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MASSAGE EFFECTIVE FOR PERSISTENT LOW BACK PAIN; ACUPUNCTURE IS NOTMassage may provide long-lasting benefits as a treatment for persistentlow back pain, but acupuncture appears to be relatively ineffective,according to a report published in the Archives of Internal Medicine.http://orthopedics.medscape.com/36526.rhtml?srcmp=orth-042701<a href="http://orthopedics.medscape.com/36526.rhtml?srcmp=orth-042701">Read it Here</a>

 

-

 

Monday, March 26, 2001 12:31 AM

Re: Channel problems/sports injuries/pulse

, WMorris116@A... wrote:> > There are no published inter-rater reliability studies in TCM which is its > greatest research weakness in my opinion. The issue you raise is not limited > to pulse diagnosis. A substantial amount of time is required to 'calibrate' > practitioners for reliability regardless of the diagnostic method being > studied. here, here. well put.ToddChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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Hi Theresa,

I have had problems for years with a herniated disc. When my

back goes " out " I like to use a massage oil with a blend of rosemary

and chamomile. I have tried many other oils and found that this blend

seems to work really well. It helps relieve muscle spasms and pain.

I know you asked for a poultice but, maybe using these herbs fresh?

Hope this may help!

Laura

 

> My SO lifted something heavy and now his back is out of whack. What

> do you

> all recommend to alleviate the pain, and just to plain help him get

> back to

> normal faster? I'm interested in what herbs would help (as a

> poultice?). He's

> done this before and it's just a matter of time before he's back to

> normal.

> I'd like to do all I can to reduce the time. Thanks

>

 

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The best thing to hit the Internet in years - Juno SpeedBand!

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In a message dated 6/1/2004 1:24:09 AM Pacific Daylight Time,

butchbsi writes:

> and I can get relief from them in a few minutes .. like

> 5-10 minutes .. just from sniffing Oregano EO.

>

 

 

I've heard so much about your oregano, Butch. It appears I'll have to place

an order soon. Thanks.

 

Teresea C.

 

 

 

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At 12:03 AM 6/1/2004 EDT, you wrote:

>Hello Everyone:

>

>My SO lifted something heavy and now his back is out of whack. What do you

>all recommend to alleviate the pain, and just to plain help him get back to

>normal faster? I'm interested in what herbs would help (as a poultice?).

He's

>done this before and it's just a matter of time before he's back to normal.

>I'd like to do all I can to reduce the time. Thanks for your help.

 

The #1 best remedy is St. John's Wort oil, maybe with some helichrysum oil

mixed in. The great thing is that mix also works for burns and sunburns,

too, since it is so antiinflammatory.http://member.newsguy.com/~herblady

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Thanks Angela. I'll try it. Euc. glob.? What is your method of

application? Inhalation like Butch's oregano, or in a massage oil?

 

Teresea C.

 

 

 

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Hi, Teresea.

I often use eucalyptus for back pain, especially low back pain. A massage

would also help. :-)

Angela.

http://serenity.boulderhealers.com/

-

<spaepiphany

 

Monday, May 31, 2004 10:03 PM

Back pain

 

 

> Hello Everyone:

>

> My SO lifted something heavy and now his back is out of whack. What do

you

> all recommend to alleviate the pain, and just to plain help him get back

to

> normal faster? I'm interested in what herbs would help (as a poultice?).

He's

> done this before and it's just a matter of time before he's back to

normal.

> I'd like to do all I can to reduce the time. Thanks for your help.

>

> Teresea C.

>

>

>

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Let me tell you it works!!

Sandra from Tn

-

<spaepiphany

 

 

> I've heard so much about your oregano, Butch. It appears I'll have to

place

> an order soon. Thanks.

>

> Teresea C.

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Hi, Teresea.

I use Euc. glob. in a massage oil. I have also used it neat on myself - a

couple of drops on the lower back where my pain was localized. No burning

for me, but use at own risk. I have also used it mixed with other oils

(can't think of the recipe right now) for muscle aches. I dilute with

grapeseed, but any good carrier should work. What I sometimes do is put a

drop or two in my hand, then add carrier oil enough for massaging the area I

am working on. Again, this is done on a localized area. The benefits are

both through inhalation and through skin absorption - and of course through

the movement of the tissue during the massage. If his spine is not out of

alignment (in which case a chiropractor or osteopath would probably be

best), then massage should help to relieve the pain and speed the healing.

