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Issue #2: Muscle Spasm/Shaking, Tremors, and Parkinson's

 

Dear Friend,
            
         
We had a really successful launch of our first newsletter, and we hope that the article had answered some questions you may have had about acupuncture and Traditional Chinese Medicine. If you haven't already done so, check out our Facebook page (Toronto School of Traditional Chinese Medicine) and our Twitter account (@TSTCM_clinic). Also, our special promotion from last month was so successful, we decided to extend it for another month! So if you have a friend or family member that you think will benefit from acupuncture, be sure to bring them in this month! 

Also, as of April 1 of this year, TCM and acupuncture is officially regualted by the Ontario and Canadian governments! This is great news for the general public, which can be ensured they get quality treatments that is standardized and approved according to the standards set by the College of Traditional Chinese Medicine Practitioners and Acupuncture or Ontario. So as of April 1, all TCM practitioners and acupuncturists must be registered with the College in order to practice, and in order to be approved, must show that they are competent in TCM theory, diagnosis, and treatment.
 
Sincerely,
Mary Wu, President

Toronto School of Traditional Chinese Medicine


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TCM Treatment of Muscle Spasms, Tremors and Parkinson's  

By: Katherine Chekhter (Specialized Honors B.A. (Psychology), R.Ac.)

 

Introduction    

Many people have experienced hand or head shaking at some point of their lives, but what causes it and what can one do if it becomes a recurrent problem?

Shaking movement is called tremor and is most often noticed in your handsand arms, but it may affect any body part and even your head or voice. This can be a simple body reaction to the stimuli or can be a sign of a more serious underlying problem like Parkinson's disease. Let us discuss shaking in Western and Traditional Chinese Medicine and various approaches to treatment.

Western Medicine Differentiation  

In Western Medicine, the disorder of the shaking palsy was first described by London physician named James Parkinson in 1817 and was later named after him. Parkinson's disease is now known to be a progressive neurological disorder involving degeneration of neurons in a region of the brain that controls movement. Such degeneration creates a shortage of dopamine and causes tremors and shaking that characterize the disease. Parkinson's disease is relatively rare overall, but it becomes a common problem of the elderly with onset around 60 years old, affecting about 6% of those over the age of 65 and affecting more men than women.  

In most cases, the first symptom of Parkinson's disease is tremor (trembling or shaking) of a limb, especially when the body is at rest. The tremor often begins on one side of the body, frequently in one hand. As the disease progresses, both sides of the body may be involved and shaking of the head may also occur. Other common symptoms include slow movement, difficulty in initiating movement, rigid limbs, a shuffling gait, a stooped posture, and reduced facial expressions. In about a third of the cases, the disease also causes or is associated with depression, personality changes, dementia, sleep disturbances, speech impairments, and/or sexual difficulties.  

Western Medical Treatment 

There is no known cure for Parkinson's disease. Many patients are only mildly affected and need no treatment for several years after the initial diagnosis. When symptoms grow severe, Western doctors usually prescribe levodopa (l-dopa) (a precursor to dopamine, which is converted in brain cells to dopamine), which helps replenish the brain's dopamine or other drugs that inhibit the breakdown of dopamine. In severe difficult to manage cases certain brain surgeries have been effective in reducing symptoms. Finally, researchers are trying to identify substances that will prevent dopamine-producing brain cells from dying, such as antioxidants, with investigation of coenzyme Q10 as an example.  

TCM Differentiation 

In Traditional Chinese Medicine the characteristic symptoms of Parkinson's such as trembling of the hands and shaking of the head are thought to be the result of generation of "internal wind" due to various pathologies. To be able to understand the basis for such diagnosis the introduction to Traditional Chinese Medicine theory with translation of certain terms into common language should be helpful.

One cause for "Interior wind" generation comes from the Liver. The Liver is not just an organ but a body system that controls body movement by ensuring proper nourishment for tendons aside from regulating overall smooth Qi movement (aka: energy flow) inside the body. To be able to perform its function the Liver needs adequate supply of Yin and Blood that are essential nourishment components that are derived from Kidney-essence (aka: the genetic basis of life). Inadequate supply of these essential components due to deficiency of Kidney-essence which declines with aging or can be initially deficient (genetic predisposition and inherited deficiencies in the kidney essence) leads to tendons malnourishment, spasmodic tendon state and creating of movement which is similar to leaves moving in the wind (shaking/tremor) which was named "interior wind" for such resemblance and is also accounted for symptoms like dizziness and stiffness.  

