Browsing articles tagged with " insomnia"

69. Occipital Headache, How Can Acupuncture Treat It?

Mar 7, 2017   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

News Letter, Vol. 8 (2), March, 2017, © Copyright

Jun Xu, M.D., Hong Su, C.M.D., Lic. Acup.

www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

How Can Acupuncture treat Occipital Neuralgia?

 

Linda, a 45-year-old female dental assistant, came to me complaining of severe headaches that started at the back of her head and continued down a portion of her neck.  The pain also radiated up to her scalp, around her ears and sometimes into the bilateral temporal area.  The pain was off-and-on, but occurred every day.  The pain ranged from dull to sharp, and was sometimes located directly behind the right eye.  As a dental assistant, she constantly turned her head to the right when dealing with patients.  This caused the headache to become more severe, and she was frustrated that it interfered with her daily work.  She had consulted several doctors about her condition, and had been prescribed Naprosyn, Percocet and Neurotin, but none of them alleviated her condition.

These headaches intensified when Linda was under stress, which was often because of her job: if she had many patients waiting for her and felt under pressure, the headaches worsened.

When I examined Linda, I discovered that when I pressed her scalp at the base of the skull and suboccipital area, the pain radiated to the back, front and side of her head, and also to the right side of the eye.  When I pressed hard on the suboccipital area (the base of the skull) the pain was exacerbated and I could feel the bilateral temporal artery palpating.

The patient probably suffers from occipital neuralgia, which is a cycle of pain spasms originating in the suboccipital area, caused by an inflammation of the occipital nerves.  The two pairs of occipital nerves (each nerve contains a greater and lesser occipital nerve) originate in the second and third vertebrae of the neck.  These nerves supply areas of the skin along the base of the skull and behind the ear, but are not always connected directly with the structures inside the skull. However, they do interconnect with other nerves outside the skull and continue into the neuro-network.  Eventually they can affect any given area along the scalp, mainly on the bilateral temporal area behind the ear and sometimes connect to the nerve branch on either side of both eyes.

Occipital neuralgia may occur continuously, often as the result of the nerve impingement, especially from arthritis, muscle spasm, or as the result of a prior injury or surgery.  Sometimes these conditions will impinge the occipital nerve root, leading to severe headaches at the back of the head, leading to muscle spasm.  Linda exhibits the severe form of occipitical neuralgia, most likely because her profession causes her to tilt her head in the same manner for a good part of her day. This stress causes the occipital nerve to be impinged, sending a constant signal to the nerve network in her scalp, leading to headaches and the pain behind her right eye.

The clinical diagnosis of this condition is based on palpation by the doctor of the bilateral occipital nerve root, which will induce or trigger the headache. Doctors currently use various treatments.  One option is to inject 1% lidocaine 5cc into the occipital nerve root, which decreases or relieves the pain, confirming the diagnosis.  A second option is to use surgery to cut or burn the nerve with a radial wave probe.  A third option is to use a small injection of Botox or a similar medication.  Western medicines include anti-inflammatory or narcotics such as Percocet or Darvocet, Naurontin, anti-epilepsy medication, etc.  For the majority, these medications do not work well, though occasionally they can reduce the occurrence and frequency of the occipital neuralgia.

Some patients respond to physical therapy and massages to decrease the spasm of the neck muscle, which might temporarily relieve the occipital neuralgia.  Though doctors may recommend surgery, many patients resist this type of treatment.

According to Traditional Chinese Medicine, occipital neuralgia belongs in the category of the side headache, i.e. the Shao Yang Gallbladder meridian headache.  Gallbladder meridians are distributed around the sides of the head, and excessive heat in the gallbladder can lead to headaches.  The gallbladder meridian originates from the outside of the eye, and continues up the temporal nerve area, around the lateral skull area, down the occipital nerve area, down through the trunk and to the outside of the leg.  If there is excessive heat along this meridian, there will be an imbalance of yin and yang.  For example, if the patient undergoes stress, muscle spasm or arthritis, the nerve and the gallbladder meridian will be impinged.  This, in turn, will cause the gallbladder to heat up, leading to excessive heat, an imbalance of yin and yang and a severe headache.

Another meridian identified in occipital neuralgia by Traditional Chinese Medicine is the urinary bladder meridian, which starts from the inside corner of the eye, continues through the middle and the top of the scalp, and follows down the back of the trunk and into the back of the leg.  Due to the connection between the gallbladder and urinary bladder meridians, heat in one will cause heat in the other to rise, generating pain around the eye, the temporal area and the scalp, and making the ensuing headache severe and highly unbearable.  Therefore, the principal acupuncture treatment is to relieve this excessive heat in the gall bladder and urinary tract.

