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The Efficacy of Acupuncture in Treating Stroke Patients: A Comparative Study Between Traditional Chinese Medicine and Western Medicine Approaches

By Dr. Winson Chen

Abstract:

This paper investigates the efficacy of acupuncture as a therapeutic intervention in stroke patients, discussing the underpinnings from both a Traditional Chinese Medicine (TCM) and a Western medical perspective. We explore the theoretical bases of strokes in each paradigm, the mechanisms of acupuncture treatment, and review existing scientific literature on the topic.

Introduction:

Stroke, a major global health concern, is characterized by the rapid loss of brain function due to disturbance in the blood supply to the brain. This is predominantly caused by ischemia (resulting from blockage, often a thrombosis or embolism) or by hemorrhage. From a Western medicine perspective, risk factors include hypertension, high cholesterol, diabetes, tobacco smoking, and obesity.

In Traditional Chinese Medicine (TCM), a stroke – known as ‘Zhong Feng’ – is viewed as a condition where wind, phlegm, and stasis obstruct the meridians, leading to an imbalance in the body’s Yin and Yang and the Five Elements, consequently impairing neurological function.

The Mechanisms of Stroke: Western Perspective

In Western medicine, the cause of stroke lies in cerebrovascular disease. Ischemic stroke occurs when a blood vessel supplying the brain is obstructed, limiting the supply of oxygen and nutrients. This triggers a cascade of neurochemical reactions, leading to necrosis of the brain tissue – a process known as infarction. Hemorrhagic stroke, on the other hand, occurs when a weakened blood vessel ruptures, causing bleeding in or around the brain.

The Mechanisms of Stroke: TCM Perspective

In TCM, stroke is seen as a consequence of underlying imbalances and disharmony within the body. The concept of Qi (vital energy), and its flow through the meridians (energy channels), is central to this understanding. Any impediment to the flow of Qi and blood is thought to cause disease. Hence, stroke is believed to be the result of wind, fire, phlegm, and stasis obstructions that disturb the balance of Yin and Yang in the heart and brain.

Acupuncture as a Treatment Method

Acupuncture is a key component of TCM that involves the insertion of thin needles at specific points (acupoints) on the body, intending to restore balance and harmonize the flow of Qi and blood.

From a Western medicine perspective, acupuncture is proposed to stimulate the nervous system, triggering neurohumoral responses. The insertion of needles may stimulate nerve fibers, which transmit signals to the brain and spinal cord. This could modulate the production of neurotransmitters and hormones, influencing the body’s self-regulating systems and promoting physical and emotional well-being.

Efficacy of Acupuncture in Stroke Rehabilitation

Several clinical studies and systematic reviews have suggested beneficial effects of acupuncture in stroke rehabilitation. These include improvements in motor function, speech, balance, and quality of life. For instance, a randomized controlled trial by Zhang et al. (2015) demonstrated significant improvements in neurological deficit scores and activities of daily living scores in post-stroke patients receiving acupuncture compared to control groups.

The proposed mechanisms of these effects involve neurogenesis, angiogenesis, anti-apoptosis, anti-inflammation, and neuroplasticity. Acupuncture is believed to modulate these processes, promoting recovery and functional restoration post-stroke.

Conclusion:

While further high-quality, randomized, controlled trials are needed, current evidence indicates that acupuncture can be a useful adjunctive therapy in stroke rehabilitation. Both TCM and Western medicine provide plausible mechanisms for these effects, with TCM focusing on restoring energy balance and Western medicine highlighting neurobiological processes

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The Efficacy of Acupuncture in Treating Chronic Lower Back Pain: A Neurophysiological and Clinical Perspective

By Dr. Winson Chen

 

Abstract

Acupuncture has been used for centuries as a therapeutic modality in traditional Chinese medicine, and its application for chronic lower back pain (LBP) has garnered increasing attention in the scientific community. This paper provides an in-depth overview of the neurophysiological mechanisms involved in acupuncture’s effectiveness in treating LBP, supported by empirical studies and clinical evidence.

