Acupuncture for Causalgia

肢端紅痛症

cau·sal·gi·a

[kôˈzalj(ē)ə, -ˈsal-]

Causalgia Toes during a burning flare

Toes during a burning flare

https://en.wikipedia.org/wiki/Erythromelalgia

 

Causalgia is a pain syndrome manifest with severe burning pain in a limb caused by injury to a peripheral nerve.  The disease also known as reflex sympathetic dystrophy (RSD), or a newer medical term called Complex Regional Pain Syndrome (CRPS).

 

 

chronic neuropathic pain syndromes

“Of all the chronic neuropathic pain syndromes, none has perplexed patient, clinician, and scientist more than the complex regional pain syndromes (CRPS), heretofore known as reflex sympathetic dystrophy (RSD) and causalgia.”

Complex Regional Pain Syndrome (CRPS) or Reflex Sympathetic Dystrophy (RSD)

 

There is another autonomic nerve system illness that I see in my clinic, with similar ANS problems but manifest quite differently from Raynaud’s (ray-NOHZ) disease, called Causalgia. Raynaud’s is more prevalent to young female, causalgia is more seen with young man.  As of the reason why and what causes these autonomic nerve system disease, both are unknown.  One things seem in common is that we can noticed that patient usually are likely been lack of exercise, as well as easily seen frostbite in winter season; for those women whom suffered from this disease are usually seen Irregular menstrual periods or to have sweaty palms.  Causalgia can be secondary to some diseases such as thrombotic angiitis(vasculitis), Diabetic peripheral neuropathy, Scleroderma, Polycythemia Vera, Syringomyelia, advanced skin lesions of nutritional change, such as thickening of the nails, or small ulcers forming at the tip of the fingers.

 
Erythromelalgia in a 77-year-old woman with longstanding

Erythromelalgia in a 77-year-old woman with longstanding polycythemia Vera.

https://en.wikipedia.org/wiki/Erythromelalgia

 

Diagnose

Redness, swelling, hot, pain accompany with burning and stinging sensation, pain is worse in the night, as standing, walking and sitting can all trigger the pain, patient liked to raise their legs and stay in cooler environment.

localized skin is hyperemia and warm or hot to touch, skin temperature can be raised moderately.  Mild swelling and sweating, localized tactile hyperalgesia and no sensory loss or motor disorders.

 

 

 

 

Treatment

  1. Treatment using Jia-Ji points:

Jia-Ji points from T1 to T5, lumbar area L1 to L3.

Retain needles for 30 minutes, 10 treatments as one session.

 

  1. Treatment using localized acu-points:

足三里  ST-36, 陽陵泉  GB-34, 三陰交  SP-6, 太溪  KI-3,太衝 LR-3,

俠溪 GB-43。

Retain needles for 30 minutes, 10 treatments as one session.

 

  1. Treatment using back side Shu-Point:

For upper limbs – 闕陰兪 BL-14, 心兪 BL-15, 膈兪 BL-17。

For lower limbs – 脾兪 BL-20, 胃兪 BL-21, 腎兪 BL-23。

Retain needles for 20 minutes, 10 treatments as one session.

 

Personal experience and conclusion:

Personally, I like to utilize ONLY the Jia-Ji Points because I have noticed that by using Jia-Ji Point Treatment sees much faster improvement and good prognosis.  I have been carefully avoiding those localized point or acu-point in the focus areas, as I have found that the situation can become worse, or stimulations can just triggered another new attack.

 

 

 

 

You can find more of the general medical information of Causalgia/RSD/CRPS in these websites:

https://en.wikipedia.org/wiki/Causalgia

www.causalgia.com

http://www.mayoclinic.org/diseases-conditions/complex-regional-pain-syndrome/basics/definition/CON-20022844

http://painmd.tv/crps/

 

This article is written by Larry Han, AP

Acupuncture Treatment Center

www.jacksonvilleacupuncture.com

www.orangeparkacupuncture.com

April 8, 2017

Acupuncture for Benign Prostatic Hyperplasia

Symptoms-wise, there are probably no comparisons from a men’s prostate enlargement to women’s perimenopause and menopause (see *), but the sensation of constant fullness in the bladder, tiredness during the day because of frequent toilet-bond in the night, regressive physical condition along with the anxiety and the concerns of procrastination of the conditions, shadows of prostate cancers, all these complicate the situations.

tiredness guy

*Symptoms of women’s perimenopause and menopause. Most women can notice signs like poor sleeping quality, fatigue, night sweats, hot flushes, difficulties in concentration and poor memory. Vaginal dryness thus it is discomfort during sex and leading to libido.

