Healing Rotator Cuff Injuries with Acupuncture and Guasha

Disclaimer: The following advice is meant for educational and informative purposes only. If you are suffering with a rotator cuff pathology, please see a licensed healthcare practitioner.

What is a rotator cuff?

A rotator cuff is comprised of four important muscles known as the supraspinatus, infraspinatus, teres minor and subscapularis. These muscles help bind the head of the humerus to the glenoid fossa of the scapula. Each rotator cuff muscle has a unique function in maneuvering the shoulder and arm. They are as follows:

When one or more of these muscles is torn, injured, tense or inflamed, you are sure to experience symptoms like shoulder pain, neck pain, limited range of motion, neuropathy (radiating pain, tingling and numbness), difficulty sleeping due to pain, and many other issues.

The muscles of the rotator cuff are involved in many movements, and such actions like brushing your hair or lifting and rotating your arm. However, even movements involving your neck could irritate the pain.

Sometimes the rotator cuff disorder is due to a sudden physical trauma, which tears one or more of the rotator cuff muscles. I personally tore my rotator cuff during a “trust fall”—someone fell forcefully on my right forearm, and I felt my Supraspinatus “pop.” You might recall a pop happening before your symptoms manifested. The location of the pop is likely the muscle/ligament that was torn. Even if the tear was only on one side, both shoulders, or the opposite shoulder can exhibit symptoms.

These tears are especially common in sports, which is reflected in the alternative names for rotator cuff tendinitis: Swimmer’s Shoulder, Tennis Shoulder, Pitcher’s Shoulder. Moving your arms repeatedly over head, a pictured below, can be an origin of rotator cuff injury, too.

In foreground, a woman is exercising, extending and abducting the left arm  with a pink barbell held in right arm. In the background, there are other women, in the same posture.
Photo by bruce mars on Pexels.com

However, a slow build up of tension and inflammation, as well as poor posture, can also irritate the rotator cuff. Tension in the muscles of the neck can compress the vertebrae and impair the flow of qi and blood. The rotator cuff muscles are innervated by nerves that exit the cervical vertebrae. Those of us that have long sessions of looking at our phone are very likely to experience chronic rotator cuff issues, for this reason. Constantly staring down at screens will stress the cervical nerves.

…When myofascial pain is referred to the shoulder joint, the infraspinatus, Supraspinatus, and sometimes the levator scapula muscles are its most likely muscular sources. (Page 556)

Travell, J. G., Simons, D. G., & Simons, L. S. (1999). Myofascial pain and dysfunction: the trigger point manual: Vol. 1:Upper half of body. Baltimore: Williams & Wilkins.

Just being stressed out can cause your shoulders to scrunch up, so the origin of rotator cuff issues is can definitely be psychogenic in pathogenesis. To further complicate matters, tension in unrelated parts of your body, like the hips, can exacerbate the issues in your arm. This can really make sleeping difficult, as one struggles to find the right position to rest without pain.

A rotator cuff tear can seriously change your life. Sometimes people undergo surgery to repair the rotator cuff, but there are alternatives that can help you avoid such interventions. Even after rotator cuff surgery, therapies like Acupuncture, Qi Gong, and Herbalism can help reduce shoulder inflammation and improve your quality of life.

An Acupuncturist’s Approach to the Rotator Cuff

In Chinese Medicine, there are several important meridians that travel through the shoulder. They are as follows:

  • Large Intestine-Yangming Meridian
  • Lung-Taiyin Meridian
  • Pericardium-Jueyin Meridian
  • Sanjiao-Shaoyang Meridian
  • Heart-Taiyin Meridian
  • Small Intestine-Taiyang Meridian

These meridians traverse the neck and head, the shoulders, and extend into the fingers (they even go inward and connect to the internal organs and other meridians). If you’ve suffered from a rotator cuff tear, you might have noticed how the injury afflicts your forearm, fingers and wrist. Tingling and numbness, sudden surges of pain, popping and crunching, are a few of the common symptoms you might experience. The trajectories of these symptoms can mimic the meridians and also the dermatomes associated with the nerves that exit the cervical vertebrae.

