Michael Tierra applies cups to a patient
with severe back pain at the East West Free
Clinic in Santa Cruz.

We have encountered many extreme acute chronic conditions among the homeless population that we’ve treated. The most common involve pain due to trauma or metabolic imbalance. Naturally enough, other common conditions perhaps just as prevalent are depression, anxiety and manic, bipolar disturbance.

Rheumatic and arthritic conditions are described in Traditional Chinese Medicine as Bi Zheng disease which includes a wide variety of back and joint pains. While diet and herbal therapy provide nutrients and healing at a deep level and ultimately provide the most lasting results, various physical therapies such as needling, bleeding, scraping, cupping, moxibustion and medicated oil massage  offer the most immediate relief.

This case was that of a homeless man, who had several laminectomies and possibly a disk fusion over a portion of his lower back in the area of L3 to L5. This man appeared to be in his late 30s and claimed to suffer from acute, disabling back pain for over 14 years. Laminectomy is a surgical procedure that removes a portion of the vertebral bone, called lamina. The muscles are pushed aside without cutting with the intention of leaving parts of the lamina intact. Disk fusions are performed when there is a problem with the disc space between the vertebrae causing painful pressure on the adjacent nerves.

I was not sure which of these or perhaps both procedures were performed on this man but it was obvious that he had at least three surgeries all in approximately the same area. Unfortunately he had no pain relief and more than likely a severe exacerbation of pain.

The man was married to a woman who loved and cared for him as best she could. Both lived on a small monthly disability and had temporary residence at the Santa Cruz Homeless Shelter. This is one of many cases where an individual suffering from such incapacitating health problems had little hope of being able to hold a job and better their living standard.

This man was taking and probably hooked on several severely addicting pain killers including oxycodone. Still, the pain throughout his body, especially his back, was constant and excruciating. He could barely move, let alone get on the table where we might try to relieve some of his suffering. With the assistance of three of us we finally got him lying face down. He was moaning and crying with every more. I palpated different areas of his back to determine where the pain was most severe and where the inflammation and blockage emanated. Again, he exhibited great sensitivity to pressure point palpitation.

I decided to use the most powerful method to relieve such conditions that I know: bleeding and cupping. Both are traditional ancient methods employed in many traditional cultures including Traditional Chinese Medicine dating back thousands of years.

Many people don’t realize that before the invention of small stainless steel needles, small sharp stones were used to extract a small amount of blood from precise areas of the body. Cupping used by creating a vacuum in a small cup applied to suck the skin and blood to the surface is used in diverse cultures ranging from throughout Asia, Greek and Central America. These were formerly considered folk traditions and are now part of the practice employed by some acupuncturists around the world.

I used small sterile diabetic needles, beginning with two points behind the knees called Weizhong or Bladder 40. These points treat lumbar pain and spasm of the lower back and extremities. They are powerfully anti-inflammatory and relieve pain. Translation of the name “weizhong” means “support the middle” because they also treat abdominal pain, vomiting and diarrhea. They are the most effective points for treating all lower back pains and for severe cases, they are most effective if they are caused to bleed. You may wonder if this was painful to this man. In fact his pain was so severe that he didn’t feel any of the quick tiny pricks which I then proceeded to do at particularly sensitive areas through his entire back, each time applying a cup and drawing out anywhere from a half to a teaspoon full of blood from each point.

After applying wan hua oil to the region, a special medicated oil to relieve pain and promote blood circulation, removing the blockage causing pain in the area, I pricked the two most painful areas near the areas where the surgery scars were evident and then applied two cups.

After 15 to 20 minutes I removed the cups, carefully wiping off the coagulated blood on the skin and inside each cup using as sterile measure as were available under the circumstances. This man’s pain was so severe, I considered this an emergency procedure. After removing the cups I lathered Ayurvedic Mahanarayana oil, the most powerful of all rejuvenative, anti-inflammatory and healing oils the world has ever known. “With a sesame seed oil base, this massage oil has some widely known homeopathic constituents like clove, camphor, turmeric, cow's milk, cedar bark, sandalwood, ginger and licorice. It also contains several historic Ayurvedic herbal tinctures known primarily in India, such as the herb blend dashmula, an asparagus extract called shatavari, the country mallow plant known as bala, and a mild sedative called tagar,” (http://www.wisegeekhealth.com/what-are-the-benefits-of-mahanarayan-oil.htm)  and these are about half of the total ingredients. This oil is available online. I use so much of it in my practice that I purchase a gallon at a time from Banyan Botanicals. http://www.banyanbotanicals.com/mahanarayan-oil/

After the cups were removed that man was reluctant to move and sit up for fear of experiencing the old pains he had before and during the process of getting on the table.

As you can see from the final picture, for the first time since our first encounter, the man was sitting up and specifically said “I feel good,” exclaiming that he hadn’t felt so much relief from pain in over 14 years of multiple and costly medical procedures and physical therapy.

I also prescribed an ancient traditional Chinese herbal formula for back and joint pains and both osteo- and rheumatoid arthritis called Du Huo Ji Sheng Pian (Wan) to be taken as pills three times daily. This formula contains up to 14 herbs and when taken over a period of weeks to 3 months is remarkably effective in treating back and joint pains especially of the lower body.

Among the powerfully anti-inflammatory, analgesic, blood-moving herbs in the formula are a species of angelica (Angelica pubescentis) and Loranthes, a particular species of mistletoe found growing on mulberry trees (do not use American mistletoe as it is toxic).

