ACUPUNCTURE
Curiously enough acupuncture is not just sticking needles into people. It is part of a coherent and observation based medicine that experienced practitioners of the art have handed down over the centuries. This form of medicine has it’s roots firmly based in Nature. Our relationship with our environment, with ourselves and with others is seen as a direct reflection of our health.
ACUPUNCTURE
If you’re familiar with acupuncture or not, the idea of placing very fine, sterile, disposable needles into specific points on the body to regulate physiology and somehow improve health and wellbeing may seem or still seem a little odd to say the least.
Curiously though, this practice has been going on over millennia in various forms. Current modern scientific evidence points to acupuncture as a potentially effective therapy to manage a range of health symptoms (link). There are many quality articles already on the net about the potential mechanisms of acupuncture if you wish to read some here, here or here. I find most people have just a passing curiosity with how it may work and are more interested in ‘Will it work for me’? In other words, just like we drive a car, we are generally not too concerned with how the engine works if it gets us to where we need to go, safely. We’re not too interested in the ‘how’ but more in end result and outcome.
In the West acupuncture has mostly become best known for its ability to assist in pain management, however, its’ historical and practical scope is actually much much broader. In Australia the potential uses of acupuncture for various health conditions is generally not common knowledge due to under representation in the media and in the marketplace. Advertising acupuncture services is highly regulated and claims of benefit for various conditons must fall within strict scientific guidelines. Acupuncturists don’t do themselves any favours either by using jargon or insisting on explaining treatments to clients through the theoretical lens of Chinese medicine. Unless a person has a foundational understanding of these concepts any descriptors can end up sounding like gobbledegook to the average person or client and does not help to promote a positive understanding of the profession or its’ capabilities.
In Australia, most people know something of acupuncture but they’re not very familiar with its’ context.
Acupuncture is just one therapeutic pillar of eight in Chinese medicines deep understanding of restoring health, increasing longevity and above all the practice of what’s known as ‘Yang Sheng’ – to nourish or sustain a full and healthy life and avoid falling into chronic ill health.
The eight pillars are:
Meditation (seated)
Taiji/Qigong (exercise/moving meditation)
Breathwork
Nutrition
Bodywork (massage/manipulation)
Moxibustion (heat therapy) /Gua sha /Cupping (or external therapies)
Herbal medicine (internal & external applications)
Acupuncture
When we consider that acupuncture sits within such a larger therapeutic framework and has interlinks and connections on many levels to all the other seven pillars, we realise that it is just one strand, albeit a powerful strand, in the web of potentially beneficial practices that we can all use or practice to keep ourselves healthy and at our best.
So, now that we know a little more about the context of acupuncture in a complete holistic health system, what about the context for its use?
How or why would we use acupuncture as a therapy?
The answer to that is twofold:
- Acupuncture can be used as a preventative health treatment and to maintain health and balance and keep our body/mind strong and optimal.
Again, I use the analogy of car. If you run it and run it and never check or change the oil, water or tyres eventually you’ll find yourself stuck on the side of the road, calling NRMA. Obviously humans are inherently more complex than a motor vehicle but you get my point, we don’t have to wait to get sick, rundown, or lose our mojo before we act. We can be proactive and use acupuncture in conjunction with an overall healthy lifestyle, just as we can choose to eat better quality foods and exercise.
- Acupuncture can be a powerful restorative therapy to return the body to homeostasis and wellbeing.
Even with the best will in the world, sometimes we will fall behind and succumb to sickness, are hit with bad luck, or find ourselves seeking support for ill health, acute or chronic. When this occurs acupuncture can help you access your internal pharmacy. It is not a magic bullet that can ‘fix’ or ‘cure’ illness or disease. Instead it acts as a triggering mechanism for your body’s own natural healing capabilities.
So, if acupuncture isn’t a ‘cure all’ or ‘magic’ then what in fact is it?
Simply, it is a natural therapeutic process that starts and ends with you and your unique situation whether that’s preventing illness or promoting health recovery. Like most processes, sometimes patience is required to see results.
If you believe that after one acupuncture session your health issues will magically be resolved, this isn’t realistic, even for acute cases a number of treatments are generally required. Before you proceed with any acupuncture treatment at Kintsugi Therapies these aspects will always be discussed with you in an open and honest way, so there are no surprises and your expectations are managed.
