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Acupuncture, Qi and the Body, Mind and Spirit

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The practice of acupuncture and moxibustion is based on the theory of meridians. According to this theory, qi (vital energy) and blood circulate in the body through a system of channels called meridians, connecting internal organs with external organs or tissues. By stimulating certain points of the body surface reached by meridians through needling or moxibustion, the flow of qi and blood can be regulated and diseases are thus treated. These stimulation points are called acupuncture points, or acupoints.

Acupoints reside along more than a dozen of major meridians. There are 12 pairs of regular meridians that are systematically distributed over both sides of the body, and two major extra meridians running along the midlines of the abdomen and back. Along these meridians more than three hundred acupoints are identified, each having its own therapeutic action. For example, the point Hegu (LI 4), located between the first and second metacarpal bones, can reduce pain in the head and mouth. The point Shenmen (HT 7), located on the medial end of the transverse crease of the wrist, can induce tranquilization.

In acupuncture clinics, the practitioner first selects appropriate acupoints along different meridians based on identified health problems. Then very fine and thin needles are inserted into these acupoints. The needles are made of stainless steel and vary in length from half an inch to 3 inches. The choice of needle is usually determined by the location of the acupoint and the effects being sought. If the point is correctly located and the required depth reached, the patient will usually experience a feeling of soreness, heaviness, numbness and distention. The manipulator will simultaneously feel that the needle is tightened.

The needles are usually left in situ for 15-30 minutes. During this time the needles may be manipulated to achieve the effect of tonifying the qi. Needle manipulations are generally involved with lifting, thrusting, twisting and rotating, according to treatment specifications for the health problem. Needling may also be activated by electrical stimulation, a procedure usually called electro-acupuncture, in which manipulations are attained through varying frequencies and voltages.

Treatment protocols, frequency and duration are a matter of professional judgment of the practitioner, in consultation with the patient. A common course of treatment may initially involve between ten and fifteen treatments spaced at approximately weekly intervals, and spread out to monthly later in a program.

A professional practitioner will always warn the patient of the possibility of exacerbation at the start of a course of treatment. The patients may find that in the short term after treatment, the symptoms may in fact get worse before an improvement sets in. This is a quite common feature of acupuncture treatment.

Patients should inquire about types of needles used prior to treatment. Most practitioners now use pre-packed and sterilized disposable needles that are used  only once. If re-useable needles are being used patients should ask to see the sterilization procedures that the practitioner adopts.

The effectiveness of an acupuncture treatment is strongly dependent upon an accurate Chinese medical diagnosis. The needling skills and techniques of the practitioner will also influence greatly the effectiveness of the outcome. Acupuncture can be remarkably effective in many conditions, but in the West, patients often use acupuncture as the last option for their long-term chronic problems. Therefore we sometimes see the treatment as slow and in some cases of marginal benefit. With the gradual establishment of acupuncture as the treatment of choice for many people, the effectiveness of the approach with acute as well as with more chronic conditions is being recognized.

Acupuncture is often conducted in combination with Moxibustion. Moxibustion is the process where moxa sticks, made of dry moxa leaves (Artemisia vulgaris) is ignited and held about an inch above the patient’s skin over specific acupuncture points. Moxa is available in a loose form that can be used for making moxa cones. Alternatively, moxa is packed and rolled in a long stick like a large cigar, about 15-20 cm long and about 1-2 cm in diameter. The purpose of this process is to warm the qi and blood in the channels. Moxibustion is most commonly used when there is the requirement to expel cold and damp or to tonify the qi and blood. A single treatment of moxibustion usually lasts 10-15 minutes. Needle-warming moxibustion combines needling and moxibustion by attaching a moxa stub (about 2 cm long) to an inserted needle. This method enhances the effects of needling and is often used to treat chronic rheumatism and rheumatoid arthritis.

Neural-Muscle Connection Discovery Could Help People with Muscle Fatigue

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Motivation. Strength. Will power. Physical condition. Stamina. All of these have long been known to contribute the extent to which humans are able to voluntarily activate muscles. But for the first time, investigators have discovered neuronal processes that are responsible for reducing muscle activity during muscle-fatiguing exercise.

