Bob Doane writes

Dear Ken and Ag,

I hit a period about 2 years ago where I was frustrated especially with sciatic problems. The method I used was basically what we all
learn: Ling Ku combo, k3 or 5, UB 60 or 65, SI 4,6 etc. The problem was only about 50% of the people with severe problems were
getting better. So I decided to get more aggressive and it has worked marvelously. Here is what I do:
1. Sacral pain is basically on the UB channel.
There are only 4 channel choices to get rid of this pain and they are LU,SI,K and UB.
2. I now needle from the heel of the hand and foot to the elbow and knee all ah shi points on these channels. I also needle on the
abdomen opposite the pain. I needle the top of the head corresponding to the pain
3. If the pain goes down the UB channel on the leg you already took care of it by treating the entire channels mentioned above. If the
pain goes down the GB channel then I add points all along the SJ channel on the opposite arm. If the pain is in between the GB and the
UB, which it often is, then I needle between the SJ and SI on the opposite arm. This method which is totally in accordance with Dr. Tan's
methods have increased my effectiveness to about 90%.
4. If there is no result in 8 treatments then I am quite sure the structural problem is so severe it cannot be overcome. This happens about
5 to 10% of the time. An MRI usually reveals a severe stenosis or severe herniation. However, as an experiment, I once treated a lady
with 4 herniations 34 times to see if it would work. I did it for free after the 8th visit. She didn't feel any improvement until the 15th
treatment and then it started to work. By the 35th treatment she was 100% out of pain and one year later she confirmed that it never
came back.
5. Too many people trying this method I feel are trying to use so few needles that they are hampering there results. It takes a new seed to
yield a new croop. If 6 needles are not solving your problem try more. Layer the systems and the imaging. Treat the entire channel if you
are not getting anywhere but don't give up. Why? Because it does work. Some cases just require more aggression.
6. Most people starting this method mix it up with everything else they learn. This I feel is a mistake. If someone gets better you will
never know what did it and consequently you will not grow in confidence. My advice is to practice this for 6 months without using
anything else. See what works and what doesn't. For what doesn't then really examine what you are doing and you will find there is
something not quite right. Usually the imaging is a little wrong.
7. Use double imaging by considering the half arm and half leg to represent everything the full arm and full leg do. This adds power to
your treatment. Consider sacral pain. Now instead of just the ankles, feet, hands and wrists you have the knee area and the elbow area to
image the sacrum. This adds power to the tx.
8. I am sure there are brilliant practitioners of TCM acup. who get marvelous results in pain relief. But how did they do it. They took the
basic priciples they were taught and through adversity they figured out how to make it work. They didn't give up.
9. Bottom line, hang in there and try harder. This frustration will pass. Above all find your own way. There is so much latitude in this
system that there are several ways to approach any problem.

I stop when the pain goes away. But with back pain very often they don't know if it is gone. I will have them wiggle their hips, or raise
their leg, etc. They will say it's better and then I continue until they exclaim wow that's a lot better. Then I stop. But in case of back pain
if they don't know if it is better I will use the whole kitchen sink. I cannot afford not to have these people get better. Using this sort of
exaggerated approach I have been able to reduce the number for back tx's in half. I have just found that sometimes I have to use many
needles to get that response but if I get it on one needle I will stop. Most of the time though, with other pains, I use at least two images
and two systems just to nuke the problem.

The best thingto do is not give up. If your patient can only see you once a week due too financial reasons, try giving him a two for one
deal - you have to see him more than once.
If your one BM approach is not working, I strongly suggest you to try other methods like Tui Na, Herbs, or other BM approaches. In
general, you just need 3 needles for sciatica - Ling Gu Da Bai on the opposite side of the pain, and UB65 or GB 42 on the same side.
Having recently fought a bout with acute sciatica, I can sympathize with your patient. I had a pain in the GB30 area and couldn't sleep,
sit, lie down, or walk. Sometimes you have to look at the factors - is he sleeping in a cold drafty area - is he deficient, how long has the
problem been around. When you manipulate his spine via Tui Na, is there relief? What I suggest is not to give up - as long as the paient
is willing. The last thing I ask is you dare tried a local needle - yes, a BM sin, but sometimes it works. You have to be flexible and try to
win the battle against disease, not just honor a method.
Robert Chu, L.Ac., QME
chusauli@msn.com