Introduction

Chronic LBP is a pervasive health issue affecting millions of individuals worldwide. It is a leading cause of disability and a significant contributor to health care costs and productivity loss (Balagué et al., 2012). Current treatment strategies often include physical therapy, pharmacological interventions, and, in severe cases, surgery, with varying degrees of success. However, these traditional methods often present side effects and do not always provide lasting relief. Therefore, alternative and complementary therapies like acupuncture have been sought after due to their reported efficacy and minimal side effects (Vickers et al., 2018).

Mechanisms of Acupuncture

Acupuncture involves the insertion of fine needles into specific points on the body, known as ‘acupoints.’ The precise mechanisms by which acupuncture works are complex and multifaceted, involving both peripheral and central processes.

Peripheral Mechanisms

One widely accepted theory explaining acupuncture’s analgesic effect is Melzack and Wall’s ‘Gate Control Theory’ of pain (1965). According to this theory, non-painful input closes the ‘gates’ to painful input, preventing pain sensation from traveling to the central nervous system. Therefore, acupuncture, by stimulating non-nociceptive fibers, can inhibit pain signals from reaching the spinal cord.

Furthermore, acupuncture needles, when inserted into acupoints, stimulate A-delta and C afferent fibers in muscles. This stimulation triggers a cascade of biochemical changes, including the release of endorphins and other natural pain-relieving chemicals in the body. These chemicals act as natural opioids, reducing the perception of pain (Han, 2004).

Another effect of acupuncture involves local peripheral changes. Acupuncture has been found to increase local blood flow and promote tissue healing (Komori et al., 2009). It also reduces inflammation and muscle stiffness, common issues associated with LBP, by inhibiting pro-inflammatory cytokines and promoting the release of anti-inflammatory cytokines (Zhao, 2008).

Central Mechanisms

At the central level, neuroimaging studies have demonstrated that acupuncture can influence the brain’s pain-processing areas. Functional MRI (fMRI) studies show that acupuncture activates areas of the brain associated with pain modulation, including the anterior cingulate cortex, the insula, and the periaqueductal gray (Dhond et al., 2007).

In contrast, it also deactivates areas associated with the sensory-discriminative aspect of pain, such as the thalamus and the primary and secondary somatosensory cortices (Hui et al., 2009). This combination of activation and deactivation in different brain regions may explain the pain-relieving effects of acupuncture.

Interestingly, acupuncture has also been found to influence the limbic system, a group of structures involved in emotion, memory, and behavior. This may explain why some patients report improved mood and well-being after acupuncture (Hui et al., 2005).

Empirical Evidence

In terms of empirical evidence, a significant volume of studies has shown acupuncture’s effectiveness in managing LBP. A meta-analysis of 22 randomized controlled trials involving 4985 participants found that acupuncture was more effective than sham acupuncture and no-acupuncture control for non-specific chronic LBP, showing improved function and pain relief (Yuan et al., 2015).

Another notable study, a randomized trial by Cherkin et al. (2009), involved 638 adults with chronic LBP. The researchers found that both individualized and standardized acupuncture resulted in more significant improvement in symptoms and function compared to usual care. The study concluded that acupuncture could be a reasonable option for patients with chronic LBP.

Additionally, a systematic review by Vickers et al. (2018) analyzed individual patient data from 29 high-quality randomized controlled trials. The review found that acupuncture was linked with significant reductions in pain intensity, improved functional mobility, and enhanced quality of life compared to no-acupuncture groups.

Conclusion and Future Directions

Emerging research on acupuncture’s role in managing chronic LBP presents an intriguing dialogue between traditional Chinese medicine and modern scientific understanding. There is a solid foundation of evidence illustrating both peripheral and central mechanisms behind acupuncture’s efficacy, with effects ranging from local tissue healing and endorphin release to modulating brain areas associated with pain perception.

However, more in-depth and extensive research is required to further elucidate the underlying mechanisms, optimize treatment protocols, and understand potential long-term effects. For instance, while numerous studies have investigated the immediate effects of acupuncture, long-term effects and how they might relate to changes in neurochemistry and neuroanatomy remain less clear.

