Addressing headaches through trigger point therapy.
Common causes of headaches are tight muscles in the upper back, shoulders and neck. There are multiple presentations depending on which muscles are in spasm. One of the most prevalent patterns is the referred pain pattern from upper trapezius.
The upper trapezius muscle connects the shoulder to the neck and head. It is commonly felt as a hard knotted lump in people who are suffering from these headaches. There are many causes for it tightening, the most common are: whiplash, postural, workplace ergonomics, and overuse. The pain it causes runs along the side of the head from the neck to the edge of the eye. Frequently this would be described as a headache on the side of the head, or a temporal headache.
The areas in red on the diagram show the areas where pain shows up when this muscle is in spasm.
This would be a headache or migraine like symptoms.
In my clinical experience, when a patient presents with this pain pattern, treatment is generally relatively straightforward to get on top of the pain. We work to find the tight fibers of the muscle, and through direct needling of the trigger point, distal meridian needle, or needle free neuromuscular techniques (generally a combination of all three) we are able to get the muscle out of spasm and alleviate the headaches. In the process, it really makes the shoulders feel better as well.
If you, or someone you know, is suffering from headaches or neck pain, please feel free to call to see if acupuncture can help you.
Treatment of neck disorders with acupuncture
Neck problems are very frequently seen in my clinic. They happen to people with some regularity, and in many cases are easily and quickly resolved. The most common of the neck complaints are tightness in the upper trapezius, and tightness in the levator scapulae. Although the names alone may not mean much to most people, you have probably suffered from one, or more likely, both conditions.
The upper trapezius is the muscle that runs from the shoulders to your neck and back. The middle and lower fibers run along your spine to the lower middle back http://www.wellsphere.com/back-neck-pain-article/pain-in-the-upper-trapezius-muscle/828069 . When there are trigger points in this muscle, the referral can send pain and tension from your upper shoulders to your jaw or even cause headaches on the sides of your head or next to your eyes. There is the additional presentation of raised shoulders.
Dependent upon the patient, constitution, severity and duration o the condition treatment options differ greatly. Treatment is tailored to give the patient the fastest and most lasting results based upon these factors. In the cases of patients with a more sensitive and responsive constitution this can frequently be addressed using neuromuscular techniques (no needles) to stimulate various reflexes and stimulating related muscles to facilitate a reduction in pain and decrease in degree of spasm. This can effectively ameliorate the degree of discomfort and dysfunction in many cases in one to three sessions.
In cases I have seen where the muscles feel like rocks and the person has been carrying their shoulders elevated for an extended period of time I use a technique called dry needle trigger point release. This involves working on the tightest fibers of muscle and stimulating them to fasciculate (twitching), which mechanically will release the spasm. Following the treatment it is not uncommon to experience some soreness, similar to after a good workout, for the remainder of the day and possibly the next day. The immediate and verifiable results following treatment are a loosening of the muscle and an increase in range of motion. Generally this decreases the related symptoms of headaches and jaw tightness (if present on intake), and also increases the strength of the muscle.
In most cases, regardless of presentation, therapy is given at distal points (areas not near the shoulders or neck), that will further stimulate the muscle to relax and mobilize the body’s healing processes. These points also help to restore overall balance in the body to assist the treatment in holding longer.
Levator Scapulae is a different kind of presentation, although it is frequently seen in conjunction with the upper trapezius. This muscle runs from the upper inside corner of your shoulder blade past the nape of your neck and connects to the upper cervical vertebrae http://www.wellsphere.com/back-neck-pain-article/neck-muscles-most-responsible-for-your-stiff-neck-and-trigger-points-the-levator-scapulae-trapezius/772158 . Some of the functions of this muscle are turning the head and raising the shoulder blade. If you have ever woken up with a stiff neck, and have problems turning your head to one side or both then you know the muscle. At times this can become severe and the duration may last more than a day or two. This patient will walk in with a demonstrable problem in cervical rotation (turning head). At that point I press on the muscle, and if it tight and painful, confirmation has been given that the muscle is in spasm.
Treatment, again, is based upon the constitution of the patient and the presentation. In cases where a patient is more responsive to distal work, there are points on the hands and feet that I have used very successfully to immediately improve the range of motion (generally by 80-90%) and decrease pain. The results are dramatic and if the situation is acute tend to show resolution within 1-2 days without further intervention.
In more severe cases I tend to use the dry needle trigger point technique. In one particular case, a patient had slept wrong while having cold air blown on her. When she came in to see me her right shoulder was raised as if she was cradling a phone with her shoulder (she wasn’t actually cradling a phone). It was immediately apparent the problem was with this muscle. I had her get on the table, and within 4 minutes of treatment her shoulder was back to normal, and she had full range of motion. I have seen many other patients who had come in with a stiff neck from sleeping, or limited range of motion turning their heads who have responded immediately once this muscle was addressed.
Acupuncture in the treatment of shingles and postherpetic neuralgia
Anyone who has ever had the misfortune of suffering from shingles and postherpetic neuralgia couls explain it is one of the worst most excruciating pains to have. Generally by the time I see someone the pain has persisted for longer than expected and the disease is at a tougher stage to treat, as it has become entrenched.
Generally with acupuncture and herbs, if done from the onset, the progression of the disease can be staunched by boosting the immune system, and possibly with the introduction of herbs containing targeted anti-virals. Symptomatically points and herbs are chosed to reduce systemic inflammation, as well as specifically targeting nerves causing pain.