Some believe that certain therapies including acupuncture are passive by nature, in other words they can encourage reliance on a practitioner or on on-going weekly treatments that disenfranchise a person and their ability to move past a health problem. In the case of acupuncture the person lies there passively while needles are inserted, hoping that something will improve. That’s certainly one view but it doesn’t tell the full story. To get to that point many questions will have been asked already of the person, they will have become engaged with their health, their choices and their circumstance. This alone can be very reflective for them in trying to understand how or why they’ve found themselves in a health challenge. In treatment their body is also being challenged to ‘kick into action’ and begin to activate its own innate healing capabilities. Areas of the person’s life may need to actively shift away from certain behaviours and more towards positive changes. This can be facilitated with the acupuncturists aid or by another qualified practitioner in a different therapeutic area or sometimes just by the person themselves if they feel they have the resources and motivation required, indeed it could even be a mixture of all three.
So, looking from the outside, the physical nature of acupuncture may give the impression of being passive, however the therapeutic dynamic for both practitioner and client makes it far from a passive treatment. As practitioners we want the person to engage with their own curiosity about why they find themselves seeking acupuncture and assess if there are changes they can make themselves or with help, information and support. In my experience, I would say that in an acupuncture treatment there is an active opportunity provided for a person to slow down and find space and time to connect with themselves. It seems many people find this valuable in and of itself not to mention the physiological benefits and positive effects it seems to have on activating the parasympathetic or rest and digest aspects of the nervous system. We now know that this activation plays a lead role in cell regeneration and healing processes.
The goal of acupuncture treatment is the resolution of imbalance, manifesting as illness or dis-ease.Resolution of imbalance requires change to take place and change requires action. This is done by stimulating the persons innate healing capabilities within and ensuring they have adequate knowledge, information, resources and support without. The support offered is there for as long as the person feels they need it. Each person’s road to improvement or recovery will be different based on their unique situation and their ability to access personal and external resources. The practitioners bears the responsibility to understand and make the correct therapeutic judgements at the right time and to always act in the clients best interest.
Finally, not to get too esoteric but I’m sure at some stage you’ve come across this symbol. 
It’s pretty much synomomous with Chinese medicine, but, you may wonder what’s its’ importance or meaning. The symbol presents as static, and perhaps that’s how we find ourselves within a health challenge, a bit stuck, however, the symbol when in active motion represents the universal laws of change, or Yin & Yang. When viewed this way the symbol is dynamic, each flows into the other, each has aspects of the other and each is in communication with the other. They are two sides of the same coin representing all potential change. Understanding the changing dynamic of life and illness is at the very heart of Chinese medicine and acupuncture practice.
If you’ve read this far and have some further questions about acupuncture and the acupuncture treatment process at Kintsugi Therapies, please visit my comprehensive frequently asked questions page linked below and check under the ‘acupuncture questions’ heading. If you still can’t find the information you’re looking for, I’ve included a form on that page if you need to get in touch with any further questions or queries.
REMEDIAL
MASSAGE
It’s said that ‘the body doesn’t lie’, a cliche, but in my experience I’ve found this to be true. These bodies of ours are sophisticated, interlinked systems that both react to and interact with the world around us. So what do we do with stress, physical and mental overload, strong emotions and all those external and internal pressures that play out daily? Our bodies are masters at hiding, storing and holding it deep in our living tissue via the nervous system. My style of massage is based on listening to your words and reason for treatment, and as importantly, deep listening based on your body’s story and it’s unique need at that time.
REMEDIAL MASSAGE
“The skin is the surface of the brain.”- Deane Juhan (Job’s Body).
This may sound like a clever aphorism but, in fact, there is much truth to it. When we start out as a fertilized egg, the egg begins to divide, and those early divisions produce a mass of undifferentiated cells that are identical to each other. At a point, something amazing happens – this undifferentiated mass begins to divide into three distinct layers.
The endoderm goes on to become the internal organs.
The mesoderm later becomes the musculoskeletal system.
The ectoderm becomes the brain, the spinal cord, the peripheral nerves . . . and the skin.
Our brains, the nervous systems, and skin are intimately linked from the very beginning.
This is not entirely surprising. Besides serving the function of keeping the outside world out of our body and keeping our insides in, providing a protective barrier between us and that which is not us, the skin is how our brain monitors our external environment. Approximately 1,000 nerve endings per square inch of skin, on average, are responding to temperature, pressure, stretch, vibration, light touch, chemical irritants, etc. The brain is constantly receiving information, processing it, responding, then continuing to monitor both internal and external changes. The brain and the nervous system never sleep, never take a break. It is constantly active and, in spite of comprising only 2% of our body mass, it uses 20% of our energy. It’s a very busy, hard working system!
