As acupuncturists, we see patients with a wide variety of complaints. This week I have treated headaches, anxiety, excessive sweating, phantom limb pain, constipation, infertility, incontinence, neuropathy and so on. Some patients who seek acupuncture for something like insomnia, do not even know that acupuncture also treats pain, and vice versa.
Acupuncture is very effective for a variety of pain conditions, and that is why insurance will often cover acupuncture for the treatment of pain - nerve pain, pain from an injury, chronic pain, etc. Low back pain stands out because of the abundance of evidence that acupuncture is beneficial, as well as the lack of great treatment options within the standard medical model, and the prevalence of low back pain in the general population.
Why is low back pain so prevalent? I would argue that it has something to do with how sedentary we have become. Our backs do a lot to support us in our day to day activities, but we just don’t move in all the ways that humans used to. Back pain is often involved with other types of pain like sciatica, pelvic pain, even urinary issues and constipation. Back injuries often become chronic, reoccurring in times of stress or with a sudden “wrong” movement. They can keep us from doing the things we love like lifting up our kids, sports, or even just sitting comfortably to enjoy a movie. Surgical options, while they might be effective for a while, can result in scar tissue that limits long term mobility. Likewise, cortisone shots or epidurals provide temporary pain relief but do not necessarily help the area to heal in the long term.
Prevention is our best long term strategy to deal with low back pain, and I have a lot of ideas about that, but first, why is acupuncture such an effective treatment for low back pain? Acupuncture works on multiple levels. On the most basic level, the insertion of needles increases circulation to the affected muscles, nerves, ligaments and other tissues in the area of injury. Muscle trigger points (aka “dry needling”) are used to release tension in specific muscles that are tight or spasmed, helping them to relax and put less strain on joints. Acupuncture also works on nerves and connective tissue pathways, improving communication between the nervous system and other structures to restore balance. Relaxation of the nervous system also improves our pain response, reducing tension and allowing for the body to go into healing mode.
Acupuncturists evaluate to determine the likely cause of the low back pain from a structural perspective (bring your xray or MRI report if you have it!). And we also formulate a pattern diagnosis which includes contributing factors that are part of the cause or contribute to its reoccurrence. We treat that pattern with acupuncture and/or herbs, supplements and lifestyle advice. Something like magnesium, better hydration or specific core exercises may be the key to sustained relief.
You may have significant relief with a single acupuncture visit, but typically we expect to do a treatment series to achieve the most benefit. We can treat other complaints at the same time because we always approach you as a whole person with unique needs. These side benefits are often what make people fall in love with acupuncture.
Movement is the key to long term prevention for low back pain. This can look different for everyone but there are some key things to focus on. Core strength (your low back is part of your core, so this includes strengthening the low back) is essential. This can range from abdominal breathing to deadlift variations. Hip extension is also important because sitting involves having the hips flexed so much of the time, and those shortened hip flexors impact overall mobility. Walking is great for hip extension and so is yoga or simply lunges and split squats. I could go on, but let’s not underestimate the power of any movement. It helps to get blood flowing, loosen up muscles, regulate blood sugar and clear the mind. If you sit all day, it is better to get up and move for 5-10 minutes every hour than to squeeze in a 60 minute workout and otherwise be sedentary. If you are in too much pain to get moving, come get some acupuncture!
Want some help getting started with movements to help the low back? New York Times just created a gentle yoga routine for low back pain. My yoga teacher, Bonnie Weeks, has a class series available online for Low Back and SI Pain. The series is a one time purchase for $35, but feel free to check out her huge library of classes with a 7-day free trial. I can’t recommend her enough. If yoga is not a good fit, there are other movement practices that incorporate mobility work such as martial arts, pilates and functional fitness classes. It’s not just about getting out of pain, it is about the rest of your life. Studies show that mobility is strongly linked with longevity and reduced risk of disability and chronic disease, particularly in older adults. Maintaining good mobility, including flexibility, strength, and balance, is a key predictor of a longer, healthier life.
by Dr. Amber Hincks LAcNew to Beaverton? Amber Hincks Acupuncture weighs in for Redfin's feature about Beaverton. Read more at Discover 9 Unique Things to Do in Beaverton, OR: A Hidden Gem Beyond Portland
by Dr. Amber Hincks LAcIf you tend to discuss your Chinese Medicine diagnosis with your provider, there is a good chance that the Liver has come up. While the body requires all the organ systems to function in harmony, we see the Liver's function as central to the smooth flow of Qi. The Liver is the General, directing the function of all the other organs, making sure that systems function with a regular rhythm and processes flow smoothly - from menstrual cycles to digestive processes and sleep rhythms.