In this article, I would like to talk about our treatment for the prostate enlargement, it’s cause, symptoms and few areas of concerns of the medications.

Cause of Benign Prostatic Hyperplasia
Symptoms
Complications
Treatment
Commonly seen side affects
Our treatment

Cause

Benign Prostatic Hyperplasia caused by hormonal changes and in cell growth, the etiology includes aging and teste’s functionality and happens to almost all men.

Symptoms

Obstructive symptoms such as troubled initiating urine, forced urination, dribbling, irritation symptoms like frequent urination, wake up at night to urinate, urinary urgency, pain and discomforted of the bladder.

Complications

Blocked bladder makes it extremely hard to urinate, backed-up urinary retention, bladder infections, stones, painless hematuria or kidney damage.

Treatment in Western Medicine

AUA test score 8 or less usually suggest watchful waiting, 8 or more maybe offer oral medication, transurethral microwave therapy, transurethral needle ablation or surgery.

Commonly seen side effects from medication

Proscar depression, a decrease in libido that persisted even after they stopped the drug, erectile dysfunction, breast enlargement accompanied by tenderness. Flomax sudden drop in your blood pressure leading to dizziness or fainting, sinus and nasal congestion, weakness, drowsiness, headache, nausea. My observations to most of my patient’s concern is decrease in libido and erectile dysfunction, with our treatment, since it is all based on how we provide excitation to the nerves that innervate the muscle functions, so far I have never heard of any complain in these areas.

Our Treatment

We use acupuncture to promote and regulate the excitation of nerves that enhanced the functions of trigon or detrusor muscle, and sphincters of internal/external urethra. Libido and sexual ability. In the case of enlargement of prostate, I give excitation to Sympathetic nerve to expand the detrusor muscle, so that the bladder pushes more during urination, this is the part that helps empty the bladder to begin with, I then work on external sphincters to the urethra to opened better, this provides a better flow of urine through the urethra; treatment provide a stronger push while urethra opens when voiding.

In contrast, when treating women’s Urinary incontinence, I use acupuncture to give excitation to the trigon muscle to make the bladder expands so it holds more and with less urgency, and at the same time to have internal sphincter closed better so they will not have a leakage during a laugh or sneeze.

You may also consider some herbal treatment, herbal formulas are been used in urination bifurcation, decrease urine output, bladder infection and decreased libido, depending on patient’s condition, herbal pills or granular formula-herbs that specifically tailored for your own symptoms may be prescribed.

Acupuncture for Neck Pain

Acupuncture for Neck Pain

我怎樣用針灸治療肩頸痛

Larry Han, AP

October 23, 2016

There are quite a few conditions that can lead to neck pain. For most people, they are related to the muscles. When the muscles create discomfort, they can be very easily corrected, often only taking one or two treatments.  I do not believe anyone needs to have 30 separate sessions of “adjustment” for “out-of-alignment” of their neck. In my experience, a muscular type of neck pain simply takes one or two treatments to correct.

Below is a list of signs and symptoms that may correspond to neck pain. Rate how severe your neck pain is using a self-assessment based on the symptoms listed. If you have any of these symptoms, you can consider making an appointment with your doctor.

  1. History of degenerative changes of your cervical vertebrae or intervertebral disc.
  2. Prior or recent diagnosis of rheumatoid arthritis.
  3. Recent trauma (i.e. Automobile accident, whip-lash, sprain, slips, falls, etc.)
  4. Pain radiating to one side of your ear or eye – most likely signifies a condition called Lesser Occipital Neuralgia.
  5. Pain radiating to your upper shoulder, deltoid muscle, upper arm, forearm, or hands – most likely signifies a more serious condition called Cervical Syndrome (this means that the degenerative change has affected the cervical spinal nerve from C4 down).
  6. Pain in the upper top area of the neck, without affecting the shoulder, arm, or hand – in this case, you are most likely to have a higher level degenerative change in the C2, C3 segments.

