I spent the most time with three doctors who work in the Spine and Joint Center at Kyung Hee University Hospital. Here they treat lots of low back pain cases, knee, hip and shoulder pain and I was able to observe a variety of treatments both familiar and advanced: acupuncture, herbal medicine injection acupuncture, electro-acupuncture, cupping, chuna and even acupotomy!
Acupotomy is an outpatient surgical procedure using a special tiny blade needle (similar to the original sword like and sharp-edge needles mentioned in the Huang Di Nei Jing Ling Shu) to cut fibrous adhesions, create space, and return blood flow. The procedures I saw were acupotomy treatments of the lumbar lamina for low back pain. The doctor would prepare the site using iodine, and using a ultrasound wand would locate the scarred tissue along the spinous process. He would then use a small blade needle to make tiny cuts to the lamina while watching the ultrasound screen. It was an amazing technique to witness with no down time for the patient.
It was during this section at the Spine and Joint Center that I learned about caffeine’s effect on pain treatments with acupuncture. Dr. Cho Jae-heung shared an article I will list below about the reversible inhibition of adenosine from caffeine that prevents the analgesic effects of acupuncture. If you’ve ever wondered why acupuncture didn’t work for your pain, it might have been your morning coffee. I myself had no idea that caffeine could be so systemically involved.
Each of the doctors at Kyung Hee took the time to share research they’ve done or used in their practice. Another area of treatment in the Spine and Joint Center is postherpetic neuralgia or pain after shingles outbreak. Shingles outbreaks occur along dermatone lines and are often on the head or abdomen and the pain and discomfort can last long after the rash is gone. I’ve worked with patients at my own clinic with this condition, and it was reassuring to see similar treatments as well as research about efficacy here at Kyung Hee.
There is a lot of research on using bee venom injections for pain and inflammation here in Korea as well as China and Japan. Many of the patients coming in for pain conditions were given bee venom injections in addition to acupuncture. Bee venom works best for inflammation and excess pain, but human placenta was also often injected for pain due to weakness or in a chronic state. All of these substances are sterile from labs and mostly injected subcutaneous or intramuscular. However, I did see a few cases of knee pain where the doctor used ultrasound guidance to inject deeper into the tissues.
Another treatment modality I was able to observe during this section was chuna or tuina treatments. In Korea and China, acupuncturists are also trained very similarly to chiropractors in joint manipulation. They even use tables very similar to a chiropractor. It is not quite as forceful as traditional chiropractic treatments, but the application is close. Sadly, in the US many of the manipulations are out of acupuncture practitioners scope of practice, especially along the spine. However, I was able to learn, observe and even experience some chuna and found the experience very similar to my practice of palpating, examining, and massaging in the US.
Xiang Cui, Wan Wei, Ziyi Zhang, Kun Liu, Ting Zao, Jialin Zhang, Ani Zheng, Hanqing Xi, Xun He, Shuya Wang, Bing Zhu, Xinyan Gao
Takumi Fujita, Changyoung Feng, Takahiro Takano
Hyoseung Jeon, Suji Lee, Sung A. Kim, Unhyung Lee, Seunghoon Lee
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