Furthermore, as current understanding of acupuncture is primarily based on group-level data, individual differences in response to acupuncture are still not fully understood. Future research could also explore the influence of individual factors such as genetic predisposition, psychological characteristics, and specific pain conditions on the effectiveness of acupuncture.

As it stands, acupuncture represents a promising, non-invasive treatment for chronic LBP, providing a potential therapeutic avenue for this prevalent and debilitating condition.

References

Balagué, F., Mannion, A. F., Pellisé, F., & Cedraschi, C. (2012). Non-specific low back pain. The Lancet, 379(9814), 482-491.

Cherkin, D. C., Sherman, K. J., Avins, A. L., Erro, J. H., Ichikawa, L., Barlow, W. E., … & Hsu, C. (2009). A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Archives of Internal Medicine, 169(9), 858-866.

Dhond, R. P., Kettner, N., & Napadow, V. (2007). Neuroimaging acupuncture effects in the human brain. The Journal of Alternative and Complementary Medicine, 13(6), 603-616.

Han, J. S. (2004). Acupuncture and endorphins. Neuroscience Letters, 361(1-3), 258-261.

Hui, K. K. S., Marina, O., Claunch, J. D., Nixon, E. E., Fang, J., Liu, J., … & Rosen, B. R. (2009). Acupuncture mobilizes the brain’s default mode and its anti-correlated network in healthy subjects. Brain Research, 1287, 84-103.

Hui, K. K., Liu, J., Marina, O., Napadow, V., Haselgrove, C., Kwong, K. K., … & Rosen, B. R. (2005). The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. Neuroimage, 27(3), 479-496.

Komori, M., Takada, K., Tomizawa, Y., Nishiyama, K., Kaw

atani, Y., Ozaki, M., & Shizuo, K. (2009). Microcirculatory responses to acupuncture stimulation and phototherapy. Anesthesia & Analgesia, 108(2), 635-640.

Melzack, R., & Wall, P. D. (1965). Pain mechanisms: a new theory. Science, 150(3699), 971-979.

Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., … & Linde, K. (2018). Acupuncture for chronic pain: update of an individual patient data meta-analysis. The Journal of Pain, 19(5), 455-474.

Yuan, Q. L., Guo, T. M., Liu, L., Sun, F., & Zhang, Y. G. (2015). Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis. PloS One, 10(2), e0117146.

Zhao, Z. Q. (2008). Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology, 85(4), 355-375.

Needles being placed in back for acupuncture treatment
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Acupuncture: Mechanism of Action from Traditional to Modern Scientific Perspectives

 

By Dr. Winson Chen

 

Abstract

Acupuncture is a significant constituent of Traditional Chinese Medicine (TCM), widely employed for thousands of years. Despite the lack of definitive consensus on its mechanism of action, significant evidence suggests it involves intricate physiological responses in the musculature, peripheral, and central nervous systems. This paper aims to review the underlying mechanisms of acupuncture from both the traditional TCM perspective and the latest scientific explanations.

Introduction

Acupuncture, an ancient TCM practice, has been used as a therapeutic modality for millennia. Its utility ranges from pain alleviation to managing chronic conditions. This ancient technique involves the insertion of fine needles into specific body points, known as acupuncture points or ‘acupoints.’ Despite its widespread use, the mechanism of action remains a topic of ongoing research and debate in modern medicine

Traditional Chinese Medicine Perspective

The traditional explanation for acupuncture’s effectiveness lies in the concept of Qi (pronounced “chi”), a vital life force or energy flowing through the body along meridians or pathways. Health is perceived as the harmonious balance and free flow of Qi. Disease, on the other hand, is believed to result from the disruption or imbalance of Qi. Acupuncture, by stimulating specific acupoints, aims to restore the balance and flow of Qi, thereby restoring health.

Modern Scientific Explanations

Modern scientific studies indicate that acupuncture’s mechanisms might involve complex neurophysiological processes affecting various body systems. These can be examined under three broad categories: musculature, peripheral nervous system, and central nervous system.