Many painful points on the arm can arise after a rotator cuff tear, as the glenohumeral joint is not being “held” properly. This injurious posture can obstruct the flow of qi and blood, as the nerves and blood vessels are cramped by the constricted muscles. Indeed, Thoracic Outlet Syndrome or carpal tunnel syndrome can be an unfortunate sequelae of a rotator cuff tear. This is why it is important to maintain and care for your shoulder injury.

A general index of points that are proximal or resting on the rotator cuff muscles are as follows:

  • Supaspinatus – Sanjiao 15
  • Infraspinatus – Small Intestine 10, 11, 12
  • Teres Minor – Small Intestine 9
  • Subscapularis – Heart 1

Interestingly enough, the Small Intestine, Sanjiao and Heart meridian are all Fire meridians! The Fire element relates to upward movement, the emotion of joy, the bitter flavor,

Distal pain often follow the trajectories of the meridians, rather than simply corresponding to the individual muscles. So, even though your tear is in your Supraspinatus or your Teres Minor, you might develop pain at your wrist, or your elbow, and not at the expected point of trauma. If you examine the photos of the anatomy model pictured above, you might see lines that parallel your own pain patterns.

Two very effective ways of remedying the rotator cuff are acupuncture and guasha. Acupuncture, applied at trigger points in the muscles of the shoulder and arm, can help unbind points of tension and relax the muscles. Acupuncture applied to trigger points is often rebranded as “dry needling,” but, rest assured, that dry needling is a form of acupuncture, and it is safe when performed by a board certified, licensed acupuncturist.

Guasha, otherwise known as Graston or IASTM (Instrument Assisted Soft Tissue Mobilization), can be used to reduce adhesion and vent inflamed myofascial tissues. Its approach is similar to cupping, insofar that it moves stagnant blood, but it relies on applied pressure instead of vacuum and suction.

Guasha can be explained as creating transitory therapeutic petechia associated with increased surface micro perfusion, increased up regulation of the genetic expression of heme oxygenate-1 (HO-1), stimulation of the immune system and evidence of pain reduction and anti-inflammatory effect that is sustained over time.

Nielsen, A. (2014). Gua sha: a Traditional Technique for Modern Practice. London: Elsevier Health Sciences UK.
Marks from Guasha. You can see the inflammation follows the trajectory of the Large-Intestine Yangming Meridian, Sanjiao-Shaoyang meridian, and the Lung-Taiyin meridian.

Focus on the Opposite Side

As the injury progresses, the unaffected side will take on greater physical burdens, which then worsens the afflicted side—it’s a vicious cycle that all unilateral injuries are notorious for. In treatments and therapies, it can be helpful to begin with the unaffected side. The arms can translate problems very readily, and if the scapula becomes unstable, there is increased likelihood that it will tug on the cervical vertebrae, the clavicle, or other anatomical structures. Take care in all movements.

Exercising the Rotator Cuff after an Injury

New symptoms can arise out of no where, so it’s important to work very gently and slowly when doing any new workouts. The Merck Manual recommends that work outs that “push objects away” like push-ups should be avoided, and those that “pull objects closer” should be encouraged. It lists Upright Rows, Downward Lateral Pulls, and Bench Press as therapeutic healing exercises, when done with proper care and guidance. Talk to your doctor or therapist about the right movements for you.

You Can Heal Your Rotator Cuff

Injuring your shoulder can be frustrating and even debilitating. If you are suffering with a rotator cuff injury, I encourage you to reach out to an acupuncturist or massage therapist in your community. They will definitely be able to help relieve your pain with the aforementioned techniques. And, if you are in or near Austin, Texas, I would be glad to discuss how I could be of service to you.

Do not give up on healing, and your shoulder will feel as good as new. Just remember that it takes time, and there are highs and lows. Be patient, be persistent and be kind to your body.

Healing Blepharitis Holistically

Disclaimer: The following advice is meant for educational and informative purposes only. If you are suffering with an eyelid pathology, please see a licensed healthcare practitioner.

Swollen Eyelid? It’s curable!

Toward the end of my acupuncture program, I developed an eyelid disorder known as blepharitis. Blepharitis is characterized by swelling and inflammation of the eyelid and its related glands, such as the meibomian glands. Blepharitis can affect one or both eyelids, the upper or lower, and the inner or outer, depending on the glands that are irritated. Blepharitis can be concomitant with a chalazion, a more bulbous swelling of the eyelid gland that resembles a pimple.

