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As I write out this latest essay, Marvin Gaye’s classic song, “Where are We Going” seems to be winding its way through my mind, bringing up memories and, simultaneously, pointing my nose forward. As those of you who follow my blog know, I’m tying up the loose ends of my 4.5-year-long program in Chinese medicine and am about to get on the board exam express. Things are moving slowly and at warp speed, it seems. I expect to be a licensed acupuncturist and herbalist by late May or so [Update: I am now a licensed acupuncturist]. Meantime, I continue to offer health coaching, mind-body wellness programs, and a Chinese-style Asian bodywork therapy in my North and South offices here in Austin, TX. I will continue to do so, even after I’m licensed. What I do now is not a doorstop to be discontinued once I’m an acupuncturist. Instead, my current practice will flourish as part of a holistic tapestry of healing and health that is characteristic of Chinese medicine.
There is so much that Chinese medicine can do for you that goes well beyond just needles. Acupuncture may be the most well known form of the medicine, and if you have been following me on social media, you know that I am a dedicated tui na practitioner, hence this essay as I ponder my future. However I also hope, via this piece, to inspire you to try a variety of healing modalities (and not just acupuncture and/or the Chinese medical massage therapy known as tui na), no matter who your practitioner is!
As much as I love tui na, I really also love acupuncture. It feels like years have passed since I took a last photo of my intern badge at North clinic just two weeks ago. I already miss needling and am about to give myself a much-needed treatment as soon as I’m done with this essay but it’s not the same as working on a patient. I am indeed thinking about what my soon-to-be-future practice will look like, too. Bodywork patients now are asking me if I’ll continue to practice tui na even after I’m licensed for acupuncture, and the answer is, “Yes, of course I will!” This question, for its part, has lead to several conversations about the benefits of acupuncture over tui na and vice-versa. As a result, it seems a good idea to write an article about the value of one in comparison to the other so that you, dear reader, can decide which is best for you. Honestly, both are great and a lot of it comes down to preference, but it’s smart to know what your options are, don’t you think? The three major considerations I see as most important are the following:
I. Pain factor
Acupuncture needles are small and really should not ever hurt you. Personally, I love getting acupuncture and I find the needles soothing. But that doesn’t mean that acupuncture is painless each and every time, or that certain areas of the body aren’t more sensitive to needling than others. Every now and again, the needles are painful. I’ve had facial rejuvenation acupuncture and I’ve performed a lot of facial rejuvenation acupuncture, and yes, that can be painful. Anything involving fingers is not fun either. That said, tui na can be pretty astonishing too. In my experience, people often don’t quite realize the origin of their muscle pain. They come in pointing to their arm and say that this is where it hurts. I press with my Chinese Iron Thumb of Doom on their shoulder blade (or wherever I think the real problem lies) and ask if it is a tender spot. *Cough* Generally, there is a tender spot. I have a thumb of doom to make Dr. Fan, my favorite teacher, proud. That said, I do not perform deep tissue treatment for just this reason: there’s no need to dig super deep if the practitioner has a good strategy and an excellent capacity to interact with the patient’s muscles.
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So yes, both treatments can be uncomfortable under certain circumstances though most of the time they are not painful at all . However, since tui na treatment is similar to a massage, it really can be quite soothing in a way that needles may not be. What’s nice about this issue is the fact that–generally speaking–you can decide to pick one or the other and not lose out on healing benefits. Remember, the Five Pillars of Chinese Medicine are, respectively: acupuncture, herbology, moxibustion, tui na and qi gong. Though I am a certified yoga instructor and not a qi gong (or tai qi, for that matter) practitioner, I–like most in the profession–am inclined to pick and choose from more than one pillar of the tradition.
Bottom line? If a patient hates needles, the patient hates needles. I have several bodywork patients now who came to me from student clinic and who, with all due hyperbole, will never go back to acupuncture even if I get better at circumventing pain than the legendary surgeon Hua Tuo. So if you’re needle shy, there are options. And if you love needles, there are options. Barring strong preferences either way, it’s also helpful to make a choice based on which one might be more effective for you and your condition.
II. Effectiveness for varying conditions
One very interesting thing about student clinic is what an intern attracts in terms of patient profile. It really is fascinating how some students will get all the fertility patients and others get menstrual difficulty and the one after that seems to see one cancer patient after the next. Me? I had a lot of musculoskeletal dysfunction, from sports injury to fibromyalgia to stress/anxiety-based muscle tension that manifested in varying ways. I was also really fortunate to draw in some some really interesting people that I ended up working on with both acupuncture and bodywork, and these ranged from musicians to people who live with so-called orphan diseases like Ehlers-Danlos hyper-mobility syndrome. I had several erectile dysfunction and male infertility cases. I treated a lot of stress/anxiety, grief, and PTSD. I also did a lot of work with aesthetic treatments, from facial rejuvenation to weight loss. I loved what I did in student clinic and have largely replicated it outside of clinic without the use of acupuncture needles.
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A separate essay in and of itself will be an explanation of why one might choose facial rejuvenation tui na (with cupping, gua sha, and the jade roller) over facial rejuvenation with needles. Personally, I LOVE dermatology in general and expect to continue to build my practice in this realm (aesthetic and otherwise) as my career unfolds. At present, for example, I have a dermatology case with a patient who has a worrisome mole. This patient has had other moles that I had treated successfully in student clinic with needles. Problem? They hate needles. The patient is in luck though. I am able to resolve the dysfunction presented by the patient’s syndrome pattern, above and beyond the actual mole itself, with tui na treatment. Further, because properly-applied gua sha with the jade instrument can in this case have an effect similar to what you’d get via needles, I was able to work on this patient to good result. It was slower than needles, true, but the skin condition resolved exactly as I expected it to do so. Win-win!