Springtime is the season of the Wood element, whose corresponding organs/channels are the Liver and Gallbladder. Beyond the specific physiology of these 2 organ systems, Chinese Medicine associates some broader patterns with the Wood season. It is a time of growth, awakening and movement. Ideally we have rested more through the winter and have been gathering our energy and intentions for the year ahead. Now it is time to move and make those changes happen. We can turn that introspective energy outward, clearing out what we are ready to move on from, and starting fresh. It is time to actively move out of confining emotional states like anger, stress and frustration and release emotional and physical tension.
Process. Release. Grow.
Problems that often show up in the Springtime are allergies, skin issues, digestive imbalance, insomnia or hormonal issues. There can also be a building energetic and emotional tension, as we are ready to see a change, a shift. When the Wood element is out of balance this can show up as anger, agitation, reactivity or a stuck feeling. This is the body saying it needs something to move. Movement itself can be the best medicine, especially something that makes you feel free, alive. Dance, run, jump, breathe deeply, make love, stomp through the forest.
Listen to what comes up. What makes you feel stuck? What still needs to heal? What toxic nonsense are you ready to be done with? What new thing are you ready to begin?
Spring is a great time to focus on eating fresh foods, especially plants. Young plants are full of Qi and many mountain herbs are harvested in Spring. While Chinese Medicine is not aggressive about detox (our bodies are not toxic cesspools!), it can be good time for a gentle cleanse. Focus on hydration, eat more leafy bitter greens, vegetable soups, add sprouts to everything. Get creative with salads, adding carrots, fennel, grapefruit, radish, asparagus, citrus peels, asparagus, chive, vinegar, grapes. Sour, bitter and slightly pungent foods can help support the Liver Qi.
Some specific herbs that can benefit the Liver are Bupleurum (Chai Hu), White Peony (Bai Shao), Scutellaria (Huang Qin), Nettles, Milk Thistle, Dandelion (Pu Gong Ying), Mint and Chlorophyll. Many of these herbs are slightly cooling which calms inflammation, and some also help to circulate lymphatics, which helps with congestion and sluggish Qi. Dandelion and Nettles are also both rich in Vitamins and minerals.
In Chinese Medicine, the Liver system will also thrive more if we nourish Blood. Blood is the nutritive foundation that supports the Liver system. Along with the common Springtime ailments like allergies and skin issues, with blood deficiency, we might notice more dryness, eye irritation, light periods, chronic muscle tension, and light sleep. (We also look for a thin pulse, pale tongue and brittle nails.). Nourish blood by having a regular sleep rhythm and eating good sources of protein and fats in the diet such as avocados, cleanly-raised meats, organ meats, lentils. Try to limit caffeine and alcohol - you will sleep better too.
Acupuncture and Herbal medicine is here to support you as well. May you listen to your body and the rhythms of nature and find yourself in the flow.
- Gather some fir tips for a tasty Vitamin C rich infusion (Spruce and Hemlock can be used also.)
- Or take advantage of the abundance of stinging nettles (gather with gloves on!) and make an iron rich nettle soup.
- Movement snacks: incorporate short bursts of movement into your day with a quick routine or some Shaking Qi Gong.
by Dr. Amber Hincks LAcThose first signs of Spring are starting to appear, but we are still in the depths of Winter. As I write this, it is DÀ HÁN, “Major Cold,” the last of the 24 terms of the Chinese Solar Calendar. The new year is coming soon and it is important not to rush things, instead allowing the cycle to finish and reflecting on the teachings of the past year. Winter is a time of storage, self care, consolidating our energy as the seed of future growth. What seeds are you planting?
Perhaps you have set some goals for the year ahead and have even started on them. Wonderful! And yet, there will likely be times when it becomes difficult to maintain these new routines, make the healthiest choices, or have the necessary conversations. Whatever it is, positive changes often require will power.
The Chinese medicine concept of will power, Zhi, is associated with the Kidneys, which belong to the water element. The water element is also correlated with the Winter season, surely a season that can test our tenacity. Will power is our ability to follow through on the things that matter to us. In Chinese Medicine, the Kidneys are a source of health and longevity, but their energy is finite. We must choose how we want to expend our energy and how to invest in the things we love. In this way, our vital force is preserved and can even grow.