Hope this helps.

Angela

-

<spaepiphany

 

Tuesday, June 01, 2004 12:59 PM

Re: Back pain

 

 

> Thanks Angela. I'll try it. Euc. glob.? What is your method of

> application? Inhalation like Butch's oregano, or in a massage oil?

>

> Teresea C.

>

>

>

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Ditto for me!! And I don't even like the smell of oregano. but let me

tell you, I'm beginning to. Nothing like quick relief!!

 

Karen J

 

 

Let me tell you it works!!

 

 

Sandra from Tn

-

<spaepiphany

 

 

> I've heard so much about your oregano, Butch. It appears I'll have to

place

> an order soon. Thanks.

>

> Teresea C.

 

 

 

 

 

 

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A girl at work asked me for something for her back. She strained it moving an

electric bed in a nursing home. She found that ginger, eucalyptus and lavender

worked wonders for her. I use Apricot Kernel oil as the carrier. She has

recommended this to others with the same results. She said the pain started in

her lower back and went down her leg. She and the others just rub it on after a

shower or bath and are very happy with the results. Kathy

 

 

-

Laura T Sarbach

 

Cc:

6/1/2004 8:39:54 AM

[Norton AntiSpam] Re: Back pain

 

 

 

Hi Theresa,

I have had problems for years with a herniated disc. When my

back goes " out " I like to use a massage oil with a blend of rosemary

and chamomile. I have tried many other oils and found that this blend

seems to work really well. It helps relieve muscle spasms and pain.

I know you asked for a poultice but, maybe using these herbs fresh?

Hope this may help!

Laura

 

> My SO lifted something heavy and now his back is out of whack. What

> do you

> all recommend to alleviate the pain, and just to plain help him get

> back to

> normal faster? I'm interested in what herbs would help (as a

> poultice?). He's

> done this before and it's just a matter of time before he's back to

> normal.

> I'd like to do all I can to reduce the time. Thanks

>

 

______________

The best thing to hit the Internet in years - Juno SpeedBand!

Surf the Web up to FIVE TIMES FASTER!

Only $14.95/ month - visit www.juno.com to sign up today!

 

 

Step By Step Instructions On Making Rose Petal Preserves:

http://www.av-at.com/stuff/rosejam.html

 

To adjust your group settings (i.e. go no mail) see the following link:

/join

 

 

 

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Hi,

 

I'm new to the list and was just reading the archives. Butch, are

you saying that if I would buy some Oregano Essential Oil and sniff

it it will relieve back pain? Just making sure I'm reading this

right.

 

Thanks much

Kris

 

 

, Butch Owen <butchbsi@s...> > >

Teresea C.

>

> Sounds like my problem .. and the problem MANY folks share ..

sounds

> like Cyatica or spasms of the Psiatic Nerve. The common short term

(but

> its longer than I prefer) treatment is heat and rest and very

careful

> stretching. More immediate though temporary relief comes from

something

> very simple .. sniffing any of the Carvacrol rich Origanums .. they

are

> ALL very anti-spasmodic. This is not theory .. its not info from

one of

> the AT novels .. its from a number of years of my personal

experience

> and the reports of those who I have shared this information with.

>

>

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heylaurag wrote:

> So far I haven't had the most spectacular success treating back pain,

Hi Laura!

 

When I have a back pain patient I do the tongue, pulse, symptoms and

signs differentiation as with any other patient. Then during the

treatment I use the points indicated by the differentiation and use ashi

points on the back for the back pain. I also look at the patient's

weight and posture as these are usually the cause of the back pain.

 

Regards,

 

Pete

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I have had great results treating back pain. I don't follow a standard

treatment regime. I select points above and below the area of pain. I use 1 in

needles and stimulate with electric for 20 minutes. I have not had one client

who has not obtained at least some relief. I also use ear points between

visits.

 

Dr. Joe

 

heylaurag <heylaurag wrote:

Greetings all,

 

So far I haven't had the most spectacular success treating back pain,

which I find surprising because I know its one of the most common

things people come to an acupuncturist for. I think I am haunted by

a study I read in my research class that claimed that acupuncture was

not effective for back pain---even though I know that research

studies are often flawed on acupuncture. In my 6 months of practice I

haven't had very many back pain clients, but I have two new ones this

week. So I wanted to hear what you all do. Do you stick to the

standard---UB 23 and UB 40 or UB 60....or perhaps SI 3 and UB 62?