In remedial massage we are of course interacting with the skin (and muscles, fascia & soft tissue under hand). But what might be happening during this interaction and what might be the response that massage invokes?
Currently, there are two generally held views. These responses are synergistic, interchangeable and a good massage should naturally and seamlessly blend elements of both.
Together, these responses can produce direct and indirect physical and emotional benefits.
The first is the relaxation response. In a massage, a caring, experienced, and safe touch is an invitation to relax and activate the relaxation response. It is as much an inborn mechanism as the stress response, and it is vital for reducing the negative effects of physical, emotional, and psychological wear-and-tear on our bodies.
The relaxation response is a deep state in which the heart and breathing rates slow down, the body begins to relax, the production of stress hormones decreases, blood pressure decreases, and the muscles begin to let go of their subconscious tension and relax.
At every moment, the brain is, in turn, responding and creating changes, the pleasant sensations we experience, allowing us to shift out of the “fight or flight” sympathetic nervous system and into the “rest and digest” parasympathetic state.
So it’s not necessarily the pressure alone on the tissues that makes them change but the nervous system doing the job, which means we don’t have to push so hard on the body to make it feel good. It may seem counterintuitive, but I’ve found that a less forceful approach can often be just as effective and does not carry the risk of causing pain or injuring the client. In massage we cannot force the body to relax; we cannot bully the nervous system into turning down the volume on pain and we cannot beat the nervous system into submission. In fact, we cannot really make the body do anything. We can try to set up the right conditions, coax it, convince it, but we cannot directly make any real changes happen to structures with our hands. It is the brain that creates all those sensations that we enjoy, it and the spinal cord are the messengers allowing us to access the relaxation response and feel refreshed. It’s the nervous system that turns down the volume on pain and relieves us of the sensation of tension. Change truly does come from within and by opening up a dialogue between the external skin/soft tissues and the nervous system. It is a skill and one I am constantly refining and reflecting on.
In terms of potential benefits, it’s believed that the relaxation response may play a role in combating the physical effects of stress and reduces the associated risks of health issues like;
* Hypertension
* Insomnia
* Cardiac arrhythmias
* Anxiety
* Persistent fatigue
* Digestive disorders
* Psychological issues
The second and other common response triggered when having a massage is known as the mechanical response.
This is the effect that happens when pressure is applied to soft tissue like muscle.
So, what are mechanical responses to massage?
The physical manipulation of massage has two major physical effects:
* An increase in blood and lymph circulation within the body to help nourish and cleanse cells.
* A recalibration of baseline tension of the soft tissue (primarily muscles), which soothes and releases nervous tension and deeper connective tissues (related to the relaxation response).
Improving circulation with massage
Massage improves blood and lymph circulation. For many of us who sit at a desk for long periods of time, massage could be considered something like a stressless physical workout in that it moves the fluids that nourish and cleanse your body in a healthy way. Simple and very effective. Of course, I advise you to exercise however you can to help maintain your health. Massage should not be seen as a replacement for that in any way.
Improving circulation can also improve the delivery of oxygen and nutrients to muscle cells.
A well-nourished and happy cell that’s functioning efficiently leads to the removal of waste products out of the body and may even reduce swelling in soft tissues.
Relaxing muscles using massage
The effects of a massage include a lowering of the everyday tension we unknowingly hold in our muscles which can lead to a reduction of any painful muscle spasms and irritated nerves.
To get a better understanding of this, visualize a tight muscle compressing the nerves around them. When these muscles are relaxed, the nerves are no longer compressed and can perform their functions more easily.
A happy and relaxed nervous system can more easily transmit messages to and from the brain, which improves the functioning of the muscles and organs (something elite athletes have understood for years)
It’s amazing how rapidly muscles begin to relax during a massage. Even deeper tissues of the body such as deep spinal musculature, which can’t be easily accessed by a massage therapist, can be positively influenced by the release of more superficial layers of muscles.
Organs can benefit from massage too!
Organs share neurological pain pathways with muscles, bones, and nerves. When muscles, bones, or nerves are distressed, organs can sometimes reflect distress and dysfunction themselves. In the Chinese medicine understanding of the body, the exterior and the interior are reflections of one another, this is also reflected in the acupuncture channel system which runs along distinct areas and lines of the body and ultimately has links to various organs and viscera. So a surface treatment from this perspective can be viewed as very beneficial to the various organs and their regulation.
