Acupuncture examination? How to place an acupuncture needle?

What kind of Acupuncture examination does a Chinese medicine practitioner do before placing an acupuncture needle? What to expect on a first visit?Most people mistakenly think that we acupuncturist's "just" stick needles into the body to help treat a condition. This is not the case! How do acupuncturists know how to place an acupuncture needle? When speaking with prospective patients on the phone, for many there is no understanding of what goes on in a consultation. I mean when you go to a doctor, you know what to expect, right? But for an acupuncturist many, not all people think you actually just stick a needle into the pain spot or area of affliction. While this may be true in SOME cases, it is not always the case. Think about it, if you think the needle always goes into the local place then where do you put needles for anxiety? For digestive trouble? For insomnia? For hot flashes? What if the person’s painful area is in a cast? What if the pain is a phantom pain and the limb has been amputated? How do you put needles into the local area?A lot goes unnoticed by many during an acupuncture and Chinese medicine consultation and evaluation. A lot of diagnosis occurs before he or she can make recommendations. So much is done without explaining during the patient exam that much of it is unfortunately lost on the patient. Let me tell you how we adress patients in our office, located in Ridgewood, Bergen County, NJ.ASKING QUESTIONSAsking questions helps the practitioner narrow down the underlying cause of a problem. Each symptom was given a specific significance that meant something. For example, if a patient is having a headache. The practitioner wants to know what the nature of the pain is. Is it sharp and stabbing or is it dull? Or does it feel like your head is in a cap or cottony fuzzy feeling? Sharp and stabbing indicates poor blood circulation to the head and a hyperactive condition of the body. Something is too hyper or excess in the body causing this problem such as stress, imbalanced hormones, and hyper-thyroid conditions. Dull headaches can be caused by the body being too weak and thus there is a lack of circulation to the head as well. But the treatment here is to strengthen and tonify the body not to sedate the hyperactivity, as in the other example. Weakness can occur to the nervous system, the immune system, the cardiovascular system or the elimination systems as examples depending on what other symptoms the patient might have going on concurrently with the headaches.  If the headache is felt as if your head is in a cap or cottony, fuzzy feeling, In this case the problem is circulation being blocked by what is termed “dampness” or a sluggish lymphatic system. This is often the case in taking medications to control pain conditions or treating depression.FEELINGFeeling the temperature of a person by placing hands on the person is done to ascertain if the person feels hot, cold or clammy. If the hands are cold it is an immune system weakness if the hands are hot there is a hormone issue.First off we use what’s called a Chinese pulse diagnosis to find the problem. Specific positions on each wrist, on the radial artery are felt for the pulsation of the pulse. Specific attention is paid to the jump of the pulse that is the amplitude that the pulse is felt like at specific conditions.The pulses are felt on the radial artery (the same artery you use to find your pulse rate when you are exercising) but there are three positions on the pulse, on each wrist, that represent different organ systems. It is believed that the functioning of the organ systems can be felt on specific positions on the pulses. We are trained to feel the jump of the pulse for strength. Is the pulse forceful and pounding? That is does the pulse easily pushes your finger off of the pulse? Is the pulse very deep - where you need to push really deep to find the pulse? Or is the pulse not felt at all? (No jump to the pulse is felt)?The type of pulse indicates the underlying cause for the problem. The more accurate you can define the pulse, the better you’ll be at selecting the proper acupuncture and herbal formulas.There are three major causes for disease in the body in Chinese medicine. Too much of something, too little or too blocked! So it is important to remember that people’s symptoms can present as having too much hyperactivity in the body, having too little energy in the body, or having no circulation at all in the body.The forceful pounding pulse tells us that the person’s problem is due to too much hyperactivity. In the case of a headache, we use acupuncture points that are more sedating to the nervous system to cause the hyperactivity to return to normal. To fix the cough we also can use herbs that not only stop cough but also herbs that kill the virus or bacteria causing the cough. Using those types of herbs takes care if the hyperactivity in the lungs.The weak pulse tells us the lungs are weak and cannot fight off the problem. Using acupuncture points that have a strengthening effect on the lungs we can make the cough less. Herbs that help strengthen the lung organ, helps to reduce the cough.If there is no pulsation at all felt in the lung position, it