Ling Ku/Da Bai?

 

Also, I'm a little fuzzy on when to choose UB 40 or UB 60...any ideas

on when one is better than the other? Thanks!

 

Laura

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Hi Laura,

 

One of the reasons I sought out a tuina practitioner was because

acupuncture provided only temporary relief for my back pain. With

tuina/qigong all of my body and energetic channels were being

vigourously manipulated finally opening up all of the channels - as

opposed to specific points. Other friends of mine have had similar

experiences suggesting that acupunture was very temporary and tuina

was more permanent. I think that what the studies have shown is that

acupuncture is as effective as other standard western modalities in

providing temporary relief. The breakthrough that I found in tuina was

the greater permanence of relief. There are currently some very mild

" stiffness " now and then when I am under stress but which I resolve

with some daily qigong exercises. I think there are some issues with

the way TCM approaches back pain and possibly those who use a more

dymamic form of acupuncture have had different experiences than mine.

I think this is a very interesting area to discuss.

 

Regards,

Rich

 

 

Chinese Medicine , " heylaurag "

<heylaurag@h...> wrote:

> Greetings all,

>

> So far I haven't had the most spectacular success treating back pain,

> which I find surprising because I know its one of the most common

> things people come to an acupuncturist for. I think I am haunted by

> a study I read in my research class that claimed that acupuncture was

> not effective for back pain---even though I know that research

> studies are often flawed on acupuncture. In my 6 months of practice I

> haven't had very many back pain clients, but I have two new ones this

> week. So I wanted to hear what you all do. Do you stick to the

> standard---UB 23 and UB 40 or UB 60....or perhaps SI 3 and UB 62?

> Ling Ku/Da Bai?

>

> Also, I'm a little fuzzy on when to choose UB 40 or UB 60...any ideas

> on when one is better than the other? Thanks!

>

> Laura

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Hello all-

 

Great to treat constitutionally, as one of the strengths of being an

acupuncturist rather than someone who practices acupuncture is treating the

individual: where are the excesses, deficiencies, stagnations?

For Qi stagnations in the lower back. I often find it useful to open

the DU Mai using Extraordinary Meridian Pts (SI 3 - Bl 60), as well as Bl 57

bilaterally. Any comments about using Extraordinary Meridian Pts? Some feel they

should only be used in extremis.

 

Larry Moore

L.Ac, RN,BSN,MSOM

 

 

 

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Many times a back pain is not a back pain but something else, such

as a structural imbalance somewhere else:

 

in cranium

at the Dai

in the scoliotic spine

in some scar which impedes

by an imbalanced musculoskeletal band

because of an old injury

because disparate venous return

because of congestion in the portal circulation

because of a 3 burner imbalance

because overuse/underused of a body segment.

 

In which case setting this right, even when quite remote to the actual back

pain,

will resolve the matter.

 

It has been ages since I ever worked directly on the back, for someone

presenting

with a back pain.

 

Best wishes

 

Dr. Holmes Keikobad

MB BS DPH Ret. DIP AC NCCAOM LIC AC CO & AZ

www.acu-free.com - 15 CEUS by video.

NCCAOM reviewed. Approved in CA & most states.

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Hi Laura

 

I had some of the same problems in the start of my practice

concerning back pain. What I have found is that it is vital that the

patient " protect the work " done by moving very slowly and conciously

for a few days after the treatment. Many times they would get off

the table with no pain only to call a few days later with a return

to their former condition. Due to the spasms involved

with " protection " , the person must be very sure to use perfect body

mechanics in movement to re-educate the muscles for a few days. They

should be encouraged to do several short, easy walks every day and

that when they must bend or straighten or get out of bed, they

should move very slowly to prevent the muscles from rebounding.

Also, stretching out from the hips while still in bed, reaching for

the foot of the bed to elongate the hip flexors at the lesser

trochanter is very helpful in staging these muscles for their " new "

length--these muscles also attach to the upper lumbar and can cause

bowing and pain if they are too short. Quick movements on muscles

which have been in spasm for a while encourage their return to

spasm. The key is slow, easy movement during the recovery phase.