Blepharitis can produce edema of the eyelid, which results in a diffuse swelling of the periorbital flesh. The occlusion of the eyelid glands can impair the lubricant oils from reaching the eye, and dry eye can result. Itchiness, irritation and changes in visual acuity can arise.

Blepharitis specifically afflicts the eyelid, and is not a disease of the eye like conjunctivitis (Pink eye). In other words, your eye will remain relatively healthy, even though the eyelid is swollen. However, Pink eye can trigger Blepharitis, and vice versa, by inflaming the local glands. If you have significant burning pain in the eye that, it is important to seek a professional opinion.

Blepharitis has many causes, such as: stress, autoimmune disorders like MGD and Sjogren’s, environmental allergies, dietary causes, bacterial infection, injury to the eyelid, and even bad glasses or outdated contact lenses. Research has shown that a small skin parasite known as Demodex has some involvement in many cases of blepharitis. Research has also shown that Metabolic Syndrome and digestive disorders have an association with increased incidence of blepharitis. No matter the cause of blepharitis, the cure is usually the same: hot compresses and massage to move congealed oils stuck in the clogged glands.

IMG_0895
It started as swelling in my forehead and brow, then the fluid began inflating my eyelid,

If There’s Pain, Seek a Professional Opinion

I personally had no pain when dealing with blepharitis / chalazion, with the exception of occasional irritation due to drainage of the swollen glands. If there is significant pain, I highly encourage you to seek a physician’s opinion, as you might have a bacterial infection that requires antibiotics to cure the issue.

If it isn’t a Bacterial infection, Try Holistic Medicine

My eyelid issue was very frustrating. The draining was very slow and it didn’t seem to be healing on its own. So, I quickly turned to my resources as an acupuncturist. I had several tools I used to cure my eyelid: guasha, acupuncture, acupressure/ tuina, magnets, herbal teas and herbal compresses, as well as smokeless moxibustion. With the exception of acupuncture, you can do just about all of these therapies for yourself.

Defining the Therapies

Acupuncture – Using acupuncture at periorbital points can help relieve inflammation, stimulate circulation and improve immunological functions in the body. It can be used to help regulate hormones, according to the individuals needs.

Guasha – Using a soft edged tool to stroke and massage the lymph / blood vessels. Guasha relieves inflammation and can help dredge out adhesions in the muscles and fascia.

Jade Rolling – Using a cosmetic tool to help increase circulation around the eyelid. Roll it across the eyebrow, under the eyes, and softly across the eyelids with the eyes closed.

Acupressure – Using your fingers or a tool to apply pressure into muscles and therapeutic points of the body. Gently press and massage around the eyelid, several times a day. This is best done after hot compresses.

Herbalism – Using (safe) herbs as tea or poultices to assist the body in healing. Salves, essential oils, and even homeopathy can help. I highly recommend Similasin Eye Relief Drops to help remove excess debris from the eyelid, and to maintain hydration of the eye.

Hot Compress – Warming a damp towel, and applying it to the affected eyelid. A warm tea bag can also be used, but the tea could irritate the eye, so be very careful.

Facial QiGong – Doing facial exercises that move the eyes, eyebrow, forehead and periorbital muscles, can really assist the body in moving stagnant fluids. Furrowing the brow, and raising the eyebrows, widening the eyes and blinking tightly. As always, if there’s pain, stop doing the exercise or therapy and seek assessment.

Hot compresses are perhaps the most important treatment method. The goal is to heat the fluids and oils that had congealed in the eyelid. The glands of the eyelid, like the meibomian gland, are tiny and they are very close to the skin surface. This makes it easier for the oils to solidify, as they near room temperature more speedily.

I recommend steeping a peppermint tea bag, then using the hot tea bag as a compress on the eyelid. Apply it often, and when the eyelid is well heated, do gentle & vigorous massage around the brow and lid. Another great idea is to get a hot towel warmer, and to have many hot towels to use throughout the day.

It Might Get Worse Before It Gets Better

As the fluid is heated and circulated through the eyelid, the gland might expand and turn into a chalazion. This can be distressing, but also indicative that things are moving. Do not get anxious—just keep heating and gently massaging to promote fluid. However, if you feel PAIN or BURNING—this is a good sign there is infection, and you should contact an Ophthalmologist, MD or OD for topical antibiotics and special care.

