paine cp acupuncture presentation - bridges northern kentucky …bridgesnky.org/public/2015 paine...

9th Annual NKY TBI Conference 3/27/2015

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Carole Paine, MS, L.Ac.

Acupuncture History, Theory and Treatment

of Injury and Trauma

welcomeAncient medicine for a modern world

©2011 Acupuncture Media Works, LLC. All rights reserved. No duplication is allowed unless approved, written consent.

5,000 Years of Wisdom, Knowledge & Healing


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An ancient system of healthcare

I - A different paradigm of health

IV - Treats more than symptoms & signs

VII - Acupuncture in a nutshell

II - Specific theories & principles

VI - Acupuncturists view of health

III - A unique diagnostic evaluation

V - Time-tested techniques


I - A different paradigm of health

• Supports the whole person

• Everything is interconnected

• Innate capacity for healing

Chinese Medicine

• The gardener within


II - Specific Theories & Principles

• Yin & Yang

• Qi

• Weather reports

• A unique medical language

• Jing & Shen

• Body as a garden


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II - Specific Theories & PrinciplesYin & Yang



• Is the energy that enlivens & animates

Qi

• Supports our daily activities

• Provides nourishment for every cell,

tissue, muscle, organ & gland

• Activates & Animates

• Transforms & Transports

• Warms the body

• Protects & Defends

• Contains & Retains

• A sufficient, balanced & continuous flow

of Qi = good health

To have Life, is to have Qi.

No Qi equals no life.


The Elemental Associations

WOOD FIRE EARTH METAL WATER


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The Elemental Cycle

Fire = Heart, Small Intestine,

Pericardium, Triple Heater

Earth = Spleen, Stomach

Metal = Lungs,Large Intestine

Water = Kidneys, Bladder

Wood = Liver, Gall Bladder


The Elemental Clock

Stomach 7-9 am

Spleen 9-11 am

Heart 11-1 pm

Small Intestine 1-3 pm

Bladder 3-5 pm

Kidney 5-7 pm

Pericardium 7-9 pm

Triple Heater 9-11 pm

Gall Bladder 11-1 am

Liver 1-3 am

Lung 3-5 am

Large Intestine 5-7 am



How Qi travels through the body.

Qi


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Meridian & Organ Connections

Qi



What happens when Qi becomes blocked?

Qi



Blockage of Qi = imbalance

Qi


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Environment

Diet

Trauma

OccupationHabits

Lifestyle

Inherited Constitution

What affects Qi flow & our health?

Qi

Environment

Diet

OccupationHabits

Lifestyle

Emotions

Inherited Constitution



Wind Heat Dry Cold Damp

• Quick

• Rapid

• Changes

• Moves

• Hot

• Red & swollen

• Cracked

• Withered

• Frail

• Chills

• Stiff

• Aches

• Cold

• Heavy

• Sluggish

• Soft

Weather

Why does diagnosis according to acupuncture &

Chinese medicine sound like a weather report?


III - A Unique Diagnostic Evaluation

Quality Quantity Balance

looking Physical exam

An acupuncturist views each individual as a dynamic,

integrated whole, observing how signs and symptoms

weave together in order to understand the underlying,

energetic profile of a person’s health.

pulseasking


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III - A Unique Diagnostic Evaluation

• Diagnosis is based upon patterns of disharmony

• Symptoms and signs appear when there is an imbalance or

disharmony:

• Yin & Yang

• Interior & Exterior

• Cold & Hot

• Deficient & Excess


IV - Treats More Than Symptoms & Signs

• Relieve pain & discomfort

• Eliminate obvious signs & symptoms

• Support immune health

• Balance & maintain organ systems

• Maintain & optimize health

Objective of care


V - Time-tested techniques

• Acupuncture

• Herbs

• Moxibustion

• Oriental nutrition

• Qi Gong/Tai Chi

• Electro-acupuncture

• Acupressure/Tuina

• Heat therapy

• Laser therapy

• Self-care

• Meridian exercises

• Gwa Sha

Acupuncturists employ various treatment methods

to restore and maintain health


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VI - An Acupuncturist’s View of Health

• An inner resiliency

“Health is a state of complete physical, mental, and social well being

and not merely the absence of disease or infirmity.”