The main acupuncture points used for treatment are: Du 20 Bai Hui, GB 20 Feng Chi, GB1 Tong Zi Liao, GB 8 Shuai Gu, Extra point Tai Yang, GB 34 Yang Ling Quan, SI 3 Hou Xi, Lu 7 Lie Que, Kid 6  Zhao Hai, Li 3 Tai Chong.

Linda underwent my treatment three times a week for one month, resulting in immediate, short-term relief of her headaches.  However, the headaches continued to plague her because of her strenuous work.  In addition, her irregular menstrual cycle and hormonal changes led to more severe headaches.  Thus, I also treated her for hormonal changes by utilizing a Chinese herb Da Zhi Xiao Yao San.  The combination of acupuncture and herbal therapy seemed to be effective and, after about two months of treatment, Linda reported that her headaches occurred only infrequently and were very mild, and that she was satisfied with her treatments.

Usually, acupuncture, with or without the addition of herbal supplements, can alleviate the problems and pain associated with these headaches.  However, sometimes it is best to combine acupuncture with a nerve block (utilizing 4cc of 1% lidocaine plus 10 mg Kenalog mixed together) injected into both sides of the occipital nerve origin.  One month of this combined treatment should give the patient 95% relief from his/her symptoms.

Tips for acupuncturists:

  1. You should identify the location of the pain and tenderness, and treat the headache accordingly.  For example, the frontal headache belongs to the Yang Ming meridian; the temporal side headache belongs to the Shao Yang meridian; the top scalp headache belongs to the Jue Ying meridian.
  2. Always use Du 20 Bai Hui for all the different types of headaches. This is based on my personal experience over 20 years of practice.

Tips for patients:

  1. You should be very specific when describing the tender points on your head because each tender-point location belongs to a different meridian, and treatment varies based on each location.
  2. Massaging the Tai Yang and UB 20 Feng Chi points for 20 minutes, 2 to 3 times a day, will greatly decrease the headache.

 

67. Dr. Jun Xu’s calling from West Africa

Mar 5, 2017   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

Dr. Jun Xu went to Leprosy village in 2013, 2014 and 2016, soon he will go to the leprosy village on March 31, 2017.

In 2013, there was no a single room being used for treatment in the leprosy village, Dr. Xu and his team had to use a tent. The temperature was around 125 Fahrenheit degrees.

The leprosy patients were waiting for their turn to be attended. Dr. Jun Xu saw about 200 patients a day.

Typical leprosy patient:
Early Stages
Spots of hypopigmented skin- discolored spots which develop on the skin
Anaesthesia(loss of sensation) in hypthese opigmented spots can occur as well as hair loss
“Skin lesions that do not heal within several weeks of and injury are a typical sign of leprosy.” (Sehgal 24)

Progression of disease

“Enlarged peripheral nerves, usually near joints, such as the wrist, elbow and knees.”(Sehgal 24)
Nerves in the body can be affected causing numbess and muscle paralysis
Claw hand- the curling of the fingers and thumb caused by muscle paralysis
Blinking reflex lost due to leprosy’s affect on one’s facial nerves; loss of blinking reflex can eventually lead to dryness, ulceration, and blindness
“Bacilli entering the mucous lining of the nose can lead to internal damage and scarring that, in time, causes the nose to collapse.”(Sehgal 27)
“Muscles get weaker, resulting in signs such as foot drop (the toe drags when the foot is lifted to take a step)”(Sehgal 27)

Long-term Effects
“If left untreated, leprosy can cause deformity, crippling, and blindness. Because the bacteria attack nerve ending, the terminal body parts (hands and feet) lose all sensations and cannot feel heat, touch, or pain, and can be easily injured…. Left unattended, these wounds can then get further infected and cause tissue damage.” (Sehgal 27)
As a result to the tissue damage, “fingers and toes can become shortened, as the cartilage is absorbed into the body…Contrary to popular belief, the disease does not cause body parts to ‘fall off’.” (Sehgal 27)

Every year, Dr. Jun Xu and his team bring around $300,000 worth of medicine donated from his team members and Americares in Stamford, CT to treat the leprosy and other patients in Senegal and Guinea Bissau. http://www.americares.org/, in 2017, his team also received medicine donation from Direct Relief in California, https://www.directrelief.org/.
Dr. Jun Xu and his team finally established a clinic in the leprosy village, one building for the clinic, and another building for the living of doctors and nurses.

Leprosy village people were celebrating the opening of the clinic.

There are 8 wards, which could hospitalize the patients if it is medically necessary.

Dr. Jun Xu’s team usually stay in Senegal for 10 to 14 days, these are the foods his team brought from US in order to keep them health and safe. They do not dare to eat street food.

