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Joan T., a sixteen-year-old schoolgirl, was brought to me by her mother because the girl had been experiencing headaches since she was twelve and first got her period. At sixteen, Joan returned to school as a junior because she needed to start preparing for college entrance exams, as well as apply to colleges. A physical examination showed Joan to be a slightly obese young girl, very depressed, and stressed. I considered that Joan might have one of the following three types of primary headaches: tension, cluster, or migraine. This type of headache is often described as a sharp penetrating or burning sensation in one eye where the person feels as if somebody had punched her or his eye. A migraine headache is a throbbing or pulsating headache that is often on one side of the head and is associated with nausea and vomiting, sensitivity to light, sound, and smell, with sleep disruption and depression.
The causes of tension headaches are usually stress, muscular tension, gouty arthritis on the neck or spine, postural changes, vascular dilation, protracted coughing or sneezing, fever and depression, or temporal mandibular joint disorder.
From the Western medicine point of view, there are many different kinds of medications to treat headaches. These headaches are usually of slow onset with mild pain and sometimes the feeling of emptiness within the head. According to traditional Chinese medicine, the head, the face, and also the liver are where all six yang meridians go. Yang Ming (Large Intestine) meridian headache: This is usually in the front of the head—on the forehead—and includes the upper portion of the eye. Shao Yang (Gallbladder) meridian headache: This is usually on both temporal areas and radiates to the ear.
Jue Ying (Liver) meridian headache: This is usually on the top of the head, sometimes connecting to the eyes and forehead.
I first ask my patient the location of the headache and its severity in order to find out which internal organ shows dysfunction.
For Tai Yang (Urinary Bladder) meridian headache on the top of the head and back of the neck, the following are used: GB 20 Feng Chi, DU 16 Feng Fu, DU 19 Hou Ding, BL 9 Yu Zhen, BL 60 Kun Run, and SI 3 Hou Xi. The Yang Ming ((Large Intestine) meridian headache centers on the front of the head, the forehead, including the upper portion of the eye.
The Shao Yang (Gallbladder) meridian headache is usually on the bilateral temporal area and radiates to the ear. For Jue Ying (Liver) meridian headache, the pain is usually on the top of the head and it often connects to the eyes and forehead. For Wind Cold: GB 20 Feng Chi, Extraordinary Point Tai Yang, St 8 Tou Wei, GB 8 Shuai Gu, UB 12 Feng Meng, and UB 60 Kun Lun. For Wind Heat: GB 20 Feng Chi, Tai Yang, St 8 Tou Wei, GB 8 Shuai Gu, Du 14 Da Zhui, and SJ 5 Wai Guan. After I made a clear diagnosis, I first used GB 20, DU 16, and Bai Hui, and then Tai Yang and LI 4.
If you have a headache, be specific as to the site of the headache and identify if you have a Tai Yang, Yang Ming, Shao Yang, or Jue Ying headache.
After you identify the site of the headache, then try to locate the points by following the tables and illustrations above. Acupressure the points with your knuckle, press with comfortable pressure on the points, count 20, and then change to another point. Since the acupressure points are located mainly on your head, use the head points as the major acupressure points.
Because the 4th and 5th fingers are supplied with ulnar nerve, therefore, his symptom made me think ulnar nerve entrapment, i.e.
The ulnar nerve functions to give sensation to the little finger and the half of the ring finger that is near the little finger.
The cubital tunnel: Ulnar nerve travels from under the collarbone and along the inside of the upper arm. Presenting symptoms of ulnar nerve entrapment can vary from mild transient pins and needles sensation, i.e. At the ulnar end of the transverse crease on the dorsal aspect of the wrist, in the depression between the styloid process of the ulnar and the triquetral bone. Temporary numbness and tingling sensation at ring and little fingers usually will disappear without treatment. STIR coronal image demonstrates increased signal lateral to the left greater trochanter (arrow). Repetitive activity such as stair climbing, bicycling, standing, running, hiking for long periods of time.
An injury such as a fall, or lying on the side for long periods of time, exerting unnecessary pressure on the hip. Previous surgery, such as surgery around the hip or total hip replacement which can irritate the bursa and cause bursitis. Leg length discrepancy.  This will change the center of gravity and cause irritation of the hip bursa. Hip pain.  The pain sometimes radiates to the outside of the thigh to the knee area, as well as to the groin area. Acupuncture.  The acupuncture usually I choose GB 30 Huan Tiao, Arshi GB31 Feng Shi, GB34 Yang Ling Quan, Sp9 Ying Ling Quan, Sp10 Xue Hai and Liv3 Tai Chong.
