Chinese Medicine



Tui Na (Chinese Medical Massage)

 

  • Tui Na is oscillating manual stimulation of the deep tissues in select regions of the body to improve circulation and promote natural healing mechanisms.
  • Tui Na (literally: push and grasp) is a task specific (which means that while it has value in and of itself, it is used to achieve a specific end, specifically to improve a health condition) form of massage, acupressure, kneading, and stretching custom tailored to each specific patient based on their individual symptoms or disease.
  • Tui Na is a deep tissue form of massage usually performed without oils, can be done with the clothes on, and the massage is specifically designed to increase blood flow to the diseased areas of the body and thus accelerate recovery time.

I've gotten a massage before, so what's the big deal?

 

  • More expert levels of Tui Na focus on treating the problem or disease at its source, and thus can be very concentrated on a few select regions or points on the body. This is opposed to a shotgun technique of massaging where a large area of the body is rubbed mindlessly, in the hopes that if everything is massaged one can't possibly miss. Such a method is diffuse and often ineffective for severe diseases.
  • Many call this crude technique 'massage therapy'. Labeling an expert in Tui Na a 'massage therapist' is like calling a highly skilled neurosurgeon a 'brain-poker' ('Brain-poking', don't knock it until you've tried it!). A true master of Tui Na can provide a level of relief from discomfort in one minute that an hour of 'massage therapy' may not be able to provide.
  • Don't be fooled by those that say they are doing Tui Na when in fact they are doing massage therapy. At the same time, don't discount the skill of all of those who say they are doing massage therapy. Some have dedicated their lives to their trade and have become very proficient but have simply not found (or didn't care to find) the vocabulary to satisfactorily describe what it is they are doing.
  • A good rule of thumb is to classify massage the way we classify drugs. There are the medicinal drugs and then there are the recreational drugs. Some would argue that these categories often overlap, but nevertheless it helps to make the distinction. So, when you feel like having some fun, choose the recreational massage. If you are looking to treat an illness, however, you require a medical massage.
  • Effective Tui Na often times focuses on the joints in treating chronic as well as acute pain as is seen in Connective Tissue Acceleration - CTA. Injuries of the joints tend to take longer to heal than those in the muscles and so should be addressed especially in chronic musculo-skeletal diseases. Ligaments, tendons, articular cartilage, and bones are mobilized manually to provide a much faster healing time than is possible without such stimulation.

Acupuncture

 

  • Acupuncture is the stimulation of select points on the body with needles to promote circulation and facilitate the body's natural healing processes.
  • Acupuncture may be applied locally to diseased or symptomatic areas, or distally along the meridians to affect organs or tissues influenced by those meridians.

How does it work?

 

  • The most basic theory is that where the blood goes, so goes the health, and where the blood doesn't go, away goes the health. You need adequate blood flow and energy flow in the body to maintain optimum health.
  • Blood flow is more likely to become impeded at sites in the body known as acupuncture or pressure points. This affects not only the area of the body where circulation is impeded, but other areas of the body related to that particular point.
  • So you may have impeded blood/energy flow in the crook of your elbow, and experience no symptoms there (or maybe you will have local symptoms, everyone's body is different in this regard) but that blockage results in stomach pain, or constipation, or maybe a fever, or possibly excessive sweating (the list of possibilities are far too exhaustive to list here). This is based on the theory that there are a network of meridians that run through the whole body and a blockage anywhere in the network can lead to problems in the system as whole.
  • So acupuncturists stimulate points that have been found through thousands of years of empirical evidence to have the greatest benefit for specific conditions related to those specific points. Points can be stimulated using needles, pressure, moxibustion (a specific heat therapy), massage, tapping, cupping, and other techniques.

What is the evidence?

