Health and Wellness assessment of Philadelphia acupuncture clinics by author Pamela Toy – read post here.

Rittenhouse Sunday Massage or Philly Acupuncture

A growing body of Randomized Controlled Trials (RCTs) continues to prove that the millennia-old practice of acupuncture can be an effective treatment for numerous conditions and illnesses.  Because of a burgeoning interest in acupuncture research among some of the world’s top medical research centers such as Stanford, Harvard, UCSF, etc, it has become known that acupuncture does work.  The question, however, remains how?

Acupuncture has been shown to create various physiological and biological changes in the body on numerous levels simultaneously, therefore, mapping out its systemic effect on the mind-body is quite a complex process.  It is a common belief that the concept of energetic channels within the body (meridians), which convey and transport subtle bodily mechanisms thoughout was developed thousands of years ago by sages and ascetics who could feel these subtle processes within their own bodies.

Acupuncture points, in general, were considered way stations along these energetic highways (meridians) where Qi or energy congregated or pooled in larger quantity in relation to other places along the meridians (places along the meridians where no points were designated).  Generally-speaking, these places where Qi tends to pool along a meridian (acu-points) are considered more therapeutic than non-Qi-pooling places.

In my humble opinion, modern science is not yet quite sophisticated enough to detect the subtle systemic changes toward health and homeostasis that acupuncture can produce.  To really map out all of the changes produced by one acupuncture session, for instance, modern science would need to invent a machine that can somehow monitor physiological and biological changes within the body for an extended period of time.  A diagnostic device like this- if ever produced- might look like a wear-able functional MRI (fMRI) machine that also can monitor subtle biological and physiological changes such as changes in inflammation levels, hormone and endorphin levels, immune response, etc.

Mapping these physiological changes has started to happen to an extent with Dr. Sean Mackey’s work at Stanford University, using functional MRI (fMRI) machines in conjunction with acupuncture.  However, despite illuminating the fact that physiological and brain activity in the body does occur with the insertion of acupuncture needles, even this type of research does not clearly display how acupuncture works in a simplified way.  This is, in my opinion, the conundrum. It is, seemingly, still too complex to map out as acupuncture creates changes on multiple levels simultaneously.

Despite this complexity, when patients, friends or colleagues ask, I do still often try to explain some of the ways in which acupuncture can effect change within the mind-body continuum.   There are a number of modern theories that explain ways in which acupuncture is thought to effect positive change towards health in humans and animals (vertebrates).

To explain this, I’ve found a helpful article by Netherlands-based acupuncturist, Johanna Biemans, which can be found online here:  https://www.linkedin.com/pulse/top-5-theories-explained-how-acupuncture-works-johanna-biemans/

The following is from acupuncturist Johanna Biemans’ article, ‘Top 5 Theories That Explained How Acupuncture Works‘:

1. Endogenous endorphin release

The all time number one when it comes to explaining how acupuncture could influence our bodies is the triggering of the endogenous endorphin release. Endorphins are our bodies own painkillers and are produced in the midbrain. Bruce Pomeranz was the first to describe the relation between acupuncture and the painstilling effect due to endorphin release. He specifically draw attention to the delay time of 20 min. between stimulation and the onset of the analgesic effect. The time necessary for processing the endorphin from the precursor pro-opiomelanocortin (POMC). The endorphins involved are most likely beta-endorphin.  

2. Triggerpoint deactivation

A definite second place belongs to the popular triggerpoint theory (our bodies expression of pain by hypersensitive knots in striated muscles).  Unlike the endorphin theory, this theory has caused a lot of debate amongst acupuncturists and the so called dry needling therapists about ownership. Basically acupuncturists are familiar with treating painspots or “Ashi”points as it is defined in the original theory. Deactivation of myofascial triggerpoints resolves stifness and pain. This can be achieved by specific needling techniques.

3. Modulation of nerve activity

In third place I chose neuromodulation: acting upon nerves to alter nerve activity. Neuromodulation is a fast growing field and when we consider the therapeutic impact that came along with it. this theory deserves a place in the Top 5. Some of the modalities are originated or closely related to acupuncture. The explanation holds that needling in the close surroundings of mostly peripheral nerves, effects can be evoked at a spinal or supraspinal level. This antidromic stimulation presumably has a modulating effect through a segmental way on organs or body functions. The most known are stimulation of n.medianus in cases of PONV ( Postoperative Nausea and vomiting) and n. tibialis posterior stimulation (PTNS) in the treatment of pelvic disorders. Discussion continues about the frequencies, intensities and duration of stimulation. Because manual needling requires a very precise craft these kind of stimulations are mostly performed with electrical devices: electroacupuncture. Very, very speculative  but worth mentioning is the riddle of “Bagdad’s Batteries”. On a site near Bagdad Archeologists found battery like objects. And in close surroundings some needle like objects. One theory states that they might have been used for electrostimulation according to acupuncture principles.

