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How to Treat Pruritus With Acupuncture and TCM


By Xiaomei Cai, L.Ac., Ph.D. and Qineng Tan, L.Ac., Ph.D.


pruritus itching
Persistent urge to scratch can be caused by many different conditions.

Itchy skin, hives all over the body, or skin rashes that itch? Pruritus, commonly known as itching, is an irritating and persistent condition that affects many people. Acupuncture and TCM herbs can offer a holistic approach to alleviate itching.

Pruritus is simply a medical term that means “itching,” or that feeling that you need to scratch your skin. It can refer to itchy skin on one part of the body, or systemic itching that feels like it moves around or affects the whole body. The sensation can be mild, even ticklish, or painful and constant to the point that it is debilitating.

The sensation of itching all over body can significantly impact one’s quality of life, as it can be painful, distracting, and make it difficult to concentrate, relax, or sleep. 

Persistent itching requires treatment that takes many possible underlying factors into consideration. This is why acupuncture and TCM can be a good alternative treatment for pruritus.


What Causes Pruritus? 

Pruritus can stem from various causes. It can be a primary condition, arising due to a skin problem or skin allergy, such as:

Pruritus can also be caused by many other conditions, such as nerve damage, renal disorders that require dialysis, blood diseases like polycythemia vera, hepatitis, liver cirrhosis, infections like chicken pox and shingles, HIV, thyroid disorders, MCAS, pregnancy and perimenopause.


Top 10 Pruritus Causes

Because the sensation of itching, like that of pain, can be influenced by so many factors, there are many possible causes of pruritus. Itchy skin can be caused by a wide variety of conditions, including:


  1. Allergic Reactions: Common allergens include certain foods, medications, and insect stings or bites. Immune system disorders like MCAS can cause pruritus.
  2. Dermatitis: Conditions like atopic dermatitis (eczema) and contact dermatitis can lead to persistent itching.
  3. Skin Infections: Bacterial, viral, and fungal infections can cause itching.
  4. Dry Skin (Xerosis): Often exacerbated by environmental factors, dry skin can cause itching.
  5. Internal Diseases: Liver disease, chronic kidney disease, thyroid problems, and certain cancers can cause systemic itching. Chronic kidney disease that require dialysis treatment, in particular, can cause a condition known as Uremic Pruritus. 
  6. Nervous System Disorders: Conditions such as multiple sclerosis, pinched nerves, and postherpetic neuralgia can lead to pruritus. Brachioradial pruritus, for example, is a condition in which irritation of the cervical nerves (C5-C8) causes itching on one or both of the the upper arms.
  7. Mental Health Issues: Stress, anxiety, and obsessive-compulsive disorder can manifest with itching.
  8. Pregnancy: Some women experience pruritus during pregnancy due to hormonal changes.
  9. Perimenopause: Some women experience pruritus during perimenopause and menopause due to a reduction in estrogen levels.
  10. Reactions to medications: Many drugs can cause pruritus as a side effect, including antibiotics like penicillin, amoxicillin, erythromycin, blood pressure medications, statins, or cholesterol medications, analgesics like aspirin, and tricyclic antidepressants.


Treatment for Pruritus

itching, itchy skin
Persistent itching, or pruritus, can be a skin condition, or something deeper.

Conventional medicine typically treats pruritus by trying to find and address the underlying cause, while using medications to alleviate the symptom of itching. This may include topical treatments like over-the-counter or prescription creams and ointments that contain corticosteroids, menthol, or capsaicin to soothe the skin and reduce inflammation. These creams may help relieve localized itching for a time, but they cannot do much to control widespread, systemic itching.

Antihistamines, such as diphenhydramine or cetirizine, may be prescribed to reduce allergic reactions and relieve itching. These can be helpful in some acute cases of pruritus, but again, they do not resolve the problem of chronic itching. Overall, most people with chronic pruritus do not get adequate relief from antihistamine treatment for itching.