IMG_0911
I used magnets over night to help stimulate local acu-points. As you can see, the eyelid became very swollen.

Jade Rolling & Facial Guasha: An Important Hygiene Method for those with Blepharitis

For people who suffer with eyelid disorders like blepharitis, there’s some bad news: it is often chronic and must be managed for our whole lives. For this reason, it is important to add in hygiene methods for the eyelids. Facial guasha is a method of Chinese bodywork that uses a soft-edge tool to promote circulation in the muscles and fascia. It is like combing the muscles. Jade rolling is very similar—it uses a stone tool to dredge out the lymphatic build-up in the tissues of the face.

By doing this daily, you can maintain a healthy flow of fluids in the face, and avoid toxic build-up in the eyelid glands. Check out this following video to see how to use Guasha for eyelid disorders!

Go to Your Doctor, but Don’t Buy into Gimmicks

If you have blepharitis, it is important to get a professional opinion from a healthcare provider. Blepharitis can come from more serious infections, and might require special interventions and medicines for complete resolution. This is especially true if you have significant BURNING, BLEEDING or BLINDNESS. Seek care immediately if those symptoms are present.

If you have seen a professional and they declared your eyelid condition a non-emergency, then the information in this blog should be safe to apply.

I am currently doing research on blepharitis. My goal is to show how acupuncture and guasha might expedite the healing of eyelid disorders like blepharitis. Research consistently points to heat compresses and massage as being the most reliable intervention for blepharitis. However, new tools like “LipiFlow” are being manufactured to do heat and massage for people are exorbitantly priced—over $500 for session series!

For those of us that lack the insurance or money to spend on such a process, we can rely on these simple techniques of tea-bag compresses and facial guasha & acupressure. It takes dedication and consistency, but you can heal your eyelid!

Also, try acupuncture from a qualified practitioner. They might have herbs that can help address the underlying issue, bringing you a greater quality of life and long-term relief.

IMG_0043
Me with Blepharitis
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Almost 2 years later — no blepharitis.

Not Healing? You Might Not Have Blepharitis

Since I originally wrote this, and began working with eyelid issues, many people have contacted me who said they had blepharitis, when it clearly was something else. For example, many people develop hard cysts on the eyelid. These are called Intratarsal Keratinous Cysts, and they are not blepharitis. You will need to see an ophthalmologist who can surgically excise the cyst.

A clear way to know if you have an IKC, and not a chalazion or blepharitis, is if the swelling does not respond to these therapies. If you are doing facial massage, guasha, herbs, and so on, and the bump on your eyelid is not going away, you probably have an IKC.

In more dire circumstances, these eyelid swellings can actually be related to Multiple Endocrine Neoplasia. It is really important to get a professional opinion from an ophthalmologist about your eyelid swelling, especially if it doesn’t begin to resolve within a couple months, or sooner.

Have Questions? Reach out to me.

If you are struggling with an eyelid issue, and you have had a physician rule out serious issues, feel free to contact me (if you are seeking holistic treatment and TCM therapies for Blepharitis, Chalazion and other eyelid disorders). I would love to help you!

Stay positive and you will heal your eyelid.

Relieving Anxiety with Traditional Chinese Medicine

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These marks are from cupping and guasha. Inflammation is the muscles is relieved as it is dredged out toward the surface. The marks go away, and symptoms of pain and anxiety often follow.

🔥❣️This patient was dealing with a general feeling of anxiety, shortness of breath and brain fog. Acupuncture was done at key points to address dampness, strengthen the spleen, reduce heart heat and soothe liver Qi. After that, some tuina, cupping and guasha were applied along the Taiyang & shaoyang meridians of the back to clear heat and unbind the chest. As you can see, the scapular muscles (especially on the right) needed some attention!