Once pain is gone, the brain will calm down it's signals to spasm,

but the muscles are slower to come around and need a little time.

Macciocia has 2 wonderful chapters on threatment of painful

obstruction and lower back pain/sciatica in The Practice of Chinese

Medicine. He believes Bl 40 is more for acute cases with blood

stasis and that Bl 60 works better for chronic cases (with pain on

the Bl channel). I have found his protocols very helpful. He usually

advocates doing a 15 minute acute protocol in the beginning with the

patient standing and moving their lower back while the distal

needles are being stimulated--a little awkward but effective.

Depending on the location of the pain, different distal needles are

used including GV 26, Bl40, Yao Tong Xue, SI 3, Bl 10, and others.

These points are then removed and a local treatment is performed.

For chronic conditions, local and distal points are combined and

there is usually presumed to be some combination of Wind, Cold and

Damp on top of the other dx's of Kid xu, blood and qi stag etc.

Tui Na is also, of course, very effective and can help take the

acupuncture to new levels. But be careful not to overwork the person

because if there is appreciable disc involvement, one can overloosen

the muscles and cause the pain to worsen. Also, pressing on the

lower back and causing it to extend too far can further irritate the

disc.

If you don't have this book, I recommend it highly. Hope this helps.

 

shanna

 

Chinese Medicine , " heylaurag "

<heylaurag@h...> wrote:

> Greetings all,

>

> So far I haven't had the most spectacular success treating back

pain,

> which I find surprising because I know its one of the most common

> things people come to an acupuncturist for. I think I am haunted

by

> a study I read in my research class that claimed that acupuncture

was

> not effective for back pain---even though I know that research

> studies are often flawed on acupuncture. In my 6 months of

practice I

> haven't had very many back pain clients, but I have two new ones

this

> week. So I wanted to hear what you all do. Do you stick to the

> standard---UB 23 and UB 40 or UB 60....or perhaps SI 3 and UB 62?

> Ling Ku/Da Bai?

>

> Also, I'm a little fuzzy on when to choose UB 40 or UB 60...any

ideas

> on when one is better than the other? Thanks!

>

> Laura

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Laura,

 

Scalp acupuncture has been the primary method for me to treat back pain

with great success. (Of course, I always do the pattern differentiation;

however, I

don't have to use it often.) The cases range from acute pain to chronic pain.

 

The key (some call it " secret " ) to the success with acupuncture, particurlarly

in pain management, is to direct the qi to the troubled spot. With the needles

on the scalp, the patient is then instructed to make certain body movements,

depending on the limit of the rangement of movement. Body points, determined

out of pattern differentiation, are typically used for only a few seconds to

help inducing the movement of qi. When you do it well, you will see immediate

result right in the first few minutes almost without exception.

 

I hope you find this helpful!

 

Mike L.

 

P.S., I am a big fan of using tui-na also and resonate with whatever Rich has

been

sharing but I find acupuncture to be far easier to do with less effort.

 

heylaurag <heylaurag wrote:

Greetings all,

 

So far I haven't had the most spectacular success treating back pain,

which I find surprising because I know its one of the most common

things people come to an acupuncturist for. I think I am haunted by

a study I read in my research class that claimed that acupuncture was

not effective for back pain---even though I know that research

studies are often flawed on acupuncture. In my 6 months of practice I

haven't had very many back pain clients, but I have two new ones this

week. So I wanted to hear what you all do. Do you stick to the

standard---UB 23 and UB 40 or UB 60....or perhaps SI 3 and UB 62?

Ling Ku/Da Bai?

 

Also, I'm a little fuzzy on when to choose UB 40 or UB 60...any ideas

on when one is better than the other? Thanks!

 

Laura

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Larry,

 

I have used the SI 3 - BL 62 pair (not BL 60, as you do) and

BL 57only a few times because

1) Scalp points (including Du 20) are good enough most of the times.

2) I count on Du 20 to open Du Mai, in the case of back pain.

3) SI 3 is simply too painful for some patients.

 

Separately, I have never learned/recognized SI 3 - BL 60 as Extra Meridian

points.

(Where did you learn this? I am curious.) I did learn SI 3 - BL62 pair as part

of

Eight Meridian Crossing (or Meeting) points.