There’s a lot we still don’t know about exactly what goes on at a physiological level during massage. Exactly how does our touch get turned into a change in physiological processes and exactly what and how are those physiological processes change is still being studied and researched. While we wait for more definitive answers on those mechanisms it shouldn’t stop us from accessing and using that which we know intuitively as being so beneficial for us.
At Kintsugi Therapies I always carry out a thorough pre-screening prior to your first massage session to cover all bases. This helps me to understand your reason for seeking treatment and the desired outcomes you are hoping for (even if just deep relaxation). I aim to make your experience as comfortable as possible and be realistic and upfront about the number of sessions you may require to see therapeutic improvement, if that is your reason for coming. I also have other therapies that I can use that complements massage very well. These can sometimes give you the edge on your road to recovery or to help get you feeling at your best again.
If you’ve read this far and have some further questions about remedial massage and the remedial massage treatment process at Kintsugi Therapies, please visit my comprehensive frequently asked questions page linked below and check under the ‘remedial massage questions’ heading. If you still can’t find the information you’re looking for, I’ve included a form on that page if you need to get in touch with any further questions or queries.
CHINESE
HERBAL
MEDICINE
A truly deep, intricate, and natural health benefiting modality. Chinese herbalism takes a lifetime or more to fully master. I continue to seek and use it’s subtlty and it’s power in delivering results for a variety of health complaints. It can often be the key in treatment to kick start change or as a potent supplement between acupuncture sessions. I provide options for herbal medicine in various forms, including liquid extract, powder, pills and topical creams. All ingredients are fully certified based on Australian (& European Union) regulations and guidelines and in strict compliance with CITES.
CHINESE HERBAL MEDICINE
Herbal medicine in China is used more than either Western drugs or acupuncture. Taking their use in other countries into account, they form probably the largest tradition (outside mainstream medicine) of healthcare worldwide.
The system of herbal medicine that developed in China differs in several significant ways from European herbal medicine. The most obvious difference is that the Western herbal tradition often focuses on “simples,” or herbs taken by themselves. In contrast, Traditional Chinese Herbal Medicine (TCHM) makes almost exclusive use of herbal combinations to produce a therapeutic effect. More importantly, these formulas are not designed to treat symptoms of a specific illness; rather, they are tailored specifically to the individual according to the complex principles of traditional Chinese medicine. For this reason, TCHM is potentially a deeply holistic healing approach. On the other hand, it is both more difficult to use and to study than its Western counterpart.
TCHM is widely used in Asian countries, both in its traditional holistic form and in a simplified disease-oriented version. There have been a few properly designed scientific trials of TCHM, but the evidence base remains highly inadequate.
History of Chinese Herbal Medicine
Chinese herbal medicine has a long historical tradition.
Ancient herbology in China focused on potions whose function was part medicinal and part magical, and it lacked a substantial theoretical base. Sometime between the second century B.C.E. and the second century A.D., the theoretical foundations of traditional Chinese medicine were laid, but the focus was more on acupuncture than on herbs. Only by about the 12th century A.D. were the deeper principles of Chinese medicine fully applied to herbal treatment, forming a method that can be called TCHM. This was further refined and elaborated during various periods of active theorizing in the 14th through the 19th centuries. Western disease concepts entered the picture in the 20th century, leading to further changes.
In China today, TCHM is used alongside conventional pharmaceutical treatment. Considerable attempts have been made to subject TCHM to scientific evaluation; however, most of the published Chinese studies on the subject fall far short of current scientific standards. (For example, they generally lack a placebo group.)
In neighboring Japan, a variation of the TCHM system known as Kampo has become popular, and the Japanese Health Ministry has approved many Kampo remedies for medical use. The scientific basis for these remedies remains incomplete, but several studies of minimally acceptable quality have been reported.
Principles of Traditional Chinese Herbal Medicine
Even a basic introduction to the principles of TCHM exceeds the scope of this article. Consider the following nothing more than a taste of this vast medical system.
The underlying principles of Chinese medicine often appear to the Western observer to be wrapped in vague or mystical notions. However, such prejudices arise from the nineteenth-century Western view of the world as clockwork mechanisms. As modern science begins to appreciate the complexities of living systems, it has rediscovered principles that may be consistent with the oriental insights.
In the language of complex dynamic systems, life maintains maximum adaptability and creativity by balancing static orderliness and turbulent chaos, and avoiding extremes of either. The essential endeavour of the Chinese physician is to restore the balance of the body, the yin nourishment and yang activity.