The above are the coolants contained food Dr. Jun Xu’s team brought from US

Dr. Jun Xu and his team from US in 2006.
If you are interested in joining Dr. Jun Xu’s team or donating to his work in Senegal, please address your check payable to AGWV, and send to
Jun Xu, MD, 1171 E Putnam Avenue, Riverside, CT 06878, USA.
Dr. Xu promises that all your donation 100% will go to Senegal and his team will nerve use a penny from your donation. You will receive the tax deductible receipt. Any amount is a great help for Africa patients.
For more info, please visit our websites at
http://www.drxuacupuncture.co/ and http://www.africacriesout.org/

45. Acupuncture and Hypertension

Sep 26, 2012   //   by drxuacupuncture   //   Uncategorized  //  No Comments

News Letter, Vol. 4 (9), September , 2012, © Copyright

 

Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.

Robert Blizzard III, DPT

www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

Fax: (203)637-2693

Hypertension

 

 

 

Hypertension

William S., a sixty-two-year-old man, works as a stock analyst. His day begins at 6AM and finishes at 7PM. His lifestyle is very stressful, but he is a regular exerciser, running five miles on Saturday and Sunday. He has no health problems, save that he smokes about half a pack of cigarettes a day and has been drinking coffee for thirty years. One morning, on awakening, he felt a sudden onset of weakness and numbness on the left side of his face and arm, as well as in his left leg, and he had a moderate headache. He had difficulty walking and called his wife who noted his speech was slurred. She called an ambulance and he was rushed to the emergency room where his blood pressure was found to be 160/100. A CT scan showed blood in his brain, so William was diagnosed with a hypertensive hemorrhagic stroke. He had emergency open-scalp surgery and the blood clot was removed from his brain, but after the surgery he felt the left side of his face drooping and there was weakness in his left arm and leg.

After three months of intensive physical therapy, his symptoms improved, but he asked his doctor how, considering that he eats right and exercises, he could have suffered a stroke. He did mention to the doctor that he had not been checked for hypertension for five years, though he and his wife had availed themselves of the free blood-pressure monitor at their local supermarket.

The doctor put him on two different antihypertensive medications and told him he needed to have his blood pressure checked yearly by his physician. For a correct blood pressure reading, the doctor advised him that the readings should be taken three times, at least a week apart, and then the numbers should be averaged.

 

Hypertension—a Leading Cause of Strokes

Hypertension is high blood pressure and it is one of the main causes of a stroke. A person can have high blood pressure for years without knowing it because high blood pressure usually has no symptoms, though occasionally headaches may occur. During this asymptomatic period, hypertension can do damage to multiple organs, such as the heart, the blood vessels, the kidneys, or the brain. For this reason, it is referred to as a silent killer because suddenly one day the hypertensive person has a stroke, or develops coronary heart disease, i.e. heart attack or kidney failure.

The following comprise the rule of thumb on how to accurately and effectively take blood pressure.

  • Blood pressure should be taken at least one hour after caffeine, thirty minutes after smoking or strenuous exercise, and without any stress present.
  • The person should be upright in a chair with both feet flat on the floor for a minimum of five minutes prior to taking a reading.
  • Some people feel nervous on seeing doctors, a fairly common phenomenon known as white coat syndrome. To avoid this, the person getting the reading should be in a relaxed situation in an isolated room. Also, to counteract any discrepancy and assure an accurate result, three blood pressure readings should be taken at least five minutes apart and the results should then be averaged.
  • Older people who are suspected of having orthostatic hypotension should be given initial measurements in both arms. And in order to obtain the correct blood pressure readings, this should be done in lying, sitting, and standing blood positions.

 

Definition of Hypertension (HTN)

Based on the U.S. National Heart, Lung, and Blood Institute 2003 guidelines, blood pressure is defined as follows.

  • For adults age eighteen and above, normal systolic blood pressure is less than 120 mmHg, and diastolic blood pressure is less than 80 mmHg.
  • Pre-hypertension systolic is 120–139, with diastolic is between 80–89.
  • Stage 1 hypertension is between 140–159 systolic, with diastolic between 90 and more than 99.
  • Stage 2 hypertension is more than 160 systolic, with diastolic more than 100.

Table 9.1

Classification of Blood Pressure (BP) for Adults:

BP Classification Systolic BP mmHg Diastolic BP mmHg Lifestyle Modification
Normal <120 <80 Encourage
Prehypertension 120–139 80–89 Yes
Stage 1 HTN 140–159 90–99 Yes
Stage 2 HTN > or = 160 > or = 100 Yes

Sources: 7th Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), 2003

 

The Two Major Forms of Hypertension

Essential or Primary Hypertension

Ninety-five percent of those with hypertension exhibit essential or primary symptoms. Essential hypertension indicates that either no specific medical cause can be found to explain the person’s condition or that it might be caused by multiple factors. Those combined effects are responsible for HTN in approximately 72 million Americans.

Secondary Hypertension

This accounts for 5 percent of those with hypertension. In this instance, the high blood pressure is secondary to a specific abnormality, as for example kidney disease or tumors, adrenal adenoma, or other endocrine tumors.