 

  • Areas of skin with acupuncture points have been shown to have greater electrical conductivity, and some have a greater concentration of nerves than other parts of the body.
  • Needling points for vision in the foot that are not related by any measurable anatomical structures to the vision still produce a change in the vision center of the brain as evidenced by MRI imaging.
  • Arguments that explain pain efficacy of acupuncture through stimulation through the neural network to the limbic system and pituitary glands to produce endorphins do not explain its effectiveness in nausea and vision studies. This basically means, it's not just endorphins that are providing relief, another mechanism is at work.
  • If acupuncture worked through endorphins alone needling any point would theoretically have the same effect, and acupuncture would be no more effective in treating illness than going on a 20 minute run. But acupuncture works on a series of specific energy channels that flow through the body, each of which have their own specialized effects. So with correct diagnosis and correct needle placement acupuncture is far superior in illness prevention and amelioration than any simplistic endorphin-based model can explain.
  • For more of this channel theory just scroll down to the Qi Nei Zang section which briefly describes the meridians. Acupuncture, by directly influencing the meridians indirectly improves the function and health of the internal organs. Qi Nei Zang, by directly influencing the organs, indirectly improves the health and function of the meridians.
  • No physiological evidence has been found to show exactly what acupuncture is doing (this is most likely because it doesn't do exactly the same thing every time, which explains its flexibility and efficacy in so many different conditions), but one explanation is as follows: The body is lazy. If it can get away with ignoring a disease, it will. But if you insert needles in the body, the body responds as though it is under attack. It sends its defensive mechanisms to the needling site, as well as distal sites stimulated by the needle. In this way the body is compelled to act, rather than to ignore the problem.

How deep do the needles go?

 

  • Depth of insertion is usually ¼ to 1 inch and depends on patient’s size, age, constitution, sensitivity to needles, and the nature of the condition being treated. Some points may go deeper, however, usually the deepest point is located on the hip, and a needle here may be inserted up to 3 inches or more.

Is there pain with needling?

 

  • Some patients feel nothing.
  • Some patients feel slight pain on insertion of needles, but this depends largely on the type of needle used, the technique employed by the acupuncturist, the location of point needled, and the sensitivity of the patient. Care will be taken to minimize needle insertion pain as much as possible. For first timers and anxious patients I use extremely skinny needles (skinny even for acupuncture needles) and a very light technique, and most of these patients hardly feel a thing.
  • The needles employed in acupuncture are much thinner than hypodermic needles employed in western medicine, and so with equal insertion speed and location are much less painful on insertion.
  • After needle insertion the needle may be stimulated at which time the patient may experience numbness, tingling, or pressure.
  • Pain may also be experienced if patient moves after needles are inserted as this will stimulate the needles. But this is also highly individual as I have seen some patients with needles inserted up to an inch and a half in their neck and lower back get up off the massage table, walk to the bathroom, and come back to lie down (all without complaining). But if you need to use the bathroom, please just ask and your needles will be removed.
  • More sensitive patients will receive thinner needles, needles will be inserted more shallowly, and fewer needles will be used. Patients that enjoy stronger stimulation will receive it.
  • Numbness, tingling, or soreness may also linger for 2-3 days after the treatment, but this is normal and will resolve naturally.

Acupuncture Safety

 

  • All needles are pre-packaged, sterilized, and disposable. Needles are discarded in puncture proof sharps container after each patient.
  • Side effects are minimal in acupuncture treatments. More common side effects are numbness, tingling, soreness, or bruising at or near needling sites which may last for a few days.
  • Soreness may linger for a few days after Tui Na Medical Massage. This is more likely for more severe and more chronic musculoskeletal diseases.
  • Overall, Traditional Chinese Medicine provides techniques such as acupuncture, medical massage, and herbal medicine that are relatively safe and free of side effects as compared to its Western Medicine counterpart.

Acupressure

 

  • Acupressure is static manual stimulation of select points on the body to improve circulation and promote natural healing mechanisms.
  • Acupressure has similar principles to acupuncture and can be performed in lieu of acupuncture for those of you with needle anxiety or revulsion.

Myofascial Release

 

  • Myofascial release therapy principles provide a physiological explanation of how acupressure works in treating pain.
  • This technique utilizes the fact that muscles sometimes are locked in a contracted state because they are contracted around the nerve that sends the message for them to contract and relax. This blocks the message of the nerve to the muscle so that relaxation becomes impossible.
  • The contraction can impede blood flow within the muscle by squeezing the blood vessels within the muscle which can lead to necrosis (or death) of muscle tissue.
  • Build up of calcium and potassium (chemicals necessary in contraction and relaxation) due to blocked blood flow will lead to further contraction of the muscles.
  • Build up of inflammatory chemicals due to impeded blood flow can cause pain as the inflammatory chemicals inflame the tissue surrounding the muscle contraction.
  • This constant muscle contraction can also pull joints out of place as it places uneven pressure on the joints.
  • The contraction may also pinch nerves and cause referred pain along the nerve.
  • It can lead to muscle atrophy as the muscle here cannot fully relax or fully contract.

