Spring Wellness

by | Apr 7, 2025 | blog

The energy of seeds bursting forth and shoots pushing through the soil may describe how we feel right now. We’re ready to throw off the blankets and scarves and get out moving.

Here are some tips to adjust to the new season:

In Chinese medicine, the liver is the organ related to the spring season. The liver is all about movement, from cellular functioning to moving our limbs. The liver feels best when we’re active, motivated, stretching ourselves, and in a creative flow.

Get outdoors as much as possible every day. Even if it’s a walk around the block. Regular outdoor time will help your body get acclimated to the new season.

Enjoy more fresh foods, especially spring greens like asparagus and other seasonal veggies and fruits. This helps the liver to wake up and process the excess that’s been stored all winter. 

Support the liver and energize sluggish digestion by taking a teaspoon of raw apple cider vinegar about 15 minutes before meals. 

Try something new this season. A new exercise class, art group, or find a place for an outdoor walk you haven’t been before.

Smartphone Boundaries for Stress Management

by | Mar 17, 2025 | blog

“A cell living in a body experiencing chronic fear is a cell that cannot fully thrive…

Don’t confuse setting boundaries to what information you allow in your ears and eyes with putting your head in the sand; it’s understanding and protecting your biology so you don’t implode. This allows you to show up with maximal energy to positively impact the world.”

-Dr. Casey Means, MD, Good Energy

One of the many issues we treat at Yarmouth Acupuncture is anxiety, and often feeling overwhelmed. While acupuncture and Eastern medicine has been shown in studies to reduce anxiety, we also talk about what lifestyle measures we can take to help feel better. Let’s look at phones/devices and socal media.

We have a love-hate relationships with our phones and devices. The convenience we all experience from our devices of interconnectivity, information, entertainment, and in some cases dependency for livelihood, must be weighed against the very real cost to our well being. 

First we can distinguish between devices themselves, general utlitities, and social media and/or anything that provides real time notifications (not counting phone calls and messages from real people). Then we can talk about the trade-offs that each aspect of this technology requires. 

1. Devices: phone, tablet, laptop, wearables such as watches. 

2. General utilities: maps, music, phone calls, text/messaging, weather, calculator, compass, e-reader etc etc.

3. Notification producing apps: social media, news apps, marketing etc.

1. Devices

The first trade-off against the incredible convenience and fun of these devices is that they produce light and noise. The grab our attention at every moment, even without notifications, even with the sound turned off, even with the device out of sight! We always wonder what exciting thing could be happpening on the device. 

The real problem with the glow and noise of devices comes when we are trying to honor our body’s natural circadian rhythms. When the sun goes down, the body is gearing up for the long night of rest, fasting, darkness, and revitalizing sleep. The body starts to produce melatonin naturally, the hormone that helps us have restful sleep. 

It doesn’t matter if we consciously register what we are looking at on the device as “stressful” or not, our nervous system and endocrine system are receiving the signal to not prepare for deep sleep. 

This is harmful to the body and can be a big contributor to insomnia, whether it is difficulty falling asleep, restless sleep, or waking very early and not able to get back to sleep. 

Solution: no devices in the bedroom. Purchase an alarm clock so you don’t need to use your phone to wake up. This has the added benefit that you won’t look at the phone first thing upon waking. If you need to have your phone on to receivei emergency calls then leave it outside the bedroom where you can still hear it if need be. 

Bonus solution: no devices at least 2 hours before bedtime. 

2. General utilities

I remember hearing a podcast with Tristan Harris, a brilliant voice warning against the dangers of social media in particular, and device dependency in general. He admitted that his particular weakness was for checking email, whereas someone else’s might be checking social media, another person a sports or news app etc. I felt a little startled because I check my email often, and I always justified it as basically a utility. I need to stay in touch, and particularly for my work I want to be available for patients, colleagues, insurance companies and all the rest. 

The reality is that although our modern lives are organized more and more around the utilities presented on devices, we can still exercise autonomy and judgement around this. I have founf that I do not need notifications on for email, that I can check email when I have a moment and can focus, and most people never expect emails to be responded to within several hours, and most of the time up to 48 hours is completely reasonable. 