Here are some of the signs and symptoms that usually indicate that the pain is likely due to nerve impairment: Coldness or pallor in the affected area, numbness, tingling sensation, loss of body hair, areas of localized skin seems to be thinner than usual, and loss of muscle mass in the affected area.

Self-assess with the symptoms listed above.

Constant and prolongingly keep your neck in a forceful position, usually are the blame for neck pain, for example:

  1. Work related. Forced your head forward (holding in a turning angle – chronically) to operate computer can strains the splenius cervices, this usually leads to discomfort when you looking down and up. Having a habit of driving with head sticking forward fatigue the same muscle.Another cause may be long hours of studying, or especially for young people, long hours of having their head in a bent down position due to constant mobile phone usage.The picture below shows the splenius cervices muscle, in which you can see the broad-based origin area and the thin, small insertions on C1, C2, C3 and C4.  When the muscle is strained, you can feel discomfort either at the origin base or along the insertions (the yellow arrows show the areas in which you would feel the pain)
    acupuncture for neck pain
    https://commons.wikimedia.org/wiki/File:Splenius_cervicis_muscle_back.png
  2. Activity or Exercise related.  Have you ever noticed that after carrying a heavy back pack, sometimes you can get sudden onset headaches? Or after several laps of freestyle in the pool, you are experiencing neck soreness instead of soreness in your arms?  Well, you are right. It is the trapezius muscle that is bothering you.  If the areas pointed by the yellow arrows (muscle origin and insertions) are tender to touch, you probably have a trapezius strain. Again, one or two treatments in our clinic should rid you of your discomforts.back and neck pain
  3. Fatigued muscle. Remember how much it hurts when you have that stiff neck?  A stiff neck can come from a sudden movement of your head or neck into an uncomfortable position, such as from looking back too quickly while driving, or just from simply waking up with a stiff neck due to hours of uncomfortable sleep placing strain on your neck.  This is a good example of a muscle reaching its limit and losing its flexibility and elasticity. When we have a prolonged and forceful strain on our neck to one side or when we sleep with a pillow with a sub-optimal pillow height and size, strained muscle can lead to spasm and inflammatory responses, including severe pain.  The best example of this is the strain on the Levator scapula muscle, pictured below.

fatigued muscle

Now you have self-assessed your neck discomfort(s). If your pain correlates with any of the above-mentioned muscular causes, use a heating pad in the affected, painful area for 20 minutes a time, 3 to 5 times a day.  You may very gently rub the muscle, but I would suggest you do this with caution – a hard massage will worsen the situation, resulting in more swelling and pain.

Acupuncture can be used to treat various causes of neck pain. For instance, performing acupuncture on a strained muscle can quickly trigger the immune response, resulting in stimulation of the micro-circulation. This quickly removes the lactic acid and other byproducts of inflammation so that the soft tissue can be re-nourished, leading to the relaxation of the muscle.

For some spinal nerve or spinal column-related ailments, I would connect the acupuncture needles on the neck to an electric stimulation machine and use it to create a regional or “segmental contraction” effect to target the specific vertebral segment for treatment purposes (i.e. vertigo, tinnitus, Normal Pressure Cerebral hydrocephalus [NPCH], bulbar paralysis, Parkinson’s disease, dementia, narcolepsy or severe insomnia).

Make sure your acupuncturist performs an orthopedic test as well as a muscle test to precisely identify the troubled muscle. He or she should also do a neurological test if required, based on the presenting symptoms, making sure that they are only targeting the problematic muscles only, and not unnecessarily placing needles all over the body in order to use acupuncture to “mask” your problems.  Remember, a muscular-related neck pain is very easy to identify and even easier to treat, requiring between one and three treatments applies to most cases.  Talk to a neurologist for all your nerve-related problems. Learning more about your condition is essential; identify the specialty areas of your acupuncturist, do your research, and do not go to just “any” acupuncturist.