4. Counterstimulation at spinal level

From the fourth place on choosing becomes harder. If I take into account: “times cited in literature” I guess counteracting deserves a place in the Top 5. Many times in a negative connotation though. Acupuncture is no more than counterstimulation. Counterstimulation is based on the wellknown gate control theory of Melzack and Wall.  Different stimuli from the periphery can inhibit each other at spinal level and thus painful stimuli can be suppressed.

5. Increase of blood flow.

At fifth place I firstly selected ‘balancing the autonomous nerve system” which is frequently quoted. But then I realised that this mode of action comes very close to the ones (3 en 4) mentioned above. And merely is a different angle of referring to similar mechanisms. I considered influencing ‘hormonal balance’ or ‘immune functions’. Then of course I came up with the mostly local effect of increasing the blood flow. The puncturing of soft tissues and muscles brings forward a production of adenosine which binds to the ephitelium of bloodvessels and induces the release of nitrooxygen which causes a vasodilatation of the bloodvessel. It’s usage preferred in local ischaemic conditions.

The most close explanation of acupuncture is likely a combination of mechanisms plus the missing link that is expressed in it’s original concepts.

Related article:

http://cim.ucsd.edu/clinical-care/acupuncture.shtml

By Dr. Aaron Cashman, DAOM, LAc 

When I meet people for the first time and they ask me what I do for a living, they often will say something like, “Acupuncture and East Asian Medicine, huh?  I heard those are helpful with infertility”.  And I will tell them that, yes, they are very helpful for increasing the odds for conception and for carrying a pregnancy to term.  Sometimes people will then ask exactly HOW acupuncture and herbal medicinal formulas work to improve these odds.  A full, comprehensive answer to the ‘how it works to help infertility’ question would fill a small book.  So instead, I’ve decided to simplify things here and to describe three of the many ways in which acupuncture and herbal medicine help to make pregnancies more viable.

First, acupuncture can assist in increasing blood flow to the uterus to help create a thicker, healthier endometrial lining, which helps with proper implantation*.  According to Valinda Nwadike, MD, “Endometrial thickness is important in pregnancy. Healthcare experts link the best chances for a healthy, full-term pregnancy to an endometrium that is neither too thin nor too thick. This allows the embryo to implant successfully and receive the nutrition it needs.” **

Second, acupuncture can help to reduce stress and thereby increase the odds of pregnancy.  According to fertility researcher Alice Domar, PhD “Your body is smart, it knows that (periods of stress) aren’t good times to have a baby”.  Dr Domar, who is the director of Mind/Body services at Boston IVF, stated that the medical community once “said I was stupid to believe that the mind had any control over the ovaries…Today (however), researchers widely accept that stress and fertility are connected.”  Also, stress hormones like cortisol can “trip up ovulation” by interrupting the “signaling between the brain and the ovaries”, says Sarah Berga, MD. ***

Third, acupuncture can help to balance hormones, which is also pivotal in conception and carrying to term.  In addition to minimizing stress hormones, other important hormones play major roles in fertility.  Restoring balance to the proper levels of some of these hormones is crucial.  A few important hormones in fertility include estrodial and progesterone, thyroid hormones (like TSH), follicle-stimulating hormone (FSH) and luteinizing hormone (LH).               (For a much more thorough explanation on hormonal balancing through acupuncture and herbal medicine, I highly recommend the book, Balance Your Hormones, Balance Your Life, written by Acupuncturist/Herbalist, Dr Claudia Welch.)

Other ways that acupuncture and herbal medicine have been shown to help increase fertility odds:

• Keeping the fallopian tubes open for fertilization by preventing or reducing spasms
• Increasing sperm motility and sperm count
• Overall increase of health and well-being of mother to ensure a smooth pregnancy

Why did I focus this blog post on acupuncture and not herbal medicines?   

In general in the West, acupuncture is typically more widely accepted and therefore has been researched more in clinical studies.  However, in my clinic and in many other EAM (East Asian Medicine) clinics, herbal medicine is just as important as acupuncture for many conditions- sometimes more important.  