Think about which utilities you actually need on your device, many are automatially installed by the device company. You can take several minutes and delete unneeded apps and all of their accompaning notifications, tracking, and attempts to make themselves indispensable. 

On that note, turn off all notifications except for very necessary ones such as phone and messages. No one needs notifications flashing every time a news event happened, everytime someone comments on social media, or any time a new product drops. 

3. Notification producing apps

This is just reinforcing the above. Once you have determined which apps are necessary then simply delete all the rest. You can always check whatever site you need to through the browser, and often the intentional lack of convenience will help you realize you don’t want or need to be checking that site any way. 

Social media has made valient efforts and in some cases succeeded at integrating utilities onto their platforms we we find that social media is the means to message with people, sell or buy stuff online, advertize our business, get news, join groups, and more. 

It takes some diligence to weigh the pros, such as convenience, interconnectivity at least digitally, agaist the cons such as time and energy stuck on the device, being marketed to by advertizers with detailed profiles of our preferences, less motivation to connect with people in person.

News media will show us a relentless scroll of shocking images and videos because that is what gets and keeps our attention. But at the end of the day, we have to live with our bodies and nervous systems hacked by stress-inducing stimuli. 

The quote at the top of this post highlights the cost to our cells health by staying in a state of constant alert.

It’s a balancing act

The solution is not as easy as get rid of all your devices. But take back control of your time, energy, money, and stress responses by controlling the device rather than it controlling you.

Moxa Self-Care

by | Mar 7, 2025 | blog

Moxibustion is a form of heat therapy used extensively in traditional Chinese and Japanese medicine.

Moxibustion uses the leaf of the mugwort plant Artemisia vulgaris, called ai ye in Chinese. The leaf is processed into a “wool” and referred to as moxa.

There are several traditional ways of applying moxibustion including direct, indirect, warming needle, and tiger warmers or moxa boxes. More recent inventions include liquid moxa, TDP lamps and moxa devices.

At Yarmouth Acupuncture we may give you “moxa homework” to use at home. It is very simple and effective if you just follow a few simple steps. 

We will provide you with the stick-on moxa. You will need a lighter and a fireproof container. 

Light the moxa first and let the flame go out so it is smoldering, similar to incense or a cigarette.

Place the moxa on the point. Your acupuncturist will help you figure out which point to place the moxa for whatever health issue you’re working on.

As the moxa burns it releases a pleasant woodsy smell. If the light smoke bothers you then remove the moxa. If the heat starts to feel prickly or uncomfortable on your skin then remove the moxa. 

When the moxa has burned down to the insulated pad, or the heat was uncomfortable, simply remove the moxa cone and place in the fireproof container.

Treating TMJ pain with Acupuncture and Eastern Medicine

by | May 16, 2022 | Acupuncture

What is TMJ Pain?

TMJ pain can be anywhere from distracting to debilitating.

TMJ stands for temporomandibular joints, referring to the anatomical structures that connect the jawbone to the skull. TMD is the term for temporomandibular joint disorders. According to the National Institute of Dental and Cranifascial Research “the prevalence of temporomandibular joint and muscle disorder (TMJD) is between 5% and 12%.” and while “there is no standard definition for TMJD; it is measured by asking about various types and durations of muscle, joint, and facial pain, difficulty with chewing, joint sounds, etc.”

Causes

The jaw area is a particularly complex meeting of several systems. In addition to this small but crucial joint there are myofascial connections from the scalp, neck, and shoulder all which attach nearby. There is the auditory tube and associated need for fluid passage deep behind these joints and muscles.

Therefore, there may be overlap with ear and sinus fluid congestion, issues with the joint itself, and the surrounding myofascia. Because of the close quarters of all of these different structures there can be several causes which perpetuate each other. Perhaps an initial trauma causes a dislocation, which lead to inflamation and tension. Or stress lead to unconscious clenching of the jaw causing trigger points and some degree of structural changes, etc.

TMD is generally classified by various causes including inflammation, structural changes, muscle tension, jaw dislocation, or degenerative conditions.