How do we balance a sense of ease and comfort, with the grit and tenacity required to achieve our goals? Where is the Wú Wéi, “effortless action,” that finds us in this delicate flow? Well, as David Goggins puts it, “there are no hacks, bro.” Easy is on the other side of hard.
What I mean is, if we keep on choosing the easy path, things inevitably start to feel harder and more out of reach. Instead, if we do the things that we have been putting off, the things that are important, we learn just how capable we are. Does it get easier? Maybe, maybe not, but regardless, you will know that you can do it. And there is joy in the knowing, along with all the rewards that come with each accomplishment, be it better health, more restful sleep, loving relationships.
Let’s circle back to David Goggins, author of Never Finished. He was a guest on a recent Huberman Lab episode - “How to Build Immense Inner Strength.” And in this discussion, Dr. Huberman brought up that there is an area of the brain, the anterior mid-cingulate cortex, associated with will power. This area of the brain grows when we do something that we do not want to do. When scientists stimulated this area of the brain, subjects felt a sense of impending struggle, but they also felt ready to take it on.
The Kidneys are associated with the brain (and bones). Strong Kidney Qi supports healthy aging and ongoing physical and cognitive strength - longevity. I personally do a lot of thinking about the ways I can keep myself and others healthy for a long time. But it was still hard for me to sit down and write this blog on a Sunday afternoon. In fact, I put it off for 2 weeks. But now that I have done it, I can share it with you. A little part of my brain just flexed, and perhaps my Kidneys did too.
By needling specific points, acupuncture can amplify the Kidneys' power and therefore provide clarity around life changes or goals. Through acupuncture, herbs, and dietary education, Chinese Medicine naturally supports the Kidneys, provides balance to the overall yin and yang of the body, and cultivates essential Zhi, will power.
*Examples of foods that nourish the Kidneys: cloves, ginger, cinnamon bark, quinoa, chicken, lamb, trout, salmon, millet, barley, most types of beans, & spirulina
My mom is the person I turn to for advice. She is very non-judgmental, which I find to be of the utmost importance in a confidante (it is something I strive for with patients). She also has great advice - spent years doing social work. And she is creative - has been writing Sci-fi for over a decade and recently one an Indie Book Award for Best Fantasy. Go Mom! So I asked her to write a guest blog for me, while I am busy with upcoming business transitions.
Self-Care During the Holidays
For some, the holidays overflow with boundless excitement and energy. There’s much to enjoy: community celebrations, gatherings with family and friends, shopping for unique gifts, and sharing laughter around a fabulous feast.
For others, family complexities, crowded stores, tight finances, and a packed calendar dampen any childlike enthusiasm. Stress prevails, and December becomes a curly checklist with the end goal simply to survive.
Granted, some challenges are beyond our control, but for many others, we have the gift of
choice, and how we take care of our bodies, minds, and spirits during the holidays is one of
them.
Care for your Body:
The holidays are infamous for ruining healthy habits. We eat more sugar, grab a mass-
produced burger while running errands, and stay up too late catching up on emails. Hustling
through the mall qualifies as exercise, and just remembering to breathe feels like an
accomplishment.
- Eat Wonderfully – Allow yourself to enjoy the delectable offerings without overstuffing.
Watch your portions, slow down, and savor each bite. - Stay Hydrated – And I don’t mean with hot buttered rum. Keep the water bottle handy
during your busy days. At celebrations, imbibe responsibly and drink water between those glasses of eggnog. - Indulge in Rest – Living with a stressed-out grinch isn’t fun for anyone, including the grinch. Get a good night’s sleep if you can, and if that’s impossible, take cat naps to relax and recharge during the day.
- Get Outside – Find time to exercise. You may not be able to stick with your routine, but
even a short walk is better than nothing. Breath in the fresh air and sunlight and let the
tension go.
Care for your Mind:
The holidays are a time for good cheer, but making sure the bathroom sparkles, the goose is
cooked, and the presents are wrapped can be overwhelming. Lack of time, finances, and
energy can bring us to tears if we think we can somehow do it all.