 

Identifiable Causes of Hypertension

  • Sleep apnea
  • Drug induced (or related) causes
  • Chronic kidney diseases
  • Primary aldosteronism (adrenal gland overproduction of the hormone aldosterone)
  • Renovascular disease
  • Chronic steroid treatment
  • Cushing’s syndrome (hormone disorder caused by high level of cortisol in blood)
  • Adrenal gland tumor (pheochromocytoma)
  • Narrowing (coarctation) of the aorta
  • Thyroid or parathyroid disease

 

How Western Medicine Investigates Newly Diagnosed Hypertension

A physician will try to identify possible causes of secondary hypertension and seek evidence of end-organ damage to the heart, eyes, or kidneys.

Damages to Target Organs—Heart

  • Muscle thickening (hypertrophy) in left ventricle, the heart’s main pumping chamber
  • Angina or prior myocardial infarction
  • Heart failure

Damages to Other Target Organs

  • The brain: A stroke or a transient ischemic attack
  • The kidneys: Chronic kidney disease
  • The arteries: Peripheral artery disease
  • The eyes: Damage to the retina of the eye (retinopathy)

Main Blood Tests Performed to Determine Causes and Results of HTN

Renal function. Creatinine test to identify any underlying renal disease as a cause of hypertension, as well as it causing the onset of kidney damage. In the meantime, a baseline needs to be set up to monitor the possible side effects of certain antihypertensive drugs on the kidneys.

Electrolytes, including sodium, potassium, calcium, chloride.

Glucose to identify diabetes mellitus.

Cholesterol to identify the possible cause of coronary artery disease.

Urine samples. A healthcare provider might take urine samples to check for proteinuria in order to find out if there is any underlying kidney disease or evidence of hypertensive renal damage.

EKG for evidence of any damage to the heart.

Chest x-ray to check for signs of cardiac enlargement.

 

A recent survey found that 30 percent of those with hypertension were not aware they had it; 41 percent did not receive any antihypertensive treatment; and only 34 percent of those surveyed had it under proper control.

 

Prevention of Hypertension

Prevention of damage related to high blood pressure is the most important issue, and lowering blood pressure to prevent end-organ damage to the retina, kidney, heart, or brain is crucial. The following prevention procedures are recommended by National Institute of Health and W.H.O.

  • Weight reduction and regular aerobic exercise, such as walking, running, swimming, or bicycling. Several studies indicated that lower-intensity exercise may be more effective in lowering blood pressure than higher-intensity exercise.
  • Reducing sodium in the diet decreases blood pressure in about 33 percent of people.
  • Reducing sugar intake also helps.
  • Quitting smoking and decreasing alcohol consumption to a minimum.
  • Adopting the DASH (Dietary Approaches to Stop Hypertension) eating plan, which is rich in potassium and calcium, with reduced dietary sodium.

Lifestyle Modifications

Modifying lifestyles can reduce blood pressure, enhance antihypertensive efficacy, and decrease cardiovascular risk. As an example, a 1600 mg sodium eating plan has effects similar to single drug therapy. Combinations of two or more lifestyle modifications can achieve even better results.

Table 9.2

The Benefits of Lifestyle Modifications in Managing Hypertension

Modification Recommendation Benefits
Weight reduction Maintain normal body weight (mass index 18.5–24.9) If you can lose 10 Kg, you may be able to lower your blood pressure about 5–20 mmHg
Adopt DASH eating plan Consume a diet rich in fruits, vegetables, and low-fat dairy products with a reduced content of saturated and total fat If you adopt this plan, you may be able to lower your blood pressure about 8–14 mmHg
Dietary sodium reduction Reduce dietary sodium intake to no more than 100 mmol per day (2.4g sodium or 6g sodium chloride) If you adopt this modification in your diet, you may be able to lower your blood pressure about 4–9 mmHg
Physical activity Engage in regular aerobic physical activity, such as brisk walking at least thirty minutes per day most days of the week If you adopt this plan, you may be able to lower your blood pressure about 2–4 mmHg
Moderation of alcohol consumption Limit consumption to no more than 2 drinks (1 oz or 30 ml ethanol, 24 oz beer, 10 oz wine, or 3 oz 80 proof whiskey) per day in most men, and to no more than 1 drink per day in women and lighter weight people If you adopt this modification, you may be able to lower your blood pressure about 2–4 mmHg

Sources: 7th Report of the Joint National Committee on the Prevention,Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), 2003

 

Pharmaceutical Treatment of Hypertension

There are many people who are currently using pharmaceutical drugs, such as angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs), beta-blockers, calcium channel blockers, and thiazide type diuretics.

Diuretics of the thiazide type have been the basis of antihypertensive therapy in most outcome trials. In many studies, a diuretic works much better than other antihypertensive medications. Therefore, in the United States, the thiazide-type diuretic is the first choice to treat hypertension.