 

Larry Han, AP

My clinical experience in treating Raynaud’s Disease

Larry Han, AP

個人在治療雷諾氏症的觀察和體驗,韓羅維 美國佛羅里達州中醫師

I have been seeing patients with Raynaud’s Disease for long time, realized it can be difficult and complicate, you see common symptoms yet every single case has its own causes, this is why that I am always amazed and remind myself to always keeping the humble and learning attitude about the disease.  Often times patient come to clinic believing that they have the disease, when they learned all they have was just merely cold hands and feet, turn out to be a wonderful ending for both patient and myself.

Acral artery spasms also known as Raynaud’s Disease, it is one type of neurological, vascular disorders (peripheral vascular dysregulation).  Cause is unclear yet it is related to the autonomic nervous system dysfunctions.

When secondary to certain diseases, it is called Raynaud’s phenomenon. The disease often occurs in young women, especially those who are easy to get nervous.  Exposed to cold air, or drastic emotional change can induce attack.

Diagnosis: slow onset, usually after exposure to cold environment, especially after the finger (toe) in contact with the cold water.  Often seen in distal extremities, mainly the fingers.  Pale white fingers are symmetry, then cyanosis can be noticed.   often starting from the fingertips, gradually move to the fingers, palm.  accompanied by localized cold, numbness, pricking-like pain, or other paresthesia.

Radial artery or dorsalis pedis pulse can be normal or weaken, attack remission after several minutes. Skin turns to flushing then returned to normal, so as the skin temperature.  There are no particular symptoms other than cold hands or feet during remission.

Affected areas can also be seen in other parts of the body, such as the nose, lips, ears and even nipples and so on.

 

Raynaud’s Diseas

【See Above pictures.  Acupuncture offers effective and significant result in treating Raynaud’s disease, gangrene is diminishing with scab and new granulation grown on the 36th day from the beginning of the treatment shown in picture. 】

 

 

Recurrence 復發的治療

 

In July 2012, same patient had another serious attack of Raynaud’s Disease. Again, it was acupuncture helped with the situation, see following dated pictures.

serious attack of Raynaud’s Disease

Raynaud’s Disease

Raynaud’s Disease

 

Acu-points used in acupuncture treatment:

  1. Jia-Ji treatment:

Primary acu-point should be in the lower cervical, upper thoracic as well as lumbar region.

  1. Localized distribution acu-point:外關SJ5 ,合谷 LI4,後溪 SI3 ,足三里 ST36, 太溪KI3 ,太衝 LR3 ,俠溪 GB43 。

Operation: reducing method.

  1. Acupuncture with Elec-stimulation:

Prescription:曲池 LI11 ,外關 SJ5 ,內八邪,太谿 KI3 ,太衝 LR3,

足三里 ST36。

use sparse continues wave,frequency 1 Hz, negative connect to distal acu-point and positive to the proximal,15~30 minutes in each treatment.

  1. Personal experience:

First, acupuncture can quickly act on the pain, neurotransmitters such as catecholamine’s can also reduce the stress and anxiety induced phenomena’s.  As the disease relapsed or during remission stage, herbal treatment can be considered.

I some time prescribed herbal prescription called Wen-Yang Tong-Mai-Yin, was developed by Professor Gao Weibin, I used herbs to help consolidate and effectiveness of the treatment, or to use it for those who cannot come to continue the acupuncture treatments.

Formula usually consist of Fu-Zi (Aconite), Wu-Zhu-Yu (Evodia), Huang-Qi (Astragalus), Dang-Shen (Codonopsis), Dan-Shen (Salvia), Chi-Shao (TPG), Dang-Gui (Angelica), Gui-Zhi (cassia twig), as well as others to be added base on patient’s condition.

Pharmacological analysis of these herbs:

Fu-Zi (Aconite) and Wu-Zhu-Yu (Evodia) both Belongs to tonify Yang herbs that containing higenamine with β-adrenergic receptor agonists like effects, worked to expand the skeletal muscle blood vessels, reducing peripheral vascular resistance.

Huang-Qi (Astragalus) and Dang-Shen (Codonopsis) can enhance adrenal function, improve body’s adaptability, expand blood vessels, reducing vascular resistance.

Salvia, TPG expansion limbs blood vessels and improve peripheral circulation.

When adding together Angelica, cassia twig and Evodia can effectively increase skin temperatures.