- Prioritize and Simplify – Prioritize what brings joy, and simplify where you can. Buy a pie
from the store. It’s okay. And it’s okay to politely say no when feeling overwhelmed. Those
who care about you will understand. - Keep Expectations Reasonable – During the holidays, we often set our expectations
impossibly high. Let go of perfection, relax, and enjoy yourself. Life doesn’t need to be
perfect to be beautiful. - Plan Ahead – Create a thoughtful plan to tackle your to-do list so you’re still able to enjoy
the season. Make under-scheduling an artform, and if you find yourself overscheduled,
rustle up the courage to delegate, ask for help, and accept the help that’s offered. You can
always pay it back by helping someone else. - Take an Internet Break – Minimize screen time in favor of connecting with others and
investing in meaningful relationships. Trust me, the virtual world will still be there in
January. - Make a Budget – Be realistic about what you can afford, set a budget, and stick to it. And
remember, love is priceless. Focus on celebrating together and show how much you care
by being present and kind. - Give Creatively – Sometimes the best gifts are those of the heart. Homemade gifts, heart-
felt notes, or giving away something special of yours has the power to show more affection than something bought in a store.
Care for your Spirit:
Cultivating an awareness of how we wish to spend our time and energy allows us to better
enjoy the holiday season. It’s easy to lose sight of what’s important when overwhelmed, and
self-care is essential in creating a life of contentment no matter what’s happening around us.
You can’t draw water from an empty well, so take care of you while you take care of others.
- Bask in Gratitude – Take a few minutes each morning to acknowledge all you’re grateful for. Did you know it’s nearly impossible to feel thankful and irritable at the same time? Gratitude has the power to make us both healthier and happier.
- Be Intentional – Before committing your time and energy, check your intention and stay
focused on what matters most. Do those things that nourish your spirit and light up your
heart, and politely bow out of the rest. - Be Generous with Kindness – Holidays can be difficult for those who are alone. Reach out
to those who are without family and friends during this time of year. Found families can be just as warm and rewarding as biological ones. - Give to Others – If within your means, nurture your spirit by giving a bit of your time, talent, or treasure to a cause you believe in. It’s an act of kindness that can remind you of all you’re grateful for.
- Give to Yourself – As you run around determined to ensure that everyone else has a
wonderful holiday, remember to make time to do something special for yourself. You’ll feel re-energized and ready to tackle the next task. As much as possible, during this holiday season, laugh, let go, and love.
I wish you a happy, healthy, and joyous holiday season.
by Dr. Amber Hincks LAcMt. Hood had its first significant snowfall of the season this week and with a sunny weekend predicted, we could not resist an excursion to our beloved mountain neighbor. It was spectacular and the weather was gorgeous. On a Saturday, it was hard to believe we only crossed paths with 4 people, despite being on a stretch of trail that belonged to both the Timberline Trail (goes around Mt. Hood) and the PCT (Pacific Crest Trail) and leaves right from the majestic Timberline Lodge, just over an hour from Portland. 
Preparing for a Winter Hike requires some different planning and is a good time to revisit the 10 essentials. This list refers to the things that you should have with you when entering the backcountry. What is not on this list is a couple of necessary steps to take before you go.
- Let someone know where you are going and when you expect to return. Make a plan for what to do if they don't hear from you.
- Check the weather forecast and make sure that you are prepared for those conditions. Also, be especially mindful that mountainous environments can have their own weather systems and can change more rapidly. Bring extra layers.
There is some additional gear that you may want to have for winter hikes. Some things are easy to overlook like sunglasses and sunscreen! Here are some tips about stuff I have found helpful.
- Snowshoes: snowshoes are not my favorite, but they are essential when hiking in snow deeper than about 1 foot. They keep you from sinking into the snow (post-holing), which can be funny the first couple of times, but you won't get very far. Consider renting if you don't want to invest in a pair. Make sure they fit you, especially if you have small feet. Many are one-size-fits-all.
- Crampons, microspikes or yaktraks: essentially these are different types of attachments that you can get for the bottoms of your boots that increase their grip on ice. You would use these in lieu of snowshoes when the snow is either not deep, or very firm and potentially icy. Yaktraks are the most basic, light-weight option and will work in most conditions. With more elevation (steeper) and really icy conditions micro-spikes or crampons are a safer bet.
- Sunscreen and Sunglasses: On a sunny day, while the sun is less powerful than in summer, the snow is reflective. I sunburned my eyeballs on St. Helens. Do not forget sunglasses!
- Extra socks: whether snow gets in your boots, you accidentally step into a stream, or you simply want a fresh pair at the end of the day, extra socks are always worth including. Wool is generally best.
- Gaiters: To avoid the above snow entering your boots, gaiters are worth having unless your snow/rain pants are secure over your boots. These wrap around your lower leg and generally loop under your boots so nothing can sneak its way inside.
