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Acupuncture and Hyperhidrosis

What is hyperhidrosis?
Hyperhidrosis or excessive sweating, is a medical condition in which a person sweats excessively and unpredictably. Although neurological, metabolic, and other systemic diseases can sometimes cause excessive sweating, most cases occur in people who are otherwise healthy. Heat and emotions may trigger hyperhidrosis in some, but many who suffer from hyperhidrosis sweat nearly all the time, regardless of their mood or the weather. The excessive sweating may occur in the face, underarms, hands, feet, or the whole body.

What are the causes of hyperhidrosis?
Hyperhidrosis is categorized into two groups: primary and secondary. The cause of primary hyperhidrosis is unknown. One under hyperhidrosis may be hereditary and it involves hyperactivity of the sympathetic nervous system (the part of the nervous system which controls the sweat glands). When excessive sweating affects the hands, feet, or armpits, it's called primary or focal hyperhidrosis.

If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body, or it may be in one area. The conditions that cause secondary hyperhidrosis include: panic attacks, anxiety disorders, menopause, obesity, acromegaly, hyperthyroidism, heart disease, lung disease, spinal cord injury, some cancers or carcinoid syndrome, diabetes, Parkinson’s disease, pheochromocytoma, tuberculosis, or other conditions.

The treatment by western medicine includes: antiperspirants that plug the sweat ducts, medication such as anticholinergics drugs, Iontophoresis, local botox injection, surgery (endoscopic thoracic sympathectomy).

Chinese medicine
Chinese medicine considers health as a balance of yin and yangand this balance is regulated by qi. The qi is body natural energy, which travels throughout our entire body and is responsible for the proper harmonious functioning of body organs and processes of the body.  The qi produces the body fluids and controls its flow, and prevents their extravasation or unnecessary loss.

Hyperhidrosis is caused by imbalance of yin and yang or disharmony of qi with blood and body fluids. Acupuncture and Chinese herbal medicine are very effective in the treatment of excessive sweating. The principle of treating excessive sweating by Chinese medicine is to adjust or regulate the imbalance of yin and yang and disharmony of qi with blood and body fluids.  Acupuncture is often combined with other modalities of Chinese medicine such as herbal medicine, TuiNa, cupping, gwasha, or moxibustion to treat hyperhidrosis.

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Acupuncture and In Vitro Fertilization

In vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside of the womb, in vitro. The process involves collecting eggs and sperm from you and your partner and placing them together in a laboratory dish for fertilization. Days later the embryos are transferred into the uterus where implantation and pregnancy will hopefully occur, as in a normal pregnancy. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. Studies demonstrate that acupuncture (before and after embryo transfer) increase the success rate of IVF, reduce miscarriage rate, enhance the live birth rate, and improve the quality of life of patients undergoing IVF. An increasing number of fertility specialists and centers start to recognize the benefits of acupuncture, offer acupuncture as a part of their IVF protocol, and suggest acupuncture as an adjunct therapy of IVF. How does IVF benefit from acupuncture? A number of physiological effects may contribute to its effectiveness:

• Reduce stress, anxiety and depression
• Normalize abnormal immune system
• Improve uterine ability of anti-oxidation
• Regulate hormones-mediating receptors in the uterus
• Modulate neuroendocrinological factors
• Regulate the menstrual cycle
• Increase blood circulation to uterus and ovaries
• Improve endometrial lining of uterus
• Reduce uterine contraction

Women experiencing infertility often have higher levels of physical and psychological symptoms, which include insomnia, headache, back pain, fatigue, anxiety or depression. These symptoms may affect the ability to implant successfully through abnormalities in the immune system. A study from Italy demonstrates that patients doing IVF who have higher scores for anxiety, also have abnormalities within their immune systems, and that this group of patients has lower implantation rates and lower success with IVF compared with patients who were less anxious and were found to have less disturbance of their immunological systems. Acupuncture and herbal treatment regulate the autonomic nervous system and activate the parasympathetic nervous system to decrease stress, muscle tension, anxiety and irritability, resulting in the improvement of immunological system, as well as the quality of life of IVF patients.

During the implantation of embryos, the uterus often has small contractions, which could cause expulsion of the transferred IVF embryos and result in the failure of implantation or early miscarriage.  Acupuncture helps to relax uterine muscles around the time of the transfer and reduces the uterine contractions, which increases successful implantation of embryos.

The condition of endometrial lining of uterus, especially its thickness, is an important factor for successful pregnancy. Studies show that acupuncture stimulates the parasympathetic nervous system, improves uterine and ovarian blood flow, and increases the thickness of endometrial lining, therefore making the uterus ready for implantation of embryos and for the changes that take place in the uterus at the site where the embryo implants itself.