For severe itching, oral corticosteroids or immunosuppressants may be prescribed to reduce inflammation and immune response.

TCM and acupuncture can be an effective alternative or adjunct treatment for itching, as TCM addressed both underlying conditions and the symptoms of itchy skin.


Can Acupuncture Help Pruritus?

TCM methods like acupuncture and moxibustion have been used for over 2000 years to help relieve itchy skin conditions and systemic pruritus. Now, scientific research is beginning to show that Chinese medicine is an effective alternative treatment for itching.

The mechanisms that cause the sensation of itching often stem from the brain and the peripheral nervous system. Acupuncture has been shown to have an effect on the nervous system, and specifically, to help reduce the activation of the itch response in the brain.

Itching responses are also activated by the behavior of mast cells, like cytokines. Acupuncture, particularly electroacupuncture, has been shown to help regulate the activity of cytokines, which can help reduce inflammation and sensation.

Acupuncture is well known, now, to help relieve pain by stimulating receptors in the brain. This same action can help to reduce itchy sensations, as well as pain.

The chemical and mechanical activations that cause itching can lead to a chronic problem referred to as the “itch-scratch vicious cycle,” which occurs because of a neural loop in the spinal cord. Acupuncture can potentially help to disrupt this chronic loop of activations that causes the urge to scratch.

Hives, itching
Acupuncture can help relieve itching.

Acupuncture and TCM herbal remedies can also help to clear up skin conditions that are directly causing itching, and can help to address deeper underlying conditions, such as liver and kidney ailments, that can be the secondary cause of systemic itching.

Uremic pruritus, which is associated with dialysis treatment for chronic kidney disease or renal failure, affects many people. This type of pruritus can cause sleep problems and affect patients on a daily basis and is believed to be caused by severe dryness of the skin, along with sweating, and chronic inflammation. It may also be related to opioid receptors and inappropriate nerve signaling that triggers the release of cytokines. A review of studies about acupuncture treatment for chronic kidney disease suggests that TCM is highly effective for reducing itching related to uremic pruritus.

One specific study looked at patients undergoing dialysis who were given acupressure treatment. The conclusion was that acupressure was both helpful for relieving itching and cost effective as a treatment alternative.

Acupuncture treatment has an impact not only on the autonomic nervous system, but also on histamine release, and studies have shown that acupuncture is more effective at controlling histamine-related itching than many antihistamine medications.

One study done with 16 patients suffering from brachioradial pruritus (itching on the upper arm/s) found that the majority experienced total resolution of their itching, while the remaining patients experienced partial relief of itching.


Acupuncture Near Me for Pruritus in West Los Angeles

Acupuncture can be beneficial for itchy skin conditions like hives, dermatitis, and rashes. During pregnancy and perimenopause, acupuncture can help balance hormones to relieve itching and insomnia. Acupuncture can also help relieve anxiety, PTSD and panic disorders that can sometimes exacerbate itching sensations. Liver problems, kidney problems, and side effects of cancer treatment can all be addressed with TCM, which may help relieve persistent pruritus.


*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.


How to Treat Myofascial Pain Syndrome With Acupuncture and TCM


By Xiaomei Cai, L.Ac., Ph.D. and Qineng Tan, L.Ac., Ph.D.


myofascial pain disease
Muscle tightness and tenderness can be a sign of myofascial pain syndrome.

Muscle aches and pains? Knotted muscles? Pain in trigger points? These could be signs of myofascial pain syndrome. Acupuncture and TCM can provide myofascial release and help relieve chronic myofascial pain (MPS pain).

Myofascial pain disorder is a common, yet often overlooked chronic pain condition that affects the muscles and fascia. Fascia is the thin connective tissue that is found all over the body, holding muscles, organs, and blood vessels together. Fascia is also filled with nerves, which makes it highly sensitive.

Healthy fascia is thin, stretchy and pliable. Stress, injuries, weakness and other issues can cause fascia to tighten up, become sticky, dry, or thicker. This can cause painful knots to develop in your muscles.

