EBHSG - JANUARY 1997 MEETING NOTES

TOPIC: HEADACHE AND ACUPUNCTURE

Hugh Wang, M.D., a family practice physician in Concord, spoke at the January 14, 1997 meeting of the East Bay Headache Support Group. The meeting was held in the Ball Auditorium at John Muir Medical Center from 7:30 to 9:00 PM, and approximately 30 people attended.

The history of acupuncture—no one knows how it all began, but 5,000 years ago or more (before written history), people started using a primitive form of acupuncture. Before metal, they used fish bones. Tradition has it that a soldier was hit in the head with an arrow and discovered the pain in his shoulder was reduced. Or, …. maybe aliens gave acupuncture to the Chinese people (laughter).

Needles of gold were reserved for the emperor and royal family, and silver needles were used for everybody else. Gold was too soft to hold a point for long (and it was too precious). Now we use stainless steel. Dr. Wang just uses disposable hypodermic needles.

Twenty years ago, President Nixon mentioned acupuncture and Americans started calling Chinese doctors looking for ones who practiced acupuncture. Dr. Wang didn’t know if it would work on Caucausians (laughter). He was in the Navy, as a medical officer on a ship. He thought he would practice on his shipmates, but they were too wimpy.

Acupuncture is now extremely popular with Americans—they go to Chinatown for acupuncture treatments. Dr. Wang’s waiting list grew to a year long. When patients are referred to him for acupuncture, he has their regular physicians work up their medical history first and screen them. Some things are inappropriate for acupuncture, such as appendicitis, a broken leg, depression, infection.

"Alternative care" is a 14 billion dollar business in America, and many books have been written on this subject. Some of the kinds of treatment labeled "alternative" are acupuncture, kinesiology, aromatherapy, naturopathy, homeopathy, aridology, reflexology, crystal therapy, etc. The Office of Alternative Medicine in Washington, D.C. says there are at least 700 types of alternative care.

Dr. Wang told us there are over 800 acupuncture points on the human body. Practitioners systematize them like astronomers describe constellations such as the "Big Dipper." There are 8 lines along the body, including the large intestine line, the bladder line, the genito-uro line, cardiovascular line, gall bladder line, small intestine line, and one other.

A line is a "meridian"—it doesn’t follow any nerve pathway. The acupuncturist draws by the number, to help him remember pathways and points (in Chinese, or by the number).

There are different kinds of acupuncture. The most common is using needles. An offshoot of acupuncture is acupressure. This doesn’t go as deep as acupuncture or last as long, but one can get some relief from acupressure.

Reflexology therapy (feet) is another alternative care type. Also, there are acupressure points in the ear.

Some acupuncturists even heat the acupuncture points with cigars, or apply suction cups, or burn the patient’s skin, to stimulate acupuncture points. How does acupuncture work? Nobody knows. There is a theory called the "gate theory" that acupuncture closes the gate in the brain that controls pain. Dr. Wang doesn’t agree with this theory, though. He said that acupuncture modifies the feeling of pain, decreasing the severity from sharp to dull. He thinks that it works through the parasympathetic nervous system. This hasn’t been proved, though, because few people have agreed to volunteer to be studied. Dr. Wang is looking for subjects to study, but his first volunteer is still hiding (laughs).

In China, acupuncture is used to treat depression, appendicitis, spastic colon, diarrhea, vomiting, itching, formication (the feeling of ants crawling all over the body). Also, acupuncture is used to relieve pain, such as in childbirth, or pain caused by cancer or surgical treatments. There are no liability problems in China, though, as there are in America. In the United States we have one lawyer for every fifty people, whereas in China they might have one lawyer for every million people.

Dr. Wang treats the following ailments with acupuncture: TMJ (temporomandibular joint disease), carpal tunnel syndrome, chronic back pain, arthritis, chronic headaches, etc. The acupuncturist approaches the treatment of headache in different ways, depending on the type of headache.

Does acupuncture hurt? "Yes, it hurts, but this varies as people have different pain thresholds." Also, the number of treatments depends on the condition. Dr. Wang said that he usually suggests three treatments for starters. 70 to 80% of his acupuncture patients who will show improvement will get better in three treatments. Treatments are performed once per week by Dr. Wang. He said an acupuncturist who says you need treatments three times per week is just after your money.

The word "cure" is not used by Dr. Wang—rather, he prefers the word "remission." Most pain comes back, so "cures" are hard to come by. Alternative care, such as acupuncture, gives you one more weapon in your arsenal, and the larger the arsenal the better.

How long does a treatment last? Dr. Wang said that it depends on the condition. Most patients will feel pain coming back and go to see him for another treatment when their pain approaches 50%, not waiting for the pain to be full blown. "It is hard to stop a rhino in full charge," he emphasized. Dr. Wang said that acupuncture seems to work better after it has been done before.

Is acupuncture the same as hypnosis? Dr. Wang also is trained in hypnosis and said there is no relationship between acupuncture and hypnosis. He mentioned that some veterinarians use acupuncture in treating animals under their care. After having a series of acupuncture treatments, how long does the relief last? Dr. Wang said it may last from one month to several years.