In general, don't expect to go as far as you would in the summer, especially if there is snow or ice on the trail. That being said, winter can be a great time of year for mountaineering. Snow can make it easier to cross a boulder field or a frozen stream. Mountaineering requires a whole different level of preparation though, so let's stick with winter hiking for the sake of this post. Here are a couple winter excursions that I would recommend.
- Old Salmon River Trail: I have mentioned this one before. It's an absolute favorite, especially in winter. It begins in Rhododendron and the trail has multiple entry points. It follows along the Salmon River and most sections are fairly level, though if you continue on into the Salmon Huckleberry Wilderness you will meet some elevation. It is a mossy wonderland. If you are interested in others like this, check out Falls Creek Falls Trail or Siouxon Creek - both in Southern Washington, or Silver Falls State Park (Oregon).
- Mirror Lake or Trillium Lake: Both of these lakes are located on the Southern side of Mt. Hood and provide breathtaking views of the mountain on a clear day. Easily accessible from Hwy 26, these lakes are a relatively short hike (you can drive to Trillium when there is no snow), but offer some options to extend your visit. When you get to Trillium, you can choose to hike or snowshoe around the lake. Consider doing this under the light of the full moon. From Mirror Lake, you can continue on to Tom, Dick and Harry, which will take you up above Ski Bowl Ski Resort. You might even be able to take the chairlift down if it is operating.
by Dr. Amber Hincks LAcI’m getting ready to teach part of the Chinese Medicine Gynecology class at NUNM this Spring. This class covers the treatment of all things related to our reproductive system - periods, fertility, pregnancy, postpartum and menopause. I also said that I wanted to do a class about sex (yay!) so I am going to teach about sex in Chinese Medicine too. I will be discussing painful sex too (boo!), which is a super important topic.
Sometimes I take for granted how amazing Chinese Medicine is for gynecological issues, because it was a big part of my introduction to acupuncture while working in women’s health and fertility clinics. I saw that many of these patients were also benefiting from acupuncture and realized that was the type of care I wanted to offer these patients. Most people associate acupuncture with treating pain and may not know about how comprehensive acupuncture can be for internal medicine issues. I figured painful periods is a great place to start this discussion.
Painful menstruation is called dysmenorrhea, and refers the pain that occurs around the menstrual, or bleeding, phase of the cycle. There may be other associated symptoms like nausea, fatigue or diarrhea. While many people experience some cramping with their period, some have pain severe enough that it keeps them from doing their regular activities. They may rely on pain relievers and heating pads, but sometimes that is not enough. There are many possible causes for dysmenorrhea that can be explored with a gynecologist - endometriosis, adenomyosis, fibroids, cysts, hormone imbalance, heavy periods, low back injury, past or present infection, pelvic nerve compression, pelvic inflammatory disease.
From a Chinese Medicine perspective, most dysmenorrhea is related to Blood Stasis. Blood stasis is diagnosed through questioning, observation and palpation. Here are some of the signs that would indicate blood stasis:
- sharp, stabbing or paroxysmal pain
- dark colored blood, possibly with clots
- firmness in the abdomen, particularly at the location called “oketsu”
- a slippery or wiry pulse
- a purple or dusky tongue, possibly with distended sublingual veins
- cold hands and feet
There may be other factors that contribute to the blood stasis - heat (inflammation), cold (constricted blood vessels and hypo-function), Qi stagnation (stress and emotions), dampness (fluid retention) and so on.
Acupuncture and Chinese Herbs are amazing for treating blood stasis and therefore painful periods. Acupuncture increases blood circulation, as shown in many research studies that document things like uterine blood flow. (Do you like reading research studies?) We use points like Spleen 6 on the lower leg as well as points on the abdomen or around the sacrum. Typically for menstrual issues, patients come in weekly for about 3 months for significant relief. Then returning in the week before the period for another few months. Though treatment plans are always individualized. Herbs can help significantly, because this brings the treatment home and works on underlying imbalances and inflammation.
Abdominal massage is also amazing for treating dysmenorrhea. While I offer abdominal massage sessions called Chi Nei Tsang - translates to internal organ massage - I also recommend having a self massage routine. A few drops of frankincense (invigorates blood and promotes healing) in some almond oil can make this rather enjoyable. Make sure to work in a clockwise direction and put a pillow under your knees to help relax your abdomen. You can view a quick instructional video here.
I have so much more to say about this topic, but it starts getting more and more individualized. I will save it for my class next month and for the treatment room. Hope to see you there!
Warm needle moxibustion with the herb mugwort is fantastic for painful periods. Mugwort is also used internally as a guiding herb to warm the uterus.
