By Xiaolong Alcocer L.Ac.
www.alcoceracupuncture.com
Abstract:
According to Chinese medicine trauma causes obstruction to the normal flow of blood in the affected or adjacent areas. This obstruction prevents the blood from circulating therefore preventing the body from receiving vital nutrients resulting in disfunction of the organ or body part, blood stagnation or stasis must be resolved in order to recover to normal body functions.
Keywords: traumatic brain injury, TBI, military, scalp acupuncture.
Introduction:
According to the Defense and Veterans Brain Injury Center, active duty and reserve service members are at increased risk for sustaining a TBI compared to their civilian peers. This is a result of several factors, including the specific demographics of the military; in general, young men between the ages of 18 to 24 are at greatest risk for TBI. Many operational and training activities, which are routine in the military, are physically demanding and even potentially dangerous. Military service members are increasingly deployed to areas where they are at risk for experiencing blast exposures from improvised explosive devices (IEDs), suicide bombers, land mines, mortar rounds and rocket-propelled grenades. These and other combat related activities put our military service members at increased risk for sustaining a TBI.
Mild traumatic brain injury (i.e., concussion) occurring among soldiers deployed in Iraq is strongly associated with PTSD and physical health problems 3 to 4 months after the soldiers return home. PTSD and depression are important mediators of the relationship between mild traumatic brain injury and physical health problems.(Hoge et al, 2008). Overall TBI admission rates were 24.6 for Afghanistan and 41.8 for Iraq per 10,000 soldier-years. TBI hospitalization rates rose over time for both Iraq and Afghanistan campaigns. (Wojcik et al, 2010).
TBI Basics and Statistics:
What is a TBI?
▪ A traumatic brain injury (TBI) can be classified as mild, moderate, severe or penetrating. The severity is determined at the time of injury.
▪ A TBI is a blow or jolt to the head that disrupts the normal function of the brain. It may knock you out briefly or for an extended period of time, or make you feel confused or “see stars” (alteration of consciousness).
▪ Not all blows or jolts to the head result in a TBI.
▪ The most common form of TBI in the military is mild. Concussion is another word for a mild TBI.
What are the causes?
In the military, the leading causes of TBI both deployed and non-deployed are (in no particular order):
▪ Blasts
▪ Bullets
▪ Fragments
▪ Falls
▪ Motor vehicle – crashes and rollovers
▪ Sports
▪ Assaults
In the deployed setting, blasts are the leading cause of TBI.
Who is at greatest risk for TBI?
Those who are at a higher risk for sustaining TBIs are young men who are performing military duties, or have a history of prior concussion and/or substance abuse.
What are common signs and symptoms of TBI?
Physical
▪ Balance problems
▪ Nausea/vomiting
▪ Fatigue
▪ Visual disturbances
▪ Sensitivity to light
▪ Ringing in the ears
Cognitive
▪ Concentration problems
▪ Temporary gaps in memory
▪ Attention problems
▪ Slowed thinking
▪ Difficulty finding words
Emotional
▪ Irritability
▪ Anxiety
▪ Depression
How long does recovery take?
▪ Recovery is different for every person.
▪ Most people recover from a concussion.
▪ Symptoms usually begin to improve within hours and typically resolve completely within days to weeks.
▪ Even after more than one concussion, full recovery is expected; however, every time an additional concussion is sustained, healing time might take longer.
What helps recovery from a concussion?
▪ Be honest about symptoms with your medical provider.
▪ Drink plenty of water.
▪ Eat a healthy diet.
▪ Rest during the day — don’t overexert — mentally or physically.
▪ Get plenty of sleep at night.
▪ Avoid smoking or drinking alcohol.
▪ Avoid over-the-counter medications unless prescribed by a provider.
▪ Take prescribed medications as directed by a provider.
▪ Avoid caffeine and “energy-enhancing” products.
▪ Take precautions to avoid another concussion: Avoid contact sports, combatives, etc.
▪ Stay engaged with family members and medical provider.
▪ If symptoms persist or worsen, see a medical provider.
▪ Be patient. Give the brain time to heal.
Warning signs
▪ Worsening headaches
▪ Worsening balance
▪ Double vision or other vision changes
▪ Decreased level of alertness
▪ Increased disorientation
▪ Repeated vomiting
▪ Seizures
▪ Unusual behavior
▪ Amnesia/memory problems
Traumatic Brain Injury treatment using Scalp Acupuncture:
Scalp Acupuncture is a technique developed in the early 70’s by Dr. Jiao Shun-fa, a neurosurgeon from China who combined traditional acupuncture techniques with the knowledge of modern neuroanatomy and neurophysiology of the brain.