In Chinese medicine, the common diagnosis of female infertility includes the following:

• qi and blood deficiency
• kidney deficiency: kidney yin deficiency or kidney yang deficiency
• Liver qi stagnation
• Blood stagnation
• Phlegm dampness

Acupuncture is often combined with other modalities of Chinese medicine such as herbs, cupping, TuiNa, or maxibustion in the regimen of enhancing IVF.   The purpose of Chinese medicine is: to tonify qi, nurture blood, improve deficient kidney yin or deficient kidney yang, disperse liver qi to reduce stagnation, strengthen spleen and clear phlegm, drain the dampness, stimulate blood circulation, and eliminate dampness. The beauty of Chinese Medicine is that it treats each patient individually, thus each patient's protocol is tailored to their specific needs, like personalized medicine.

It is recommended to have eight acupuncture treatments (2-3 times per week) before embryo transfer. It starts at the beginning of the fertility cycle (usually with the start of Lupron) and continues until the embryo transfer date or until 12-14 mm of endometrial thickness. After the embryo transfer, acupuncture can be continued once per week for the first trimester to help prevent miscarriage by strengthening the kidney qi. However, if the patient has one of above-mentioned diagnosis, I strongly suggest that patients be given acupuncture or other modalities of Chinese medicine to improve abnormal situation before Lupron is given.  

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Acupuncture and Sports Injury

Acupuncture and Chinese herbal medicine are becoming very popular in the sports medicine. Many countries include acupuncture and related therapies in their regular training regimens. Many teams and clubs are also catching on and offering acupuncture to their members. A growing number of professional and amateur athletes visit acupuncturist for the treatment of injuries, enhancement of sports performance, acceleration of recovery time, improvement of mental focus and rebalance of body energy.

Regardless of your age or skill level and no matter whether you play recreationally or professionally, sports injuries are very common. Sudden voluntary contraction of a muscle or sudden overstretching can cause tearing of muscle tissues. Repetitive use or overuse of our body parts results in repeated micro-trauma of tissue. These injuries often happen to wrist, elbow, shoulder, low back, shin splints, hamstring, Achilles tendon, or plantar fascia.  The tissue injury initiates an inflammatory response, which results in redness, swelling and pain, as well as reduced range of motion of the joint. If acute tissue damage is not given proper treatment, it becomes chronic. Thus, the injured tissues such as muscle, tendon or bone produce degenerative changes or become fibrotic, which lead to weakness, loss of flexibility and sustained pain.

Locally, acupuncture improves blood circulation, reduces inflammation and swelling, and relaxes the tension of muscle and tendon, which result in alleviation of pain. Acupuncture not only provides immediate relief but also long lasting benefit. Acupuncture is particularly effective for tennis elbow, arthritis, back pain, shoulder pain, knee pain, repetitive strain injury, sprains, stiffness, or numbness. Systematically, Acupuncture will help balance your body, reduce your stress and irritability and anxiety, improve insomnia, eliminate fatigue, and accelerate recovery time.  Whether your sport is golf, biking, running, skiing, basketball, hockey, tennis, soccer, martial arts or weightlifting, acupuncture can provide healing benefits to improve your sports performance and enjoyment.

Acupuncture is part of a broad-based treatment approach. Acupuncture may be combined with other modalities of Chinese medicine such as herbal medicine, TuiNa, cupping, gwasha, moxibustion or acupressure to alleviate pain and accelerate tissue healing.

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Acupuncture and Pain Management

Pain is the most prevalent health condition in U.S. and in the world. One survey reveals that as many as nine out of 10 Americans suffer some sort of pain on a monthly or more frequent basis and another one shows that more than six out of 10 adults over the age of 30 experience chronic pain. Furthermore, one of the primary reasons people seek acupuncture treatment is to address pain in the body relating to a specific illness or problem, or relating to a chronic condition.

• External physical injuries caused by sports, motor vehicle accidents, slip and falls, or surgery: strains and sprains, carpal tunnel syndrome,tennis elbow, frozen shoulder, or rotator cuff syndrome
• Inflammation: cystitis, cholecystitis, bursitis, shingles, or hepatitis
• Metabolic disorders: gout, cholelithiasis , choledocholithiasis, bladder stones, ureteric stones, or kidney stones
• Immune or autoimmune disorders: rheumatoid arthritis, psoriatic arthritis, lupus, Raynaud’s disease, or multiple sclerosis
• Oxygen deficiency/ ischaemia: angina pectoris, infarction, claudication, or mesenteric arterial ischaemia
• Central or peripheral neuropathy: cerebral palsy, tremor, Bell's palsy, facial spasm, trigeminal Neuragia, TMJ, sciatica, headaches, or migraines,
• Degenerative disease: osteoarthritis or osteoporosis
• Cancer-induced pain
• Emotion-induced pain: such as over angry or sadness induced pain
• Others: fibromyalgia

Pain is categorized as acute or chronic. Acute pain can be brief (lasting moments or hours) or it can be persistent (lasting weeks or several months until the disease or injury heals). Chronic pain is defined as persistent pain, which can be either continuous or recurrent and of sufficient duration and intensity to adversely affect a patient's well-being, level of function, and quality of life. If a patient's pain has persisted for six weeks, it is considered to be chronic.