On the midline fo the lateral aspect of the thigh, 7 inch above the transverse popliteal crease. On the dorsum of the foot, in the depression distal to the junction of the first and second metatarsal bones. Cindy underwent my treatment for about 10 visits and with soft massage, ice, and acupuncture with electrical stimulation and she feels much better after the treatment.  She followed up once after two months and her hip pain is completely gone. Always ask the patient to rest and ice massage, and if you understand some Chinese herb, you can choose some Chinese herb cream with anti-inflammation function to massage the patient’s hip and ITB.
If the patient’s hip has obvious severe inflammation or infection, do not treat and you should refer the patients to her or his primary care physicians to check if there is any infection. A large diameter needle with electrical stimulation will be much more effective than the small diameter needle without electrical stimulation. Ice massage is very important treatment method, you must use ice to massage your hip 15 min 2x a day in order to reduce the inflammation and decrease pain.
The most important key part of plantar fasciitis is overstretched or overused of the thick band of tissue on the bottom. Hard surface of the shoes, especially tight and hard shoes without any arch support or Cushing function. The pain in the bottom of the foot usually is sudden onset with most often sharp or burning sensation, sometimes you may feel dull pain. The pain usually feels better after you warm up with first steps or take hot shower.  The pain may develop slowly over time, or suddenly after intense activity. Anti-inflammatory medications: Acetaminophen (Tylenol), or ibuprofen (Advil, Motrin) to reduce pain and inflammation. Fascia-specific stretching exercise by gently pulling back the toes for 10 sets of 10 seconds.  Repeat 3 times a day. The use of anti-inflammatory properties of ultrasound targeted to the bottom of the heel is beneficial.  A typical treatment would be around 8 minutes and can be performed by your physical therapist.
Her headaches were so severe that four or five days a week during her period she was often unable to go to school. Soon afterward, the pain had grown so severe that Joan was sleeping poorly and was extremely stressed, which often resulted in tears and depression, and, in turn, made her eat too much, causing a large weight gain. She spoke in a low tone; did not like light, and felt pain when her temporal area and the back of her scalp, the occipital area, were touched.
The symptoms include steady pain on both sides of the head with a feeling of pressure and tightness around the head, as if a band was put tightly around it. The pain comes on suddenly, without warning, and within a few minutes, excruciating pain develops that can be so severe some women report it is even worse than childbirth. These attacks are very often recurrent and do not change with age, sometimes developing into chronic migraine headaches. Most auras are visual and are described as bright shining light around objects or at the edges of the field of vision, hallucinations, or zigzag lines with a wave image.
However, cluster headaches are known to be triggered by alcohol, nitroglycerin, or similar drugs. There may be a family history of the disorder, or a migraine can be triggered by many stimulants: alcohol, altitude, color, contrasting pattern, exertion, food, hormonal change, hunger, lack of sleep, medicine, perfume, stress, and weather.
For example, Topamax and Imitrex are used for migraine headaches with some successful result. The headaches are usually characterized by an acute onset and a very severe and constant attack. This causes periodic attacks, where the pain always is connected with the neck and upper back and an aversion to wind and cold. This type feels like a headache expanding from inside the head, accompanied by fever and an aversion to heat and wind, with a reddish face and eyes. Since these meridians go up to the top of the head, headaches can be diagnosed based on the meridian distribution. This is usually located at the top of the head, or the back of the head, and is connected to the neck. I next ask about the accompanying symptoms in order to differentiate the wind cold from the wind heat. The acupuncture points are Yin Tang and Tai Yang (Extraordinary Points), Lu 7 Lie Que, LI 4 He Gu, and GB 14 Yang Bai. The following points are chosen: GB 20 Feng Chi, Extraordinary Point 1 Tai Yang, SJ 5 Wai Guan, ST 8 Tao Wei, and GB 38 Yang Fu, and GB 39 Jue Gu. I gave Joan this treatment three times a week for about two months and also injected her with cortisone to block the left and right nerve pain in the back of her head.