Eastern Medicine Perspective

The Eastern medicine perspective utilizes the above causes as additional data points in arriving at a pattern diagnosis. Individual diagnosis and treatment always takes the entire state of health into account. An acupuncturist also asks other questions to determine best treatment: Are there other areas of inflammation in the body? Is there is tension in the neck, back, scalp, or shoulders? If there is a dislocation was it caused by external trauma or perhaps degeneration or laxity of the structures? If there are trigger points, adhesions, or other patterns of tension what is the underlying cause? Stress can be a huge trigger in generating tension around the jaw and face, what are the factors contribute to holding stress in the body? Is there fluid or heat stagnation in the area or in other parts of the body? Is pathological cold or wind a factor? Are there headaches, sinus issues, ear or throat congestion? All of these together can help determine the best course of treatment.

Treatment with Acupuncture and Facial Gua Sha

In my practice I have found that directly addressing the areas of myofascial tension is tremendously helpful for the majority of TMJ pain. I release knots and areas of tension in and around the jaw, head, and neck using acupuncture. I use facial gua sha to coax residual tension out of the face and jaw and encourage circulation of blood and lymph. The acupuncture treatment in total addresses underlying imbalances while bringing about stress relief.

Self Care Strategies

Facial gua sha tools are easy to come by and use at home. The best tools for the face are the round edge semi-precious stone tools such as jade or quartz. Using a gently gliding motion, move from the chin along the jawline up to the area surrounding the ear. Use pressure as needed to give a massage to areas of tension. If jaw clenching at night is an issue I receommend practicing letting your jaw go slack, literally having your mouth hang open, particularly before bed, and consciously letting all of those muscles relax. Taking several deep breaths with the jaw slack signals to the body what a relaxed jaw feels like before you fall asleep and help reset that pattern. Work on any underlying condition whether it is inflammation, chronic stress, posture issues, or healing from an injury with the appropriate healthcare practitioner. Sources https://www.nidcr.nih.gov/research/data-statistics/facial-pain/prevalence https://www.acupuncturetoday.com/mpacms/at/article.php?id=32862

Dry Needling is Acupuncture

by | Sep 16, 2019 | Acupuncture

There is a common misconception that dry needling is fundamentally different from acupuncture, that while dry needling treats pain, acupuncture works on supposedly imaginary acupuncture points and meridians.1 The reality is that dry needling is acupuncture, but the vast majority of acupuncture is dry needling.

The term dry needling originally came from the use of empty (“dry”) syringes to stimulate trigger points for pain relief. This technique was developed by Janet Travell MD, who distinguished it from “wet” needling which used substances such as lidocaine injected into the trigger points.

Depending on state laws, dry needling can now be practiced by medical doctors, chiropractors, nurse practitioners, and physical therapists using the same filiform needles that acupuncturists use.

Dry needling essentially developed in parallel with the rise of acupuncture and Chinese medicine in the United States over the past 50 years or so, crossing over with the use of the filiform acupuncture needle.

Although dry needling is a new term, it overlaps exactly with the traditional acupuncture technique of treating ashi points.

The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) Dry Needling Position Statement states, “Dry needling is a recently coined name for an acupuncture technique that involves the insertion of acupuncture needles directly into muscles and trigger points for the relief of musculoskeletal pain. Licensed acupuncturists have practiced and documented this acupuncture technique, now referred to as ‘dry needling’, for decades in the US.” 2

Acupuncture Approaches

Acupuncture is part of a system of Chinese and Eastern medicine used for thousands of years. But it is not an untouched fossil, this medicine is always evolving, just as Western medicine continues to grow based on clinical evidence and new research.

As a modality of medicine, acupuncture treats all manner of disorder and disease of the body, including musculoskeletal pain and dysfunction. Acupuncture tools are very simple: the filiform needle, but the methodology and application are very diverse.

Acupuncture may be applied according to any number of treatment theories, including: distal points on an affected channel, empirical points for a particular affliction, microsystems on the ear, scalp, hand, or foot, mirroring on the opposite side of the body, or opposite-analogous on the opposite but related joint. Acupuncture may also be applied directly to an affected area, focusing on a point of tension or soreness, called an ashi point.

Needling ashi points is a part of every acupuncturist’s training and scope of practice. Some acupuncturists get additional post-graduate training to specialize in orthopedic or sports acupuncture.