The investigators say their discovery opens up new areas of research to help people who experience muscle fatigue related to illness.

“The findings are an important step in discovering the role the brain plays in muscle fatigue,” said investigator and neuropsychologist Kai Lutz. “Based on these studies, it won’t just be possible to develop strategies to optimize muscular performance, but also specifically investigate reasons for reduced muscular performance in various diseases.”

In an earlier study, the researchers showed that nerve impulses from a muscle, much like pain information, inhibit the primary motoric area during a tiring, energy-demanding exercise.

In a second study, using functional magnetic resonance imaging, the researchers were able to localize the brain regions

that exhibit an increase in activity shortly before the interruption of a tiring, energy-demanding activity—the thalamus and the insular cortex—and are thus involved in signalizing the interruption. Both of these areas analyze information that indicates a threat to an organism, such as pain or hunger.

The latest study indicates the inhibitory influences on motoric activity are mediated via the insular cortex. In tests using a bicycle ergometer, the researchers determined that the communication between the insular cortex and the primary motoric area became more intensive as fatigue progressed.

“This can be regarded as evidence that the neuronal system … not only informs the brain, but also actually has a regulating effect on motoric activity,” said investigator Lea Hilty.

Prolonged reduced physical performance is a symptom that is frequently observed in daily clinical practice, a press release noted. “It can also appear as a side effect of certain medication [and] … chronic fatigue syndrome is often diagnosed without any apparent cause.”

Active Lifestyle Reduces Risk of Depression

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Previous studies have reported an inverse association between physical activity and depression. Michel Lucas, from Harvard School of Public Health (Massachusetts, USA), and colleagues studied data co0llected on 49,821 US women enrolled in the Nurses’ Health Study, all of whom did not experience symptoms of depression in 1996.

Surveying for physical activity a total of five times during the study period, and following subjects for 10 years to assess for clinical depression, the team found that women who reported exercising the most in recent years were about 20% less likely to get depression, as compared to those who rarely exercised.

As well, the more hours the subjects spent watching TV each week, the more their risk of depression rose.  The researchers warn that:  “Analyses simultaneously considering [physical activity] and television watching suggested that both contributed independently to depression risk.”

According to findings published in the American Journal of Epidemiology, researchers found that women who reported exercising the most in recent years were about 20 percent less likely to get depression than those who rarely exercised.

On the other hand, the more hours they spent watching TV each week, the more their risk of depression crept up.

“Higher levels of physical activity were associated with lower depression risk,” wrote study author Michel Lucas, from the Harvard School of Public Health in Boston.

More time spent being active might boost self-esteem and women’s sense of control, as well as the endorphins in their blood, although the study could not prove directly that watching too much television and avoiding exercise caused depression, she added.

The report included close to 50,000 women who filled out surveys every couple of years as part of the U.S. Nurses’ Health Study, and covered the years 1992 to 2006.

Participants recorded the amount of time they spent watching TV each week in 1992, and also answered questions about how often they walked, biked, ran and swam between 1992 and 2000.

On the same questionnaires, women reported any new diagnosis of clinical depression or medication taken to treat depression.

The analysis only included women who did not have depression in 1996. Over the next decade, there were 6,500 new cases of depression.

After the researchers accounted for aspects of health and lifestyle linked to depression, including weight, smoking and a range of diseases, exercising the most — 90 minutes or more each day — meant women were 20 percent less likely to be diagnosed with depression than those who exercised 10 minutes or less a day.

Women who watched three hours or more of television a day were 13 percent more likely to be diagnosed with depression than those who hardly ever tuned in, but Lucas said at least part of that link might be due to women replacing time they could be exercising with TV watching.

One alternative explanation the researchers brought up is that women might have been experiencing some symptoms of depression before they were diagnosed, leading them to exercise less. A formal diagnosis could have come later.

“Previous studies have suggested that physical activity is associated with a lower risk of depressive symptoms,” said Gillian Mead, who studies geriatric medicine at Edinburgh’s Royal Infirmary but was not involved in the study.