In the realm of fertility and conception, acupuncture sometimes has enough of an impact alone that adding herbal medicine or a supplement is not needed.  But more often, patients get better, faster results when both herbs and acupuncture are administered consistently over time.  

According to the AMA’s (American Pregnancy Organization) website, “Clinical observations from the Berkley Center for Reproductive Wellness suggest that the most effective fertility treatments involve both a combination of acupuncture, herbal medicine, and traditional medicine.  However, conception occasionally occurs when acupuncture and herbal medicines are used without traditional medical interventions. “.

– Dr. Aaron Cashman, DAOM, LAc, is the founder of Mind-Body Acupuncture in Philadelphia, USA (www.acuforus.com)

*https://americanpregnancy.org/getting-pregnant/acupuncture-for-fertility/

**https://www.medicalnewstoday.com/articles/327036

*** https://www.webmd.com/baby/features/infertility-stress

Resources:

https://www.pacificcollege.edu/news/blog/2015/04/17/how-does-acupuncture-fertility-work-increase-chance-conception-without-side-effects

https://www.webmd.com/infertility-and-reproduction/features/ancient-art-of-infertility-treatment

“(Excellent) Health is a state of complete harmony of body, mind and spirit.”  – B.K.S. Iyengar

“Your body hears everything your mind says.”  – Naomi Judd

I’m an Acupuncturist and get Acupuncture treatments often.

Why do I also get regular Massage Therapy?

First of all, massage feels great.  Massage can feel like floating on a cloud on a breezy, warm, summer day.  All one’s worldly cares vanish into that liminal, dream-like state between being awake and sound asleep.  It can feel, as though through magic, someone (the LMT) finds a very soothing, supportive means of slowly draining my mind-body continuum of all its fears and doubts, frustrations and anxieties.   Massage therapy has a unique ability to allow one’s body-mind-spirit to pour out the world’s stressors that the body accumulates (usually unintentionally/subconsciously) throughout daily life.   

Massage therapy can be miraculous at releasing unwanted mind-body accumulations.  In Ayurveda, there is a word for these accumulations or toxins: ‘Ama’.  ‘Ama’ usually refers to food or drink that was not properly digested and assimilated by the body, but can also refer to mental-emotional toxins or energetic ‘sludge’ that remains in the system until it feels safe and has a chance to allow it to leave the mind-body continuum.  When these accumulations- Amas– stay in the system for long periods of time, they can eventually lead to greater problems or various ‘Amayas’ (disease).  Fortunately, Massage Therapy is excellent at removing these physical and energetic toxins from the body and mind.  

I particularly find that lymphatic drainage massage techniques are excellent at helping the body find an exit door for more mental or psychological-based Amas, whereas I find that myo-fascial or trigger point massage techniques excel at releasing Amas that are bound to the system on a more physical/bodily level.  Of course, mind-body-spirit can never be separated completely.  Still, I find that sometimes I need more of mental-emotional-lymphatic release and other times it feels like I just need work done on my tight I-T band or rhomboid muscles.  

Can’t Acupuncture do all of this?  

Well, yes, but it is different.  First, it feels different.  There is often more of a ‘flow’ feeling with massage where techniques are continuous.  Acupuncture techniques are more sporadic.  Massage, then, excels at unifying or integrating all of the trigger and acupuncture points and tissues at all levels and locals- from head to toe, epidermis down to bone.  

While acupuncture is incredible at quick-focused release, massage works its wonders in a more broad-spectrum way, since it attends to a large majority of the body’s surface area.  In an acupuncture session, however, it can be the case that only a handful of acupuncture points are chosen and thus, only those few areas are touched upon by the practitioner.

In other words, Therapeutic Massage and Acupuncture are like Yin and Yang- inseparable companions, each with their own invaluable strengths and efficacies.

To book a Therapeutic Massage session with Tho Lam, LMT, at Mind-Body Acupuncture, please visit www.acuforus.com  (Located in the Rittenhouse/Grad Hospital area of Phila)

Tho focuses on Sports Massage, Myo-fascial release, PNF & Lymphatic Drainage techniques.

This article was written on June 16, 2022 by me, Dr. Aaron Cashman, DAOM, Acupuncturist-Herbalist and Founder of Mind-Body Acupuncture.  

And, yes, Tho Lam is the highly-skilled therapist that I personally see almost every week.