For the treatment of traumatic brain injury the acupuncturist is going to assess the condition, signs and symptoms of the patient and needle areas on the scalp that corresponds to the neurophysiological functions in the brain. Also needles may be inserted in other areas of the body to help promote blood flow and to stimulate motor neurons to help regain sensation and movement. After all the needles are in place the acupuncturist may stimulate the needles manually or by using an electrical stimulation device that runs electrical current to the needles, also known as electroacupuncture which provides stimulation to the desired areas for greater effectiveness.
During the treatment patients may feel like a slight pinch sensation, numbness, tingling, itching, tiredness, heaviness and/or muscle twitches, all those sensations are normal and usually well tolerated. The needles are left in place for about 30 to 45 minutes, then the needles are removed; there might be slight bleeding, especially the scalp due to the normal increased vascularity.
Treatments are given 1-5 times a week depending on the severity of the TBI until desired results are achieved or if no significant results are observed after a few treatments; some patients may also receive maintenance treatments to help with their symptoms. The most common adverse effects are soreness and bruising, rarely patients may feel lightheaded and usually goes away within a few minutes.
According to research acupuncture improved neurological recovery after traumatic brain injury by activating BDNF/TrkB pathway. (Li et al, 2017), acupuncture increases the excitability of the cortico-spinal system in patients with chronic disorders of consciousness following traumatic brain injury (Matsumoto-Miyazaki et al, 2016) patients with TBI who receive acupuncture treatment have reduced the use of emergency care and hospitalization in the first year after injury. (Shih et al, 2013) and acupuncture treated insomnia in patients with traumatic brain injury (Zollman et al, 2012).
Source: Captain Robert L. Koffman, M.D., MC, USN
Conclusion:
Acupuncture can be an important part of the integrative medicine model for the treatment of TBI. The US Department of Defense (DoD) shows particular interest in and usage of IM for managing chronic conditions including the signature "polytrauma triad" of chronic pain, traumatic brain injury (TBI), and post traumatic stress disorder (PTSD) among its beneficiaries in the Military Health System (MHS). These modalities range from conventional nondrug, nonsurgical options such as cognitive-behavioral therapy to nonconventional options such as acupuncture. (Madsen et al, 2017).
It is important to always consult your Doctor first to see if Acupuncture can be an option for you, and be sure that the Acupuncturist has a valid license to practice in your state.
For License verification in California click here or visit http://www.acupuncture.ca.gov/ for more information about Acupuncture.
References
Hoge CW, Mcgurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med. 2008;358(5):453-63. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18234750
Li X, Chen C, Yang X, et al. Acupuncture Improved Neurological Recovery after Traumatic Brain Injury by Activating BDNF/TrkB Pathway. Evid Based Complement Alternat Med. 2017;2017:8460145. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28243312
Madsen C, Vaughan M, Koehlmoos TP. Use of Integrative Medicine in the United States Military Health System. Evid Based Complement Alternat Med. 2017;2017:9529257. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28690665
Matsumoto-miyazaki J, Asano Y, Yonezawa S, et al. Acupuncture Increases the Excitability of the Cortico-Spinal System in Patients with Chronic Disorders of Consciousness Following Traumatic Brain Injury. J Altern Complement Med. 2016;22(11):887-894. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27662495
Shih CC, Lee HH, Chen TL, et al. Reduced use of emergency care and hospitalization in patients with traumatic brain injury receiving acupuncture treatment. Evid Based Complement Alternat Med. 2013;2013:262039. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23970929
Traumatic Brain Injury. Defense and Veterans Brain Injury Center website http://dvbic.dcoe.mil/article/tbi-basics. Updated on November 6, 2017. Accessed November 7, 2017.
Wojcik BE, Stein CR, Bagg K, Humphrey RJ, Orosco J. Traumatic brain injury hospitalizations of U.S. army soldiers deployed to Afghanistan and Iraq. Am J Prev Med. 2010;38(1 Suppl):S108-16. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20117583
Zollman FS, Larson EB, Wasek-throm LK, Cyborski CM, Bode RK. Acupuncture for treatment of insomnia in patients with traumatic brain injury: a pilot intervention study. J Head Trauma Rehabil. 2012;27(2):135-42. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21386714
This blog share important information on TBI in military and how they get TBI treatment. Get more information on traumatic brain injury treatment guidelines. Thanks
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