Table 9.3

Commonly Used Drugs

Class Name (Trade Name) Usual dose range in mg/day Usual Daily Frequency
Thiazide diuretics Chlorothiazide (Diuril) 125–500 1–2
Loop diuretics Furosemide (Lasix) 20–80 2
Potassium-sparing diuretics Amiloride (Midamor)Triamterene (Dyrenium) 5–1050–100 1–21–2
Aldosterone receptor blockers Spironolactone (Aldactone) 25–50 1
Angiotensin converting enzyme inhibitors Lisinopril (Prinivil, Zestril†)Quinapril (Accupril) 10–4010–80 11
Angiotensin II antagonists Irbesartan (Avapro)Losartan (Cozaar) 150–30025–100 11–2
Beta-blockers Atenolol (Tenormin) 25–00 1
Calcium channel blockers—Dihydropyridines Amlodipine (Norvasc) 2.5–10 1
Calcium channel blockers—non-Dihydropyridines Diltiazem extended release 180–420 1

Sources: 7th Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), 2003.

Thiazide-type diuretics should be used alone or in combination with one of the other classes, such ACE inhibitors, angiotensin receptor blockers, beta-blockers, or calcium channel blockers.

The Goal of Antihypertensive Therapy

The ultimate public health goal of antihypertensive therapy is the reduction of high blood pressure and cardiovascular disease. The aim of treatment for most people should be getting blood pressure readings to <140/90 mmHg, and even lower in certain contexts, such as diabetes or kidney disease (some medical professionals recommend keeping levels below 120/80 mmHg).

Achieving Blood-Pressure Control

Most people who are hypertensive will require two or more antihypertensive medications to achieve their blood-pressure goals. An additional second drug from a different class should be initiated when the use of a single drug in inadequate doses fails to achieve the blood-pressure goal. When the blood pressure is more than 20/10 mmHg above the goal, consideration should be given to initiate therapy with two drugs, either as separate prescriptions or in fixed dose combinations. However, the likelihood of a dramatic decline in blood pressure leading to dizziness when people attempt to stand (orthostatic hypotension), must be mentioned, as it can occur in people who have diabetes, or in older people and there could be a dysfunction of the autonomic nervous system that regulates unconscious body functions, including blood pressure and heart rates.

 

Treatment for Hypertension in Traditional Chinese Medicine—Acupuncture

There is a thousand year history of acupuncture treatment for different symptoms of hypertension, but there is no word in Chinese history for hypertension. The hypertension diagnosis is always found where there are symptoms of dizziness, faintness, strokes, and headaches. In recent studies, it was shown that acupuncture treatment can be an excellent adjunct to medical treatment, especially for those who are diagnosed with prehypertension or stage 1 hypertension, even stage 2 hypertension. In these instances, acupuncture might greatly decrease the dosage of antihypertensive medications, and also decrease the side effects of these medications. I do not, however, recommend discontinuing antihypertensive medications and using acupuncture as the only treatment.

In traditional Chinese medicine, hypertension is manifested as following two types.

Excessive Liver Yang

The person usually shows dizziness, tinnitus, and headaches, sometimes emotional upset, anger, facial redness, insomnia, and vivid dreams or nightmares. The treatment should be focused on lowering the excessive liver yang.

  • The points should be liver UB 18 Gan Shu, Liv 3 Tai Chong, Xia Xi, UB 23 Shen Shu, GB 20 Feng Qi, Li 4 He Gu, and Li 11 Qu Qi.
  • Sp 6 San Yin Jiao, PC 6 Nei Guan, and Zu Ling Qi are sometimes added.

Table 9.4

Points Meridian Number Conditions Helped
1 Gan Shu UB 18  Backache, blurred vision, epilepsy, jaundice, mental disorders, night blindness, redness of the eye, spitting blood
2 Tai Chong Liv 3  Headaches, dizziness and vertigo, insomnia, congestion, swelling and pain of the eye, depression, uterine bleeding, retention of urine, epilepsy
3 Xia Xi GB 43  Headaches, dizziness and vertigo, tinnitus, deafness, swelling of the cheek, pain in the breast, fever
4 Shen Shu UB 23  Asthma, blurred vision, deafness, diarrhea, dizziness, swelling, impotence, irregular menstruation, low back pain, nocturnal emissions, tinnitus, weakness of the knee
5 Feng Chi Gallbladder 20  Headaches, vertigo, insomnia, pain and stiffness of the neck, blurred vision, glaucoma, red and painful eyes, tinnitus, convulsion, epilepsy, infantile convulsions, common cold, nasal obstruction
6 He Gu Li 4 
7 Qu Chi Li 11 
8 San Yin Jiao Sp 6 
9 Nei Guan PC 6 
10 Zu Ling Qi GB 41  Headaches, vertigo, pain in the breast, irregular menstruation, pain and swelling of the back of the foot, spastic pain of the foot and toe

Please refer to the accompanying Figures (illustrations) for the locations of

the points. And please note that these illustrations are for information only

and may not show all the exact locations of the acupuncture points.

