Acupuncture Vs Viagra
With the cost of Viagra still high and the increasing number of expensive, biologically active “herbal–Viagra” remedies available, acupuncture can still play a part in male impotence/erectile dysfunction. I am impressed by Dr Joseph Wong’s article in Medical Acupuncture Online Journal, Volume 13 No.1,
(www.medicalacupuncture.org). He reviews the possible causes of male sexual impotence and has compiled an excellent table of the possible acupoints, and their neuro, anatomical and physiological connections. He very usefully categorises the points according to their use in erectile dysfunction, retarded ejaculation, orgasmic failure, premature ejaculation and loss of libido – a much wider range of conditions than Viagra!
Interestingly he cites animal studies showing that endorphin release in animals (eg LI4 at low frequency, 4HZ) can suppress copulatory behaviour and that needling GV20 increases cGMP (which relaxes smooth muscle in penile blood vessels thus producing an erection).
As he says “careful selection of acupuncture points & stimulus variables that manipulate different neurotransmitters and peptides could be the key to success in using acupuncture for sexual impotence.”
WEBWATCH on LASERS I
Much of the laser info on the web focuses on LLLT (Low Lever Laser Therapy) rather than pure acupuncture. I like the Swedish Laser Medical Society’s page http://www.laser.nu/lllt. The guest editorials are written by laser experts from all over the world and are very informative. Some of the contributors here have an amazing wealth of information and research material. Dr Wilden has some excellent graphics in his article on LLLT for ear conditions. Another article by Dr Wilden re the LLLT effect on mitochondrial energy transfer and ATP is text book quality.
I was intrigued by a Dr Witt describing the use of Ginko biloba as a photosensitiser prior to laser therapy.The herb was injected but I wonder if an oral dose (if high enough) would work?
WEBWATCH on LASERS II
There is an elegant hypothesis to justify the use of lasers in the visible spectrum at www.earthpulse.com/health/laser.html. Father and daughter medicos Dr Reyo & Anu Makela from Finland suggest that cAMP is the second messenger in a hormonal signal, which is influenced by photostimulation. Essentially a number of hormones (including dopa, dopamine, noradrenalin, adrenalin, thyroxine and tri-iodiothyronine) attach to a protein receptor on the cell wall which then binds to intracellular GTP (guanine triphosphate). This, in turn activates adenyl cyclase which catalyses cAMP from ATP formed in the citric acid cycle. CAMP increases glycogen breakdown, decreases glycogen synthesis and increases production of noradrenalin and adrenalin.
LLLT stimulation at 620-642nm stimulates the production of phosphodiesterase which breaks down the cAMP. LLLT stimulation at 630-640nm stimulates Nicotinic acid (from NAD/NADP in citric acid cycle) to react with urea or ammonia to form Anthranilate. At wavelengths between 620-670nm Anthranilate is step-wise converted to phenylpyruvate and between 628-652nm phenyl pyruvate is converted to phenylalanine which
(i) delays the breakdown of endorphins and
(ii) is converted to tyrosine,
the precursor of dopa, dopamine, noradrenalin, adrenalin and both Thyroid hormones (T3 and T4}.
WEB WATCH
There were three excellent slide presentations at the AGM in Perth.
(1) Successful treatment of Xerostomia (dry mouth) by Dr Paul Ghaie.
(2) Acupuncture for shoulder problems by Dr David Lee.
(3) A comparison of laser acupuncture and low level Laser Therapy by Dr Roberta Chow - this is a must see lecture if you are considering purchasing a laser!
The presentations are on our website:
www.medicalacupuncture.org and can be viewed without sound or downloaded with audio for the ultimate audio-visual event. The A-V files are very large (15meg) and will take a long time to download, but it’s worth it.
If this is all too hard -
Send $10 to:
The Editor, AMACupuncture
PO Box 459
Fullarton SA 5063
and I’ll send you a CD-ROM with all three presentations on it.