Another cause for "interior wind" is the result of diseases that damage Liver system such as excessive use of alcohol and drugs that can damage the liver, or from a long history of emotional irritability and anger. In addition, external wind may penetrate the channels and invade the liver to induce the internal wind syndrome. External wind is a mysterious concept invoking environmental factors of various types that adversely influence the body, starting at the body's surface and penetrating inward. The experience of external wind usually produces symptoms of aches and pains. The internal wind, whether generated from within or from the influence of external wind, produces symptoms of shaking and trembling.
The mental disturbances that arise in some Parkinson's patients may be attributed, from the perspective of traditional Chinese anatomical connections, to a failure of the kidney to nourish the brain. In addition to genetic components contributing to this decline, there may also be weakening of the kidney by exposure to cold, by excessive fear, by excessive sexual activity, and by consuming foods, drugs, or other substances that harm the kidney and especially that deplete kidney yin. Also, physical injuries, surgeries and scaring can disrupt the normal interconnection of the internal organs and result in depletion of yin of the kidney and liver.

TCM Treatment 

This interpretation of symptoms and signs associated with Parkinson's disease assigns the following treatment principles: nourish the kidney and liver, with focus on nourishing yin, and sedate internal wind. While nourishing kidney and liver is often accomplished by herb therapy, calming wind syndromes is more frequently attempted through acupuncture therapy. In China, herbs and acupuncture have been used both independently and in combination and provide promising results as documented in various clinical trials.  

Clinical Studies of Efficacy of TCM Treatment 

In one study 40 cases of Parkinson's syndrome were involved: 31 male and 9 female patients, aged 54-80 years (mean 69 years), with cases classified as being severe (3 patients), moderate (27 patients), or mild (10 patients). They were treated with the same herbal decoction three times per day for 3 months while discontinuing Western medications (such as l-dopa or cholinesterase inhibitors). Improvement was evaluated on the basis of scores for symptoms characteristic of Parkinson's disease, including tremor, rigidity, hypokinesis, gait disturbance, and mask-like face According to the authors of the report, 5 of the patients were "markedly improved" by the treatment and 15 additional cases were improved, while the remaining 10 only had slight changes (Li Genghe, Clinical observation on Parkinson's disease treated by integration of traditional Chinese and Western medicine, Journal of Traditional Chinese Medicine 1995; 15(3): 163-169).

In another study of Chinese herbal medicine 700 cases of treatments of Parkinson's patients at a hospital were reviewed; 50 of them, involving prolonged therapy, were analyzed. The case reports were concerning 32 men and 18 women, with age ranging from 35 to 75 years. The patients were divided into three categories by the traditional method of differentiation and were treated with herbs accordingly. The authors reported that of the 50 patients analyzed, the treatment was markedly effective in 15 cases, and somewhat effective in 24 cases, the remainder did not respond to therapy significantly. (Chen Jianzong, et al., Traditional Chinese medicine treatment of Parkinson's syndrome-a report of 40 cases, Journal of Traditional Chinese Medicine 2003; 23(3): 168-169).

In an Acupuncture treatment study, acupuncture therapy was administered to 29 patients with Parkinson's. The patients were treated every other day for three months. Western drugs (mainly l-dopa, dopaminiergic receptor stimulants, and anticholinergics) were used as per usual practice; a control group taking Western drugs alone (24 patients) was also monitored. The authors reported that there was a significant improvement in symptoms for those treated with acupuncture, while for patients treated with drugs alone, there was a worsening of symptoms. Further, the patients treated by acupuncture ended up using a lower total dosage of drugs after the three months of treatment, while those using the drugs only retained their original drug dosage (Zhuang Xiaolan and Wang Lingling, Acupuncture treatment of Parkinson's disease-a report of 29 cases, Journal of Traditional Chinese Medicine 2000; 20(4): 263-267).

In another study, scalp acupuncture treatment was administered every other day for ten consecutive treatments over a three week period and was repeated each month for three months. It was noted that there were some responses immediately after treatment, with calming of tremor in 2/3 of the patients (Wang Lingling, et al., Influence of acupuncture on brain blood flowing state in Parkinson's patients, Chinese Acupuncture and Moxibustion 1999; (2): 115-116).  

Conclusion 

In summary, both acupuncture and herb therapies have been reported to show benefits for some patients suffering from Parkinson's disease. The herbal therapies are mainly high dosage preparations of herbs that nourish yin and blood, sedate wind, vitalize blood circulation, and resolve phlegm-obstruction of the channels. Prompt effects of acupuncture (right after treatment) may be observed, but standard therapeutic regimens are three months.  

If you or your loved one experiences occasional or recurrent tremors, see if Traditional Chinese Medicine can provide help.

 

 


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TSTCM offers professional training programs in Acupuncture and Traditional Chinese Medicine and provides supervised health services in Traditional Chinese Medicine, acupuncture, Chinese herbal remedies, and Tuina massage to our local community and beyond.
 


Toronto School of Traditional Chinese Medicine | 700 Lawrence Avenue West, Suite 433 | Toronto | Ontario | M6A 3B4 | Canada