Acupuncture for Migraines Provides Significant Benefits

As I’ve written before, I really enjoy treating migraines and headaches because I used to suffer from headaches for many years. When patients respond so well and so quickly to acupuncture to reduce or eliminate headaches, it’s a wonderful feeling for me. It’s a daily reminder that I really love what I do.

Since many health care practitioners and patients alike are curious about research in the area of Chinese medicine, I thought I would reprint this article from Acupuncture Today.  In reality, there’s a lot of research being done on the efficacy of acupuncture and one only needs to search under complementary medicine under the NIH (National Institutes of Health) to see all the articles.

Acupuncture Provides Significant Benefits for Migraine Patients

by Michael Devitt

A new report published in the online version of the British Medical Journal has found that acupuncture is a useful, cost-effective treatment for chronic headaches, particularly migraines. The report found that over a 12-month period, headache patients who received regular acupuncture sessions reported fewer headaches, had a higher quality of life, missed fewer days from work, used less medication, and made fewer visits to a general practitioner than patients given standard treatment for headaches.

The research was conducted at a series of single acupuncture practices and general practices in Wales and Great Britain. In the study, the authors recruited 401 patients who suffered from chronic headaches, predominantly migraine headaches. The patients were randomized to receive either acupuncture or “usual care” from a general practitioner. In the acupuncture group, subjects standard care for headaches, and were also treated with acupuncture up to 12 times over a three-month period. Treatment patterns were individualized to each patient, and different points were used based on the discretion of the acupuncturist providing care. In the usual care group, patients received standard headache care from their general practitioner, but were not referred out for acupuncture.

At various times throughout the study, patients used a daily diary to track the frequency and severity of headache pain, and any related medication use. Headache severity was measured four times a day on a six-point scale, with the total summed to give a headache score. In addition, the patients completed the SF 36 Health Status Questionnaire at the start of the study, and at three months and 12 months after treatment. Patients also completed a series of questionnaires every three months that monitored use of different headache treatments, days missed from work due to illness, and other usual activities.

Initially, there was not much difference between patients in either group. By the 12-month interval, however, striking differences were noted in terms of frequency of headache, doctor visits and medication use:

  • Patients given acupuncture had an average of 1.8 less days with headaches over the first four weeks of the study compared to the control group. When projected over 52 weeks, the authors estimated that acupuncture would result in an average 22 fewer days of headaches per year.
  • The effects of acupuncture appeared to be long-lasting. At the start of treatment, the average weekly headache score among acupuncture patients was 24.6. Three months after the start of the study, the average score had dropped to 18.0; at 12 months, it had dropped by more than 34 percent, to 16.2. In the standard care patients, weekly headaches scores dropped only 16 percent over the course of the year.
  • Results from the SF-36 questionnaire showed significant benefits for acupuncture patients in terms of physical role functioning, energy levels and changes in health. Over the course of a year, physical role functioning, energy and health change scores increased an average of 9.6, 7.4 and 10.3 points, respectively, for those in the acupuncture group. These scores also increased in usual care patients, but at much lower levels.
  • Acupuncture patients used an average of 15 percent less medication to treat headaches than patients receiving only usual care. They also made 26 percent fewer visits to a general practitioner, and missed fewer days from work due to sickness.

“Acupuncture in addition to standard care results in persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine, compared with controls,” the researchers commented. “We also found improvements in quality of life, decreases in use of medication and visits to general practitioners, and reductions in days off sick.”

In their conclusion, the researchers admitted they could not rule out the occurrence of a placebo effect, as the study did not include a sham acupuncture group. In addition, since the patients knew which treatment group they were assigned to, there remained the possibility that patients could give somewhat biased assessments of their treatments. However, the authors noted that the results of their study were similar to results seen in blinded, placebo-controlled trials, which “provides further evidence that bias does not completely explain the apparent effects of acupuncture.”

The authors recommended that their findings should be taken into account by policymakers when assessing the most cost-effective ways of treating patients. They also called for an expansion of acupuncture services for the treatment of chronic headaches in the National Health Service, which provides health care to millions of Britons each year.

In an interview with the BBC, Dr. Mike Cummings, the medical director for the British Medical Acupuncture Society, called the study “innovative” and agreed with the authors’ assertions.2

“It is very positive for us,” he said of the research. “This should help to lift acupuncture out of what is seen to be alternative to mainstream medicine É It should be made available in primary care to treat pain and to prevent costly referrals to hospitals.”

References

1. Vickers AJ, Rees RW, Zollman CE, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomized trial. British Medical Journal Online First; doi:10.1136/bmj.38029.421863.EB. Published March 15, 2004. Available at www.bmj.com.