Figure 9.1

 

Deficiency of Blood and Qi (Energy)

The person very often feels dizziness and faintness; the dizziness is triggered by fatigue and always becomes worse when getting up from a sitting position. This deficiency is always accompanied by a pale face, and sometimes heart palpitations, insomnia, fatigue, slowed speech, and poor appetite. The treatment for this condition should be focused on nourishing the qi and blood and improving the function of the spleen and stomach. The acupuncture points for this are the following.

  • UB 20 Pi Shu, St 36 Zu San Li, Du 20 Bai Hui, Ren 6 Qi Hai, Li 3 Zhang Men, Shen Ting and Li 4 He Gu.
  • For an acute hypertensive crisis, Extra Point Tai Yang, Du 20 Bai Hui, and St 40 Fen Long can be used.
  • Some studies show that by piercing extra points of Tai Yang and Yin Tang with slight bleeding the blood pressure will usually drop quickly.
  • If there is a severe headache in the forehead, UB 2 Zan Zhu is used.
  • If the headache is on the top of scalp, Du 20 Bai Hui and Extra Point Si Shen Chong are added.
  • If there is neck pain with stiffness, GB 20 Feng Qi is used.
  • If there is dizziness accompanied with tinnitus, St 8 Tou Wei is also added.

Table 9.5

Points Meridian Number Conditions Helped
1 Pi Shu UB 20 
2 Zu San Li St 36 
3 Bai Hui Du 20 
4 Qi Hai Ren 6 
5 Zhang Men Li 3
6 Shen Ting Du 24  Anxiety, epilepsy, headache, insomnia, palpitations, runny nose, vertigo
7 Feng Long St 40 
8 Tai Yang Extra Point  Headaches, eye diseases, deviation of the eyes and mouth
9 Yin Tang Extra Point 
10 Zan Zhu UB 2 
11 Si Shen Chong Extra–HN 1 
12 Feng Chi GB 20 
13 Tou Wei St 8 

Please refer to the accompanying Figures (illustrations) for the locations

of the points. And please note that these illustrations are for information

only and may not show all the exact locations of the acupuncture points.

 

Figure 9.2

 

Fig 9.3

 

Fig 9.4

 

Treatment for William

William was diagnosed with excessive liver yang and underwent my treatment. After three months, his blood pressure became stable and under control, and only minimum dosages of the antihypertensive drugs were used.

 

Hypertentsion Tips for Use at Home or Office

  • Be calm and relaxed. Do not add stress on top of your blood pressure.
  • Massaging Tai Yang and Bai Hui will usually help you decrease your headache and your blood pressure. Acupressure the points with your thumb or knuckle, pressing with comfortable pressure on the points; count to 20, then change to another point.
  • After the blood pressure comes down, maintenance with acupuncture is necessary once a week in the short term, and is also very useful and effective in the long run.

 

43. Acupuncture and Insomnia

Jul 28, 2012   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

News Letter, Vol. 4 (7), July  , 2012, © Copyright

 

Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.

Robert Blizzard III, DPT

www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

Fax: (203)637-2693

 

Insomnia

Alice E, a forty-five-year-old woman, came to me complaining of insomnia. She had the same difficulty falling asleep, especially after experiencing stress, that she’d had at college on the nights before exams. She would lie in her bed, staring at the ceiling, and not fall asleep. If she was lucky enough to doze off, she would wake up frequently, even at the slightest noise. She had experienced this problem for about ten years, but recently the problem had escalated, owing to her marital situation. Her husband, the CEO of a large company, had quit his job because he would not fly from New York to Houston each Monday, then return to New York each weekend. He had managed this schedule for two years, but it had become too burdensome to him, hence his decision to quit. Though he sent out many résumés each week, his job search had produced no results, and the family’s financial situation had become difficult over the six months her husband had been unemployed. For the last two or three months, she could only sleep an hour or two each night, owing to stress, and this caused her difficulty during the day, as she found it hard to concentrate on any issue. This sleep deprivation impaired her memory, her social interactions, and her motor coordination, which caused problems with her driving. It was at this point she consulted me.

 

Types and Causes of Insomnia

Insomnia is a symptom, not a disease. It is defined as difficulty in initiating, or maintaining, sleep—or both. It is due to an inadequate quality or quantity of sleep. Most adults have experienced insomnia or sleeplessness at one time or another in their lives.

Insomnia can be classified based on the duration of the problem:

  • Transient insomnia. These symptoms last less than one week.
  • Short-term insomnia. Symptoms last between one and three weeks.
  • Chronic insomnia. Symptoms last longer than three weeks.