Chinese medicine (acupuncture, herbs, or other modalities such as cupping, TuiNa, or moxibustion) is best known for its effects in reducing or eliminating pain and its usage dates back for over 3000 years in China. For the past 26 years since it was first introduced to the US after President Nixon’s visit to China in 1972, acupuncture has been becoming the choice of treatment in pain management. In terms of pain control, the effects of Chinese medicine include:

• Relieve pain completely, or give as much relief as possible
• Reduce pain levels
• Improve the ability to deal with  pain
• Regulate the emotions
• Increase the energy
• Increase the ability to perform everyday functions
• Reduce reliance on inappropriate medication
• Enhance the quality of life

Over the years, scientists in the United States and throughout the world have done numerous studies to explore the mechanism of how acupuncture attenuates or eliminates pain. The results show that acupuncture possesses scientific basis in term of reducing or eliminating pain. The following are some of the evidence:  

• Block the conduction of sensory fibers in the algetic nerves
• Increases the release of natural pain-relieving endorphins
• Increases the levels of Serotonin (5-HT), acetylcholinesterase, dopamine and homovanillic acid, all of which help to increase the pain threshold and result in pain relief
• Stimulate the brain to produce polypeptides that reduce pain sensitivity
• Inhibit the production of pro-inflammatory cytokines, therefore reducing inflammation and edema
• Increase blood circulation to the injured areas and reduce the muscular contraction, therefore alleviating tissue swelling and lessening muscle spasm

Some people may wonder what the principle of Chinese medicine is applied in term of attenuating or eliminating pain. Chinese medicine considers that the body maintains a balance between yin and yang, and a balance among qi, blood and body fluid. qi and blood travel through the body along the pathways called meridians or channels. When there is not enough qi and blood, or when they are stuck in some area, there is an imbalance between yin and yang or an imbalance among qi, blood and body fluid, which result in dysfunction of the tissue or organs, and illness or pain develops.

There are two major theories regarding the mechanism of pain:
1. Stagnation or obstruction

• qi stagnation
• Blood obstruction
• Both qi stagnation and blood obstruction
• Cold  retention to stagnate the flow of qi and blood
• Excessive heat to consume qi and stir blood
• Dampness retention to block yang qi, therefore blood can not be passed along smoothly
• Excessive food, bugs, or stone retards the qi flowing

2. Disharmony of yin and yang

• Yin deficiency:  yin consists of blood and body fluid. If blood or body fluid is deficient, the tissue or organ can not get nurtured and pain develops.
• Yang deficiency: yang initiates, activates, and maintains the function of body and promotes blood circulation. Yang deficiency may happen to heart, spleen, or kidney.

The purpose of acupuncture treatment for pain is to use selected points on the meridians or channels to regulate disharmonized yin and yang, stimulate stagnated or obstructed qi and blood, dispel coldness and dampness, or relieve heat. Acupuncture works better if it is combined with other Chinese medicine modalities such as Chinese herbs, cupping, TuiNa, or moxibustion.

Arkansas is one of very few states in the US that grant the title of doctor of oriental medicine (DOM). To be a DOM, one has to have both Diplomates in Acupuncture and in Chinese Herbology by National Certification Commission for Acupuncture and Oriental Medicine in America (NCCAOM). As a DOM in Arkansas, I am able to use my knowledge of Chinese herbal medicine to prescribe herbal formula, in addition to acupuncture. I consider Chinese medicine a personalized medicine because the accupoints are chosen and the herbal formula is made according to each individual specific need or situation. For a new patient visiting my clinic, I will first carry out a detailed inquiry of individual’s medical history, perform a thorough physical examination that  includes pulse and tongue diagnosis. After diagnosis, a treatment plan is then conceived. Each plan varies according to the patient’s specific situation. For most patients, two weekly treatment sessions are required, even though for some once per week may be sufficient. Depending upon each individual’s body response, I have had the patients who become better after only one or two treatments. However, for most patients with acute pain, a recommended 8-10 treatment sections is needed. On the other hand, for severe or chronic pain sufferers, more extensive treatments are required. 

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