☯️💧Anxiety is not always contingent on our emotional circumstances. Sometimes it is due to physical conditions affecting the viscera, such as the heart. For example? Drinking too much coffee or alcohol can inflame the blood, which can then irritate the Shen (aka the mind/spirit). By working with the physiological aspects of the body, and extracting the heat, the mind and spirit can be positively altered and anxiety can be relieved. It’s a win – win situation for muscle health and mental health! 😁

Tuina Techniques

Have you heard about Tuina? Tuina loosely translates to “push grab,” and it is an ancient form of bodywork that is still practiced today in China. Now it is rising in popularity in the United States & Europe. I was introduced to tuina when I began studying at integrative medicine many years ago, at AOMA Graduate School of Integrative Medicine. I took courses on Tuina and even completed a thorough internship focused on tuina therapy. When I combine tuina with cupping, guasha and medical Qi gong, the pain experienced by clients seems to melt away. Tuina is a wonderful treatment for people who have a fear of acupuncture. 

Photo by cottonbro on Pexels.com

Tuina has specific techniques such as:

  • Yizhichan Tui – working with one thumb
  • Na – grasping 
  • An – pressing with the finger or palm
  • Mo – rubbing with the palm
  • Rou – kneading 
  • DiAn – acupressure with the knuckles
  • Gun – rolling 
  • Zhen – vibration
  • Cuo – foulage (twisting)
  • Mo – wiping
  • Tina – lifting and grasping
  • AnRou – pressing or kneading
  • Boyun – kneading with the forearm
  • Ji – striking 
  • Pai – patting
  • Dou – shaking
  • Yao – rotating 
  • Ban – pulling/ stretching joints
  • Bashen – pulling and extending for traction

This list of techniques was sourced from Dr. Xiangcai Xu’s book “Chinese Tui Na Massage: The Essential Guide to Treating Injuries, Improving Health and Balancing Qi”. 

Photo by Pixabay on Pexels.com

Tuina has helped me in my own recovery, too. I was experiencing a lot of pain in my hip, lower back and neck since a hip & shoulder injury I endured a few years ago. I’ve received treatments of all sorts, but mostly Tuina & Acupuncture. Combined and with self applied techniques I’ve learned, my body is pain free and more flexible. 

Chinese massage therapy (referred to as tuina) is commonly defined as the ancient healing art of fingers and strength [24]. Tuina has been practiced in China for over 5000 years [25]. It is a well-respected treatment modality known to be helpful and safe for a wide range of conditions. For these reasons, it is rapidly gaining international favor [26]. Tuina involves a wide range of technical manipulations conducted by a practitioner’s finger, hand, elbow, knee, or foot applied to muscle or soft tissue at specific body locations. It incorporates many of the principles of acupuncture including the use of acupoints. For instance, tuina often uses manual techniques such as pushing, rubbing, kneading, or high-intensity, high-frequency patting to clear energy blocks along specific meridians associated with particular conditions —http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4228121/

Check out that research article above to learn more about how research is being conducted on Tuina’s effect on lower back pain. It looks like very promising data will manifest. I’ve seen wonderful transformations of patient’s posture and health. I personally think all you need is a single treatment to become a fan of Tuina. 

If you’re in Austin, Texas, feel free to book an appointment. If you’re far away, we can do a call and I can show you how to treat yourself with acupressure and tuina! I think you’ll really enjoy this amazing technique of Traditional Chinese Medicine. 

What does it mean to be AOBTA-C.P.?

The letters behind my name stand for American Organization for Bodywork Therapies of Asia, and C.P. means Certified Practitioner.

“The American Organization for Bodywork Therapies of Asia is a national not-for-profit professional membership association of the practitioners, instructors, and schools/programs of the various Asian Bodywork Therapy (ABT) Forms.

The AOBTA® was formed in 1989 when a number of associations and representatives of the various Asian Bodywork Therapy professions decided to unite into a single organization.” — About AOBTA

To become a Professional member who can acquire certification from this reputable organization, one must complete a 500 hour curriculum of the following :

160 Hours Asian Bodywork Technique and Practice
100 Hours Traditional Chinese Medical Theory
70 Hours Observed Clinical Practice
100 Hours Western Anatomy & Physiology
70 Hours Other: Must include first aid, CPR, business, legal & ethics courses.  May include Tai Chi, Qigong, massage, etc.)

For comparison, Naturalhealers.com expresses that “a common requirement for states with massage licensing criteria is the need for 500 to 600 hours of training.” Take confidence that this AOBTA-C.P. got a graduate level experience to achieve a similarly rigorous certification.

