Nice to see you, to see you NICE

Today has been quite a day for acupuncture.

The National Institute for Health and Clinical Excellence (NICE) have now recommended acupuncture as a viable treatment method for tension-type headaches and migraine.

Information released by NICE today reported MEDICATION OVERUSE is one of the most COMMON CAUSES of headaches affecting about 1 in 50 people. Women are five times as likely to suffer with these.

NICE conclude that acupuncture is the only proven method to prevent tension-type headaches and migraine and that doctors should prescribe it.

Some of the press coverage on the new NICE guidelines

But how exactly does acupuncture work to treat headaches and migraine?

In Chinese Medicine there are lots of different causes of headaches, but let's discuss a couple of common causes.

1. HEADACHES CAUSED BY TENSION (Back and sides of head)

Overwork. Poor posture. Lack of exercise. Stress. What do these all lead to? TENSION.

Stress, overwork and lack of exercise in Chinese Medicine generally affect the Liver and Gallbladder, of which the associated emotion is ANGER. Long-term MEDICATION USE also affects the LIVER. 

This can lead to a very common condition we call LIVER QI STAGNATION. This means the Qi (energy) of the Liver stops circulating around the body as effectively as it should, and is often reflected in the GALLBLADDER MERIDIAN (energetic pathway). This leads to a build up of TENSION across the SHOULDERS, NECK and SIDES OF THE HEAD. You can see the first part of the Gallbladder meridian in the diagram below:

Treatment of these headaches is actually very simple. Ultra-fine needles are inserted into specific points on the Gallbladder meridian, in particular I like to use GB20 and GB21 as shown in the above diagram. These points work like magic with regards to treating tension-type headaches. 

What these points also do is have a direct action on the MUSCLES. The particular way that I work is to use the acupuncture needles to release TRIGGER POINTS. These are tender areas in the muscles that will often produce pain elsewhere in the body. For example, there is a trigger point In the upper trapezius closely located or directly located to acupuncture point GB21 which if active will produce a pain pattern similar to the shape of the Gallbladder channel shown above. If this point is needled in a certain way I am able to release the trigger point by causing a MYOFASCIAL RELEASE, meaning the fascia (surround) of the muscle is stimulated and causes the muscle to jump or spasm, realigning the muscle fibres and causing the muscle to relax. 

2. MIGRAINE 

Before treating migraine, I first need to determine where it is coming from. It may well be REFERRED PAIN from TRIGGER POINTS located in the sternocleidomastoid muscle. As you can see from the diagram below, the points in the muscle can produce several PAIN PATTERNS (shown in red) and if this is the cause then I need to release these trigger points. 

But many of the underlying causes of migraine are down to a condition known as LIVER YANG RISING. Again, note how the LIVER can be the main cause of MIGRAINE. With Liver Yang Rising, the Qi rises in a quick, almost violent fashion, going completely against its natural path. We call this REBELLIOUS QI. 

The Rebellious Liver Qi again tends to be reflected in the Gallbladder meridian causing PAIN, VISUAL DISTURBANCES (the Liver opens into the eyes in Chinese Medicine) and NAUSEA. The nausea is due to the sudden surge of Rebellious Liver Qi invading and affecting the Qi of the STOMACH. 

Treatment for classic migraine requires a much more subtle approach. As well as releasing any TRIGGER POINTS and using points on the upper GALLBLADDER CHANNEL, I need to use a series of UNDERLYING POINTS which will redress any INTERNAL IMBALANCE. Points are usually Liver or Gallbladder points located on the lower leg or feet, or points on the hand, but will VARY FROM PERSON TO PERSON depending on what other imbalances are present. 

Two common points used in treating any kind of headache are:

LIVER 3 

and

LARGE INTESTINE 4

These are points that can be MASSAGED to reduce the pain of the headache. MRI RESEARCH has shown that when the point Large Intestine 4 is needled or strongly massaged it actually causes AREAS OF THE BRAIN to light up. These areas actually SWITCH OFF your receptors to pain. In China, they use Large Intestine 4 as a natural anaesthetic during Caesarian sanctions and even open heart surgery. 

It's about time that the West finally realises the potential behind these tiny needles. 

Well done NICE. 

Is life a pain in the neck?

The National Institute of Health and Clinical Excellence (NICE), which provides the majority of clinical guidelines for GPs across the UK, now recognises acupuncture as a viable treatment form for non-specific lower back pain. 

But how does acupuncture help treat lower back pain? And can it help with any other forms of pain? 

