Endometriosis treatment with Acupuncture

Endometriosis is a relatively common problem. Between 2~22% of women are estimated to have endometriosis, climbing to 40~60% of women with dysmenorrhea (painful periods).

Endometriosis is a chronic condition. It is the presence of cells from the uterus lining (endometrial tissue) outside the uterus. The endometrial tissue can be found in the pelvic cavity, for example on the bowels, but also in other parts of the body. It still responds to the hormonal changes of the menstrual cycle in the same way than the cells in the uterus lining which leads to bleeding, inflammation and pain.
Some women are unaware that they have endometriosis or have very mild symptoms. Others however experience pain, from mild to severe, painful sex, heavy bleeding and fertility problems.

Western medicine approach to the treatment of endometriosis include painkillers such as NSAIDs, hormone treatments such as the combined oral contraceptive pill and surgery, most commonly through laparoscopy. There is no definite cure for endometriosis and the management of pain in women with endometriosis is often inadequate.

Endometriosis and Acupuncture

A 2010 study on acupuncture and endometriosis has shown that women receiving acupuncture showed a significant reduction of pain intensity after the first 10 treatments. Previous studies also show that electroacupuncture can effectively relieve endometriosis-induced dysmenorrhea and that Japanese style acupuncture may be an effective, safe, and well-tolerated adjunct therapy for endometriosis-related pelvic pain.
Acupuncture has also been shown to be efficient in the treatment of dysmenorrhea.

How does Acupuncture help with endometriosis

In Chinese Medicine, endometriosis is seen mainly as an issue with Blood Stagnation (which is exactly what it sounds like) with some associated pathologies (Heat, Cold, Qi deficiency...).
The aim of the treatment will be to reduce the pain, reduce the Blood stagnation and regulate the menstrual cycle.

The treatment is quite often linked to the woman's cycle, the intend of the treatment depending if it's the second part of the cycle, the time during the periods or just after the periods.
As the aim of acupuncture is to treat the whole person, other imbalances are also taken care of during the treatment so each patient will have a personalized treatment plan.

As it is often the case with acupuncture,  the length of treatment will vary a lot from one person to the next. However, endometriosis usually requires regular treatment on a on longer term than other conditions, around 3 to 9 months.

How often do I need to get an acupuncture treatment?

This is probably one of the most common questions that people ask during their first consultation. The other is whether they will need to keep having acupuncture on a weekly basis to keep the getting the effect.

Traditionally, in China, doctors were not paid when their patients were getting ill. They were paid when their patients were well and healthy. This is in contrast with the way we only go and see our GP when we are ill. Traditional Chinese Medicine has a strong emphasis on re-establishing balance within the body and on preventing illness rather than trying to get better once the person is ill.

So let’s say someone is coming to see with nausea and vomiting during the first trimester of her pregnancy (also called morning sickness). Acupuncture can achieve fantastic results and calm the nausea and vomiting down very quickly, sometimes even after just one treatment.

However, that patient will need several treatments after that. This is because, with acupuncture, I would be trying to treat both the symptoms and the root causes of the problem. If only the symptoms are treated, they are very likely to come back. This is a bit like taking one pill to calm the nausea down. As the effect wears off, so the nausea comes back. As the root causes of the problem are tackled and the body is brought back into balance, the length of time without nausea increases and the results are sustained.

How long this will take depends largely on the patient and the length of time he or she has had that illness. The longer the problem has existed, the longer the treatment will take to re-establish balance within the body. Even when the illness is very recent, it may take time to ensure that the results are sustained. This is because an illness can be the sign that your body has been out of balance for a long time, even without obvious symptoms, and therefore will take time to recover. This also explains why 2 persons who have had a similar accident can heal at such different rates.

So as a general rule, I usually say that people will have some improvements within 5 to 8 treatments, with some people experiencing major changes after just one treatment. The length of the treatment itself will depend a lot on the patient and the length of time the imbalance has been present and if there are still some external causes for the illness (for example, stress or a very physical work).

Finally, I would really recommend to anyone who has had acupuncture in the past and found it beneficial to have some regular ‘top ups’, perhaps every 6 weeks or so.

Turning breech babies with acupuncture

In 2005, a Cochrane review on turning breech babies with moxibustion showed that moxibustion, a type of Chinese medicine which involves burning a herb close to the skin, may be helpful in turning a breech baby when applied to the little toe.
 In 2008, a systematic review of studies assessing the effectiveness of acupuncture-type interventions (moxibustion, acupuncture, or electro-acupuncture) on acupuncture point BL 67 (situated on the little toe) to correct breech presentation suggest that acupuncture-type interventions on BL 67 are effective in correcting breech presentation.

So what is actually involved in turning a breech baby with acupuncture?

Well, in most cases, the acupuncturist will use moxibustion. This treatment protocol is over 1,000 years old and has been developed in China. It involves burning a tightly compacted herb (artemisia vulgaris) near the little toe of the pregnant woman. There is no need for needles and women only feel a pleasant feeling of warmth in the area.

After checking that there is no contra-indication to the treatment, the acupuncturist will do one treatment with moxa, showing the woman (and if possible a partner) the procedure at the same time.
The same procedure will have to be repeated at home for 10 days so full explanation and enough moxa for the treatment will be given too.

It is usually recommended to start the procedure between 34 and 36 weeks in the pregnancy as the baby has more room to turn. However it can be used up to full term.
Moxibustion may also be helpful even if the woman decides to have an ECV (external cephalic version) to help and turn the baby.