According to the principles of all Chinese medicine, health exists when the body is balanced and its energy is freely flowing. The term “energy” refers to Qi, the life energy that is said to animate the body. The term “balance” refers to the relative factors of yin and yang—the opposing forces of the universe. The yin and yang concepts may be seen as means of classifying the experience of constant change. The yang is the active aspect of any phenomenon, the dispersive, centrifugal, transforming and expansive. Such descriptors are similar to those ascribed to chaotic tendencies in complex dynamic systems. The yin is the substantive or nourishing aspect of any phenomenon, the condensing, centripetal, sustaining and preserving. Yin and yang find their expression in various subsidiary antagonists such as cold vs. heat, dampness vs. dryness, descending vs. ascending, at rest vs. active, and full vs. empty.
In an ideal state, yin and yang in all their forms are perfectly balanced in every part of the body. However, external (e.g. environmental) or internal factors (e.g.emotions) can upset this balance, leading to disease. Chinese medical diagnosis and treatment involves identifying the factors that are out of balance and attempting to bring them back into harmony. Diagnosis is carried out by means of “listening” to the pulse (in other words, taking the pulse with extraordinary care and sensitivity), observing and palpating various parts of the body, and asking a long series of questions.
The herbal formulas used in TCHM consist of four categories of herbs: ministerial, deputy, assistant, and envoy. The ministerial herb addresses the principal pattern of the disease. Deputy herbs assist the ministerial herb or address coexisting conditions. Assistant herbs are designed to reduce the side effects of the first two classes of herbs, and envoy herbs direct the therapy to a particular part of the body.
Chinese herbal medicine in its’ most traditional fashion, consists of preparing dried herbs into a decoction and drinking. The herbs are prepared according to the instructions, which typically involve adding water, boiling for several hours in a ceramic pot, pouring off the liquid, adding more water, and repeating the process twice more. In modern Australia where most people are time poor, this process seems highly inconvenient. Compliance is herbal medicine is key if progress is to be achieved and nothing stops compliance quicker than a multi-step process especially one that is unfamiliar to people. Cooked raw herbs can be notoriously unsavoury to drink also. For that reason, I provide ready to take herbal extracts (in dropper form) which pack all the punch of the ingredients without either a potentially bad taste or the investment in time required to prepare. I also offer powdered extract, just add boiling water and drink.
What Is Chinese Herbal Medicine Used for Today?
In the traditional system of Chinese herbal medicine, herbal formulas can be used to assist in treating various conditions. Some of the most common uses in China include liver disease ( hepatitis and cirrhosis ), sexual dysfunction in men , infertility in women , insomnia , colds and flus , sports and post operative care, menstrual pain , irregular menstruation, menopause , and cancer treatment support .
Acupuncture is often used along with herbs as a supplemental treatment or vice versa; in addition, detailed lifestyle suggestions are offered to instigate and consolidate health improvement.
CUPPING
THERAPY
The origins of cupping are lost to history but suffice to say we humans have been using this wonderfully simple yet effective therapy for a very long time, across cultures and across continents. In our modern times it has become associated with certain sports and movie stars who have popularised it through media curiosity and yes those marks! In clinic I find cupping a very useful tool for a variety of ailments, including sports injuries, musculoskeletal and joint pain but also its’ ability to help regulate and calm an agitated nervous system. Regular cupping sessions, as with acupuncture and massage can promote a true sense of wellbeing.
CUPPING THERAPY
The practice of cupping is a technique where a vacuum is created in a cup, drawing the skin up and inside the vessel and decompressing the layers of the epidermis and subcutaneous superficial fascia for the purposes of activating a therapeutic effect.
Cupping is a cross cultural therapy with traditions in many countries across Europe, Africa and Asia.
Generally, in the East, cupping is performed in the context of Chinese medicine and its use is indicated based on the fundamental theories that underlie that practice.
Chinese or East Asian Medicine for millennia has used cupping therapy. Entrenched folk practices among ordinary people, much as in Europe but on a more culturally advanced level and scale, places China as the main advocate and practitioner of cupping therapy on the global stage. Advances in cupping development and research into potential mechanisms of action are mainly due to China’s long associated history with cupping therapy. In the 1950’s co-research with the then Soviet Union claimed to confirm clinical efficacy and cupping therapy was once again established as an official therapeutic practice in hospitals all over China (http://www.acos.org/articles/chinese-medicine-cupping/).
