Everyone has experienced some level of sinusitis. It is inflammation of the cavities around the nasal passages. Many people, including myself, have no luck with over-the-counter medications to relieve the symptoms. Those of you will be glad to know that you can use acupuncture for allergies and sinusitis to get nasal inflammation relief. If you wonder, does acupuncture help with allergies, read on to learn about how we use acupuncture for sinusitis, including etiology, manifestations, diagnosis, treatment, and preventative measures.
Sinusitis, a symptomatic inflammation of the paranasal sinus and nasal cavity, is a relatively common medical condition in the United States; almost 30 million adults report having sinusitis annually. From a Western Medicine perspective, Acute Sinusitis is etiologically caused typically by an infectious agent, either a bacterial or viral infection. These infections result in a buildup in, blockage, and swelling of the sinuses resulting in pain and other clinically significant symptoms. In the case of acute sinusitis, this condition is usually related to a prior upper respiratory tract infection.
From a Chinese Medicine perspective, Flaws & Sionneau explain that sinusitis is caused by “external contraction of evil qi, retaining evils, unregulated eating and drinking, taxation, fatigue, internal damage by the seven affects, and habitual bodily vacuity due to immaturity or aging.” This condition may be caused by an invasion of an external pathogen, a complication due to internal pathogens (emotions), and lifestyle factors (ex: overeating and overdrinking). Kastner makes a further distinction that sinusitis can be caused by repeated external attacks of wind-heat or wind-cold, but typically it is a wind-heat invasion; Lung and Spleen qi deficiency can also be etiological factors for sinusitis. Using this knowledge, we can use acupuncture for allergy treatment and relief.
As described above, acute sinusitis is most often caused by an infectious agent. The presence of bacteria or a virus is understood in Western medicine, to negatively impact the paranasal sinuses and the sinonasal mucosa, both of which are responsible for the protecting the body, as well as for moisturizing and humidifying the air we inhale into the lungs. Under normal, healthy conditions the mucosa can flush out the sinus properly, but impairment of this system can result in the stasis of mucus, which can result in the harboring of bacteria growth which results in infection. This blockage and subsequent infection result in rhinorrhea, facial pain, and nasal obstruction (manifestation and symptoms will be discussed later to a greater extent). As explained previously, in many cases acute sinusitis follows the impairment of the respiratory system, typically from an upper respiratory infection. Other factors can contribute to the contraction of acute sinusitis, including cigarette smoking, allergies, and anatomical issues such as septum deviation.
According to Chinese Medicine, in the condition of the invasion from and external pathogenic factor, the body, and the body’s wei qi, is unable to safeguard the exterior or expel the pathogenic factor; this can be understood as bodily deficiency or vacuity. If there is such deficiency in the body, wind may enter the body and attack the LU and be held in the nasal passageway. If the wind being held in this area turns to heat, the heat will interact with the fluids and result in phlegm, further interfering with the LU’s charge of controlling respiration, resulting in nasal congestion and cough. Understanding this helps plan our acupuncture for sinusitis relief treatment. It is also important to note the dietary pathology of sinusitis. Overindulging in spicy, hot, sweet, and fatty foods, as well as over-imbibing of alcohol, leads to the genesis of dampness and heat in the body. Dampness can congeal and convert into phlegm, and the heat can move the phlegm upward to the nasal cavity. Kastner notes that when considering damp-heat as the mechanism of this condition, one is looking more toward acute/chronic sinusitis rather than strictly acute sinusitis.
The onset and duration of symptoms are critical in determining a particular diagnosis of sinusitis. As the name implies, acute sinusitis involves the sudden onset of symptoms. These symptoms include facial pain or pressure, facial congestion or fullness, nasal blockage, obstruction or discharge, postnasal drainage, hyposmia or anosmia, and fever; additional symptoms can include headache, fatigue, dental pain, cough, and ear pain. Acute sinusitis is typically diagnosed in the case that these symptoms present for four weeks or less. In Chinese medicine theory, further additional signs and symptoms may present. When addressing a condition of LU invasion of wind-heat, there may also be an aversion to cold and/or wind, a dry mouth with a desire to drink, a red tongue with a thin, white or yellow fur and 1) a floating, rapid pulse, or 2) a floating, slipper, and rapid pulse.