Image: Sura Nualpradid / FreeDigitalPhotos.net

Treating Back Pain with Acupuncture

When I am asking people if they’ve had acupuncture before and what it was for, back pain is probably the most common answer. This is hardly surprising as acupuncture is known for its ability to relieve pain but also because back pain is a very common complaint.

Back pain is one of the most prevalent reasons people seek health care. It is the UK leading cause of disability and one of the main reasons for work-related sickness absence.

In most instances, people are suffering from lower back pain. One of the top causes of back pain are sprains (overstretching one or more of the ligaments in the back) and strains (a rip or tear in the muscle caused by sudden force). This can happen from an injury, poor posture, or improper lifting.
Sciatica is another common form of back pain. Sciatica is a term used to describe pain that extends down into the buttocks and leg which comes from an irritation of a larger nerve in the lumbar spine called the sciatic nerve. Sciatica can accompany sprains, strains, herniated discs as well as back pain emanating from other sources.
Back pain can also happen during pregnancy, because of stress, viral infection or kidney infection.

Research has shown that acupuncture can help back pain by providing pain relief, improving muscle stiffness and joint mobility and reducing inflammation.

The National Institute for Health and Clinical Excellence (NICE) guidelines on best practice now recommend that GPs offer a course of 10 sessions of acupuncture as a first line treatment for persistent, non-specific low back pain.

Acupuncture and Back Pain:

The aim of acupuncture is to restore the flow of energy in the body to promote self-healing. Different techniques can be used: needling but also cupping (vacuum cups to help relax the muscles, improve blood and energy flow) and moxibustion (a warming technique which involves burning tightly packed herbs near the patient skin on a needle or with a stick).

When treating back pain, an acupuncturist will palpate your back to find the areas that are the most sensitive and needle those. But it is also possible to use distal points, acupuncture points that are further away from the area of pain, usually on the hands and feet. These are just as efficient as local points and are particularly suitable in case of an acute injury.
He/she might also check where are the restrictions in movement and where is the pain associated with a certain movement (referred pain).
Cupping will help improving the blood flow in the area and relax the muscles.
Moxibustion, because of its warming effect, helps relaxing the muscles, especially if the area is cold to the touch.

Finally, the acupuncturist will also choose constitutional points to work on the root causes of the problem, i.e. what sort of imbalances are present that made the body weaker and therefore more prone to back pain.

 This is an important point of an acupuncture treatment. As a holistic therapy, acupuncture and Traditional Chinese Medicine always seek to treat the whole person and not just the symptoms. By concentrating both on the symptoms (reducing pain) and on the root cause of the problem (the energetic imbalances in the body), acupuncture can achieve long lasting relief and avoid a pattern of recurring back pain.

Acupuncture and Menopause

Hot flushes plague many women during menopause because at that of their life, women experience fluctuations in hormone levels. Well, it looks like acupuncture is now recognized as providing relief from this miserable symptom. Studies have shown that acupuncture may help relieve hot flushes from menopause. And another study also showed that acupuncture can improve not just the frequency of the hot flushes but also the women's quality of life.

What is Menopause?

Menopause is a transitional period marking the cessation of ovulation in a woman's body. This time of change may last a few months to several years. Symptoms vary from mild to severe, and are brought on as our bodies try to adapt to decreasing amounts of oestrogen. Symptoms include hot flushes, night sweats, insomnia, fatigue, mood swings, memory loss, vaginal dryness, headaches, joint pain, and weight gain.

Practitioners of Traditional Chinese Medicine (TCM) offer another paradigm in which to consider the experience of menopause. In TCM, life goes in cycles of 7 years for women (and 8 years for men). At the end of the seventh cycle (7x7 so 49 years old), menopause occurs and the woman becomes infertile.

In TCM, Essence is responsible for birth, growth, development, sexuality, maturation, and aging and is associated with the Kidney.  The gradual depletion of Kidney Essence is the mechanism responsible for the timing and signs or symptoms of menopause. It is also responsible for weakening of the bones, loss of teeth, hearing loss, confusion and memory problems—all manifestations associated with the Kidney. Weakness and lack of energy are also a common condition of depleted Kidney Essence, along with lumbar pain, as the Kidney is located in the lower back.

It is important to note that in Traditional Chinese Medicine, the organs, such as the Kidney, do not share the same meaning than in Western Medicine. They are rather symbolic entities whose function is defined at the level of the body but also on an emotional level and in relation with the other organs in the body. So the Kidney is associated with the formation of urine but also with Fear and houses the Essence.

Diagnosis and Treatment of Menopause

In Western Medicine, the treatment of choice for hot flushes is HRT (Hormone Replacement Therapy). Whilst HRT can certainly help women, it can have a number of significant side effects including increasing the risk of breast, ovarian and uterine cancer. It is therefore an unsuitable choice for some women, for example women with a family history of breast cancer.

Like many other conditions that patients bring to acupuncturists today, menopausal syndrome is a biomedical disease category. There is actually no evidence that it was recognised as a medical problem in Traditional Chinese Medicine. Instead Traditional Chinese Medicine is working as a holistic therapy, treating the person as a whole and taking into account all the different symptoms of that particular patient to establish the diagnosis. Because not everyone will have exactly the same symptoms, each patient will receive a treatment specific to his own imbalances, including a different acupuncture points prescription and/or lifestyle and diet advice.

 As more and more research shows that acupuncture can be an effective modality to treat hot flushes, acupuncture is proving to be one option to ease the transition phase during menopause. So don’t suffer in silence!