I've been working as an acupuncturist for over 6 years. I've had my own private practice, I've been a tutor at the college where I trained and I have practised acupuncture on cruise ships, working alongside highly skilled teams of sports therapists, physios and chiropractors. I have gathered as much information as I can with regards to treating pain, both from a Chinese health perspective and a Western health perspective and continue to do so. 

I have literally treated hundreds people who suffer with pain. 

All kinds of pain. 

Headaches. Migraines. Neck pain. Shoulder tension. Frozen shoulder. Tennis elbow. Golfers elbow. Repetitive Strain Injury. Carpal Tunnel Syndrome. Upper back pain. Lower back pain. Sciatica. Bursitis. Knee pain. Osteoarthritis. Rheumatoid arthritis. Ankle pain. Plantar fasciitis. 

I could spend a whole day talking about all these different conditions and how I work with them, but unfortunately, neither you nor I has all day! So let's focus in on one particular complaint that almost everyone is familiar with: MUSCULAR TENSION. The cause behind the majority of neck, shoulder and lower back pain. 

Now I have to be honest, I know for you poor people out there muscular pain is horrid. It slows you down, it makes you irritable, it distracts you from your work, your family, your life, it restricts you. I, on the other hand, LOVE IT. I love it because I know I can fix it! Quickly and effectively. It is one of my favourite things to treat. 

You probably all know what muscular pain is, but for the sake of argument, let's briefly touch on some of the different types of muscular pain you can get. 

You can an ACUTE MUSCULAR INJURY. Generally brought about through a sports injury, or lifting something heavy, the muscle gets a small tear and to heal it LOCKS UP. There is STIFFNESS, sometimes SWELLING, and is normally very TENDER. 

Generalised muscular pain can present in a FIXED LOCATION. It can be DULL and ACHY and it generally FEELS BETTER FOR PRESSURE. 

You can also get RADIATING PAIN.  Often confused as a trapped nerve, this is actually what is known as a TRIGGER POINT in a muscle which causes pain to radiate to another part of the body. These are generally TENDER to palpate and can be exacerbated on touch. 

So how do I deal with these different types of muscular pain? 

First let's look at MUSCULAR INJURIES. Before I can administer any acupuncture or massage the SWELLING needs to be dealt with. ELEVATE and ICE the injury until the swelling reduces. It may still feel tender to touch, but nothing can be done until the swelling goes down. Once the swelling is reduced, you may find the injury clears up with REST. If after two or three days there is still a lot of pain present that is the time to seek some help. 

Acupuncture on MUSCULAR INJURIES is as gentle as possible. Ultra-fine needles are used to RELEASE THE KNOTS and promote the flow of blood and Qi (energy) to the affected area.

DULL, ACHY, MUSCULAR PAIN is dealt with in a slightly different manner. The affected area is needled which will elicit a response similar to a feeling of PRESSURE, but other points may be administered to boost your Qi as a whole and often MASSAGE techniques are used after treatment. 

RADIATING PAIN. My favourite! Working with TRIGGER POINTS is something not all acupuncturists do, but it is one technique I have learnt and use it to great effect. First the trigger point needs to be LOCATED. It is then needled which will cause the muscle to JUMP. We call this a MYOFASCIAL RELEASE. This means the fascia that surrounds the muscle relaxes, which releases the knot and REALIGNS THE MUSCLE FIBRES. Quite often the sensation from the needle is felt elsewhere and then these places are needled and released. 

The radiating sensation found in TRIGGER POINTS often correspond to the MERIDIANS (energetic pathways which channel your Qi) found in Chinese Medicine. There is actually recent research to show that the FASCIAL PLANES (the areas of connective tissue found in the body- muscular surrounds, tendons and ligaments etc.) are almost exactly the same as the meridians, which shows that needling the FASCIA in one area can relieve muscular tension elsewhere on the plane/meridian. For example, the REAR FASCIAL PLANE corresponds to the BLADDER MERIDIAN which starts in the medial corner of your eyes, runs over the top of your head and down either side of spine, into your buttocks and down the backs of legs and into your feet. 

In all cases it is important to REST after treatment and DRINK PLENTY OF WATER to allow the muscles to settle down and aid the healing process. Often the area will feel sore after treatment for about 24-48 hours, but a different kind of soreness to the initial pain. Once this settles, that is when you get a significant improvement. 

So that's a very brief introduction into how acupuncture works with muscular pain and how I work as a practitioner. 

And because it is so effective at helping treat muscular pain, this is why NICE recommend it to help treat lower back pain. 

Wishing you the very best in health and happiness