(? Writes)
I have a teacher who uses balance method combined with a technique involving electrostim that actually corrects herniations smaller
than 4mm. Simply needle the inner and outer UB merdian line adjacent to the area of the herniation. Usually this means ub22-26, and
ub51-53. Attach your electostim to the uppermost and lowermost ub points you needle - in this case, ub 22 and 26 and ub 51 and 53. Its
also helpful to run current along the affected meridian down the leg - say, if the pain goes down the gb channel, you could do electrostim
from gb30 to 34 or 41. I've seen amazing results with this. You need to treat them 3x/week for 6-8 weeks, but then you will actually see
the improvement on x-ray.
I mention it here because my teacher also uses balance method to help these patients with their acute pain. It seems the combined
bm/local electrostim approach works beautifully for people with herniated discs.
I am aware that Dr. Tan has sometimes advocated against such an approach. However, in "Twenty - Four More," Dr. Tan uses local
electrostim along the affected meridians on the jawline of a TMJ patient along with distal points(pp42-45).
Hope this suggestion does'nt generate any controversy here - I've seen the technique work very effectivly and thought I should share it.
Good luck with your patient!
(Deb writes)
As far as treatment of that type of pain, I typically use opposite side ling gu, da bai, SI 3 and same side UB 65. Works beautifully. I
agree, that you probably wouldn't reduce the herniation, but make the person asymptomatic. Also, remember that many people have disc
herniations with no symptoms, so there are often other factors at play in why/how people become symptomatic.
Bob writes
Pain at the ichial tuberosity can be tricky. Here is how approach it:
Imaging: The wrist,ankle, knee area all image the IT. This is using 1/2 the leg and 1/2 the arm to image the whole leg and whole arm.
UB36 is at the top of the thigh or bottom of the buttock. In any case the best image seems to be the wrist and ankle and just distal to
UB40 and K10.
Target channel: UB
Points: Choose points on the K,LU,SI and UB.
Needle according to the above imaging and keep adding needles above and below the suggested imaging until the pain goes away while
on the table. Remember to add in the LING KU combination. You can also add points on the UB channel on the head across from Du20
and then down the head a little and towards the front of the head a little. This image corresponds to the leg. Treat the same side of the
head as the problem. Needle all the above suggested channels in all the above suggested image areas. When one area has a dramatic
effect then take special note. Treat 3 times a week and not 2 times. Two times gives too much of a chance for the pain to re-establish
itself. Let us know what happens and based on that I can give more suggestions. Remember to use strong stimulation.
(and continues.)
When it comes to pain in a specific locality the BM technique is basically using distal needles according to theories layed out by Dr. Tan
to treat the pain. The BM technique is not one of using a few needles. If a few needles work then great but if you need to use more then
that is ok too. The most important thing is that the pain goes away. If you watch Dr. Tan he might put 3 needles in one place. He
considers that this was one needle. He used three to make sure that one acupoint was treated properly. When I began Dr. Tan's methods 4
years ago I also was hesitant to use more needles and if I put one more in and the pain got worse I would have lots of doubts and pull the
needle out etc. However, I learned over time that some problems, especially back pain which spread over a large area, need more
needles. If you watch Dr. Tan he might use 12 needles for such problems. I use probably 20 but the pain goes away. So I stick with what
works.
If you put in a needle and the pain is worse wait a minute and it will get much better. You will also find that in most cases strong
stimulation works better than very little stimulation. Consequently, I make sure the patient feels every needle. They might complain but
they will complain more if the pain doesn't go away. Remember in this method Dr. Tan gives a lot of room to find your own way. Do not
deviate from the theory and do not deviate from the imaging methods but do not worry about using a lot of needles. Try using a few and
try using a lot. See what happens. I think you will discover what I discovered and that is more needles are very often more helpful. I
have found, however, that you do not want to treat more than 3 to 4 problems at once.
Bob writes
For sacral pain I have found the following very useful:
1. Image the elbow and knee as the sacrum using LU5a, SI8, K3, UB40 on both sides, if the pain is bilateral of course
2. Needle on the abdomen exactly opposite the area of pain in the sacrum. Use several needles.
3. Use all of Dr. Tan's ofther points that you have been using.
4. Needle on the scalp posterior to Du20 and just lateral on the same side as the sacral pain.
5. Remember that the proper image for the sacrum is the hand and foot. Therefore, Lu10, Si4, K5/6/7,2, UB62,63,64 I find to be the best
points assuming the pain is on the UB channel.
If the pain ends up on the GB channel on the leg then put several needles on the SJ channel on the opposite arm with the right imaging of
course. Also needle the opposite leg on the Lv channel and needle the Ht channel on the same side as the leg pain. If you do this 3 times
a week it will definitely go away after a few treatments.
Bob Doane

Josh writes
If a spinal stenosis case it can be very challenging if not impossible to treat depending on the grade of narowing in the spine. Also
spondolysthesis is a toughie to treat, very recalcitrant.