With the broad acceptance that Traditional Chinese Medicine (TCM) has gained throughout the world as a viable, effective medicine, cupping therapy has in recent times begun to be seen by some as an option for treating disease, particularly for relief of pain and associated musculoskeletal disorders. In the west both movie stars and sports stars have been seen sporting cupping marks, spiking an interest from the general public as to the nature of cupping therapy.
The benefits of cupping from a TCM perspective depends on the application. These vary from abdominal complaints to cosmetic treatments; however cupping is commonly used to unblock stagnation (causing pain/discomfort) and to release pathogenic influences from the system. Cupping can and is also applied to maintain and regulate TCM bodily substances and therefore according to TCM it can also be used as a preventative therapy, boosting immunity, and benefiting blood circulation (Chirali, 2014).
Research and empirical knowledge would suggest that cupping therapy’s efficacy is applicable for a wide range of health issues, not just pain related. Whether it is seen as a passing fad or becomes more established once again as a valid and accepted medical intervention, only time will tell. Regardless of this it seems that cuppings ease of application, relatively simple and safe methods and low-tech equipment ensure that cupping practices continue to be used by a variety of clinicians and home users alike.
Cupping practices have a long history and strong undercurrents of tradition flowing through them.
There is empowerment in taking your own health or that of your family in your hands. Cupping therapy along with perhaps massage, and the practice of scraping (Gua Sha), seems to have filled the space between medical and domestic healthcare at least in some parts of Asia. Whenever a cup is placed on the skin for therapeutic purposes this tradition continues to thrive and the echoes of the ancient past and our modern lives meet at the surface.
In the West, modern science dominates, therefore, research and investigation into cupping is usually carried out within the framework of modern physiology and scientific analysis. Research in the west into cupping therapy’s effects and mechanism are still in the early days, however, some studies and information are beginning to be published.
There are several theories that biomedicine currently has under the spotlight. One theory, known as the Detox theory, suggests that due to the skin being highly vascularised i.e. rich in blood supply, the application of a negative vacuum is understood to ‘improve microcirculation, promote capillary endothelial cell repair, accelerating granulation and angiogenesis in regional tissues’ (Mehta & Dhapte, 2014).
This increase in local freshly oxygenated blood circulation and lymphatic flow may thereby ‘increase cell metabolism helping in relieving painful muscle tension by reducing the amount of inflammatory or toxic substances’ (in circulation) (Musemeci, 2016).
The Pain gate theory, first proposed in 1965 by Ronald Melzack and Patrick Wall, may also be relevant to cupping therapy. The proposed mechanism in this theory may be due to both local and distal factors. Locally the application of cups stimulates certain fibres through deforming the skin at the cup site. Distally in the spinal cord, the action of cupping may stimulate inhibitory receptive fields of the dorsal horn neurons. Together these factors may reduce the patient’s perception of pain, with the effects being persistent (https://www.britishcuppingsociety.org/?portfolio=how-does-it-work).
Another theory is the Prostaglandin theory. The mechanism of cupping may be the removal of inflammatory markers (prostaglandins) which transmit pain signals to the brain from the body (Shaban,2008). ‘Inflammatory substances in skin and tissue might further induce hypersensitivity to noxious stimuli which is reflected by lowered pressure pain thresholds. Cupping is supposed to evacuate toxins and inflammatory agents from the affected area and restore normal circulation, this might explain the local effects on pressure pain thresholds’ (Musemeci, 2016).
Other theories put forward are for the release of endorphins and encephalin, commonly known as ‘happy hormones’ in response to the tight vacuum action of the cups on the body (http://www.tibb.co.za/articles/cupping%20as%20a%20therapy.pdf).
Finally, Nitric oxide acts as a vasodilator, muscle relaxant, is anti-thrombotic, prevents stenosis and decreases inflammation. The Nitric Oxide theory for cuppings’ mechanism suggests that the vacuum pull on the skin in cupping activates a natural chemical cascade that releases nitric oxide and causes blood vessels to dilate. This may facilitate the release of ‘dead blood’ from vessels that formerly might have been pathologically closed or tight. Blood is flushed out of the tissues and into the blood stream so it can be flushed out the system via normal bodily processes (Shaban, 2008). While studies into the mechanism of cupping continue, the inability to currently perform blinding or to compare placebo in gold standard RCT’s for cupping seems to be a limitation. Therefore, despite published studies showing positive results for cuppings effects as a means of therapy, quality results of high-level scientific value remain elusive.