WEB WANDERING
1. Top Ten Points
How would you like a computer program that gave you the Top Ten Acupoints for any common condition? Phil Rogers at http://homepage.eircom.net/~progers/adtop has such a program. It cross references hundreds of different sources (books, journals, manuals) and lists the acupoints for a particular problem in order of frequency cited in the reference material. Generally the first five points are the most successful.
e.g. Need a recipe for sweating? Try the following five points:- KI7, LI4, HT6, SI3, SP2.
Others to consider if these do not work are, in descending order of success are:-
LV2, LU8, LU10, LU11, LU14.
2. Laser Tutorial
Check out our own site www.ozacupuncture.com - for a web/PowerPoint presentation on Laser acupuncture by Dr Charles Cassar. I hope to have more of this style of presentation after our AGM and include audio synched with the slides.
3.Emergency Device
In the late 1980’s I attended a course on Vega Bioenergetics. Before measuring the body’s changes in electrical resistance through an acupuncture point, the patient was ‘stimulated’ with a piezoelectric stimulator.
During a break on the second day of the course one of the attendees, on demonstrating a karate movement, felt his back ‘seize up’. In extreme pain he was unable to straighten.
I wondered if my new piezoelectric stimulator would have an acupuncture effect and began clicking it over his lower back. To my delight, it worked. Within a minute he could straighten and move freely, pain free.
From that time, my pen-sized piezoelectric stimulator became my “traveling acupuncture kit”, going with me everywhere.
I found it especially useful for my son and his football teammates – any acute injury could be quickly and painlessly treated – many times the player could resume playing within minutes. At work it became my favourite modality for treating trigger points and acute torticollis and acute back spasm.
I was reminded of this useful acupuncture technique when I came across an excellent overview of “Piezoelectric Stimulation Technique of Acupuncture Points: Clerical Application” by Niemtzow, Ory and Johnstone at www.medicalacupuncture.org/aama_marf/journal/vol12_2/article4.html. They describe its use both as a single modality and as a precursor to needle acupuncture.
“Piezoelectric stimulation may provide quick and temporary relief, and sometimes may be the the only treatment necessary to the patient. Its usefulness is especially appreciated when the debilitated patient is unable to undress or lay on a treatment table without considerable discomfort. It is beneficial for some patients in that it frequently relieves enough pain for them to undergo definitive acupuncture therapy without discomfort.”
As a novel treatment for migraines,the authors suggest using piezoelectric stimulation of LI4 bilaterally plus needling ear points, Shenmen, Point Zero and Point Omega 2, bilaterally.
WEBWATCH I
With the increasing use of computers on doctors’ desks - ready internet access, the next step could be a free acupuncture program at www.acutempo.com. It links your computer’s clock to the horary clock - every two hours another channel isand the appropriate Luo connecting point/Mother & Son/Husband & Wife/Confluent point and Front Shu point are nominated. Clicking on any point brings up a window showing that point’s location and properties. This is an excellent way of learning TCM “on the job”. As well there is a drop-down list of 277 symptoms/diseases using western medical terminology and an associated list of useful points on the body and in the Microsystems (face, nose, ear, hand & foot). This program would be an excellent learning tool, leading up to Part I and Part II AMAC exams.
WEBWATCH II
“Stop Treating Your Paediatric Patients Like Little Adults” is an intriguing article (at www.acupuncturetoday.com/archives2001/jus/06silver.html) on the background TCM approach to treating children. The authors suggest ten points need to be considered….
1.Children tend towards Excess in Wood & Fire, Deficiency in Earth, Metal & Water.
2.Children are susceptible to External Pathogens
3.Children have undeveloped digestive systems
4.Children produce Phlegm easily
5.Children tend towards Excess Yang and Deficient Yin
6. Children inherit foetal toxins (emotional, infective & psychological) 7.Children are highly susceptible to emotional stress
8.Children are prone to convulsions
9.Children depend on the kidneys for growth and development
10.Pathogens easily become entrapped in Children
PRACTICAL TIPS: Tinnitus
Tinnitus is one of the most difficult conditions to treat. There is no one specific treatment that works for everyone. This is definitely where “treat the whole patient” is required as there are a range of causative factors:-
1)Cochlear damage from infection or prolonged noise exposure.