I got my training and education in Tuina from AOMA, Graduate School of Integrative Medicine. The amazing Dr. Fan works there as a Tuina specialist and teacher. I learned from him, and conducted my clinical internship with him. I continue to study alongside many TCM practitioners as an Acupuncturist intern, too. Soon I will also offer that modality, but I urge you to try tuina, guasha, cupping, medical qi gong and tai chi.

 

 

Patient Enrollment

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Treatments are performed with clinical expectations and parameters, but eclectic diagnostics like pulse and tongue observation are used to generate treatment plans. The treatment is tailored toward the individual, and is not a routine. I work with you, and we make a plan together to achieve true healing. You are encouraged to bring any relevant medical results (i.e. x-rays, lab results, etc.).

If you are curious about the healing techniques,  read more about them by clicking here.

Things New Patients Should Know

  • New patients are asked to fill out in-take forms regarding the chief complaint & the history of their health.
  • Treatments are done one-on-one, though if the patient desires a relative or friend be present, that is acceptable.
  • Treatments can be booked by calling or texting 512-216-4325.
  • Many of the techniques require direct access to skin, so patients are asked to wear loose clothing, or outfits that are easy to change out of, so that a clinic gown can be worn. [Note: This is completely at the discretion of the patient, and I will gladly respect your style and adapt the treatment to your clothing choices. No changing is required.]
  • Acupuncture, Cupping and Guasha can produce hematoma (bruising) and petechiae, which manifests as a redness on the skin’s surface. These marks go away quickly and are indicative of inflammation held in the fascia and muscles. If you’ve ever got questions about these marks, please contact me.
  • If you are needle sensitive, we won’t have to use needles. We can use acupressure and other techniques.
  • Insurance is not accepted.
  • A single treatment can be very effective, but in order to completely resolve an issue, more treatments are possibly necessary.
  • Intake Form

Some questions can only be answered by experiencing a treatment. Call 512-216-4325 or visit the online booking page to schedule a free phone consultation or your first treatment.

What are some of my techniques?

What are some of my techniques?

TUI NA

Tui na  is an ancient technique defined by strong and precise pressuring & manipulation of specific tissues and points, which regulate the harmonious flow of qi in every body.  Combining knowledge of modern anatomy with Traditional Chinese Medicine, careful stimulation of specific acupuncture meridians are assessed and focused upon throughout the treatment. The entire body typically achieves complete relaxation, as the individuated treatment relieves aches, soothes nerves, and promotes detoxification in the brain, heart, spleen, lungs, kidneys and liver.  It provides great relief to overworked muscles and sore joints.

GUA SHA

Gua Sha is a powerful technique for releasing wind-bi from the muscles, purging inflammation and moving stagnant qi from sore spots like the shoulders and neck. The muscles in our body can build up and retain inflammatory substances that perpetuate chronic irritation. Gua Sha breaks apart the densely knotted muscular tissue and vents the blood, promoting relief while dispersing excessive body heat. Oil and a metal / horn tool are used to dredge the microfibers of muscle, which provoke a colorful response from the skin. The marks typically remain for no longer than one month.

CUPPING

Cupping uses glass or plastic cups to create vacuums on the flesh. This pressure helps draw out stagnant blood from muscles, which can build up due to tension and poor posture. Regulating the flow of blood and qi through cupping can improve energy, motivate circulation and reduce pain. The result often looks like a crimson moon has been stamped onto the skin. Marks typically disappear within one month or sooner.

Enkephalin, the Acupuncturist’s Opioid

Have you ever heard of an endogenous opioid peptide? It certainly is a mouthful. I had no clue what it was until I was first introduced to the term Enkephalin in an anatomy audiobook from Audible. The lecturer was listing off advances in peptide research. Then I read about enkephalin in Kiiko Matsumoto & Steven Birch’s book Reflections on the Sea. They mentioned that notable studies were correlating an increase of enkephalin with patients receiving acupuncture treatments. I found this to be so fascinating that I wanted to know more distinctly what enkephalin looks like and how it operates.