Most Common Reasons for Insomnia

  • Stress. Many people experience stress from the environment, including that caused by life, work, family, and the like. This keeps them thinking about the stress and trying to deal with it, which makes falling asleep extremely difficult.
  • Anxiety. Everyday activity and anxiety, or severe anxiety disorder may keep the mind too alert to fall asleep.
  • Depression. This is a very pronounced reason to keep people alert and make sleep difficult.
  • Long-term use of sleep medication. Drugs such as Ambian or Wellbutrian cause psychological dependence on them.
  • Pain. Many conditions, including arthritis, fibromyalgia, neuropathy, trigeminal neuralgia, plus assorted injuries, will cause pain, making it hard to fall asleep and stay asleep.
  • Aging. When people age, they do not need as much sleep as they did when young. The reasons for this include changing life patterns, family changes, and other worries, all of which can cause insomnia.

 

Treatments in Western Medicine

From the perspective of Western medicine, there are two major types of treatments.

Non-Medicinal Treatments and Behavioral Therapy

  • Sleep hygiene. This is a component of behavioral therapy, with several simple steps that can be taken to improve the quality and quantity of sleep, such as timing of sleep, food intake, sleeping environment etc. Sleep hygiene combines advice about aspects of sleep control, how to avoid sleep deprivation, and how to respond to unwanted sleep interruptions if they occur.
  • Increased exercise. Exercising a minimum of 45 minutes a day, 6 days a week, will greatly improve the quality of sleep.
  • Relaxation therapy. Massage, meditation, muscle relaxation, or a hot bath or shower can assist in falling, and staying, asleep. No one should ever try to force themselves to sleep, but should retire in a relaxed mood.
  • It is best to keep a regular sleeping and waking schedule and not drink caffeine, or any beverage, before sleeping. Nor is it good to smoke. Do not go to bed hungry, and make sure the sleeping chamber is adjusted for light, temperature, and noise to make sleeping easier.
  • Stimulus control: It’s important to go to bed as soon as you feel sleepy, and not watch television, read, eat, or worry in bed. It is not advisable to take long naps during the day. (Oversleeping does not improve insomnia.)

Medication

  • Benzodiazepines. There are many different types, including temazepam, lorazepam, triazolam, and clonazepam. All of these benzodiazepines are very effective in improving the quality and quantity of sleep.
  • Nonbenzodiazepine medicine, which includes Lunesta, Sonata, and Ambien.
  • Melatonin. This is a hormone secreted by the pineal gland. It is produced during the night and helps body relaxation. (Attention needed here, however, because regular use causes the body to permanently lose its ability to produce the hormone.)
  • Rozeren. This will stimulate the melatonin receptor to improve sleep quality and quantity.
  • Some antidepressants, such as Elavil, Endep, or Desyrel, have also been used for a long time to aid in depression as well as sleep.
  • Antihistamines. Benadryl, for example, and other antihistamines can be used to induce drowsiness. The drawback to this is that, during the day, they can make it dangerous for a patient to drive or operate machinery.

 

Treatments in Traditional Chinese Medicine

Chinese medicine indicates five types of insomnia.

Excessive Fire in the Heart and Liver

The main symptom is irritability, difficulty falling asleep, sleeping intermittently, waking up easily, sometimes experiencing dizziness, dry mouth, bitter taste in the mouth, and dry tongue body, with yellowish coating on the tongue and a rapid pulse. The method of treatment is to decrease the excessive fire of the liver and heart. The acupuncture points are Xing Jian, Feng Chi, Sheng Men, and An Mian.

Table 7.1

Points Meridian Number Conditions Helped
1 Xing Jian Liver 2See Figure 7.1 Insomnia, abdominal distension, headaches, dizziness and vertigo, congestion, swelling and eye pain, deviation of the mouth, hernia, painful urination, retention of urine, irregular menstruation, epilepsy, convulsions
2 Feng Chi GB 20See Figure 7.3
3 Sheng Men Heart 7See Figure 7.4
4 An Mian Ex HN13See Figure 7.2 Insomnia, vertigo, headaches, palpitations, mental disorders

Please refer to the accompanying Figures (illustrations) for the locations

of the points. And please note that these illustrations are for information

only and may not show all the exact locations of the acupuncture points.

 

Figure 7.1

 

 

Figure 7.2

 

Fig 7.3

 

 

Fig 7.4

 

 

These points can calm the mind and improve sleep. Xing Jian belongs to the liver meridian which, when treated, can decrease the fire of the heart and liver. Feng Chi is located in the gallbladder meridian, and together with Sheng Men, a point of the heart meridian, they will decrease the fire of the liver and heart, and help to calm the brain. An Mian is also a very important point for alleviating insomnia.