These areas are sometimes called fascial adhesions, or myofascial trigger points, and they can be very tender to the touch and cause muscle soreness, aches and pains. 

Chronic myofascial pain can seem very similar to fibromyalgia, or symptoms of ME/CFS, and is sometimes misdiagnosed as such. However, these conditions are distinct from one another. 

Fibromyalgia causes widespread, diffuse pain and tenderness all over the body, while myofascial pain is centered around specific trigger point sites. Fibro, as it is sometimes called, is believed to be caused by a disorder within the central nervous system. Fibromyalgia is usually triggered by stress, trauma, hormonal changes, lack of sleep, or sensitivities to weather changes.

It has been suggested that long-term myofascial pain syndrome may ultimately lead to a person developing fibromyalgia, as the brain and nervous system become so used to experiencing pain that they begin to produce disordered pain signaling.

Acupuncture treatment, cupping, and therapeutic Chinese massage can provide trigger point therapy that is effective for relieving tight muscles and soreness.

Myofascial Pain Syndrome Symptoms

myofascial pain syndrome trigger points
Myofascial pain can be localized or refer to other areas.

People experience myofascial pain differently from one another; each case is unique. For some people, the pain can come and go suddenly; for others, it’s a constant, dull pain.

Myofascial pain syndrome can feel like:


  1. Tight muscles, stiffness
  2. Throbbing pain
  3. Dull, aching pain
  4. Sore muscles, tender areas
  5. Knotted muscles, nodules or bumps in specific areas that are sore
  6. Muscle weakness
  7. Limited range of motion
  8. Trouble sleeping
  9. Headaches
  10. Fatigue

Myofascial pain can be localized in one area, or referred pain, which spreads to other nearby areas. Myofascial referred pain patterns can look like pain that originates in the rotator cuff which then spreads to the deltoid, and even down the arm to the hand.

What Causes Myofascial Pain?


Medical science is not entirely clear on the causes of myofascial pain syndrome, but it seems to occur more often in people who have experienced things like:


  • Periods of inactivity, such as having one of your limbs in a cast
  • Repetitive movements in your work
  • Pinched nerves
  • Injury to a muscle or muscle group
  • Having to work outdoors in the cold
  • Diabetic neuropathy
  • Thyroid disorders, hypothyroidism
  • Deficiencies in Vitamin D or folate, or iron deficiency
  • Stress, chronic tension that leads to clenched muscles
  • Structural conditions like scoliosis, spondylosis, or osteoarthritis

Estimates suggest that the majority of people who are treated for chronic musculoskeletal pain may have myofascial pain syndrome. Up to 85% of the general population may experience myofascial pain at some point in time.


Treatment for Myofascial Pain Syndrome

One of the primary approaches to managing myofascial pain syndrome is physical therapy. Physical therapists may use manual therapy, stretching exercises, and postural correction to address muscle imbalances, improve flexibility, and release tension in affected muscles. Trigger point therapy, which involves applying pressure to trigger points to release muscle knots and promote relaxation, is a common component of physical therapy for MPS.

Modalities such as heat therapy and cold therapy may also be used in conjunction with physical therapy to provide pain relief and enhance the effectiveness of treatment. Heat therapy helps to increase blood flow and promote muscle relaxation, while cold therapy can reduce inflammation and numb the affected area. 

In addition to physical therapy and modalities, medications may be prescribed to manage pain and improve symptoms associated with myofascial pain syndrome. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be recommended to reduce inflammation and alleviate pain. Muscle relaxants such as cyclobenzaprine or benzodiazepines may also be prescribed to help relax tense muscles and improve sleep quality. In some cases, tricyclic antidepressants or anticonvulsant medications may be used to modulate pain signals and improve overall pain management.

Trigger point injections are another treatment option for myofascial pain syndrome, particularly for individuals who experience severe or persistent symptoms that do not respond adequately to conservative measures. During a trigger point injection procedure, a local anesthetic or corticosteroid is injected directly into the trigger point to help alleviate pain and reduce muscle tension.