1. Musculature

When an acupuncture needle is inserted into the skin and underlying muscle tissue, it causes a minor injury or “micro-trauma” at the site of insertion. This minor trauma stimulates the body’s natural healing response, causing inflammation and release of various chemicals. Among these chemicals are histamines, prostaglandins, and cytokines, which are part of the body’s immune response.

Histamines and prostaglandins cause vasodilation or widening of blood vessels at the site of injury, increasing blood flow to the area. This increased blood flow brings more nutrients and oxygen, which are necessary for healing. Cytokines are small proteins that play a critical role in cell signaling during the immune response. They help to promote the proliferation of cells necessary for healing, such as fibroblasts, which are responsible for wound healing by producing collagen.

2. Peripheral Nervous System

The peripheral nervous system (PNS) serves as a communication relay between the body and the central nervous system (CNS). When an acupuncture needle is inserted and manipulated, it stimulates specific nerve fibers in the PNS. These stimulated nerve fibers then send signals up to the spinal cord and brain.

One significant effect of this stimulation is the release of endogenous opioids, including endorphin, enkephalin, and dynorphin. These are the body’s natural painkillers, working by binding to opioid receptors on nerve cells and blocking the transmission of pain signals. This local release of endogenous opioids at the site of needle insertion is one reason why acupuncture can have an analgesic or pain-relieving effect.

3. Central Nervous System

Acupuncture’s effects on the central nervous system, which consists of the brain and spinal cord, are complex and multifaceted. As mentioned, the stimulation of peripheral nerve fibers by the acupuncture needle sends signals up to the brain. These signals can alter the activity in various brain regions involved in pain perception and processing, including the anterior cingulate cortex, prefrontal cortex, and insula. This can lead to a reduction in the perception of pain.

In addition to influencing pain-related neural areas, acupuncture has also been found to modulate the activity of the limbic system, the brain’s emotional center. This could explain why acupuncture can be beneficial in managing stress and anxiety disorders.

Moreover, acupuncture stimulates the release of various neurotransmitters in the brain. These include serotonin and norepinephrine, which can help modulate mood and are involved in the body’s natural pain inhibitory pathways. Acupuncture also triggers the release of adenosine, a neuromodulator with potent analgesic effects, in the vicinity of the needle placement.

 

Conclusion

Although acupuncture’s mechanism of action remains partially elusive, modern science has illuminated its multifaceted physiological impact, spanning from local tissue to the brain. These insights allow for an increasingly nuanced understanding of its therapeutic potential beyond the traditional Qi-based explanation. Despite the differences between traditional and modern perspectives, both share a common emphasis on balance and homeostasis. Further research is warranted to fully elucidate acupuncture’s complex mechanisms, which could potentially pave the way for novel therapeutic interventions.

 

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Roxane and her infertility

Hello friends,

Today I wanted to share one of my patients stories. Her name is Roxane and she was able to get help with my treatment. Roxane was kind enough to share her personal story. Without further ado let me introduce Roxane…

I want to open up and share a deeply personal story—one that revolves around the challenging journey of infertility. It’s a topic that is often shrouded in silence and pain, but I believe that by speaking openly about it, we can create a supportive and understanding community. Through my own experience, I discovered the incredible impact that acupuncture had on my life, bringing warmth and healing to a path that felt overwhelmingly difficult.

The Weight of Infertility: Infertility is a burden that weighs heavily on the hearts of those who long to become parents. It’s a journey filled with highs and lows, hope and disappointment. Month after month, the anticipation builds, and the heartache deepens with each negative pregnancy test or failed attempt. It’s a rollercoaster ride of emotions that can leave you feeling isolated and questioning your self-worth.

For my husband and me, the struggle with infertility was a constant presence in our lives. It seemed as though everyone around us effortlessly achieved what we so desperately desired. It felt unfair and deeply disheartening. The journey was riddled with medical appointments, invasive procedures, and a constant battle against feelings of inadequacy. We longed for a sense of normalcy and the fulfillment of our dreams.

Discovering the Healing Power of Acupuncture: In the midst of our fertility journey, we reached a point where conventional medical treatments alone weren’t providing the desired results. We knew we needed to explore alternative approaches, and that’s when we discovered acupuncture—an ancient healing technique with a reputation for addressing reproductive health.