How it works

 

  • Manual pressure is applied (generally with the thumbs) on the belly of the contracted muscle, where it is contracted around the contracting nerve.
  • Pressure is held any where from 5 seconds to 1 minute. When done correctly, symptoms of pain, numbness, or tingling will temporarily increase along the same pathway they were originally felt. If pressure is released too quickly, pain will not resolve (and the temporary increase in pain will be useless, other than as a diagnostic measure). But if pressure is applied to the appropriate degree, for the appropriate amount of time, the muscle will reset and relax around the nerve.
  • Often this is followed by an unnerving (but extremely welcome) degree of relief from the original pain.
  • Please note that I (and I advise other practitioners as well) only use this technique after muscles and other tissues have been appropriately warmed up with acupuncture and/or Tui Na massage. This type of stimulation can be too much for some patients and is often unnecessary if proper Tui Na and Connective Tissue Acceleration is employed, as this is usually enough to provide noticeable or complete relief from patient’s pain directly following the treatment. But after proper warm up most patients can tolerate the stimulation and almost everyone appreciates the after effect.

Qi Nei Zang – Abdominal Massage (Abdominal Tui Na)

 

  • Qi Nei Zang is an abdominal massage technique designed to regulate the function of the internal organs.
  • Qi Nei Zang is sometimes static, sometimes osscillating manual stimulation of the abdominal organs and tissues to promote organ function, circulation, and promote natural healing mechanisms.
  • Patients typically lie relaxed on their back with clothes on. The practitioner sits or stands at the side of the patient and uses hands to massage patient’s abdomen. This procedure is usually done without oils.

How does it work?

 

  • This is one of the few ways to influence the internal organs directly without medicine, herbs, or surgery.
  • Proper body function depends on proper organ function.
  • The internal organs are of utmost importance in the discussion of Chinese medicine as almost every mental and physical malady in internal medicine can be linked to a disharmony of the internal organs.
  • Each of the 12 primary meridians links to the internal organs, and is named after the primary organ that it links to. For example, the lung meridian primarily links to the lung, the heart meridian to the heart, and so on.
  • These 12 meridians flow through the entire body, over the head, torso and limbs.
  • Because the internal organs influence the health of the meridians, and the meridians influence the health of the internal organs, the health of the internal organs is inextricably linked to the health of the entire body.
  • While acupuncture influences the health of the internal organs indirectly, through the meridians, Qi Nei Zang provides a technique whereby the function, health, and vitality of the internal organs can be directly influenced.

So what’s the big deal?

 

  • In Traditional Chinese Medicine practice, many different techniques and strategies can be employed to treat the same underlying issue. This is important, because when a patient fails to see results using one technique, another can be employed.
  • Sometimes acupuncture provides dramatic results, but other times the results are more subtle.
  • By providing a direct link to the abdominal organs, Qi Nei Zang can be employed when the affects of acupuncture have seemed to plateau, providing another tool with which to improve your health.

Herbology

 

  • You may have already noticed that all of the above therapies promote circulation and facilitate natural body healing mechanisms. Acupuncture, acupressure, tui na, myofascial release, and qi nei zang all function under the assumption that all the materials necessary for healing are already in the body.
  • These techniques redistribute the body's existing resources, drawing them away from where they are unnecessary and excess and guiding them to where they are more wanted and advantageous. In this way these techniques are the Robin Hood of natural medicine, taking the fat of the land and converting it into good useful lean muscle.
  • Herbs, on the other hand are the technique of choice when the body's natural resources are wanting, when there is something missing from the system as a whole so that no redistribution of wealth is possible.
  • Herbology is the use of herbs to supplement the body when the natural healing mechanisms of the body are inadequate to successfully overcome or prevent disease.

What treatment is best for me?

 

  • I will base needle selection, medical massage technique, and herbal supplements on your individual diagnosis. Diagnosis for internal medicine diseases is based on a taking a complete history and may include examination of your tongue and pulse. Diagnosis for external diseases such as musculoskeletal disorders will be based on the history of the problem, your posture, and manual palpation.