My Clinical Approach
Acupuncture, like any craft or art, is not practiced as a monolithic school of thought. Yes, all acupuncture entails insertions of file filiform needles for the purpose of effecting therapeutic changes. And yes, the origin of acupuncture school of though is rooted in the traditional Chinese medicine. However, there is a huge variation in how it is practiced, meaning, how the points are selected, needled and the conditions diagnosed varies tremendously from one patient to another, etc.
So, I want to give you more details my clinical approach. Now, why would you care as a patient? Well, for the following reasons:
- the work I do is interactive and closed-loop, meaning, there is a lot of palpations, feedback, and verification all done in real time. So unlike your typical Traditional Chinese Medicine (TCM) approach, my approach entails certain level of passive participation from the patient. The payback, of course, is more accurate and comprehensive treatments that yield better result. And that takes time and expertise.
- Depending on your needling preference, you may like gentler insertions and manipulations or more vigorous. By and large, how vigorous you stimulate the body, ie, the whole De Qi claim, in my opinion is more academic than clinically necessary. So it helps to know about the default approach of your acupuncturist.
- Although most patients don’t want to know about all the nitty gritty details of why an acupuncturist works on certain areas or what he is trying to do, patients in generally do want to have certain level of understanding of the high level treatment strategy and focus.
It does not matter to me what the patient’s chief complaints (ie, the reason you come to see me in the clinic at the first place) are, I always following sequence:
- Constitutional treatment of the abdominal area
- Constitutional treatment of the back
- Targeted treatment for lingering chief complaints
- Supplemental herbal medicine
So this is where I begin, systematically palpating your abdominal areas for tenderness, pains, hardness, and temperature. For the treatment, I utilize the famed Kiiko Matsumoto approach extensively.
For each positive finding (eg. tender, painful, ticklish, hard, or cold), I will press my finger on the appropriate distal points on your arms, legs or feet re-palpate the problem spot. I will solicit your subjective feedback on whether the tenderness/ache lessens or dissipates with my point selection. And if no improvements are reported, I will look for an alternate points. The needle will only be inserted on the point that yields the most benefits. From my side, I am constantly monitoring if the selected acupuncture point reduces the muscular tension of the palpated area. So, I am verifying the correctness of my point selection based on your feedback as well as the level of softening of muscular tension. And this process is repeated until all the problem areas around the abdomen have been addressed. If the mid section of your abdomen is particularly stubborn and/or cold (from poor blood circulation), I will supplement the treatment with warm needle, which further relaxes the abdominis muscles.
Now, why do we bother doing all this, especially when you come in for a shoulder pain or knee pain. What does the softness have to do with my pain elsewhere? For two reasons:
- I am practicing holistic medicine, meaning, I am not just treating your symptoms. I am treating your whole body.
- Most people carry their stress around their abdomen, this is especially relevant for white collar professionals who have to think around the clock. Over time, the accumulated stress responses manifest as unrelenting muscular tension around the abdomen, which inadvertently keeps signaling the body that it is dealing with stressful situations. This is subtle yet prevalent as most people have no prior knowledge of the tension they are carrying around the abdomen until I palpate them.
- The acupuncture session relieve these accumulated muscle tensions, which in term, clears the latent stress signals that the muscles are sending back to the brain. So, the body now has “fewer” distracting battles to fight and it can now focus on fixing things that require the most resource.
- People who habitually consume cold food and beverages, eg. beers, cold liquid, cold salad, ice cream, also tend to have a cold mid-section without ever realizing how that can negatively impact their health. For example, allergies, low back pains can all at least partially attributed to the cold rigid middle section. The front abdominal constitutional treatment definitely helps improve the aforementioned conditions.
- When the middle section is hard and unyielding, it affects your balance and freedom of movements. As a result, you are prone to overuse certain muscles and often that results in low back pain or knee pain.
Once the front treatment is complete, I will have you lay on your stomach so I can work on your back.
I will palpate along the inner Urinary Bladder (UB) meridian to identify any problem area (ie, tender, ache, hard). Again, the same process utilized in the front constitutional treatment will be applied to the back area.
The rationale for treating the back is very similar to the front treatment. It’s all about taking away as many residual stress signals that your body is carrying so you can feel more centered and relaxed and heal faster.
For the back treatment, again, the Kiiko Matsumoto approach offers amazing results and it is again my starting point for the back treatments.
The reason for saving the targeted treatment at the end is simple. It is difficult to deliver desired clinical results if the patient has so many latent lingering issues that distract them from functioning properly and smoothly, particularly if the chief complaint is related to some kind of pain or dysfunctions (like stress, insomnia, allergy). By centering the patient, I can now work on the chief complaint more effectively and efficiently.
At this point, patient’s pain complaint usually has noticeably reduced. However, I will continue the treatment, this time, with the balance method pioneered by Dr. Richard Tan. Whilst I use Kiiko Matsumoto approach for the well-being of the abdomen and the back, I use the Balance Method for specific pain complaints, particularly the skeletal muscle pains and joint pains on the extremities and the neck. The Balance Method, again, entail a feedback from the patient to help ascertain the most effective point, for this patient’s specific condition. Like the Kiiko approach, the Balance Method also utilizes points on the limbs, although with a bit more emphasis on the hands and forearms and feet and the legs (as opposed the thighs).
The Balance Method is specially effective for targeting specific pains, the primary reason why people turn to acupuncture in the US. It combines the traditional meridian and point layout with a modern system-based diagnostic approach, and it is one of my key clinical approach.
Lastly, for people who have super stubborn tight muscles or a vicious cycle of healing and re-injury from sports or physical labor, I will finish the treatment with direct needling coupled with electrical stimulation. However, this approach is only applicable to well-define pathology of skeletal muscles. As a matter of fact, my initiation to acupuncture treatment was direct needling with electrical stimulation on my hamstrings, gluts, and quadriceps. This is a viable and effective approach for skeletal muscles, but I would not apply to anything else. Electrical stimulation takes a little getting use to. And the name sounds a lot worse than it actually is. But it’s not bad at all.
I am increasingly emphasizing the importance of herbs because they are fantastic complement to acupuncture treatments and they help the patient stay on the healing path between acupuncture sessions.
For certain situations, for example, seasonal cold or chronic constipation, I would shun acupuncture and prescribe only the herbs for the patients.
So that gives you a summary of what to expect in my clinic. Because all the steps I go through, it is often for the session to last more than an hour. So if you have any time requirement, you should tell me ahead of time.
If you have any questions about how I can help you with your condition, please feel free to contact me. I also encourage all patients to take advantage of my free 20 minutes phone consultation before making the initial appointment. I will confess that I almost never answer the clinic number because I am usually with a patient during business hours, and you would not believe how many obnoxious telemarketing calls I get everyday.