In terms of imaging for the purposes of diagnosis, it is noted that typical X-rays yield little diagnostically significant information and that CT scans should be used when there are suspicions of more severe complications. Shu and Chiu go on to say that if a patient is not responding well to conventual medicine and surgical intervention, laboratory tests can be done; they include testing cytoplasmic-antineutrophil cytoplasmic antibodies, perinuclear-antineutrophil cytoplasmic antibody, IgE, erythrocyte sedimentation rate, c-reactive protein, rheumatoid factor, and antinuclear antibody levels. In addition to a physical examination of the neck and head, rigid or flexible fiberoptic endoscopy are helpful in further evaluating the sinuses and nasal cavity; findings such as mucus, pus, or erythema are noteworthy. Endoscopically guided cultures can also be taken in the nasal cavity or sinuses and tested for aerobic, anaerobic, fungal, and acid-fast basilic cultures.
Western practitioners diagnose acute sinusitis based on presenting physical respiratory symptoms, as well as the results of endoscopic cultures that may have been taken. As previously stated, acute sinusitis is diagnosed when the symptoms have been experienced by the patient for four weeks or less and the symptoms have an acute onset. Chinese medicine diagnosis would utilize these presenting symptoms as well and will also consider the presentation of the patient’s tongue and pulses. A Western medicine practitioner will diagnose these signs and symptoms as Acute Sinusitis. A Chinese medicine practitioner will address the exterior and interior symptoms, tongue, and pulses to come up with their diagnosis. Based on the symptoms of the WM diagnosis, a Chinese medicine practitioner can diagnose this condition as an invasion of the Lung by wind-heat. If there were more signs of damp-heat present in the patient, a CM practitioner can go further and diagnose GB and SP disharmonies, including damp-heat and qi vacuity. Note: these patterns fall more under chronic sinusitis as their symptoms have a less acute onset. These additional patterns of more chronic sinusitis include GB bowel depressive heat and SP damp-heat. With our diagnosis, we are able to design a care plan using acupuncture for allergies and sinusitis treatment.
Treating this diagnosis with Western methods can include antibiotic treatment (ex: amoxicillin), nasal irrigation, and nasal decongestants (such as Sudafed) to kill the bacteria causing the infection and clear the blockage. There is also a consideration in which a patient can choose to not accept antibiotic medication immediately and see if symptoms begin to clear up on their own; antibiotic treatment is not one hundred percent necessary in this condition but may be advised if symptoms do not begin to clear up in a realistic period of time. Over-the-counter pain relievers, such as Tylenol or Advil, can be used to relieve symptoms and pain. Additional Western treatment methods can include the use of antihistamines, saline nasal wash, and if needed, surgical intervention can be considered (this is in the situation of more chronic sinusitis rather than acute).
In addressing the CM pattern of LU invasion by wind-heat, the acupuncture for allergies treatment principle is to expel the wind-heat and support the LU proper function. To treat this pattern and to use acupuncture for allergies and sinusitis, Flaws and Sionneau offer the points LI4, LI11, LI20, and LU5, all reduced. LI4 and LI11 are classic points for clearing (heat, wind, and pathogens), and LI20 can be used locally to relieve sinus-symptoms, as well as to expel wind and clear heat. LI4 and 20 also regulate defensive qi, activate the LU channel, and helps to alleviate pain. LU5, the He-sea and Water point on the LU channel, works to clear heat from the LU, alleviate pain, and descend rebellious qi; this point can also be bled for severe LU heat. Bitong (M-HN-14) can also be used to relieve local pain and congestion. A practitioner may also use a reducing technique on LU7 and GB20. LU7 can release and expel wind, as well as promote the proper descending function of the LU, and GB20 can be an effective local point to clear the sense organs and eliminate wind. Following this expulsion of the pathogen, during a following subsequent treatment, the practitioner can tonify LU9, the source point on the LU channel, as well as BL13, the back-shu point of the LU to help support the LU and strengthen it against further invasions.
A study was done comparing the effects of acupuncture compared to conventional Western treatment for chronic sinusitis; while this article does not directly address acute sinusitis, it is important to consider their findings as patients may develop chronic sinusitis after failing to recover from acute sinusitis. While the addressed pattern of disharmony may differ from that of acute sinusitis, much of the treatment principle is the same: expelling pathogens. Researchers Rössberg, Larson, Birkeflet, Söholt, and Stavem designed a three-armed single-blind randomized control study in which participants received 1) medication with antibiotics, corticosteroids, a 0.5% sodium chloride solution, and local decongestants, 2) 10 traditional Chinese acupuncture treatments, or 3) 10 treatments with minimal stimulation of non-acupoints. Both the acupuncture and non-acupoint groups received 10 treatments with bilateral stimulation of the selected points over a 4-week period. In the “traditional Chinese acupuncture” group, patients were diagnosed with various patterns of disharmony, and the following points were selected: “to remove damp/heat from the Yangming channel, LI4, LI11, ST40, and ST44 were reduced… to remove phlegm/fire from the Shauyang channel, GB34, LR2, LI4, and LR3 were reduced… we sometimes reduced EX-HM-5 when the symptoms affected the lateral area of the eyes.” The sham treatment group received non-points outside of acupuncture channels and the points were stimulated with a maximum depth of .25cun (very superficial and minimal stimulation).