– World Health Organization (WHO)

• The ability to thrive when confronted with stressors:

• environmental

• physical

• emotional

• mental


What is your body telling you?



Adopting a healthy lifestyle

Meditation

Balanced healthy diet

Herbs

Smiles

Exercise

Nature

Yoga

Fresh air

Tai Chi &Qi Gong


Meditation

Balanced healthy diet

Herbs

Smiles

Exercise

Nature

Yoga

Fresh air

Tai Chi &Qi Gong


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VII - Acupuncture in a Nutshell

• Treated billions of people over thousands of years

• Virtually no side-effects

• Out of 55,291 acupuncture treatments (5 years)

• 64 = minor adverse events

• 99.8% without any event

• Safe, effective and drug-free

Acupuncture is Extremely Safe



• Tiny

• Cat’s whisker

• Flexible

• Single-use

• Disposable

• Stainless steel

Let’s Get to the Point



According to the National Institute of Health (NIH) and the World Health

Organization (WHO), acupuncture has proven effective in the treatment of many

common problems.

• Facial palsy/tics

• Fatigue

• Fertility

• Fibromyalgia

• Gingivitis

• Headache

• Hiccup

• Incontinence

• Indigestion

• Irritable bowel syndrome

• Low back pain

• Menopause

• Menstrual irregularities

• Migraine

• Morning sickness

• Nausea

• Osteoarthritis

• Pain

• PMS

• Pneumonia

• Reproductive problems

• Rhinitis

• Sciatica

• Seasonal affective disorder (SAD)

• Shoulder pain

• Sinusitis

• Sleep disturbances

• Smoking cessation

• Sore throat

• Stress

• Tennis elbow

• Tonsillitis

• Trigeminal neuralgia

• Urinary tract infections

• Vomiting

• Addictions

• Anxiety

• Arthritis

• Asthma

• Carpal tunnel syndrome

• Chronic fatigue

• Colitis

• Common cold

• Constipation

• Dental pain

• Depression

• Diarrhea

• Digestive trouble

• Dizziness

• Dysentery

• Emotional problems

• Eye problems


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1 Wang, R., Integration of Chinese medicine into supportive cancer care: a modern role for an ancient tradition, Cancer Treatment Review, (4): 235-46.

2 Coan, R., Wong, G., et. al., The acupuncture treatment of low back pain: a randomized controlled study, American Journal of Chinese Medicine, (8): 181-189.

3 Loh, L., Nathan, P., et. al., Acupuncture versus medical treatment for migraine & muscle tension headaches, Journal of Neurology, Neurosurgery, and Psychiatry, (47): 333-337.

4 Yang, X., Luo, H., and Jia, Y., Clinical observation on needling extra channel points in treating mental depression, Journal of Traditional Chinese Medicine, (14): 14-18.

5 Fung, KP., et. al., Attenuation of exercise-induced asthma by acupuncture, Lancet, (2): 1419-1422.

6 Hyde, E., Acupressure therapy for morning sickness: A controlled clinical trial, Journal of Nurse-Midwifery, (34): 171-178.

7 Berman, BM, et. al., effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Annals of Internal Medicine, DEC 21, 2004; 141(12)901-910.

cancer

pain

headaches

depression

asthmanausea

• Evidence suggests that the holistic approach of Traditional Chinese Medicine

is effective in the supportive care of cancer patients.1

• Acupuncture can provide significant benefits and relief from pain.2

• Acupuncture produces better relief from migraines and muscle tension

headaches than standard drug therapies.3

• Acupuncture is an effective alternative to drugs for treatment of depression.4

• Acupuncture provides a natural approach for asthma.5

• Acupuncture can reduce psychological and behavioral problems that

accompany morning sickness at the same time as it suppresses nausea

and vomiting.6

• Acupuncture produces significant pain relief and improved function in

patients with osteoarthritis of the knee. 7arthritis

Traumatic Brain Injury (TBI): Overview of Diagnosis and Treatment Chung, et al

TBI is currently defined as an ‘alteration in brain function, or other

evidence of brain pathology, caused by external force’.

There is insufficient evidence for acupuncture, hyperventilation;

hypothermia therapy; and speech therapy for improving dysarthria in

TBI (Table 3). Robust trials in these areas is urgently required to

build evidence-based practices in rehabilitation.

TBI is currently defined as an ‘alteration in brain function, or other evidence of brain

pathology, caused by external force’.