2. Acupuncture beats headache pain. BBC News, March 15, 2004.

Reposted with permission from Acupuncture Today

If you suffer from headaches or migraines, or know of anyone who does, encourage them to give acupuncture a try. It’s really a great way to manage or eliminate headaches and migraines without the side effects of drugs.

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Some Observations on Healthcare from Training in China

I just returned last week from three weeks in China. The last two weeks were spent shadowing doctors and observing treatment strategies for various problems. The clinics in the hospitals I went to mainly were in the departments of gynecology, internal medicine, pain and gastroenterology. Some of the many medical problems I observed included: chronic and acute body pain, migraines and headaches, dizziness and vertigo, depression, gynecological issues including fibroids, cysts & painful menstruation, various digestive problems including gastric pain, reflux and gastritis.

It was interesting to watch the various approaches, both herbal and acupuncture. Most of the doctors of TCM (Traditional Chinese Medicine) do either one. I was told there is a pretty clear boundary on these areas. I would imagine it might be different in other parts of China however. In order to practice in Texas, we are required to be Board Certified in both Chinese Herbal Medicine as well as in Acupuncture.

In general, patients tend to respond better when both acupuncture and herbal medicine is prescribed. But it does depend on the condition and the number of Western prescriptions a patient takes.

I found the general population seeking medical care at the TCM clinics of two types. Those who only believe in Chinese medicine (and consequently don’t go to Western style MD’s) and those who tried Western medicine but didn’t like the effects of the drugs on their bodies. It was interesting to note that there seemed to be a larger percentage of younger men who were having strokes in China. My guess is that many of them did not go to Western doctors to monitor blood pressure or cholesterol. ( I maintain my mantra that if you get the best of Western and Chinese, you can have really good healthcare).

There were a few glaring observations that I would like to share. We in the USA are very blessed to have good healthcare and healthcare facilities. As broken as some people think it is, it is wonderful in comparison to healthcare in other parts of the world. We have requirements for cleanliness, proper disposal of trash and needles, disinfecting exam tables and surrounding areas, washing hands and sterilizing equipment, to name a few. We have the right to meet with the acupuncturist, doctor or nurse privately. We would never tolerate having five patients waiting in the same room listening until it is their time to meet with the doctor. We expect that the health care provider will use clean needle technique when giving a treatment or injection. We take these “little things” for granted and would be appalled if it would not be the case when we visit our doctor. The TCM doctors I observed were good doctors. They had different styles and philosophies about treating the different problems but they were all trained doctors of Chinese medicine. The patients were completely willing to submit to the treatment strategies the doctors recommended and there were very few, if any, questions asked…

With all the above said, I have to say that the doctors see a lot of patients every day. There is a waiting line out the door. Which means that patients feel they get better whent they see the doctor. Although it would not seem up to our “sanitary standards,” there is a cultural understanding that this is sufficient. Patients need healthcare and they get it in the manner they know and are accustomed to. Through my interpreter, patients responded that they like coming to the clinics and they like getting their acupuncture and/or herbal prescriptions. They say it helps and they feel better. I guess at the end of the day, that’s what we all want when we go to the doctor.

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Houston, Texas! It’s Allergy Season

Allergies are in full bloom these days. I actually started seeing the itchy, watery, sneezy, goopy stuff in the office starting in January, but it’s in high season with the budding and flowering of our trees and bushes. The good news is acupuncture and chinese herbs are a great way to beat the allergy blues while concurrently building your immune system to better fight the allergy problems for next season. I can say that my patients who started last year to treat allergies are doing significantly better during this allergy season as a result of previous treatment. One patient told me it’s the first time she has not developed bronchitis and a severe environmental allergy attack in years.

I used to have allergies. After taking some allergy medication and almost going off the road in a hallucination type of reaction with my scalp feeling like it was crawling, I decided to get off the prescription drugs. Luckily it was about the same time I started studying acupuncture and Chinese medicine. That was twelve (12) years ago and I have not had one bout of sinusitis or an allergy attack since. (I also have not been to the chiropractor in the same amount of time for a back adjustment). It’s amazing how the benefits extend to the whole body with acupuncture!!

Even though we recently had some good rain to wash some of the pollen out of the air, I am continuing to get calls from people who are at their wits end with allergies. All of these new patients have tried everything Western medicine could offer and finally decided to give acupuncture and Chinese herbal therapy a try.

Treating acupuncture in Chinese medicine generally involves the Spleen, which manages the distribution of fluids-think congestion, runny nose, dampness as well as the stomach and Large intestine channels (as they traverse the face, nose and sinus areas). Interesting those channels that affect the digestion have a lot to do with allergies that affect the face, nose, sinus and lungs. It makes sense that a strong, healthy core makes for a healthier body.