Acupuncture needling is also considered an effective and valuable treatment option for myofascial release and relief of musculoskeletal pain.


Can Acupuncture Help Myofascial Pain Syndrome?

myofascial pain syndrome acupuncture
The acupoints used in acupuncture correspond with myofascial trigger point.

Many studies conducted over the past two decades point to acupuncture as an effective mode of treatment for myofascial pain syndrome.

Acupuncture is effective for myofascial pain because it can positively affect the central nervous system, increase blood flow, increase endorphin production, improve fascial adhesions, and promote muscle relaxation. Acupoints used in TCM correspond closely with myofascial trigger points.

One study looked at patients who received two acupuncture treatments per week for four weeks on trigger points in the upper trapezius. Patients reported significant reduction in pain after just two weeks.

Another study followed two groups of patients with myofascial pain centered in the neck area. One group received acupuncture treatment. The other group had acupuncture and also engaged in regular aerobic exercise. Findings showed that both groups experienced significant improvement in pain symptoms.

A review of studies found that acupuncture was effective both for reducing myofascial pain and improving function and mobility.

Acupuncturists may also use electro-acupuncture, cupping, and massage techniques like gua sha and tui na to help move lymph and blood, release muscle trigger points, and improve muscular movement that has been limited by pain.


Acupuncture Near Me for Myofascial Pain Syndrome in Los Angeles

At Art of Wellness Acupuncture in West L.A., we have over 35 years of experience helping people find relief from musculoskeletal pain of all kinds. Dr. Tan and Dr. Cai are able to use electro-acupuncture, cupping, and massage techniques like Tuina for myofascial release. If you are suffering from muscle pain and tenderness, do not hesitate to make an appointment with us.


*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.


How to Treat Costochondritis With Acupuncture and TCM


By Qineng Tan, L.Ac. Ph.D. and Xiaomei Cai, L.Ac., Ph.D.


sternum pain, chest pain
Chest pain where the ribs meet the breast bone can be Costochondritis.

Chest pain? Rib pain, sternum pain? These can be costochondritis symptoms, caused by inflammation of the cartilage that connects the ribs to the sternum. Acupuncture and TCM can provide costochondritis treatment to relieve pain and inflammation.

Costochondritis is a pain condition caused by inflammation of cartilage in the rib cage. It can be scary, because the pain can feel like a heart attack or a symptom of heart disease. 

It is quite common for people who are experiencing costochondritis pain to visit the emergency room complaining of chest pain. Almost 10% of ER visits are related to chest pain symptoms, and a significant number of those turn out to be related to something other than heart problems.

Sometimes called “chest wall pain syndrome,” or costosternal syndrome, costochondritis is considered a syndrome because it presents as a set of symptoms that often does not have a clear cause.

Possible causes of costochondritis include:

  • Trauma or injury to the chest or ribs
  • Persistent cough
  • Repeated bouts of vomiting
  • Chest or lung infection
  • Allergies that affect the lungs
  • Fibromyalgia
  • Tietze syndrome

Suddenly doing some kind of heavy labor or intense workout that you’re not used to, that causes you to be winded, could cause inflammation of the chest. Playing contact sports in which you may be tackled or collide with another player or get hit hard with a ball in the chest could also cause costochondritis.

Tietze syndrome is a rare condition in which the cartilage connecting the ribs to the breastbone becomes inflamed and swollen. With Tietze syndrome, the pain and swelling in the chest is usually higher up, around the second and third ribs.

Costochondritis pain usually is felt more on the left side of the chest, radiating outward, and there isn’t any swelling involved. 

Rib pain may be exacerbated when lying down, which can make it difficult to sleep comfortably.

Costochondritis is most commonly experienced by people in middle age (40-50s), but it can occur in children and adolescents, as well as adults.

In most cases, costochondritis is temporary. However, costochondritis pain can limit your activities and be debilitating for weeks, or even months. One study showed that up to a third of adults reported pain persisting beyond a year.