A final factor that we should also include is the biopsychosocial model of health care. This provides a practical framework for investigating the complex interplay between cupping therapy and clinical outcomes. Based on the biopsychosocial model, investigation into mechanisms of action should extend beyond local tissue changes and include peripheral and central endogenous pain modulation. An observed favourable outcome may be explained by overlapping mechanism in the periphery, spinal cord, and brain including, but not limited to:
- Affective Touch – Interpersonal touch and therapeutic stimulation of somatosensory nerves (C-tactile afferent) mediates the release of oxytocin. Which can result in reduced reactivity to stressors and improved mood/affect.
- Contextual Factors – A positive therapeutic encounter is tied to clinical outcomes, the magnitude of a response may be influenced by mood, expectation, and conditioning.
- Mechanical Factors – Gentle stretching of neurovascular structures and muscles induces a molecular response that helps diminish oedema and expedite clearance of noxious biochemical by-products of inflammation (cytokines, prostaglandins, and creatine kinase).
- Neurological Factors – The skin, subcutaneous tissue and fascia are all embedded with mechanosensitive nerve fibres, so the application of cupping invokes a number of neurophysiological responses. One being input from low-threshold Aβ fibres inhibits nociceptive processing and contributes to the activation of endogenous pain inhibitory mechanisms.
If you’ve read this far and have some further questions about cupping therapy and the cupping therapy treatment process at Kintsugi Therapies, please visit my comprehensive frequently asked questions page linked below and check under the ‘cupping therapy questions’ heading. If you still can’t find the information you’re looking for, I’ve included a form on that page if you need to get in touch with any further questions or queries.
GUA SHA
Used extensively throughout east Asia for centuries, this powerful and simple therapy is slowly finding its’ way into use amongst Western Allied health practitioners, including physiotherapists. While it can be very beneficial in the treatment of musculoskeletal issues, east asian medicine has used it more broadly to treat a variety of health conditions. Modern research shows Gua sha produces an anti-inflammatory and immune protective effect that persists for days following a single treatment. This may account for its reported positive effects especially on pain & stiffness and in helping to relieve common upper respiratory symptoms.
GUA SHA
Gua Sha is a traditional healing technique widely used in Asia, Asian migrant communities and is a lesser known therapy applied by acupuncturists and practitioners of traditional East Asian medicine worldwide.
The word ‘Gua’ in Chinese means ‘to scrape’. Therefore, the technique involves using instrument assisted unidirectional strokes on a lubricated body area, with the aim of causing ‘Sha’. The word ‘Sha’ in Chinese means ‘sand’ or ‘small pebbles’ and this refers to the transitory therapeutic petchie (marks) that usually show up on the skin from the strokes.
Generally, I find outlining the east Asian medicine perspective on Gua sha for a Western audience not particularly helpful and may even lead to confusion due to lack of context both in terms of the medical terminology (do you need to hear about Qi or Blood stasis?) or even culturally. Most western people did not grow up receiving guasha from their grandmother or see it performed on street corners by vendors.
Instead, let’s focus on the modern research into Gua Sha which has been peer reviewed and analysed to help provide a clinical window into the potential physiological mechanisms involved in its’ action.
It may be helpful to summarise the main studies findings and provide references (below) for anyone who wishes to delve a bit deeper into that side. It’s important to note that on-going studies are always required to gain a better understanding of potential benefits and applications.
To summarise what these main studies have found:
Increased blood flow
The scraping action of gua sha acts as a minor irritation that causes a rapid rush of blood circulation to the treatment area. In one study, scientists using laser doppler imaging demonstrated a four-fold increase in micro-circulation to the treatment area for 7.5 minutes after gua sha treatment followed by a sustained increase in microcirculation 25 minutes later1. The measured increase in microcirculation was accompanied by immediate decrease in muscle pain at the treatment area. Additionally, some participants reported pain relief in untreated areas of the body, as well.
Pain suppression
Certainly, the immediate localized swelling draws pro-inflammatory molecules such as histamine, prostaglandins, and bradykinin, as well as serotonin – which activates pain receptors at the site of the treatment2. And, while the increased blood flow is short-lived, pain reduction has been known to persist for at least 2 days, and in some cases as long as a week3.
The answer to how gua sha induces inflammation but reduces pain may lie, in part, in its effects on the nervous system. The microtrauma created by the minor superficial irritation associated with gua sha activates particular pain fibers belonging to a nerve relay known as the spino-thalamo-cortical pathway.
