People come to acupuncture for the first time for a wide variety of reasons with an equally vast array of expectations. Sometimes individuals struggling with chronic illness arrive in an acupuncture office with the explicit goal of addressing their chronic illness. More often, these individuals come with hopes to manage pain or another adjacent symptom of the chronic illness as opposed to the illness itself. During our time together, we often find that East Asian medicine and acupuncture are an ideal fit for managing the chronic illness.
How does this work? Well, acupuncturists often employ multiple modalities of treatment in an acupuncture session. All of this is Chinese medicine, which includes acupuncture, herbal treatment, lifestyle recommendations based on Chinese medical theory, nutrition, and sometimes supplements to address the whole person. We also treat people as individuals, as opposed to treating all illness of the same name with the same treatment strategy.
Treating The Individual
First and foremost, an acupuncturist focuses on treating the individual in front of us. We often spend a great deal of time in the initial appointment reviewing all of your health systems, including your general moods, sleep and eating patterns, regardless as to whether or not they seem related to the chief focus that the individual wishes to treat. This helps us to identify what organ system or systems are the biggest culprits in driving the underlying process of pain or illness in your body.
Another big difference in Chinese medicine is the types of correlations we see related to various ailments, or quality of life issues paired with specific organ systems. For instance, the stomach and spleen/pancreas is not only in charge of the initial breakdown of food with stomach acid and pancreatic enzymes, but it also relates to a tissue structure: the muscles; an emotion: worry; a cognitive pattern: analytical thought/thinking; the ability to hold blood in the vessels, and the ability to see what we want/need in our life, to move towards it, and incorporate it into the body. This just names a few of the associations we have with the stomach and spleen/pancreas organ system pair in East Asian medicine.
In the frame of looking at an individual with chronic fatigue syndrome, if the patient has trouble with digestion, has frequent gas, bloating, and looser bowel movements paired with difficulty thinking (being foggy headed or trouble focusing), worries frequently throughout the day, and has trouble falling asleep at night due to worrying about things that either happened during the day, or are on their to do list for the week, then an acupuncturist would often treat the chronic fatigue through the organs of the digestive system. Another individual with chronic fatigue could experience a sense of fear of what could happen if something changed in their lives, feel instantly reactive to stressful emails/events/text messages, they could be afraid of the next stronger bout of fatigue, experience difficulty exercising without making fatigue worse, never wake feeling rested, have dark circles under their eyes despite regularly sleeping 10+ hours a night, struggle with feeling depressed, have frequent urination throughout the day and a couple times a night, and possibly have night sweats at a young age. This is a completely different organ system pair driving the chronic fatigue, and requires a different approach to treatment. Often chronic illness involves multiple organ systems.
Ultimately, we are looking for what an acupuncturist calls the underlying pattern of the pathology at hand. Many illnesses that have the same name in the Western world such as rheumatoid arthritis, sjogren’s, scleroderma, lupus, chronic fatigue syndromes, and fibromyalgia, have 10-12+ common patterns in East Asian medicine. Each pattern is treated completely differently. To put it slightly differently, we can have 10 patients with rheumatoid arthritis come into the office, each with their own underlying pattern of why their body is manifesting rheumatoid arthritis.
Chronic Illness and Chinese Nutrition
With most chronic illness, whether it is chronic pain, fatigue, digestive or autoimmune in nature, investigating the diet becomes an important aspect of treatment. Two main approaches are often taken with diet and nutrition with an acupuncturist. First, it is important to review a patient’s typical daily meal routine to see if they are
a) getting enough food, too much food, or could benefit from a different timing of meals
b) identifying if any foods they eat seem to elicit an increase in symptoms– these are often called food sensitivities. Food sensitivities often increase inflammation throughout the body and exacerbate the symptoms of chronic illness.
Second, an acupuncturists will often incorporate Chinese medical nutrition which employs many of the theories of how the body functions in Chinese medicine with ingredients in meals. Food is considered our first medicine, and everything we eat and drink has the potential to influence different organ systems and physiologic processes in the body. Each organ system has foods that naturally strengthen the organs themselves, and other foods that help curb common symptoms of imbalance in those organ systems. Furthermore, each organ system is associated with a season, and eating strategically during that season is the best time of the year to improve the health of that organ system. You can employ food techniques to help organ systems outside of their associated season, but if an organ is particularly tired, addressing it during its season can give you the most bang for your buck, so to speak.