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With other conditions, especially sports-related injuries, one needs to consider the length of the dysfunction. Acute vs. chronic injury requires different strategies. Context matters also. For instance, the first year I participated in a field acupuncture event at a Spartan race, it was hot and I relied primarily on acupuncture to treat the athletes. The second year that I went, it was raining and Spartans’ cold muscles really responded better to tui na and I did a LOT of bodywork that round. In my work with musicians, I find that tui na is a good place to start because this is a group that needs to use their hands or their shoulders (for instance) in a particular way and that results in functional issues that are very specific to the individual. Having a good feel for EXACTLY where the problem is benefits this group tremendously.
Another consideration might be dysfunction and individual emotional state. Depending on personality and preference, for example, e-stim acupuncture (acupuncture hooked up to a little machine that gives an electrical stimulation along with the needle) is fantastic for scars. However, if the patient is anxious to begin with, e-stim can be a bit much. In this case, no electric add-on and even potentially tui na or cupping is the best bet. Moxa treatment with heated herbs, either with needles or hand-held as part of a tui na treatment, is great for any kind of muscle pain too. It really depends on the case in question.
There are a lot of options here for sports-related injury.
For male infertility, herbs plus acupuncture can be highly effective; at the same time, I’ve seen tui na used to great effect in this realm. For erectile dysfunction, though, herbs and acupuncture (unless the cause is anxiety/stress related) is probably going to be more effective because of the need to get deep into the lower back and sacrum region in order to effect a lasting result. That requires needles. In any case, herbal medicine would definitely be a part of a comprehensive men’s health protocol based on my experience thus far.
With psychological trauma, there are also pros and cons involved. If a person is hyper-sensitive and can’t turn it off, nerves-wise, then it could be that needles are either painful or too stimulating for a first treatment or two. Generally, we start with fewer needles and keep the treatment gentle until we know how the patient will do with acupuncture in these cases. Acupuncture is incredibly good at treating trauma and stress and there is no end to protocols, from five small needles in the ears to protocols that involve many insertions. Tui na, for its part, can be incredibly soothing and comforting…assuming the person isn’t extremely guarded and disinclined to be touched. In that case, maybe one starts with just the hands and feet and avoids the face, for instance. Discussion with the practitioner about comfort level and, in some cases, having a therapist concurrent with your Chinese medicine treatments, is the smart way to take control of your health if you suffer from trauma-related concerns.
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III. Personal preference
This is not going to be my final essay on the subject, but I will conclude here by saying that one’s treatment strategies (and healing journeys) are in many ways a matter of personal choice. Needles can be quicker and more private–you get some time to yourself while the acupuncture treatment “cooks” and some times that is more comfortable and appropriate. Getting a mole to diminish with (in part) a needling protocol known as “surround the dragon” is a quicker than doing the work with a jade instrument, for example. But if you really don’t like needles, the manual treatment is going to be a lot more pleasant for you. Some things, like a really sore throat, can be relieved more readily by eliciting a few drops of blood from a point at the thumb tip than by tui na. Other things, like back ache or post-surgery dysfunction, really respond well to tui na in a way that they may not with acupuncture. And of course, there are also many ways to enhance any treatment strategy, including but not limited to cupping or gua sha and other like.
What matters is that your practitioner has a variety of approaches and that you have a good idea of how much there is available to you as a patient in a Chinese medicine office or clinic. Ask your practitioner about different treatment possibilities, and feel confident that there is something (and someone) perfect for you in the field of Chinese medicine. If you are in Austin, I would love to see you and you can book an appointment online, here. If it turns out that I think I’m not the right practitioner for you, I will gladly refer you to any one of my friends and colleagues in the community. If you are not in Austin and would like to sign on for some health coaching, part of your health and wellness program can include me helping you to find a Chinese medicine practitioner in your area. (And if you are in London, I know just the person for you to go see, here.)
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Taking care of your health is not a matter of doing something only once you are ill, though that is part of it. Truly, though? Taking care of your health means that you are proactive and that you nurture your wellness as a natural part of your routine lifestyle. That can mean the more well-known acupuncture, it could be something less-familiar to you, like tui na or other manual therapies. It could be herbs or mindfulness practice. There are a lot of things you can do to make your health the very best it can be. No matter how you go about it and what you choose to do, you can be confident that your qualified practitioner has undergone a three or four year program, he or she will have passed board exams, and that this is someone who is sincerely dedicated and caring and passionate about health and wellness. When all is said and done, you have an incredibly rich resource for your health if you go with Chinese medicine.
Try it, you’ll see!
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Paula Bruno, Ph.D., L.Ac., is a licensed acupuncturist and herbalist, an AOBTA-CP traditional Chinese bodywork therapist, and a wellness educator. She maintains an active and growing practice at her Austin, TX offices. Dr. Bruno is also available for distance appointments for wellness consultation or coaching.
In her first career, she was a Spanish professor.
Dr. Bruno’s specialties as a traditional Chinese medicine practitioner include: • Musculoskeletal health (acute or chronic pain relief; Ehlers Danlos syndrome & hypermobility support) • Digestive support, gut health, and weight loss • Aesthetic treatment, including scar revision • Men’s health • General preventative care and immune support for all persons.
When you are ready to discover what traditional medicine plus a vibrant and engaged approach to holistic health can do for you, either contact Dr. Bruno or book an appointment online.
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Two Hearts Wellness does not accept paid advertising on this website
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Note: Material on this web site site is not intended to diagnose, prevent, treat, or cure any disease, illness, or ailment. A TCM practitioner in Texas identifies syndrome patterns but does not diagnose illness. Material on this web site does not purport to identify syndrome patterns.
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