Jeff Rippey

Acupuncture can be very beneficial in chronic pain conditions. There are a few things you want to keep in mind if you're planning to try acupuncture for pain or chronic pain.

1. A licensed acupuncturist attended and graduated from an accredited school of Chinese medicine. The minimum education requirement to receive a practice license is a master's degree, many of us have doctorates. This level of education is a 3-5 year investment. There is a stark difference between an actual L.Ac. and some other healthcare provider who is offering "acupuncture-like" services under the scope of some other license (chiropractors, physical therapists, and increasingly nurse practitioners). For the best results, you want to make sure you're seeing a bona fide L.Ac.

2. Not everyone responds to acupuncture. At a population level, most studies show something like a 5-6% non-response rate. We don't know why this happens, and there's no test we can give a prospective patient to see if they're in that 5-6%. What this means is there's a 94-95% chance that acupuncture will work just fine for you.

3. Assuming you're in the 94-95% who respond to acupuncture, there can be varying response rates. Going to one acupuncture session and then deciding it doesn't work is the same as taking one dose of antibiotic and then being upset that your infection hasn't cleared; you have to take all the doses. A single acupuncture treatment is a single dose. You're probably going to need multiple doses. How many is going to depend on the exact nature and severity of your chronic pain.

The first thing would be to get some idea or understanding of why you're experiencing ankle pain. Is this a sprain/strain? A break/fracture? Arthritis? Is this referred pain from somewhere in the calf or somewhere in the foot? Effective treatment is going to be dependent on an accurate diagnosis, a generic statement like "ankle pain" only goes so far.

If you haven't already, I suggest starting with your primary care provider or maybe an urgent care clinic. Get an evaluation and an x-ray to see if the cause of the pain can be determined.

Once you have a cause in hand, figuring out treatment becomes a lot easier.

There are a range of treatments that could, potentially, help manage pain from arthritis. Everyone always wants the one thing that solves their problem. Sometimes that's the case, and sometimes it takes more than one treatment modality to provide relief. In other words, you may get the best results by combining treatments/providers.

What that in mind, here's a short list of things you could consider.

Acupuncture and Chinese medicine have a long and successful track record with pain management and arthritis. Make sure you're seeing a provider who attended and graduated from an accredited school of Chinese medicine. You want someone with an L.Ac. or R.Ac. credential.

Physical therapy can often help. A good PT can provide exercises that will keep the arthritic joint mobile while minimizing compensation in other areas of the body as you try to adjust to the pain.

Conventional medicine/conventional pain management. There are a range of medications, both prescription and over the counter, which can help to manage the pain and inflammation that comes with arthritis. Sometimes, if the degeneration in the joint is severe, surgery may be an option.

Chinese medicine/acupuncture has a pretty good track record with most kinds of allergy. Otherwise, you're looking at management with a variety of over the counter or prescription medication.

A lot is going to depend on how severe a case of anxiety we're talking about.

There are some natural treatments that can work. Herbal medicines and, especially, acupuncture almost always work better when you're also participating in some form of talk therapy. If your case is in the more moderate to severe category, you're looking at extended treatment - likely months at least.

There are, potentially, a variety of things that can help with ankle arthritis. Sometimes patients have to combine treatments from different providers to get the best effect.

Some things you could try:

Acupuncture and Chinese medicine.

Over the counter pain relievers/non-steroidal anti-inflammatory medications.

Prescription pain relievers/non-steroidal anti-inflammatory medications.

Topical pain relievers (creams/ointments/patches).

Physical therapy.

Whatever treatment or combination or treatments you end up trying, it's important to keep the joint moving.

There are lots of treatments than can, potentially, improve your situation with respect to migraine. There isn't really an objective "best". There is, however, a "best for you".

Acupuncture and Chinese medicine have a very good track record with headache and migraine. I treat it a lot and I'm usually very successful in bringing people relief.

Prescription medication can often help.

Identifying triggers and making lifestyle changes can also help.

Sometimes sinus infections can be self-limiting (i.e. go away on their own). If you've had the infection for more than 10 days, it's probably not going away without antibiotics.

Whether the arthritis is the cause of the heel pain is going to depend on where, exactly, in the ankle the arthritis is located and where, exactly, on the heel you're experiencing the pain.

It's possible the arthritis is impacting structure in such a way that you're experiencing pain in the heel.

It's equally possible that the ankle arthritis is causing you to walk differently which is creating excess tension in the calf. The calf muscles turn into the Achilles tendon which wraps under the back of the heel. Excess calf tension pulls up on the Achilles tendon which then pulls on the heel bone and can cause pain.

Acupuncture has a very good track record with most kinds of pain including arthritic pain. Make sure you're seeing someone who is licensed to practice as an acupuncturist in your area - they should have an L.Ac. or R.Ac. credential.

One of the places where the evidence for acupuncture's effectiveness is virtually overwhelming is pain management. Whether this is OA or RA, it's important to keep the joint moving and reducing pain levels is fundamental to your ability to continue using the ankle.

Will acupuncture/Chinese medicine make your arthritis go away? Anything is possible, but most probably not.