 

Regards,

 

Mike L.

 

 

 

 

Galenway wrote:

Hello all-

 

Great to treat constitutionally, as one of the strengths of being an

acupuncturist rather than someone who practices acupuncture is treating the

individual: where are the excesses, deficiencies, stagnations?

For Qi stagnations in the lower back. I often find it useful to open

the DU Mai using Extraordinary Meridian Pts (SI 3 - Bl 60), as well as Bl 57

bilaterally. Any comments about using Extraordinary Meridian Pts? Some feel they

should only be used in extremis.

 

Larry Moore

L.Ac, RN,BSN,MSOM

 

 

 

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Laura,

 

 

 

 

 

Pete Theisen has laid out a very well-thought out and versatile plan for

treating back pain, and it is the same general guidelines I would use to treat

pain of any kind. I'll just add or elaborate on a few points for you to

contemplate.

 

 

 

As we all know from our studies of TCM, all pain may seem like just a localized

phenomenon until we examine its underlying causes. Sometimes it's just that

simple, and we use local points and we are done. Most of the time, there are

underlying causes that needs to be differentiated using patient in-take, tongue,

pulse, symptoms, signs differentiation, Eight Principles Diagnosis, etc. to

determine how complex the problem is. On many occasions, you may find that pain

is just the tip of the iceberg, and you end-up doing TCM internal medicine

anyway. Of course, the pain would go away if the diagnosis and treatment is

laid out correctly. What separates us from the allopaths and make us more

effective is that we always look for underlying causes and the kind of problem

that these problems can cause in the future. Like I have said before, gain

control of these ideas about your patient's pathology and you will give pain a

headache and not the other way around.

 

 

 

From my own personal experiences and observations, treatment of pain needs to

involve some sort of release of negative energy out of the patient's system.

The hand-yin channels and the foot-yang channels are responsible for this

process. Find the location of the pain and use the corresponding channels to

release the pain. For instance, if the pain is located in the area around the

scapula, use a distal point of the SI channel to release the negative energy.

On the other hand, if the pain is caused by deficient conditions, then your

hand-yang and foot-yin channels become important.

 

 

 

Some specifics:

 

 

 

UB40 is effective for lower back pain, but its effect is limited if not combined

with other points. Those points are up to the discretion of the practitioner

depending on patient's condition.

 

 

 

I've been told that UB60 is also effective for lower back pain, but my own

personal experiences told me that the much underrated and publicity-shy UB61 is

much more effective especially if the patient has trouble walking. Part of the

reason being that it is a Yang Chao Mai meeting point. This comes from my

experiences in treating a wonderful patient with a fall injury. Try it

sometimes. You may be surprised.

 

 

 

Ba Hue Xue (Eight Meeting Points) are good if your patient's condition is

related to blood, qi, tendon, bone, etc. Never ignore the internal

(organ)-external (channel) connection in pain.

 

 

 

SP10 is good for circulating blood, and LI4+Liv3 is good for circulating qi.

They should make your treatment extra-effective as stagnation=pain.

 

 

 

I don't know the English name for " Ba Hue Xue " or " Yang Chao Mai " . If anyone

can provide feedback on the proper terminology of the above in English, it would

be much appreciated.

 

 

 

As you can see, treating pain and internal illness are not that different.

Depending on prominence of the conditions, you would have different emphasis in

the treatment plan.

 

 

 

Hope this helps.

 

 

 

Ming

 

 

Pete Theisen <petet wrote:heylaurag wrote:

> So far I haven't had the most spectacular success treating back pain,

Hi Laura!

 

When I have a back pain patient I do the tongue, pulse, symptoms and

signs differentiation as with any other patient. Then during the

treatment I use the points indicated by the differentiation and use ashi

points on the back for the back pain. I also look at the patient's

weight and posture as these are usually the cause of the back pain.

 

Regards,

 

Pete

 

 

 

 

http://babel.altavista.com/

 

 

and adjust

accordingly.

 

If you , it takes a few days for the messages to stop being

delivered.

 

 

 

 

 

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Larry,

 

I use extra points in combination with meridian points and the results are

phenomenal. They are very specialized points that will give you fast results

for a particular problem.

 

Ming

 

Galenway wrote:

Hello all-

 

Great to treat constitutionally, as one of the strengths of being an

acupuncturist rather than someone who practices acupuncture is treating the

individual: where are the excesses, deficiencies, stagnations?