Initially, we were skeptical. Could a few needles really make a difference? However, we were willing to try anything that might offer a glimmer of hope. We found Winson who specialized in fertility, and from the moment we stepped into his office, we felt a sense of comfort and understanding.

Acupuncture became a sanctuary for us—a place where we could openly discuss our emotions, fears, and dreams. Winson  approached our journey with compassion, empathy, and a deep understanding of the intricate connection between mind, body, and spirit. He created a personalized treatment plan that focused not only on the physical aspects of fertility but also on restoring balance to our entire being.

Through regular acupuncture sessions, I began to experience subtle shifts within myself. It wasn’t an immediate change, but rather a gradual unfolding of healing and hope. Acupuncture helped regulate my menstrual cycle, rebalance my hormones, and reduce the stress that had become intertwined with my fertility journey.

Beyond the physical benefits, acupuncture offered me something invaluable—a safe space to process my emotions, fears, and frustrations. It became a refuge where I could release the weight of infertility, even if just for a short while. The calming presence of Winson, coupled with the gentle touch of the needles, created an environment where I could find solace amidst the chaos.

Miraculously, our journey with acupuncture led to a profound outcome—we finally conceived our precious child. The combination of acupuncture’s physical and emotional support played a significant role in our journey to parenthood. The arrival of our baby brought indescribable joy and fulfillment, and we are forever grateful for the transformative power of acupuncture in our lives.

While the physical aspects of infertility were undoubtedly challenging, the emotional toll was equally, if not more, significant. Acupuncture not only addressed the physical aspects but also provided immense support for my emotional well-being.

Through acupuncture, I learned to be kinder to myself, to embrace self-care, and to navigate the complex emotions that accompanied each step of the journey. It allowed me to release pent-up stress, anxiety, and grief, making space for healing and resilience to grow within me.

Infertility is a deeply personal and often lonely journey. It challenges the core of our identity and can leave us feeling lost and broken. However, I want to emphasize that you are not alone. There is a community of individuals who have experienced or are currently facing the same struggles.

If you find yourself on this path, I urge you to seek support and consider incorporating acupuncture into your journey. While infertility may feel insurmountable at times, acupuncture has the potential to bring warmth and healing to your experience.

Remember, the road to parenthood may not unfold as expected, but that doesn’t diminish your strength or worth. It’s important to surround yourself with a compassionate network of professionals, loved ones, and support groups who can uplift you during the challenging moments.

Infertility is a chapter in your story, but it does not define you. With each acupuncture session, you are taking a step towards physical and emotional well-being. Be patient and kind to yourself throughout this process, honoring the strength and resilience that resides within you.

In closing, I want to emphasize that there is hope. Infertility is a difficult journey, but it is not the end of your story. Trust in your own strength, embrace the warmth and healing of acupuncture, and hold onto the belief that, in time, the joy you seek may come to fruition. I want to sincerely thank Winson and Juliet for their kindness.

 

With love and solidarity,

 

Roxane.

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Heat Therapy

As an Acupuncturist, I have witnessed firsthand the transformative effects of heat therapy in facilitating the body’s natural healing processes. When it comes to addressing pain and promoting recovery, the age-old debate between using a heating pad or ice has left many individuals confused. In this article, we will explore the profound benefits of heat therapy and shed light on why heat is far superior in helping heal the body, both from the perspective of Traditional Chinese Medicine (TCM) and Western medicine.

Understanding Traditional Chinese Medicine (TCM): In TCM, the body is viewed as an intricate network of energy channels called meridians. The free flow of Qi (vital energy) and blood within these meridians is crucial for maintaining health and promoting healing. When injury or illness disrupts this flow, pain and dysfunction occur.

Heat therapy, a fundamental modality in TCM, aims to restore the balance of Qi and blood. Applying heat to specific acupoints along the meridians helps to invigorate circulation, disperse stagnation, and encourage the body’s innate ability to heal itself. Heat therapy can be delivered through various methods, including moxibustion, warm herbal compresses, and hot packs.

