fibula –the bone next to the shin bone; one foot bone talus sitting above the heel bone. Ankle joint moves the foot up and down and from side to side. Ankle joint bones are surrounded by numerous ligaments binding the bones together. All ligaments have a specific range of motion and boundaries that allow them to keep the joints stabilized and mobilized.
Chronic ankle pain is long term pain (lasts more than three months) at the ankle. This is usually caused by inflammation in the ligaments and tendons surrounding the ankles. Pain is accompanied with swelling and tenderness. Research has shown that acupuncture is effective for chronic ankle pain.
A bunion is a bony bump on the joint at the base of the big toe. It starts when the big toe pushes against the nest toe, forcing the joint of the big toe to get bigger and stick out. Persistent or intermittent pain in the big toe joint is main symptom. In severe case, it makes walking difficult. Other symptoms include a bulging bump on the outside of the base of the big toe; swelling and redness around the big toe joint; corns or calluses — these often develop where the first and second toes overlap; movement restriction, tenderness when pressed. Sometimes, the skin over the bunion can become red, blistered or infected because it has been rubbing against the shoe. The risk factors to develop bunion include wearing high heels, which forces the toes into the front of the shoes, often crowding the toes; ill-fitting shoes which are either too tight, too narrow; rheumatoid arthritis, inherited structure foot defect.
Golfer's elbow, also known as medial epicondylitis. It is a condition caused by damage to the muscles and tendons that control the wrist and fingers. These tendons of the forearm muscles attach to the bony bump on the inside of the elbow. It is the opposite side to tennis elbow which occurs on the outside of the elbow. The main symptom is pain at the inner side of the elbow and the pain sometimes extends along the inner side of the forearm. Pain typically worsens with certain movements. The inner site of elbow is tender to touch. The elbow may feel stiff and making a fist might hurt. There may be weakness in the hands and wrists. There could be also umbness or tingling present. These sensations might radiate into the ring and little fingers. This condition is caused by overusing the muscles in the forearm that allow you to grip, rotate the arm, and flex the wrist. Repetitive flexing, gripping, or swinging can cause pulls or tiny tears in the tendons causing inflammation.
Tennis elbow a condition that causes pain around the outside of the elbow, also known as lateral epicondylitis. It often occurs after strenuous overuse of the muscles and tendons of the forearm on the outside of the elbow joint. If the muscles and tendons are strained, tiny tears and inflammation can develop near the bony lump (the lateral epicondyle) the elbow. The main symptom is notice pain: on the outside of the upper forearm, just below the bend of the elbow, when lifting or bending the arm, when gripping small objects, such as a pen, when twisting the forearm, such as turning a door handle or opening a jar.
Acupuncture is effective for golfer’s elbow and tennis elbow reducing pain, and inflammation.
Wrist pain is often caused by sprains or fractures from sudden injuries. Wrist pain can be caused by disease or injury affecting any aspect of the wrist joint, including the bones, ligaments, and connective tissue surrounding the area. Wrist pain can often result from long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome.
The symptoms of wrist sprains are sudden pain with redness, swelling and bruising, difficult to move wrist or grip anything.
Repetitive stress from any activity that involves repetitive wrist motion such as playing tennis, driving etc can cause wrist pain. It is caused by inflaming the tissues around joints. The symptoms include pain, swelling, redness and stiffness at the wrist.
Carpal tunnel syndrome (CTS) is a common condition that causes pain, numbness and a tingling sensation in wrist, the hand and fingers. This is caused by compression of median nerve that passes carpal tunnel and controls sensation and movement of the hand. If the nerve is entrapped in the tunnel, an unpleasant tingling, pain or numbness will occur in the distal distribution area which is in the hand and fingers. About 10% of people in the UK develop this condition. The symptoms include slowed median nerve conduction velocity, local pain and abnormal sensations such as tingling, burning, numbness etc. The symptoms develop gradually and are worse during the night. The affected fingers include thumb, index finger, middle finger and half of the ring finger. The risk of developing carpal tunnel syndrome include a family history of CTS, pregnancy, injuries to the wrist, other health conditions such as diabetes and rheumatoid arthritis and strenuous, repetitive work with the hand.
Research has shown that acupuncture could be an effective treatment for CTS and has greatly improved the symptoms in patients with CTS.
Skier’s thumb, acupuncture can help.
Skier’s thumb also called gamekeeper’s thumb is an injury of the index finger side of the ligament of the thumb that connects the bones of the thumb together. Skier’s thumb is the second common skiing injury after knee injury. In severe cases, the ligament is completely broken and the injury must be repaired by surgery. The symptoms may occur after the fall that causes the injury. The symptoms include: pain at the base of the thumb in the web space between the thumb and index finger which is worsens with thumb movement; swelling of the thumb; inability to grasp or weakness of the grasp between the thumb and index finger; tenderness along the index finger side of the thumb; change colour of the skin over the thumb; pain in the wrist which is referred pain from the thumb. Acupuncture can help relieve the pain and improve local blood flow to help recovery.