2)Middle ear disorders
3)Head trauma
4)TMJ disorders
5)Trigger point overactivity
6)Emotional/Stress conditions
7)Drugs
Acupuncture can be used as adjunctive therapy. A careful history can reveal possible causes. Palpation for trigger points on face/jaw/neck and for TMJ dysfunction is mandatory.
Acupoints: Rogers reviewed the data on acupuncture success for tinnitus and found the success rate was of the order of 20-40%. He did suggest the technique used in the Kalmar Hospital in Sweden was much more successful and suggests selecting:
a) 2-3 local points (select from GB2, 20; SI19; ST7, TE17, 12)
b) plus 1-2 distal points
(from BL23,62; GB40, 41; KI3,6,7; LI4,11;LV 2,3; SI3,4; SP6;ST36; TE2,3,5) and
c)one occasional point
(from GB8,12; TE20; GV20; TaiYang).
Rotate the points used such that all the points are treated during the course of therapy.
He suggests twice weekly needling for up to 15 sessions but some response must be achieved by 8 sessions. (users.med.auth.gr/~karanik/english/articles/trinnit.html)
Trigger Points
Travell, in her book on Head and Neck Trigger Points, identified a trigger point in the upper posterior portion of the deep layer of the masseter muscle as a cause of tinnitus. This TP affects the stapedius muscle, causing the middle ear ossicles to vibrate,thus generating a tinnitus sound.
If a patient has Tinnitus, how do I know if the masseter is involved?
1. Failure tothe mouth wide enough for three knuckles to be inserted
2.A tender point in the depression, when the mouth is anterior to the head of the mandible and just below the zygoma.
When the Tinnitus Trigger Point has been located, a fine needle is inserted until the muscle twitches and the patient jumps. If no twitch or jump occurs, the needle must be moved deeper or in a different direction until these sensations occur.
Approximately 1ml of 0.5% or 1% Xylocaine is injected and pressure is applied as the needle is withdrawn.
Immediately after the injection, the masseter muscle must be stretched to its fullest several times byng the mouth as far as possible. Placing two or more fingers into the mouth can help this stretching exercise.
Some therapists will also apply coolant spray to the skin between stretches.
The treatment is usually concluded with the application of a hot pack over the Trigger Point for several minutes.
Regular stretching of the masseter needs to be performed several times each day to help reverse the shortening of the muscle caused by the Trigger Point.
Some people may experience numbness at the site and down along the jaw line for several hours. Occasionally there is some bruising at the injection site but this is usually prevented by applying pressure immediately after injection.
RESULTS
Most people will notice a change in their Tinnitus after one or two treatments.
The most immediate and obvious sign will be a change in the pitch and purity of the sound. In its place will be one sound rather than many as if the static from the noise had been removed. With further treatment the intensity or volume will be further decreased and the Tinnitus becomes less and less obvious during the course of the day.
For most people, there is relief from the constant noise in their ear. In some cases full resolution does not occur but there is at least a lessening in volume and pitch.
In a review of my last ten patients with unilateral tinnitus, using Travell’s TP injection technique, one had complete remission, six had a 50% or more reduction in intensity of their tinnitus and one had no response.
Whilst Travell suggests this technique can help bilateral tinnitus I have never found it successful.
Complementary treatments for tinnitus
The addition of Ginko bilboa (up to 2000mg daily) and regular vitamin B12 injections can help. Melatonin (1-3 mg sublingually at bedtime) can also be used particularly where the tinnitus prevents sleep.
More conventionally tranquillisers, antidepressants, cognitive behaviour therapy, biofeedback, hearing aids emitting a masking sound and bite plates can also be considered.
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