This pathway takes incoming messages from the spinal cord (spino) to the thalamus – a critical sensory filtering system located above the brain stem, and then on to the cortex – where the brain interprets and decides how to respond to the messages. Most notably, this pathway also activates parts of the brain that strongly inhibit pain. In fact, this is the system your body uses to suppress pain in times of stress or sudden trauma.
As a result, the mild trauma induced by gua sha results in big pain-suppressing paybacks. By contrast, other therapeutic modalities, such as massage, for instance, use a different pathway that exerts different, and in some cases less influence on pain inhibition4.
Anti – inflammatory effects
While it’s hard to miss the immediate swelling and fiery red appearance of gua sha, scientists are finding that the procedure leads to a decrease in inflammation throughout the body. One such study on laboratory mice measured the levels of a particular anti-inflammatory and antioxidant enzyme known as heme oxygenase-15. Levels of the enzyme were measured before and after the mice received gua sha using an imaging procedure. The images, taken 18, 36 and 120 hours after the treatment showed that a wave of heme oxygenase swept through the internal organs of the mice, first concentrating in one area, then progressing to the next. The overall result was a deep, systemic anti-inflammatory effect.
Documented pain relief
In a clinical trial, patients with chronic neck pain received gua sha treatment to their entire neck and upper back6. Results 7 days after treatment showed a 26% overall decrease in pain and a 51% decrease in pain related to movement. By contrast, a control group that received heat therapy reported an 8% overall decrease in pain and 10% reduction in pain associated with movement. Overall, more than twice as many participants who received gua sha were satisfied with the results of the treatment as those who received heat therapy.
In another study, patients with chronic neck or low back pain who received a single gua sha treatment reported experiencing significantly less pain immediately after the gua sha treatment and continued pain relief 7 days later7.
Benefits for other health conditions
Gua sha alleviated headache pain in an elderly patient with longstanding chronic migraine headaches, according to a published case report8.
A common and painful problem that occurs in some women after giving birth is breast engorgement. In one study, gua sha treatment successfully reduced the swelling and pain associated with this condition and was as effective as the conventional protocol of massage and hot packs9.
Though gua sha is one of the safest therapies available, it is not without certain risks. It is important to learn proper technique before performing gua sha on yourself or administering gua sha to someone else.
Occasionally, the scraping action of gua sha can draw blood to the surface of skin. If you share your gua sha tool with others be sure to exercise proper hygienic precautions to prevent transmission of blood borne diseases10.
(Credit: Tracey Roizman)
References
- http://www.ncbi.nlm.nih.gov/pubmed/17905355
- http://www.karger.com/Article/FullText/353392
- http://www.ncbi.nlm.nih.gov/pubmed/15475622
- http://www.karger.com/Article/FullText/353392
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149908/
- http://painmedicine.oxfordjournals.org/content/12/3/362.long
- http://www.ncbi.nlm.nih.gov/pubmed/22928824
- http://www.ncbi.nlm.nih.gov/pubmed/17971671
- http://www.ncbi.nlm.nih.gov/pubmed/20220605
- http://www.ncbi.nlm.nih.gov/pubmed/22863649
If you’ve read this far and have some further questions about Gua Sha or the Gua Sha treatment process at Kintsugi Therapies, please visit my comprehensive frequently asked questions page linked below and check under the ‘Gua Sha questions’ heading. If you still can’t find the information you’re looking for, I’ve included a form on that page if you need to get in touch with any further questions or queries.
DRY NEEDLING
An highly effective needling technique borrowed from the classical Chinese lexicon of acupuncture. Dry-needling has been repackaged, promoted and used by non-Acupuncturist therapists to assist people with muscle release and pain. Now we Acupuncturists are claiming it back! Used for sports injuries, repetitive strain injury (RSI) and postural muscular overload, this technique can bring fast relief to aching muscles for weekend sporting warriors to keyboard warriors.
DRY NEEDLING
More information coming soon
MOXIBUSTION/
HEAT THERAPY
Originally, acupuncture in China was known as Zhenjiu or AcuMoxa. Over time the skill base and emphasis leant more towards acupuncture and less towards moxibustion as it’s known. Make no mistake this therapy is a huge part of east asian medicine practice and when used appropriately it has been shown to have tremendous health benefits. In clinic it is mostly used to treat musculoskeltal disorders but it’s therapeutic range from a Chinese medicine viewpoint is vast. I consider use of moxa/heat therapy in those with weakened immune systems, digestive issues, musculoskeletal issues, mental /emotional issues and for women’s health.
MOXIBUSTION/HEAT THERAPY
More information coming soon