An example: feeling reactive to stress, easily frustrated, having a hard time making plans, and getting frequent tension headaches or migraines, may relate to a condition we call liver qi stagnation (this can be further differentiated, but let’s keep this example simple). The season of the liver is the spring, and often we’ll see quick mood swings between feeling frenetic, stressed, and easily angered, to feeling depressed and overwhelmed to the point of wanting to give up. During the frenetic, stressed, and rising emotions of anger, it is helpful to eat sweet root vegetables, like a steamed beet salad tossed with balsamic vinegar, cilantro, and green onions. The root vegetables help anchor the rising energy of the liver, and the natural sweetness of the vegetables sooth the energy of the liver. The cilantro helps circulate energy, and the sour flavor of the vinegar helps further to anchor and consolidate the energy of the liver. Recipe here.
For the feeling of depression in the spring (make sure your practitioners helps you to identify it as a depression with a liver source, as depression can come from multiple organ systems), then it is helpful to eat fresh, tender young vegetables, like young kale, sprouted grains, sprouts, and baby carrots/beets like the ones you thin out of your garden in the spring. These young and sprouting plants bring their naturally rising energy to play in the body, helping to counteract the downward mobility of feeling depressed. It is also important to use aromatic herbs, like thyme, tarragon, mint, rosemary, cilantro, chives, basil, etc and citrus fruits or zests to help keep the liver energy circulating. If you are interested in learning more about the basics of Chinese medical food therapy, check out our educational video series here.
Chronic Illness and Lifestyle
Similar to the approach of learning how to use food as medicine with Chinese medical theory, East Asian medicine brings a unique lense to lifestyle practices that can either improve or hinder our health goals.
In one of the classical texts of Chinese medicine, the Yellow Emperor’s Classic, there is lifestyle advice on how much or little we should sleep, how and when to exercise, and how to dress for each season. The idea is that each season again relates to different organ systems in the body, and by employing exercises that specifically improve or support those systems during the appropriate season of the year, then we are not only living with the seasonal energies of the year, but we are also keeping our bodies in ideal health.
For instance, winter is a time to rest and restore our foundation of health. It is best to exercise during daylight hours, to avoid sweating heavily after dark (why?), to slow down our exercise (ie-focus on slow weight training with repetitions, yoga, snowshoeing, etc instead of HIIT workouts), and to try to sleep just a tiny bit more. It’s great if we can create a little down time for reflection during the winter too. Whereas spring is when the energy is coming back into the earth. It is a great time to do HIIT exercises, to get outside and run, bike, jump, etc. We can eat very differently in the spring, and stay up a little bit more if we properly built our foundation in the winter.
When a patient has a chronic illness, an acupuncturist will tailor these seasonal recommendations for diet, exercise, approaches to how many project one juggles, and work-life balance, with their individual pattern of their chronic illness. For instance, someone may have limits on the type of exercise or the intensity for 4-6 months, until their system shows that they have rebuilt their foundation enough to add more intensity to their exercise. Another individual may need to take 6 months off from intentional exercise altogether, while another individual may be asked to exercise more. It completely depends on the pattern of their chronic illness.
The treatment plan is also a highly individual scenario. Often with chronic illness, you can expect to work with your acupuncturist long term. Often it is important to come in 1-2x a week for 4-8 weeks in the beginning to help your body acclimate to acupuncture treatment. Then as your symptoms and health improve, your acupuncturist will guide you towards seeing them 1x a week, then 2x a month, then once a month. Eventually, you may only need to come in for maintenance or only if symptoms start to occur after a period of remission.
Chronic illness can feel daunting, overwhelming, and at times insurmountable. It can be addressed, and often requires a team effort between the practitioner and the patient. We can see great results in improving health when we combine the individual approach of treating the patients as individuals as opposed to an illness label, and when we incorporate the many facets of Chinese medicine. Utilizing acupuncture, herbs, nutrition, and lifestyle are integral ways to approach chronic illness from an East Asian medical perspective. Diet and lifestyle in East Asian medicine often incorporates concepts that are new to us in the Western world, and can open the doors to new ways of understanding both our health and our bodies. The number one goal of acupuncture is to help our patients develop tools to feel empowered in their health.