SO try the following forget the lower back focus on the leg use these points. Lu10 ahshi (balances Foor taiyang in the buttock area)
Ht7ahshi (balances FootShaoyang along the piriformis muscles and the greater trochanter two or three needles posterior and slightly
proximally along the transverse wrist crease may be needed!!!), and PC71/2 may be needed.
In addition use Lingku combo opposite side with sanchar/ or Sojing dian, extra point between first and second metacarpals (it is called
"shang bai" in dr Tong's book used for sciatica), and SJ4 ahshi for the hip pain aim towards under the tendon of the flexor carpi ulnaris.
IF it is ok forget about adding any additional points as in what will follow next, in this message.
Use UB58 (Luo) and UB65 (shu) opposite side of pain with contralateral Lu7 (ahshi Luo) and Lu9 (shu) point along with GB40 Ht7,
ST40 with PC7.
....an experimental approach.
acujosh
Eric writes
If the pain is quite intense, there are probably a couple of things you can do to help. ONe, is see her more frequently, like every other day
to every day until the pain calms down. Second, put her on some herbs. Depending on her TCM diagnosis, Shu Jing Huo Xue Tang is
pretty good for lower body stuff and sciatica. Also can use Du Huo Ji Sheng Tang. Can even combine the 2 50%/50%. Putting her on
herbs can help you stabilize her much faster. Thirdly, earseeds can help greatly too. Palpate for tender spots on the hip, thigh, and sciatic
areas. You can usually find some very, very tender spots there. Then the patient can squeeze the seeds all day if they like. My chronic
pain patients love the seeds and say that they work great in between treatments.
In terms of acupuncture, again, I'd try the opposite upper arm and shoulder area. Target the SI, Li, and SJ channels from the hip all the
way to the elbow. Going up to the elbow not only images up to the knee, but also to the opposite foot and even hip areas. Bob Doane in
some of his posts has explained this quite well. Use 1.5 cun needles, go deep, and look for ashi. If that doesn't seem to help, try the same
side wrist area up to the forearm. After you insert the needles have the patient walk around and test the leg. I also like them to lie down
during the treatment because it seems to relax the leg and the nerve better than sitting. I have found some of my patients' sciatic pain
didn't get any better until they would lie down.
Remember, if the pain is between the channels, you also need to needle in between the channels.

I'd definitely bleed UB40,same side of the pain, then do my balance tx. Works great, the bleeding really helps open up the back and
leg.....like a pressure relief valve. I've treated alot of back/leg pain and this can really make a big difference in results. I usually do it as a
matter of course with their first tx. I learned this from some Japanese ideas and it works great with Tan stuff. I would also like to add that
the body wants to resolve disk protrusions and damage, naturally, and what we do does influence and speed up this process,remember
we're not just about pain relief but actual healing, right? Just because an imaging picture is positive doesn't automatically negate what we
do. I'd venture to say that we can be seen first, then if we don't work, go on to more extensive allopathic methods. We all know what
follows a positive imaging in an allopathic setting, drugs/surgery. That is when we usually lose them, usually before we ever "had" them
anyway....no use speeding that damaging process up unless absolutely necessary, which of course it sometimes is, referrals are
occasionally necessary. Michael

If the pain is in GB30 area and you are targeting cvorrecty,then perhaps you may consider using Ht8, Ht7, Ht6--whichever in this area is
most painful to palpation. Also add SJ4 ahshi and really poke around above and below and even to the sides of the "official" point of
SJ4. I see what you are trying to accomplish with the SJ points by imaging the entire body on the arm but try doing reverse image on the
hand. I haven't as yet gotten great results using those points for Foot Shaoyang pain, as you've described, but, if you find ahshi or have
the idea, by all means image it and measure your technique by the success or failure of the treatment. The LZD combo didn't work
because it images along the transverse processes of the spine, along side the actual Du mai channel, from T12 to L5 and you need to be
working on the Foot Shaoyang channel.
Also consider GB40 and 39 ashshi with LV4-5 ahshi.
Finally, give yourself a break, you cannot expect always to get a result on the first visit, so your patient needs to understand this. I
always tell patients they may be slow responders or fast responders, we won't know until we try a few treatments, so what I'd like to do
is try three treatments out, and see how they respond. I then ask if this makes sense to them and would they agree to it.
Also depending on the time you have you can return in 5 to 15 minutes, if there is not a result pull the needles and try something else.
This will put you at ease so you don't feel you've got to have it in one shot. I work in NJ and it is definitely a tough crowd out here. We
usually get the "three strikes and your out of a patient" mojo going on here.So if she doesn't want to stick around she ain't going to stick
around even if you did help her on the first shot. Believe me, I've been there and I get this stuff day in and day out. If you set the
parameters with the patients, especially like this you get breathing room to work and do your best. As Dr. Tan always says "I'm not Dr.
Christ!!!"....so patients need to understand they need more than just one treatment." Hope this is of help.
acujosh