TMJ for 10 yrs

30 yr old female came complaining of TMJ pain. She says it is a chronic problem. Left side is worse than right side and pain is worse when she is stressed and tired.

normally, LI 4 is good enough but since it has been there for 10 yrs I asked more questions.

s/s: slightly low blood pressure, thin body type. hands and feet are sweaty and cold. prefers summer. heavy feeling worse with fatigue, dry skin stuffiness in chest, lots of dizzy spells which is worse when she stands up from sitting position, blurry vision pain in her eyes, neck ears are itchy, dry eyes, low ab filled with gas with pain near left st 25 point area, sl acid relux, frequent bowel movement (loose) worse when she is stressed. frequent urination (scanty)

very irregular menses with PMS. right ovary removed due to cyst 7 yrs ago. tai yang HA, right calf spasms at night, cant stay asleep, history of depression and anxiety, fobia, OCD.

there are lots of s/s. some seem to be related to HT, LV, GB, SI...

TX: SI2 - SI 3+ GB 41 + UB 66- (seemed this would be good for her tmj out of all other channels)

TMJ left side is much better. then patient tells me she is always very anxious and recently she is going through lots of stressful and anxious issues.

upon the following visit she tells me she is very pleased with the result. she is not as anxious, palpitation is almost gone and TMJ pain is much better. there is still clicking sound but no pain.
her face did not look deviated anymore.

TX: same as above.
then tried LI4 but did not work. patient says pain is completely gone but again the clicking sound remains the same.

coldness heat deficient or excess?

long ago I thought reducing LV2 would treat millions problems and a number of patients benefited from this particular point. It took me awhile to realize it works only when patients have liver excess or heat s/s. and many patients in the city have such disorder.

if liver problem is suspected, we can treat it with

1. tonifying liver LV 8 KD 10 + LU 8 LV4 -
2. sedate LV 2 HT 8 - LU 8 + LV 4 +
3. cool it LV 2 HT8 - LU 5 LV 8 +
4. heat it LV 2 HT 8 + LU 5 LV 8 -

then what?

what about LV 1? you can Tonify or sedate LV 1 and it can be liver problem that is related to SP HT KD PC channels. for ex, LV invading SP or LV is mother of HT and so forth.

this is very complicated but as an acupuncturist it is so much fun to think about .

another frozen shoulder case

50 yr old sl heavy came to my office complaining of her left shoulder pain for 2 months. rom is restricted with pain at 80 degrees.

s/s: insomnia, indigestion with nausea, palpitation without urination issues

tx: tonify GB channel gb 43 + LI 1-.

patient says about 40 % better in terms of pain. rom is almost full.

again differentiation is the key

nausea for many days = (

45 yr old female patient complained of nausea for 1 wk or so. she is very health otherwise.
there is stomach distension. she does not throw up.

s.s: slightly less appetite, Ren 14 and 12 area are tender upon pressure. low energy. diarrhea.

TX: sp 4 - (she feels a just little better)

Sp1 Lv1 - Sp 2 HT 8 +

tenderness in Ren 12 14 are gone. patient states she feels much better and less gassy n bloated in stomach.

different frozen shouder cases

case #1: 60 yr old thin female suffers from right shoulder pain for 3 months ever since she fainted which made her fall on the ground. since then she states it is extremely painful (worse at night) and cold so she cant sleep at night. she had tried ashi points at a different acupuncture clinic which failed to improve her condition.

she has been going through lots of stress in life for the last 6 months. ROM abduction is restricted. 0--70 with severe pain. sleeping is fine. digestion is fine. palpitation with stress and anxiety. cold hands and feet.

Tx: Sp 3 + LI 11 - ROM improved about 5 degrees.

then Si 2 - UB 66 - Si 3 + GB 41 +

so far she came 3 times. she says her coldness and pain in her right shoulder have improved a lot so she can sleep at night. ROM is still restricted with relatively less pain at 0--100 degrees.

case # 2: 45 yr old with frozen shoulder for 6 months. all s/s are negative except for st dampness.

TX: ST 41 +
patient's shoulder improved about 10 % after treatment.

differentiation is the key!!!