It also controls most of the little muscles in the hand that help with fine movements, and some of the bigger muscles in the forearm that help to make a strong grip.
When the palm faces the chest, the point is in the bony cleft on the radial side of the syloid process of the ulna.
If the compression is at the wrist, the incision is made there and the decompression is performed.
The other one is called deep trochanteric bursa, a deep bursa,  which is underneath the  gluteus medius muscle.  Hip bursitis are inflamed conditions of  hip bursa. The pain may be worse during activities such as running or sitting with the leg crossed over the opposite knee. She runs every morning for about 4 to 5 miles, who complains of right heel and plantar foot pain, difficulty walking, especially in the morning after waking up from sleep for 2 years.
There is no ankle pain, no numbness nor tingling sensation at right leg.  Based on my examination and clinical information, the patient most likely has right plantar fasciitis with possible heel spur. A calcaneal spur (or heel spur) is a radiological (X-ray) finding, and when it is located on the inferior aspect of the calcaneus, is often associated with plantar fasciitis. These headaches manifested themselves on both temporal regions of her head and also caused severe pain to the left eye. Her mother had taken her to many doctors over the years, and she had been prescribed a variety of drugs, but nothing seemed to help the migraines. The pain radiates from the back, eyes, neck, or other parts of the body, and usually increases over period of hours. Some people may experience dizziness, motor weakness, numbness, speech or language abnormalities, temporary vision loss, tingling, or vertigo.
However, when beta blockers, antiseizure medication, calcium channel blockers, tricyclic antidepressants, and analgesics, such as aspirin, ibuprofen, and acetaminophen, are used to treat migraine, cluster, or tension headaches, they cannot provide significant improvement for any of these headaches. The person feels thirsty, has constipation, yellowish urine, a red tongue body, with yellow coating on the tongue, and a floating pulse.
If you know the meridian distribution, it will be easier to make a clear diagnosis and treatment. However, her headaches were always triggered by nerve pain in the back of the head and worsened with her hormonal changes and menstruation. Her headaches improved a great deal after this treatment and she was able to take her SATs and apply for college. By physical examination, the patient had weakness to make a full fist, and weaker to spread out his 5 fingers. Patients may report difficulty opening jars, spreading out hand and fingers or turning door knobs.
Or your surgeon may choose to move the nerve to the inner part of the arm so that it is in a more direct position.
The patients with hip bursitis typically complain lot of hip pain, although the hip joint itself is not involved.  The pain very often radiates down to the lateral aspect of the thigh. She went to the podiatrist, who gave her an x-ray, which showed a mild heel spur at her heel. However, sometimes, people may have heel spur without any pain, some people may have severe heel pain and the pain may mixed with plantar fasciitis to cause the entire plantar foot pain. Her SAT exams were coming up in two months when the mother finally brought her to me for evaluation. These headaches usually last about two to twelve weeks, though some chronic cluster headaches may continue for more than a year.
Therefore, more and more people are starting to look for alternative treatments, and acupuncture is one of the best. The person does not feel thirsty, and has a thin, white coating on the tongue, and a floating pulse.
She had four to five attacks a week, and every time she had the nerve pain or a hormonal change, her headache symptoms would get worse.
She was accepted by Boston College and when I followed up on her two years later, her mother reported that Joan had no more major headache attacks. About 2 months ago, he started to feel both hands had weakness and tenderness along with numbness and a tingling sensation bilaterally at the 4th and 5th fingers. The patients may feel early fatigue or weakness after repetitive hand motions, such as typing, sorting mails, etc.
She was given orthotics for the right foot, but she still feels pain, therefore, she comes to me for evaluation and treatment. The pain is located at the medial heel, however, if the pain is severe, it will spread out to entire foot arch.
An inferior calcaneal spur consists of a calcification of bone, which lies superior to the plantar fascia at the insertion of the plantar fascia, most common in the medial side heel of the foot. Joan had to call her mother several days a week to pick her up from school, which, for several years made it necessary for the mother to quit her job and begin to home school Joan. He even felt coldness at the 4th and 5th fingers.  He sometimes has difficulty typing, and has to shake his hands to rid of numbness after waking up from sleep. He visited his primary care physician, and was given Advil for his pain and told that after a few weeks the pain and numbness might go away.
However, he still feels it and is getting worse, therefore, he comes to me for evaluation and treatment.



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