• In the sports setting this is basically a significant enough head trauma

that leads to brain injury.

• These injuries will vary in intensity and accordingly vary in level of

dysfunction.

• As the brain is the hub of the nervous system, injury here leads to

whole body affects.

• There is growing concern and focus on treatment of TBI.

• Due to this concern alternative therapies are being considered.

• Many studies have found compelling benefits from use of acupuncture

as a modality.

• Often these studies will say that there is insufficient evidence to fully

support acupuncture.

• However, there is enough interesting data and results to also say

robust study or trials of acupuncture is warranted.


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Trauma Spectrum Response

TRAUMA SPECTRUM RESPONSE

Cognitive Function

Memory, Attention,

Concentration, Problem Solving

Somatic Function

(fatigue, sleep disturbance,

sexual function)

Chronic Pain

Substance Abuse

Headache

Emotional Function

Anxiety

Depression,PTSD

The effectiveness of acupuncture research across components of the trauma

spectrum response (tsr): a systematic review of reviews Lee, et al

Acupuncture may be a promising whole-person treatment option for TSR as dynamic,

‘multi-mechanism’ responses are elicited by the insertion of thin needles at specific body

points which influence several interacting pathways in trauma response and recovery.

Because acupuncture has been found to be effective in treating several individual

conditions that form TSR (that is, insomnia, depression, chronic pain, headaches) and

other multiple co-morbidities, it could be potentially advantageous for treating the multi-

symptom complex of TSR.

Chronic pain may be better treated with a biopsychosocial approach that considers the

complex interplay of physiological, psychosocial, environmental, cognitive, behavioral,

and affective factors that influence an individual’s pain experience. This whole person

approach can assess the ‘full spectrum of trauma-related morbidities (rather than

individual components)’, in order to enhance the patient’s inherent healing mechanisms

and capacities.

The Elephant in the Room


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Acupuncture for chronic headache in primary care: large, pragmatic,

randomised trial Vickers, et al

Acupuncture is known to have physiologic effects relevant to analgesia,

but there is no accepted mechanism by which it could have persisting

effects on chronic pain. This lack of biological plausibility, and its

provenance in theories lying outside of biomedicine, makes acupuncture

a highly controversial therapy.

The total effects of acupuncture, as experienced by the patient in routine

practice, include both the specific effects associated with correct needle

insertion according to acupuncture theory, non-specific physiologic

effects of needling, and non-specific psychological (placebo) effects

related to the patient’s belief that treatment will be effective.

Acupuncture for chronic headache in primary care: large, pragmatic,

randomised trial Vickers, et al

Acupuncture for Treatment of Insomnia in Patients With Traumatic Brain

Injury: A Pilot Intervention Study Zollman, et al

Nthe central nervous system depressant effects of these medications may have long-term deleterious

consequences for neural plasticity, and therefore on the ultimate degree of recovery post-TBI.

“Acupuncture using auricular meridian points is equivalent to the use of tranquilizers and sedation.” Further,

“there are no associated adverse effects, drug dependence, or habit formation.”

Of the 8 studies included in this meta-analysis, which specifically addressed outcomes, there was an aggregate

greater than 80% efficacy.

N5 weeks of acupuncture treatment, provided twice weekly resulted in a statistically significant increase I

nocturnal endogenous melatonin secretion and improved sleep onset latency, arousal index, total sleep time, and

sleep efficiency. Anxiety and depression were also significantly reducedN

This pilot intervention study, although not conclusive, supports the contention that acupuncture has a beneficial

effect on perception of sleep or sleep quality and on cognition in patients with TBI.

N recent fMRI studies, suggesting a broad effect (seen with stimulation of a variety of acupuncture points) on

limbic, prefrontal and basal ganglia function.


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“The doctor of the future will give no medicine, but will interest

patients in the care of the human frame, in diet, and in the cause and

prevention of disease.”– Thomas Edison

“Health is like money, we never have a true idea of its

value until we lose it.”– Josh Billings

“Health is a large word. It embraces not the body only, but the mind

and spirit as well…and not today’s pleasure or pain alone, but the

whole being and outlook of a person.”– James H. West


What is Health?

paine cp acupuncture presentation - bridges northern kentucky …bridgesnky.org/public/2015 paine...

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