Overeating

Many people experience a restless night after overeating; they feel bloated and gaseous, and have constipation or diarrhea, with white coating on the tongue. The treatment is to strengthen the spleen and stomach to calm the mind and induce sleep. The acupuncture points are Pi Shu, Zu San Li, Sheng Men, and An Mian. Pi Shu and Zu San Li are the best points for the stomach bloating, constipation, and diarrhea. Digestion will be much improved by stimulating Pi Shu and Zu San Li. As mentioned, Sheng Men and An Mian will greatly facilitate sleep.

Table 7.2

Points Meridian Number Conditions Helped
1 Pi Shu UB 20See Figure 7.8
2 Zu San Li Stomach 36
3 Sheng Men Heart 7See Figure 7.4 See Table 20.2
4 An Mian Ex HN13See Figure 7.2 Insomnia, Vertigo

Please refer to the accompanying Figures (illustrations) for the

locations of the points. And please note that these illustrations are

for information only and may not show all the exact locations of

the acupuncture points.

 

Fig 7.5

 

Depression and Sadness with Deficiency of Lung Energy

The main symptoms are depression, low energy, slowed conversation with low tone, accompanied by congested lungs, difficulty sleeping, and always waking up during the night. Sometimes there is a shortness of breath and a thin white coating on the tongue, with a deeply weak pulse. The points should be Fei Shu, Lie Que, Sheng Men, and An Mian. The acupuncture points will help the energy of spleen, stomach, and lung to improve their function.

Table 7.3

Points Meridian Number Conditions Helped
1 Fei Shu UB 13See Figure 7.7
2 Lie Que Lung 7See Figure 7.6
3 Sheng Men Heart 7Fig 7.4 See Table 20.2
4 An Mian Ex HN13See figure 7.2 Insomnia, vertigo, headaches, palpitations, mental disorders

Please refer to the accompanying Figures (illustrations) for the locations

of the points. And please note that these illustrations are for information

only and may not show all the exact locations of the acupuncture points.

 

Fig 7.6

 

 

 

Fig 7.7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Disharmony of the Heart and Kidney

The main symptoms are anxiety, chest pain, difficulty maintaining asleep and easily waking up, heart palpitations, and stress, as well as weakness of the low back and legs, night sweats, and hot flashes, with red coating of the tongue and rapid and weak pulse. The points are Sheng Shu, Tai Xi, Sheng Men, and An Main.

Table 7.4

Points Meridian Number Conditions Helped
1 Sheng Shu UB 23

See Figure 14.1See Table 14.42Tai XiKidney 3

See Figure 16.6See Table 16.23Sheng MenHeart 7

See Figure 20.2See Table 20.24An MianEx HN13

See Figure 23.2Insomnia, vertigo, headaches, palpitations, mental disorders

Please refer to the accompanying Figures (illustrations) for the locations

of the points. And please note that these illustrations are for information

only and may not show all the exact locations of the acupuncture points.

 

Deficiency of Qi (Energy) and Blood

The main symptoms of this type of insomnia are dizziness, drowsiness, forgetfulness, poor sleep, tinnitus, and weakness, as well as cold in all the extremities, a pale face and tongue, poor digestion, and a weak pulse. The method of treatment is to calm the mind, and tonify the blood and qi, thus improving sleep. The points are Pi Shu, Sheng Shu, San Yin Jiao, Sheng Men, and An Mian.

Table 7.5

Points Meridian Number Conditions Helped
1 Pi Shu UB 20

See Figure 7.8 2Sheng ShuUB 23

See Figure 7.8 3San Yin JiaoSpleen 6

See Figure 7.9 3Sheng MenHeart 7

See Figure 20.2 4An MianEx HN13

See Figure 23.2Insomnia, vertigo, headaches, palpitations, mental disorders

Please refer to the accompanying Figures (illustrations) for the locations

of the points. And please note that these illustrations are for information

only and may not show all the exact locations of the acupuncture points.

Fig 7.8

 

 

Fig 7.9

 

 

 

 

Alice’s Treatment

Since stress caused her poor sleep, Alice belongs to type three. I selected the acupuncture points UB 13 Fei Shu, Lu 7 Lie Que, Heart 7 Sheng Men, and Ex HN13 An Mian, and she reported that, after the first treatment, she slept three to four hours. After the second week, her sleeping increased to five or six hours a night and she was starting to feel much better. After a month, her sleep pattern became normal, and she could sleep through the night. Her husband’s news that he found a job locally and would no longer have to commute to New York also alleviated her stress, which further helped her establish a normal pattern of sleep. After her course of treatment, Alice thanked me for how much I had helped her achieve relief from her insomnia.

 

Tips for Personal Use at Home

  • Take a hot shower and then press An Mian points (see Figure 23.2) for 15 minutes on each side before you go to bed. Acupressure the points with your thumb or knuckle, pressing with comfortable pressure on the points.
  • Do not force yourself go to bed if you do not have desire to sleep.
  • Do physical exercise at least 45 minutes per day, 6 days per week. The exercise will help you a lot.

 

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