 

【Raynaud’s Disease cause and treatment from a western medicine point of view】

Presently the cause for Renault disease is still unclear, overreaction to cold environment, anxiety and emotional change seems also have associated with the condition. Vasospasm may cause long-term harden and thickening of the small arteries can further worsen the situation.

Primary Raynaud’s Disease
Also known as Raynaud’s disease, the majority of Renault’s disease fall into this category, the cause is unknown, there is no specific predisposing conditions.

The second category of Raynaud’s disease, also known as Raynaud’s phenomenon, which has a specific incidence of the condition, although cases number is relatively small, but symptoms are much more severe. Usually pathogenesis seen in the middle age, about 40 years old.

Cause for Raynaud’s phenomenon may include the following:

Connective tissue disease: for example, scleroderma patients can also have Raynaud’s phenomenon. Other risk includes lupus, rheumatoid arthritis, Sjogren’s syndrome.

Artery disease: :動脈硬化 atherosclerosis,伯格氏病 Buerger’s ‘s disease, 原發性肺動脈高壓 primary pulmonary hypertension。

Carpal tunnel syndrome.  Long hours of repeating

Long-term and repeated hand exertion, such as the piano practicing, continuous using pneumatic tools.

Smoking, side effects of certain drugs such as beta blockers; migraine drugs containing ergotamine or sumatriptan; drugs for ADHD or drugs for inattentions, even cold medicine, etc. are likely to cause vasoconstriction phenomenon and leading to attack.

Injuries: wrist and ankle contusion, surgery and frostbite may also induce the disease.

 

Primary Raynaud’s disease morbidity and risk factors include:

Gender: Women were more common

Age: between 15 to 30 years old

Climate: Cool Region

Family history: 1/3 of patient’s first-degree relatives has higher incidence, such as parents, siblings, children, etc.

Risk factors for the second category which is the Raynaud’s phenomenon are:

Related diseases: scleroderma or lupus erythematosus.

Certain occupations: Some job can cause repeated trauma, such as vibration-type tools.

Hazardous substances: smoking, drugs, chemicals, such as vinyl chloride vinyl chloride.

Complications:

Rare and severe Raynaud’s disease may lead to a permanent fingers and toes deformity, resulting from long-termed blood supply reduction.

When attacking area is having a completely blood supply cut off, skin ulcers and gangrene will happen immediately. Ulcers and gangrene are difficult to treat, usually ended with amputation.

 

Prognosis

Once Raynaud symptoms (primary or secondary) has been confirmed, patient would have to go through life time treatment. In the case of Renault phenomenon, the situation is more complicated and difficult; patients usually develop adaptation to the drug, not only reduce the efficacy, but the symptoms will be more frequent and more severe.

 

Treatment and Research

The current study is primarily focused on an enzyme that connect with vasoconstrictions called tyrosine kinase (human proteins), it is associated with heredity.

There are several new treatment options are being conducted, including BOTOX® therapy, Viagra®, traditional Chinese medicines such as ginkgo biloba, and St. John’s wort.

Prognosis for Raynaud’s Disease

Once primary or secondary Raynaud’s develops, the condition usually must be managed over the course of the patient’s lifetime. Although Raynaud’s attacks can be stressful, it is important to remain patient, follow your doctor’s instructions, and be open to other therapies if necessary.

Patients who have secondary Raynaud’s may have an especially difficult time. Treatment options often require adjustments because medications can become ineffective over time and the attacks can occur with more frequency and severity.

Renault’s Disease Disease Research

Researchers are studying possible causes for primary Raynaud’s Disease. Ongoing studies are focused on genetic links and on the role that a protein called tyrosine kinase (PTK; an enzyme involved in constricting blood vessels) may play in development of the condition.

A number of new treatment options also are being studied. These treatments include using botulinum toxin injection therapy (BOTOX® therapy), Viagra®, and herbal therapies (e.g., ginkgo biloba, St. John’s wort) to treat Raynaud’s Disease.

Publication Review by: Stanley J. Swierzewski, III, M.D.

Published: 03 Nov 2008

Last Modified: 21 Sep 2010

http://www.healthcommunities.com/raynauds-disease/prognosis-research.shtml

 

韓羅維 Larry Han, AP

February 14, 2016