Benefits of Heat Therapy in TCM:

  1. Promotes blood circulation: Heat application expands blood vessels, enhancing blood flow to injured or tense areas. This increased circulation brings vital nutrients, oxygen, and immune cells to the affected site, accelerating the healing process.
  2. Relaxes muscles and tendons: Heat helps to soothe and relax tight muscles and tendons, reducing pain, stiffness, and spasms. By relieving tension, heat therapy promotes better mobility and range of motion.
  3. Expels cold and dampness: In TCM, certain conditions are attributed to the accumulation of cold and dampness in the body. Heat therapy helps to dispel these pathogenic factors, providing relief from conditions such as arthritis and chronic pain.

Exploring Western Medicine’s Perspective: In Western medicine, heat therapy is commonly employed in physiotherapy and rehabilitation settings. It complements the principles of TCM, providing additional scientific explanations for its effectiveness.

Benefits of Heat Therapy in Western Medicine:

  1. Increased metabolic activity: Heat application boosts metabolic activity in tissues, leading to increased oxygen and nutrient delivery. This enhanced cellular metabolism aids in tissue repair and reduces recovery time.
  2. Pain relief: Heat therapy stimulates thermoreceptors in the skin, effectively blocking pain signals from reaching the brain. It also triggers the release of endorphins, the body’s natural painkillers, promoting analgesia and a sense of well-being.
  3. Muscle relaxation: Heat promotes muscle relaxation by reducing muscle spasms and tension. Relaxed muscles are less likely to become strained or injured, facilitating the healing process.

Heat vs. Ice: Why Heat Prevails: While ice has its place in acute injuries to reduce swelling and inflammation, heat therapy offers distinct advantages in the healing process. Here’s why heat takes the lead:

  1. Heat is conducive to healing: Unlike ice, which constricts blood vessels and reduces blood flow, heat widens blood vessels, promoting circulation and nutrient supply to damaged tissues.
  2. Heat targets both symptoms and underlying causes: Heat therapy not only alleviates pain but also addresses the root cause of the problem by improving circulation, relaxing muscles, and expelling pathogenic factors.
  3. Versatility and convenience: Heat therapy can be easily applied at home using heating pads or warm compresses, allowing for regular and consistent use. Its accessibility empowers individuals to actively participate in their healing process.

Conclusion: From the lens of TCM and Western medicine, it is evident that heat therapy holds numerous advantages over ice in promoting healing and pain relief. By understanding the principles of TCM and the scientific explanations provided by Western medicine, we can appreciate the multifaceted benefits of heat therapy.

Heat therapy, with its ability to improve circulation, relax muscles, and dispel pathogenic factors, aligns with the holistic approach of TCM in restoring the body’s balance and facilitating natural healing processes. In Western medicine, heat therapy is recognized for its capacity to increase metabolic activity, provide pain relief, and promote muscle relaxation, making it an essential tool in physiotherapy and rehabilitation.

While ice can be beneficial for acute injuries to reduce swelling and inflammation, heat therapy surpasses ice in addressing the underlying causes of pain and promoting comprehensive healing. By increasing blood flow, delivering nutrients, and relaxing muscles, heat therapy not only alleviates symptoms but also enhances the body’s ability to repair and recover.

The versatility and convenience of heat therapy, with options such as heating pads and warm compresses, make it accessible to individuals for regular and consistent use. By incorporating heat therapy into their self-care routine, individuals can actively participate in their healing journey, experiencing the long-lasting benefits it offers.

However, it is important to consult with healthcare professionals, such as physiatrists and acupuncturists, to determine the most appropriate and effective treatment plan for specific conditions. They can provide personalized guidance, taking into account individual needs, medical history, and the nature of the injury or condition.

In conclusion, heat therapy emerges as a superior modality in aiding the body’s healing process, bridging the wisdom of Traditional Chinese Medicine and the scientific knowledge of Western medicine. By embracing the power of heat, individuals can harness its remarkable benefits and embark on a path to holistic recovery and well-being.

 

~Dr. Winson Chen
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