Acupuncture has been shown to help alleviate costochondritis pain, often in a matter of weeks.

Costochondritis Symptoms

Costochondritis pain can range anywhere from a slight tenderness to severe chest pain. In mild cases, the pain may go away in a matter of days, but in other cases, the pain can become serious.

Symptoms of costochondritis include:

  1. Sharp chest pain
  2. Chest pressure, chest ache, tenderness in breastbone
  3. Pain on the left side of chest, to the left of the breastbone
  4. Rib pain in more than one rib
  5. Pain radiating to shoulders and/or arms
  6. Chest pain when coughing, sneezing, or taking a deep breath
  7. Pain in chest when reaching up or twisting the torso
  8. Rib pain when lying down
  9. Pain when hugging someone
  10. Pain when putting on a seatbelt


Medical Diagnosis and Costochondritis Treatment

chest pain, rib pain, Costochondritis
Pain near the sternum can be Costochondritis.

Other than the doctor palpating the area around your breastbone and ribs, there is no specific test to determine if you have costochondritis.

Chest pain can be an indicator of a variety of health conditions, including heart problems or lung problems, so it is always important to get it checked out with a healthcare professional. They will rule out other problems by ordering an EKG or chest X-ray in order to get to a diagnosis of costochondritis.

Treatment will consist of recommendations for ways to alleviate pain. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB) or naproxen (Aleve) can help reduce inflammation and pain.

In cases of more severe or persistent pain, a doctor may prescribe stronger pain medications such as prescription-strength Motrin or muscle relaxers.

Applying heat or cold packs to the affected area can help reduce inflammation and alleviate pain. Some individuals find relief by alternating between heat and cold therapy.

In cases where pain is severe and not responding to other treatments, corticosteroid injections directly into the affected area may provide temporary relief by reducing inflammation.

Acupuncture treatment is a great way to relieve pain and reduce inflammation, without the side effects that can result from using pain medications or steroids for several weeks or months.


Can Acupuncture Help Costochondritis?

Adolescents and children can have costochrondritis.
Costochrondritis can happen during adolescence.

Acupuncture has been used for many centuries to treat pain and inflammation. Now, research is able to show how and why this modality is able to regulate inflammatory responses. Acupuncture affects the nerve signaling that produces hormones like dopamine and can reduce the production of cytokine storms. This is why acupuncture can help relieve inflammation and chest pain of costochondritis.

In TCM theory, pain and inflammation are usually considered to occur because of stagnation, or stasis, of blood and/or Qi (life force energy). The same symptoms can occur in different individuals because of different imbalances in the organs systems that are causing the blockages and different pathogenic factors, such as excess heat, dampness, etc. 

Costochondritis inflammation can occur due to dampness and stagnation of Qi in the liver, spleen, and/or kidney systems. Depending on each patient’s specific situation, your acupuncturist will choose acupoints to open channels, clear dampness, heat, and phlegm. This allows for Qi and blood to flow smoothly again, cooling down the inflammation and relieving pain.

One case study of six women who were treated for costochondritis pain with acupuncture found that all patients reported improvement and were able to discontinue taking OTC pain medications.

One pediatric study looked at young students suffering from costochondritis; they were missing school, limiting their sports, dance, and work, and having trouble sleeping. After 4-6 weeks of acupuncture treatment, these patients reported a significant reduction in pain, and were able to resume their usual activities.

Not only is acupuncture treatment effective for relief of costochondritis pain; it can work quickly. In many cases, patients feel better after one or two treatments.

Acupuncture Near Me for Costochondritis in Los Angeles Area

Dr. Tan and Dr. Cai of Art of Wellness Acupuncture in West L.A. have been helping treat pain conditions for over 35 years. Our office is a home away from home where patients are able to relax and find relief from pain and inflammation. If you or someone you love is experiencing chest pain due to costochondritis, please do not hesitate to come in for a consultation.

*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.

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