Trigger Points

Ashi points are found through palpation and are indistinguishable in function from trigger points. There is evidence that trigger points, as mapped out by Janet Travell MD in her book Myofascial Pain and Dysfunction: The Trigger Point Manual, have a high correspondence rate with traditional acupuncture points.3

Acupuncturists are trained to find traditional acupuncture points by way of physical anatomical landmarks, and all experienced acupuncturists know that the active point is ultimately found though palpation of the body.

Stimulating a tender and active point, (aka ashi point, aka trigger point) with a filiform needle to provide pain relief is a part of acupuncture theory, training, and practice.

Translation of Terms, Scope of Practice

There are efforts being made in several states to include the term dry needling in the acupuncture scope of practice, to protect this aspect of our medicine that is being taken out of context.

When the state scope of practice for acupuncturists is written with terms such as “ashi points” or “stimulation of qi” it is very difficult from outside the acupuncture profession to really qualify what type of medicine we are practicing.

As acupuncture moves more mainstream and its benefits become more widely accepted, there is a need for translation of language and concepts from Chinese medicine to Western medicine. This translation of language and concepts also has to be very conscientious to not lose the essence of what makes Chinese medicine so uniquely effective.

Acupuncture Training and Safety

One way to think about dry needling is that there are two kinds of acupuncturists practicing: licensed acupuncturists in the US who have completed at least 2000 hours of acupuncture-specific training, didactic material and supervised clinical training, as well as biomedical training; and practitioners of dry needling, who may be physical therapists, chiropractors, or medical doctors, but only complete up to 300 hours of acupuncture training, and in some states much less. 4

“As ‘dry needling’ is acupuncture, it presents the same inherent risks including but not limited to perforation of the lungs and other internal organs, nerve damage, and infection. Recent reports of serious and potentially life-threatening injuries associated with ‘dry needling’ include pneumothoraces and spinal cord injury. These and other injuries support the statement that ‘dry needling’ presents a substantial threat to public safety when performed without adequate education, training, and independent competency examination. Adequate training and competency testing are essential to public safety.“4

Dry Needling Billing Code

Currently the acupuncture CPT (Current Procedural Terminology) codes are based in units of 15 minutes. Acupuncture CPT codes did not used to be time-based, and since sometimes needles are not retained, particularly in ashi point treatment or trigger point treatment, there was a recent proposal of a Trigger Point Acupuncture code to the CPT committee, which is run by the American Medical Association. The proposal coincided with the submission by the physical therapists and chiropractors of a code for “Dry Needling” and so has been in discussion by the CPT committee.

The American Society of Acupuncturists (ASA) Report from the American Medical Association CPT Code Committee meeting 5  is worth reading in full, but the “Outcomes” and “Points to Take Home” sections are important so I am posting them here:

Outcomes

After much deliberation, the AMA Committee concluded the following:
1. Codes describing the procedure of needling with no needle retention are to be created.
2. The placement for these codes will be under the code set for trigger point injections. (This resides in the medical-surgical section of the code set, and not under either acupuncture nor physical medicine and rehabilitation.)
3. Accepted addition of codes 205X1, 205X2 to describe needle insertion(s) without injection(s). Codes will become active January 1, 2020
With these codes, representative vignettes were agreed upon. These vignettes make it absolutely clear that the intent of these codes is to describe a procedure with no needle retention and no auxiliary electric stimulation. These will become available upon the publication of the full code set, presumably just prior to 2020.

Points to take home

  • There is no “dry needling code”. There is now a code for “needle insertion(s) withoutinjection(s)”. This procedure is deemed identical to both Trigger Point Acupuncture and Dry Needling. The two are equated.
  • If there is needle retention or e-stim used, only the acupuncture codes are appropriate.
  • Every code in the code set can be used by any practitioner with that code’s procedure inscope. If a profession does not have a procedure in scope, it cannot use a code because of scope issues. Licensed Acupuncturists all by definition may use the new codes. Thereis no expansion of practice act language needed to protect scope.
  • If a profession does not have invasive needling in scope, it cannot use this code.
  • This is a non-time-based code usable by practitioners with often cursory training. Its valuation is the next step in the process, but it should not be as highly valued as the acupuncture codes.

 

References