Is it 100% certain that acupuncture/Chinese medicine will work for you? No. There is no treatment offered by any provider that is 100%. There's a high probability acupuncture will work for you, but the only way to figure that out is to try acupuncture and see what happens. Trying acupuncture means committing to 3-5 treatments. Some people are a little slow out of the gate in terms of response.

Usually, yes.

Not necessarily. There are lots of things you can try to help manage the pain.

Acupuncture has a long track record of success with this sort of pain. I just saw an article stating the WHO now recommends acupuncture over most interventions when it comes to managing back pain.

There are lots of topical ointments, creams, and patches you can try. Sometimes these can offer relief, though it'll probably be temporary.

Occasionally medication (over the counter or prescription) can help. I don't often run into cases where they help a lot.

Using traction - either a traction table at a chiropractor or PT office or an inversion table can sometimes provide relief.

PT exercises can sometimes help.

There are a few different underlying causes for ear ringing (tinnitus). Almost none of them respond well to any kind of treatment.

The most common cause of ringing in the ears is repeated exposure to loud noises (earphones, concerts, car stereos, firearms, airplanes, heavy construction equipment, etc.) This type of noise causes cumulative, irreversible damage to the structure of the inner ear responsible for detecting and transmitting sound. Once the damage has accumulated to a certain point, hearing loss and tinnitus result. Getting hearing aids may help a bit, but it's not going away.

In my experience, the second most common cause is excessive tension in the jaw and neck. Usually this is associated with TMJ, TMD, and/or grinding the teeth at night. Dealing with whatever is causing this (usually stress) and getting the muscles to relax will improve any ringing, but it rarely goes away completely.

I don't like to dissuade people from trying to improve their situation, but tinnitus is extremely difficult to treat.

Acupuncture has a very good track record with most types of pain, including arthritis pain. If you decide to go this route, make sure you're seeing an actual licensed acupuncturist (usually an L.Ac. credential) rather than a chiropractor or physical therapist.

Going to a physical therapist for exercises, though, would be a good idea. You need to keep the ankle moving despite the pain or discomfort.

Topicals like BenGay, IcyHot, Aspercreme, or topical Voltaren (diclofenac). Can help. Sometimes herbal topicals like arnica, frankincense, or CBD can help.

Over the counter ibuprofen or aleve are sometimes useful. Prescription pain relievers can sometimes be useful.

A variety of things can potentially help improve insomnia:

Fixing your sleep hygiene can make a big difference. Light in the blue spectrum can fool your brain into thinking it's morning. Devices like phones, tablets, computers, and televisions all emit light in this range. Using devices like this at or close to bedtime can make you brain think it's time to get up and can cause or exacerbate insomnia. Better to read a book or do something else that helps your brain to calm down and indicates to your body it's time to sleep.

Eating too much just prior to bed can cause stomach/GI discomfort, making it difficult to get in a comfortable position and fall to sleep. A light snack prior to bedtime is ok, a full meal should be avoided.

Acupuncture and Chinese medicine have an excellent track record in treating insomnia (though sleep hygiene is still important and will still need to be addressed).

Sometimes having some white noise in the room helps. Either a small fan or a white noise generating machine can help people fall to sleep.

Over the counter sleep aids like melatonin or diphenhydramine (benadryl) can sometimes help folks get to sleep.

Prescription sleep aids can often help. It's important to note that prescription sleep aids often have side-effects, can cause daytime drowsiness, and are sometimes addictive.

If you have anxiety that is preventing sleep, addressing the anxiety issues either through prescription medication, therapy, Chinese medicine, or all three can often improve the situation.

What will help with bloating is going to depend on what's causing bloating.

This could be a food sensitivity, it could be some sort of loss of function in the GI system due to an issue in the stomach/small intestine/large intestine, it could be function loss in the GI system due to pinched nerve in the spine, and that's probably just scratching the surface.

Your best bet is to visit your primary care provider and let them do some testing to see if you can get to the root cause of the problem. Once you know why you're bloated, then you can figure out what might be the best treatment.

I'm guessing we're talking about a herniated disk?

Yes, treatment with acupuncture or physical therapy or both can often help relieve the pain associated with a herniated disk.

I understand and appreciate people's desire to avoid prescription drugs, and especially antibiotics. Some kinds of infection are self-limiting and will resolve on their own. In my experience, kidney infection is not one of those kinds.

Kidney infection isn't something to fool around with. Left untreated, this type of infection can lead to sepsis and result in death. If you have a kidney infection, get on antibiotics, please.

I'm not sure what you mean by "spine hernia". Are we talking about a herniated disk? If that's the case, a lot is going to depend on where the herniation is located and how bad it is.

For the most part, spinal disks do not have dedicated blood supply. Because they don't have dedicated blood supply, it's very difficult for them to heal and they are very slow to heal. In my experience, outside of surgery (which is really only cleaning things up), there isn't a lot that can be done to the disk.

Pain that you may be experiencing can sometimes be managed, but a lot is going to depend on how the herniation is impacting nerve structures.