It is moments such as this that provide me with the most satisfaction and joy. 

I'm not sure when the use of poppy for the relief of pain was made illegal for herbalists, but it certainly is. In fact, in California one can be cited and made to uproot and discard any poppy plants that are even remotely suspected as being used for medicinal purposes. It is certainly clear why this is the case; the latex of the poppy plant has a long history of addictive abuse both in China and later in its extracted and refined form today as morphine and heroin.

However, herbalists are finding other members of the Papaveraceae family to have similarly powerful analgesic pain-relieving properties. Even California poppy, today one of the most popular herbs sold for insomnia in Europe, has somnolescent and mild analgesic properties.

Corydalis yanhusuo from itmonline.orgRecently, a study appearing in the January 20,2014 issue of Current Biology and conducted by a team of researchers together with Chinese herbal practitioners at the University of Irvine in California found yet another member of the Papaveraceae family, Corydalis yanhusuo, to also be an effective non-addictive analgesic for both acute inflammatory and nerve pain. (Image of Corydalis yanhusuo at right from http://www.itmonline.org/arts/pain.htm)

Tests were done on rodents who had induced inflammatory pain associated with tissue damage and infiltration of immune cells, and injury-induced neuropathic pain. The latter is particularly important because evidently Western medicine has no adequate treatments for neuropathic pain. This makes corydalis at least the second and arguably the most powerful herb one can use for the treatment of pain (the other herb commonly used by Western herbalists for nerve pain is St. John's wort, or Hypericum perfoliatum).

The teams screened 10 traditional Chinese medicines known as analgesics and nearly 500 compounds known for their pain-relieving abilities. Only dehydrocorybulbine (DHCB), the constituent found in Corydalis yanhusuo, produced a reproducible effect. Unlike poppy and its biochemical derivatives, DHCB does not necessitate the raising of doses with its subsequent addiction as do other conventional pain relievers. This is the first time that the coordinated efforts of both Chinese medical doctors and researchers East and West have been able to extract, identify and test a specific biochemical constituent that seems largely responsible for the remarkable analgesic properties of this medicinal herb.

These are several species of corydalis throughout the world, and indeed many of these may have the same or even greater analgesic properties, but the one most used in Traditional Chinese Medicine (TCM) for thousands of years grows in Siberia, Northern China and Japan. Corydalis yanhusuo is one of the herbs most frequently used by Chinese herbalists for the treatment of pain and various other circulatory problems. As such, it is also used for the treatment of cancer and coronary heart disease. It is classified as a powerful Blood-moving herb, which relieves the stasis that causes pain according to TCM theory. The root is administered in 4.5 to 9 grams per dose in a divided decoction, taken twice daily to alleviate menstrual cramps, chest pain and abdominal pain. According to Olivier Civelli, chief researcher at UCSC Irvine, more than 50 million Americans are affected by neuropathic pain, for which DCBH could be of great benefit. These people could receive the relief they need through this powerful herb.

As an aside, marijuana-infused oil or ointment (made with lard) is a traditional Central American folk use of the herb for the relief of arthritis, sprains and other aches and pains. Increasingly with the legalization of marijuana in some states, its use for pain has been widely acclaimed as medicine-makers produce their novel pain-killing marijuana ointments and tinctures. But remember, herbal formulas are usually (though not always) more effective than single herbs. A good formulation would be a combination of cannabis with corydalis.

Last time, I talked about moxibustion and its uses on the acupuncture point Stomach 36. There are several other uses and locations for moxa, which I will discuss in this and subsequent blogs. Best of all, moxa is an inexpensive treatment that can be applied at home. Following are a few more highly useful moxa points that yield profound, nearly immediate positive results.

back_painLower back pain

Indirect moxa applied for 10 to 20 minutes over the lower back and wherever reactive points can be located provides immediate and oftentimes long-lasting relief from pain. It is a far better treatment than the application of icepacks which stop the pain by cutting off circulation; moxa relieves pain by facilitating circulation.

The application of five stick-on moxa pellets directly on Governing Vessel 4 (Ming Men, or "Life Gate") located directly on the spine between the second and third lumbar vertebrae, supplements Yang Qi for the entire body and effectively treats lower back pain. Using indirect moxa about an inch and a half to the left and right of this point in the area of Bladder 23 on the small of the back will further add to the treatment. Of course, always try to find the sensitive trigger points as these are the most effective for treatment of acute pain.

feverColds, Flu and Fevers

Moxa on the point called Governing Vessel 14 (Da Zhui or "the Great Hammer") raises the Yang immune system of the entire body and is the most effective treatment for colds, flus and fevers. It is located directly on the seventh cervical vertebra of the spine.

The value of doing moxa on this point cannot be understated. It will induce perspiration, which is the first line of treatment for all invading pathogens. Being the meeting point of all the Yang acupuncture meridians, it is indicated for all exterior conditions, protecting the body from the invasion of exterior pathogens. It prevents and treats colds, flu, fevers, clears heat, and strengthens the neck and spine. It is also used for bone issues, arthritis, spurs, scoliosis, problems with the arms and hands, epilepsy, hypertension, insomnia and nosebleed.

It seems counterintuitive that one would apply heat to treat inflammation, but with moxa it is not only the heat that is having an effect, but the stimulation of circulation and the proliferation of white and red blood cells.

Next time: Moxa for insomnia and infertility.

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