Managing repetitive strain injuries with channel-based acumoxa therapy

Townsend Letter for Doctors and Patients,  Feb-March, 2005  by Honora Lee Wolfe

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Using the affected or unaffected side

One of my teachers, Dr. Miriam Lee, quotes an old Chinese medical saying, "If a child is hurt, don't punish it." This means not to needle right on top of the area of pain. Dr. Lee frequently does not even needle on the same side as where the pain exists. While I consider Dr. Lee's saying carefully with each patient, I sometimes treat on the same side as hand pain and numbness appear and sometimes on the opposite side. While it is somewhat difficult to describe how I make this choice, I will try to give some general guidelines.

If there is numbness, I mostly treat the affected side with both needles and moxa. Whereas the use of needles can manipulate existing qi and blood, it cannot directly create fresh qi and blood where none exists. Only with internal herbal medicine or the use of moxibustion can something be added to the body. (8) Since numbness may often involve at least local blood vacuity, I like to use moxibustion directly on the numb areas to add qi and encourage the infusion of blood into the area. Needling of numb areas encourages the increased flow of qi to them.

If there is no numbness but the pain is chronic, my usual procedure is to use thread moxa in the local area and needle either the exact area of pain on the opposite arm and/or choose a point on the corresponding channel on the contralateral leg. For example, if the pain is on the yang ming channel of the left arm, I would needle any tender point below the knee on the foot yang ming channel on the right leg.

Also, how chronic or acute is the problem is and what makes it worse or better affects the decision as to which side to treat. If the pain is worse with movement (local qi stagnation and/or blood stasis) and relatively acute, I am more likely to use needles in the local area. The more chronic and longterm the problem or if it worsens during sleep or rest, the less likely I am to do so. If the problem is definitely adversely affected by cold, indirect moxibustion and local massage seem to give better results than local needles. Beyond these recommendations, each practitioner must experiment and use a combination of intuition and Chinese medical theory to decide how best to treat.

What to try if treatments are unsuccessful

1. Akabane testing/stimulation to balance the channels of the arm/hand will help you confirm your diagnosis of which channels are replete and which ones are vacuous.

2. Ear needles in points for Wrist, Fingers, Pain Master, and Neurogate (Shen Men). You can use mild electrical stimulation if you have it. Use the ear on the affected side.

3. If there are any purple/black veins, if there has been surgery, or if the pain is fixed and stabbing, consider bleeding one or two points, removing one drop of blood at each. If such veins are visible and you do not bleed, you will not get the best possible result.

4. Pay more attention to treating the root. Reexamine the patient's pulse and tongue and go back over what questions you asked to see if you overlooked any factors that may contribute to the condition. Re-examine the abdomen and think through that part of your treatment.