A few facts about enkephalin / endogenous opioids:

  • It is a pentapeptide. This means it has five amino acids (Tyr, Gly, Gly, Phe, Met).
  • It is an opioid peptide. These are short chains of amino acids that bind to opioid receptors in the brain. The activation of these receptors inspire the similar responses as an opiate like morphine would.
  • “Brain opioid peptide systems are known to play an important role in motivation, emotion, attachment behaviour, the response to stress and pain, and the control of food intake.”—Wiki
  • Its “brother & sister” peptides are endorphins and dynorphins. Pain and our mood do seem to wax and wane together, don’t they?

Picture of enkephalin structure below

Biochemistry has done a great job of exploring the mechanisms of these endogenous peptides, but I wondered more about how acupuncture could elicit or provoke the release of enkephalin. I scavenged research such as the following articles / books:

Acupuncture Therapy for Neurological Diseases: A Neurobiological View 

This book compiled many different research experiments and compared the literature & statistics. It seemed like the actual points, depth of insertion and intensity of manipulation were not scrutinized exceptionally. They had methodologies that compared chemical profiles of animals, before & after acupuncture. I found the following excerpt to be very informative:

“It has been well documented that opioid receptors play a crucial role in many of the effects induced by manual acupuncture/ EA. The simplest and strongest evidence is that many of the acupuncture effects can be eliminated or attenuated by the opioid receptor antagonists.” — Xie et al. 1985, 1989; Zhao et al. 2002; Tian et al. 2008a, 2008b.

Substances like Naloxone are opioid receptor antagonists. This substance blocks the effects of opioids by shielding or de-activating the receptor. Naloxone is widely used as a remedy for opioid overdosing, and is being sold over the counter in many states now to combat the drug epidemic in America.

Check out the similarities between Enkephalin and Morphine

Morphine itself also comes from older medicinal traditions, namely Herbalism. The herb Ying Su Ke (Poppy husk) has been used within the Chinese herbal pharmacopeia for a long time. The actual opium war was not due to Ying su Ke, but rather British imports and imperialist trading habits that inundated China with strong opium (though it was nothing compared to modern pharmaceutic productions). That caused all sorts of trouble, and I wager we’re seeing history repeat itself presently in the context of America’s opioid crisis. Acupuncture could be the key to positive change in the healthcare of our country, by circumventing the need for chemicals to relieve patients of their suffering.

Acupuncture is widely used in drug detoxification and for suppression of symptoms of addiction. Associations like NADA—National Acupuncture Detoxification Association, certify healthcare providers of all realms to perform an auricular protocol that was developed for meth and heroin addicts. It might be anticipated that the activation and proliferation of endogenous opioids helps to level out the body’s cravings for chemical stimuli. I am starting to see how acupuncture can be good for both pain relief, as well as reducing stress of those recovering from addiction and withdrawal.

Unfortunately, it seems if a person is taking Naloxone while receiving acupuncture, the pain relief effects are greatly diminished. Enkephalin relies on the availability of opioid receptors, though one might wonder if the body still accumulates the peptides, and if they can be absorbed after Naloxone is excreted. The following research on mice could help explain:

Electroacupuncture in awake mice produced analgesia to noxious heat stimuli causing a 54% increase in latency to squeak. Subcutaneous naloxone completely abolished this acupuncture analgesia implicating endorphin. Naloxone injections in control mice caused a 17% hyperalgesia suggesting that “normal” mice also release endorphin. These results imply that endorphin is released at a low basal rate in “normal” mice, and at a much higher rate during acupuncture.

Naloxone blockade of acupuncture analgesia: Endorphin implicated
Bruce Pomeranz, Daryl Chiu

There is a ton of research regarding this subject, and it is very promising to see biochemistry helping to bridge the gap of efficacy and understanding within the realm of Acupuncture. And, in spite of Naloxone, I believe there are many other vectors and mechanisms of acupuncture that can relieve pain and improve bodily function (check out this article to learn more about that). So, even those with Naloxone prescriptions could find it beneficial to some degree, especially if they are seeking to diminish all chemical consumption.

Enkephalin is definitely a key player in understanding acupuncture and, really, the way pain works in response to stress and other deleterious effects of living on this planet. I will continue to explore how peptides, neurotransmitters and other chemicals promote amelioration in the body. Stay tuned, and maybe schedule an appointment so we can get some enkephalin brewing in your body!