My preferred techniques for targeting the nerve pain are using distal techniques (I prefer not to needle into area that are already irritated. The styles that are most conducive to that are Sujok (using allpoints on the hand to influence the body), Master Tong’s/ Dr. Tan’s methods (using areas of the body to influence distal regions), channel theory, and Kiiko Matsumoto style.
One particular case sticks in my mind. A woman in her late 50’shad gastric bypass surgery, but suffered from complications. Once she got to her desired weight she continued losing. She was not getting sufficient calories or nutrients from her food. She succumbed to Shingles on her face, and the postherpetic neuralgia would not go away. By the time I go to see her, half of her face was inflamed, painful, and distorted from the nerve inflammation. It looked as I there was a line drawn down the midline as the other half was undisturbed. She was also experiencing significant pain in her mouth as well. We started at 3 treatments a week, and by the end of the first week, we had reduced the pain in her mouth to almost zero, and her face was 70% better. This was all done by having her test an area to gauge the level of pain. I would find a corresponding point elsewhere on the body that should stimulate a healing reaction there, and then I would have her test again. We would repeat this testing until we had reached maximum improvement for the session.
By the end of the second week, we had surpassed 85% improvement, and looking at her there were no signs of the shingles. Over the course of 6 weeks, we achieved a 95% improvement, and she was discharged.
Treating Shoulder problems with acupuncture and neuromuscular techniques Pt1.
Frozen shoulder – or adhesive capsulitis – gives multiple presentations, and several different underlying causes. What they have in common with each other is movement of the shoulder is very limited, cause tends to be undetermined, and treatments have not been very effective. Pain, however, is the real deciding factor. This condition tends to be painful with the pain ranging from somewhat intermittent pain to constant and intense pain.
The cause of frozen shoulder is unknown, there are multiple theories, but what is known is the capsule of the shoulder becomes inflamed restricting motion and causing pain. By the time a patient is in my office, generally multiple doctors had been seen. In the case of this condition, there is not a lot that conventional medicine can offer. The usual course of treatment may be anti-inflammatories, or physical therapy.
Treatment modalities that I tend to use in with frozen shoulder are dry needle trigger point technique. This is a muscule based technique that assists local musclulature in the shoulder to loosen, allowing greater blood flow by reducing pressure in the joint, allowing greater blood flow and a decrease in inflammation. This technique generally would be accompanied by distal needling along the channels, encouraging a reduction in inflammation.
Another technique I have used very successfully has been Kaufman’s pain elimination technique. There are multiple approaches in this system, in general they involve using neuromuscular techniques to instantly get muscles out of spasm, and various other techniques to gently encourage mobilization of the joint.
Following the application of either of these techniques, I check the range of motion (generally the improvement should be between 30-60%) and the pain should be significantly reduced. Following that, I do bodywork to encourage the muscles to set. Both have these techniques have rapidly cleared acute and chronic frozen shoulders, and given people back their lives (or at least the ability to grab cans from high shelves, and brush the tops of their heads).
For anyone suffering from plantar fasciitis, or heel spurs you know what it is like and what the limited treatment options are. For anyone who has never had or is not sure if they have had this condition, please let me assure you it is not comfortable, and the conventional treatment options leave something to be desired.
Prior to practicing acupuncture, I was practicing yoga one day. Unfortunately I was doing so in a competitive mindset, and was determined to nail downward facing dog with proper form. I did get the pose, but the next morning I woke, and as soon as my heel hit the floor I lit up with pain. Throughout the day and the subsequent months I was greeted with an indescribable discomfort in my heel area as I walked. It was certainly most severe in the morning when my heel would hit the floor. As the day progressed the pain would become less severe and I would more be aware that something was wrong than experiencing strong discomfort. In later experience I realized I had a minor case of what turned out to be plantar fasciitis.
The condition itself is due to micro tears on the plantar fascia. This is the thick tough connective tissue on the bottom of the foot http://en.wikipedia.org/wiki/Plantar_fascia. It provides strength stability and protection to the foot. Since it is fascia, it is not supplied with good blood flow, and when there are the micro tears. This condition is often associated with heel spurs – protuberances o bone that place excess stress on the plantar fascia. Treatment options, as I have said, are limited and vary in efficacy.
My first case of plantar fasciitis that I had in my office was very interesting. A woman came in severely limping. I had just completed my training in Sujok acupuncture, and being that I knew this to be a difficult condition, I decided to test out what I had learned. I found the most tender spots on her heels and would press them for a baseline on the level of pain that she experienced. I located the points on her fingers that significantly reduced the pain when I pressed on her heels. I then placed small needles in the finger points. I did this with all of the tender spots on her feet. Once I had completed the placing of the needles, I had her walk the hallway of my office. She was amazed at the reduction of pain. After several minutes of needle retention, I removed the pins, and placed small metal beads where the pins were and asked her to leave them on for a day.
At the second treatment she had maintained a 40% improvement. I repeated the process. On the third treatment I had my office manager call to confirm and she was going to cancel her appointment because it hadn’t been working. I was shocked, as I thought she had been making great progress. It ends up she thought that I was her podiatrist, and it was her conventional treatments that had not been getting results. After 2 more visits she was completely pain free, and 4 years later continues to be.
Since that time I have seen many more patients suffering from this condition, and the vast majorities have had rapid and dramatic improvement in their pain while getting great improvement in function. This is all without any drugs or pain killers.