I get great satisfaction treating patients who have had long standing issues with allergies. The response can be fast, like right on the table. Congestion, post nasal drip, runny nose quite often is relieved within minutes of an acupunture treatment. Truthfully, it takes more than one treatment to resolve a long standing problem, but in the interim of treatment, symptoms go away while we gently strenthen the lungs and spleen and make you stronger for the next season of allergies. The good news is that patients often will become less dependent on prescription medications for managing their allergy symptoms. My patients are always amazed and pleased about that. Why wouldn’t you want to be more drug free?

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Patients Are Customers

In many ways we should consider ourselves healthcare customers. We are customers with our doctors just like we are customers in a restaurant or store. There are certain ways we expect to be treated. If we don’t like the service in a restaurant or how a salesperson has spoken to us, we have the right to leave and to complain to management. When it comes to healthcare and medicine, I also believe that we can have a say in how we are treated and to ask as many questions as necessary to understand what is being recommended for our care.

I do believe everyone with a new condition or problem should be evaluated by a medical doctor. Western medicine does have the best diagnostic equipment in the world. Western medicine is also the best for emergency medicine.

When there is a non-emergency or chronic condition, we can become advocates in our own healthcare. It’s good to hear what the doctor recommends and take it under consideration. Afterall, the doctor does have your best interests in mind. But the doctor may not be well versed in options that may be less invasive or requiring less medications. This is where we as patients have a right to have a voice in our treatment process.

I believe that one of the many reasons acupuncture has become such a popular option for many, is that in addition to making all kinds of physical problems better, acupuncturists listen to patients and treat them as a whole person. The doctors today who still subscribe to the “my way or the highway” mentality are not the doctors that patients like to go to or speak well of to others.

So, it’s up to us, as healthcare customers to consider all of the options to treat our specific problem. Because there are alternatives and different ways to treat problems, we have to do our research and find out what might work as well or even better and with fewer side effects.

Just because a doctor tells you to take another drug or have asurgery, (it might be that you need to take that drug and have that surgery), you can also wonder and question whether there may be another way to treat the pain or deal with the problem (reflux, depression, hot flashes, migraines, etc). Is it possible to manage or treat the problem without drugs? Can surgery be avoided through acupuncture and physical therapy? Remember, once you cut, you can’t go back. It’s certainly worth trying everything before undergoing anesthesia. So I do think we have to be smart consumers of medical care. It’s about taking responsibility.

We are very lucky in Houston as we have a world class medical center and hospitals and world class doctors. But it’s also ok to have a little healthy skepticism and consider all our options.

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Depression, Anxiety, Bi-Polar Disorder & Acupuncture, Houston, TX

Questions about acupuncture for mental health issues are one of the most common inquiries I receive after questions about pain.

Acupuncture can help with depression, anxiety, stress and bi-polar disorder. So in terms of various mental health issues, yes, acupuncture can frequently help.

I caution to say that acupuncture is not in lieu of continuing or being in therapy. I do not take patients off of their Western medication if they’re already on it. Medication is a discussion between the patient and their doctor. Acupuncture, and in many cases Chinese herbal formulas, work just fine in conjunction with Western medication as the mechanism of action is quite different. They can complement each other beautifully.

When a patient comes in with a Western diagnosis of depression, anxiety or bi-polar disorder, my job is to determine what the underlying problem(s) are from a Chinese medical perspective. For example, if someone presents with anxiety along with insomnia, excessive worrying, hypervigilance and internalizing feelings, the strategy might be to balance the heart and kidney channels. However, if the main complaints include depression, irritability, sleep disruptions and digestive problems, the approach might focus on smoothing the liver channel.

Usually, a patient will present with a combination of the above plus more. After a thorough evaluation, a point selection is chosen based on the most disruptive concerns working our way in to the deepest and most chronic issues. We as human beings are rarely uni-dimensional, therefore it is more complicated than I have described. However, it gives you an understanding that the treatment strategy is quite individualized.

I have treated bipolar disorder and have found that acupuncture can be stabilizing; but with bipolar, it’s really important to stay on your Western drugs and/or be in regular communication with your therapist. What the acupuncture can do is help balance and stabilize some of the mood swings: the degree, frequency and intensity of the ups and the downs. You might be able to reduce the dosage of some of the medications, but again, that’s between you and your psychiatrist.

Stress is a major variable in just about every health issue we have. I think that stress is the one variable in our life that cannot be controlled in a double-blind, placebo control study. So you can have everything, all variables equal, but how do you really control for stress? Stress definitely triggers mental health issues and it triggers health issues overall.

Because stress is a major factor in all of our lives, acupuncture in and of itself helps with mental health issues because it works to balance the mind, body and spirit. When we are in balance, our emotional and physical health is improved.

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