tells us that this organ lacks proper blood flow running through it, and it needs herbs to open up the pulse and increase micro-circulation to the organ. In the case of the cough, need moving acupuncture points in the body to activate and increase the micro-circulation to the chest, to stop the cough. If we are using herbs in addition, for added effect we use herbs that open up the chest to stop the cough.I had a case of a woman who was dealing with cough. She caught a “cold” which turned into a cough. This cough caused this 58 year old wheezing; shortness of breath, coughing that is made worse with lying down. She had caught it at a child’s birthday party. She started with a sore throat that quickly went into her chest. She felt miserable but was able to breathe out of her nose, which meant the cough wasn’t affecting her sinuses. Based on her pulses, she had a hard to feel pulse in the Lung position. The lung position of the pulse is felt on the right hand, the very first position, which is located just beyond the wrist crease. The pulse was only felt on the deep level, had very LITTLE feeling at all, with a deep feeling on the bottom. Normally, this pulse should have a “normal" jump to it. In this case, the lack of a pulse indicated poor blood circulation to the chest. The bug she caught caused her lungs to shut down. Improving vascular blood flow to the chest and including Chinese herbs that could “roto-root” the blood flow in the chest is what she needed in order to take care of the cough. And it did!Tongue diagnosis is another way we can look at the body to see where it is out of balance. The tongue mirrors the different organs of the body as we as looks at general trends of the body as well.  We look at the tongue for anything irregular is color and any changes to the tongue itself such as discolorations, cracks, bumps, “deep valleys” or anything else unusual. Again three main things are looked for. Is there too much of something, is there too little of something, or is there something too blocked. Ifthe tongue is red it means too much hyperactivity, if it is pale, it indicates too much weakness in the body, and if the tongue is a dusky dark color, it indicates poor blood flow throughout the body. If the tip is red we know this person is overheated, dealing with some sort of inflammation, has insomnia, is very anxious, and is irritated all the time. If the sides are red and slightly raised, it indicates a lot of repressed anger and feelings not being met with a sensation of the tongue are swollen upward. Different areas of the tongue correspond to different areas of the body as well, so if there is a discoloration in a specific area, it could mean a dysfunction of the organ system.Ear and eye diagnosis: The ear serves as a map of the entire human body from head to toe. We look for salient features such as general color of the ear. Too pale means the immune system is weak. We look for areas of red veins or discolorations. For example, many people have a red vein in the stomach area. This relates to dyspepsia or gastritis. Many have red veins on their buttocks and sciatica area. This means that even if they aren’t having lower back pain now, it is a possibility that they will get back pain and in these specific areas.We look in the eyes to see if they contain any spirit, or sparkle. So many people I treat are often exhausted and mentally washed up. Their eyes don’t contain this penetrating sparkle that shows they are still emotionally healthy and not prone to pessimism, fatigue, or imbalanced emotions causing anxiety and depression. We also look for red horizontal veins. This indicates the level of stress. If there are red veins with dark circles it tells us this person has been in a fear state and working like a stressed person. The amount of stress in this person’s life, whether it is home stress or work stress, is extremely high. This person is in the fight-or flight pattern which can exhaust him or her and keep them pushing on all the while burning themselves out.We also will press on certain acupuncture points to see which are more tender and which seem to feel weak, that is, do they cave in on pressure, indicating exhaustion to a certain area.We also do range of motion tests and orthopedic tests if we are looking at a musculo-skeletal problem.So this is the basics of a Chinese medicine exam! It’s a lot of stuff I know. But by doing this we get to the root cause of the problem and treat it so we can make longer lasting changes to the conditionAs to when the needles go, based on what we find – is there too much, too little, or too blocked. Acupuncture points have different actions on the body. Some calm and sedate strongly. Some help strengthen the body while others help circulation and promote the flow of blood. So depending on what we are treating and the underlying cause for the symptom, will determine what type of acupuncture points we will use. In Chinese herbal combining it is a necessity to check the pulse and tongue to see what the nature of the problem is. Ever try a vitamin or herbal supplement and it didn’t work? Chances are it doesn’t fit your pattern properly. So now you know what goes into a Chinese medicine assessment and de-mystify this whole area of evaluation.