Some side effects experienced by acupuncture patients may include:

* Feeling lightheaded or passing out (some people can’t stand the sight of needles or blood).

* Some bleeding may occur (but most needle holes don’t bleed—Dr. Wang uses 30-gauge needles).

* Experiencing pain from the needles.

* The needle could break (but Dr. Wang has never had that happen).

Dr. Wang said it is good to look for an acupuncturist who is also a physician. Since the physician is trained in anatomy there should be less chance for complications. Always look for a certified acupuncturist. People who advertise in the newspaper may not be legitimate acupuncturists. "Don’t believe all the ads—most of it is bunk." He mentioned "caveat emptor—let the buyer beware."

Acupuncture is a legitimate treatment for chronic pain, but if the acupuncturist says you will need treatments three times a week for a year, don’t believe him.

Acupuncture can be used as a preventive measure. Also, it works better when the headache is mild, or just coming on. Dr. Wang has treated headaches in full bloom, and acupuncture has worked to abort headaches. He said, "It’s not predictable, but it has an excellent chance of working." He also said, "It’s an art, not a science."

How much do you charge for an acupuncture treatment? Dr. Wang said he currently charges $55 for each treatment (but that will be going up soon). The first treatment takes longer as he has to take your medical history and do a work up, but it is also $55.

The number of needles used varies depending on the patient’s condition to be treated. For example, for a migraine on one side of the head he might stick one needle in your hand, one in your elbow, and two to three into your head on the side where the pain is felt (maybe in the forehead, temple, and back of neck). To treat low back pain, Dr. Wang would use lots of needles (going down the leg).

Dr. Wang was asked how far the needles are stuck into the patient. On the forehead, the needles can go in only 1/8" or less. In the hand, the needle can be stuck into muscle to a depth of about ½." And, to stick the needle in one’s butt he would have to go in up to 3" depending on the patient’s fat content. He sticks the needle in to the depth of the "fascia," where it lies on the surface of the muscle (it has to go through skin and fat to get to the muscle). If acupressure is used, pressure has be to applied down to the fascia level. Dr. Wang said the needles are placed and left in the patient for ten minutes and then removed.

Hormones can’t be regulated with acupuncture, but menstrual cramps can be treated. Also, nausea can be relieved with acupuncture. Dr. Wang treats symptoms along with the condition. Irritable bowel, or spastic colon, is aggravated by stress, and is treatable by acupuncture.

When is it appropriate to see an acupuncturist? Dr. Wang said that acupuncture fits in somewhere before a craniotomy (laughter). Acupuncture is invasive, but not as invasive as surgery, and it doesn’t leave a scar to speak of. He suggested that after a neurologist exhausts his bag of tricks in attempting to treat your headaches (but before lots of narcotics are used), it is good to try acupuncture. He has used acupuncture to wean people off narcotic addictions.

A medical doctor must "above all, do no harm." And the patient must consider "is the cure worse than the disease?"

Dr. Wang’s success rate on the treatment of migraine headaches with acupuncture: He doesn’t cure the headaches, but around 75 to 80% of his patients have had their headaches controlled or their medications reduced with acupuncture. Dr. Wang said that surgery typically has a 50% success rate (for all conditions), and he sees a 60 to 65% success rate with acupuncture.

How many times should you see an acupuncturist before giving up? "Because it’s an art, try different practitioners before giving up (and see them two to three times each)."

As acupuncture is an invasive procedure, Dr. Wang said that one should try using drugs to treat their headaches first. He said that drugs are hard to obtain in China, so the Chinese use acupuncture more.

Dr. Wang then told us how he learned acupuncture. He was born in China, but left that country at the age of six. Then, the U. S. Navy sent him to China where he first studied acupuncture. Then he studied under a German acupuncturist, and finally, a French acupuncturist.

Dr. Wang suggested again that we build up an arsenal of methods to treat our headaches. When one method doesn’t work, look for another. Others he mentioned were: air acupuncture, electrical stimulation, and using suction cups.

Dr. Wang doesn’t treat his patients with Chinese herbs, however many acupuncturists do. He said he just doesn’t have the time to learn all about all the many herbs available. There are up to 500 herbs that an herbalist may use, and the odds are tough on picking the right one. In China, though, herbal medicine and acupuncture are combined. Dr. Wang does use some homeopathy on his patients. It works together with acupuncture, as adjunctive therapy. He said the difference between herbal medicine and homeopathy is that homeopathy uses pills which are easier for him to learn than herbal medicine.

Dr. Wang’s primary practice is general family medicine and acupuncture. In closing, Dr. Wang said that acupuncture is worth trying on every kind of headache.

The notes provided above were taken by an EBHSG volunteer and have not been reviewed by the speaker for accuracy. If you have any questions regarding the notes, please contact the EBHSG.

The intention of the East Bay Headache Support Group is to provide information and resources. It does not provide medical advice, which should be obtained directly from a physician.