For Qi stagnations in the lower back. I often find it useful to open

the DU Mai using Extraordinary Meridian Pts (SI 3 - Bl 60), as well as Bl 57

bilaterally. Any comments about using Extraordinary Meridian Pts? Some feel they

should only be used in extremis.

 

Larry Moore

L.Ac, RN,BSN,MSOM

 

 

 

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Chinese Medicine , " Ming H. Lee "

<aceqihealer>

wrote:

>

>

> I don't know the English name for " Ba Hue Xue " or " Yang Chao Mai " . If anyone

can

provide feedback on the proper terminology of the above in English, it would be

much

appreciated.

>

 

Still no standard English terminology of CM. Your translation of " 8 Meeting

Points " is as

good as any, also sometimes they are called " 8 Influential Points " , i.e., UB17

for Blood,

GB34 for Sinews, UB11 for Bones, GB39 for Marrow, etc. Yang Chao is commonly

Pinyin-

ized as Yang Qiao and usually gets translated as Yang Heel or Yang Motility

Vessel.

Probably less confusing to just call it Yang Qiao Mai.

 

rh

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Thank you for the explanation. It is much appreciated.

 

Sincerely,

 

 

Ming

 

kampo36 <kampo36 wrote:

Chinese Medicine , " Ming H. Lee "

<aceqihealer>

wrote:

>

>

> I don't know the English name for " Ba Hue Xue " or " Yang Chao Mai " . If anyone

can

provide feedback on the proper terminology of the above in English, it would be

much

appreciated.

>

 

Still no standard English terminology of CM. Your translation of " 8 Meeting

Points " is as

good as any, also sometimes they are called " 8 Influential Points " , i.e., UB17

for Blood,

GB34 for Sinews, UB11 for Bones, GB39 for Marrow, etc. Yang Chao is commonly

Pinyin-

ized as Yang Qiao and usually gets translated as Yang Heel or Yang Motility

Vessel.

Probably less confusing to just call it Yang Qiao Mai.

 

rh

 

 

 

 

http://babel.altavista.com/

 

 

and adjust

accordingly.

 

If you , it takes a few days for the messages to stop being

delivered.

 

 

 

 

 

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Larry Moore:

Any comments about using Extraordinary Meridian Pts? Some feel they

should only be used in extremis.

>

>

 

These are the first order of the day in terms of a root treatment. Nowadays

I have

replaced these with taking care of asymmeirc body sectors.

 

Often the presenting complaint disappears or is radically remedied without

having

to address it directly.

 

I like the octahedral model of Manaka on which the 8 Ex Chs are grafted. He

would say

that tweaking one will have the others fall into place.

 

Dr. Holmes Keikobad

MB BS DPH Ret. DIP AC NCCAOM LIC AC CO & AZ

www.acu-free.com - 15 CEUS by video.

NCCAOM reviewed. Approved in CA & most states.

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Hi Laura,

 

I always use Si3 and UB62 when treating back pain, no matter where the

location of the pain. Inserting Si3 first and then UB62 - withdrawing in

the opposite sequence.

 

The principle I also use is to needle in the acu-points in the area of the

pain and then use the distal points on the same channel.

 

Herbs are also usually very helpful and I struggle to remember a back pain

client that didn't respond very well to treatment.

 

Kind regards

 

Dermot

 

-

" heylaurag " <heylaurag

<Chinese Medicine >

Monday, August 23, 2004 8:49 AM

Back pain

 

 

> Greetings all,

>

> So far I haven't had the most spectacular success treating back pain,

> which I find surprising because I know its one of the most common

> things people come to an acupuncturist for. I think I am haunted by

> a study I read in my research class that claimed that acupuncture was

> not effective for back pain---even though I know that research

> studies are often flawed on acupuncture. In my 6 months of practice I

> haven't had very many back pain clients, but I have two new ones this

> week. So I wanted to hear what you all do. Do you stick to the

> standard---UB 23 and UB 40 or UB 60....or perhaps SI 3 and UB 62?

> Ling Ku/Da Bai?

>

> Also, I'm a little fuzzy on when to choose UB 40 or UB 60...any ideas

> on when one is better than the other? Thanks!

>

> Laura

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