The researchers used sinus CT-scans, patient-reported sinus symptoms, and patient-reported health-related quality of life measures to determine the outcomes of their study. Their results showed improvements via the sinus CT-scan and health-related quality of life scores over 12 weeks in the conventional treatment group. The researchers did also find “signs of improvement in symptoms” over four weeks in all groups, and also found a non-significant difference between the conventional medicine group and the sham acupuncture groups, as well as less difference between the conventional medicine group and the traditional acupuncture group; they go on to further explain that they only found a non-significant difference in symptom score changes from 4 to 12 weeks between conventional treatment and traditional Chinese acupuncture and that after 52 weeks, there was minimal difference in symptom scores across the groups. The researchers note that theirs may be the first study, at the time, done on acupuncture for allergies and sinusitis, and they struggled to find studies to which they can compare their findings. Further research needs to be performed to study the effectiveness of acupuncture for treating acute sinusitis, possibly comparing that to antibiotic treatment, as well as acupuncture treatment for chronic sinusitis.
Western Medicine would advise allergy and allergen exposure management as a prevention method for acute sinusitis. Frequent, or somewhat-regular sinus irrigation/rinsing is also a prevention method that can ward off further infection by keeping the sinus cavity open and clear of buildup. Regular handwashing, particularly during allergy season or cold and flu season is also beneficial. Getting proper hydration, nutrition, and adequate exercise is also important for the body healthy and to prevent further disease. Chinese medicine would agree with these prevention recommendations and would offer additional methods to support it.
Along with acupuncture for allergies and sinusitis, various lifestyle modifications can be made to help prevent further or returning sinus inflammation. In addition to proper nutrition, hydration, and exercise, CM would also recommend avoiding excessive physical activity and overwork. This overwork can lead to qi depletion and deficiency, which can allow for external pathogenic factors to re-invade the body. Engaging in yin activities, such as sitting, reading, and getting adequate rest, will help to strengthen the body’s qi to help fight off external and internal pathogenic factors in the future. A CM practitioner would also warn the patient to avoid damp and hot climates, as well as to avoid wind; the patient can be advised to wear a scarf or something with a high collar to protect the back if his/her heck from wind invasion.
Nutrition recommendations from a CM perspective can also be very helpful in this setting. Kastner recommends for those diagnosed with the acute sinusitis pattern of LU invaded by wind-heat, avoiding foods with sour flavor (ex: lemon) which can pull pathogenic factors deeper into the interior, as well as avoiding foods that are warm/hot in thermal nature. Further nutritional recommendations include eating foods that are cool to cold in thermal nature, as well as foods that are mildly acrid or sweet in flavor; the acrid flavor will help to expel pathogenic factors while the sweet will help to moisten). To help cool the body further, a practitioner can recommend specific cool foods such as watermelon, pears, grapefruit, dandelion, mung beans, radishes, tomatoes, and peppermint; to address the dryness from the condition, a practitioner can recommend pears, pear juice, tomato juice, and melon juice. Kastner also makes two specific food recommendations for addressing this pattern: 1) “juice mix made from tomatoes and watermelon,” and 2) “for dryness: pear juice with honey.” Finally, receiving regular, or at least seasonal, acupuncture treatment can help to keep the wei qi strong to prevent contracting illness in the future.
Take a break, sit back, and breathe easy. We can use acupuncture for allergies and sinusitis to bring significant relief and improvement of symptoms. By using various acupuncture points and lifestyle modifications, we can build a treatment for you to see lasting results from your congestion and inflammation symptoms. Contact me to learn more about acupuncture, what it can do for you, and how you can start to breathe easier.
References
Flaws, B., & Sionneau, P. (2005). The treatment of modern western medical diseases with chinese medicine (2nd ed.). Boulder, CO: Blue Poppy Press.
Kastner, J. (2009). Chinese nutrition therapy: dietetics in traditional chinese medicine (tcm)(2nd ed.). New York, NY: Thieme.
Morcom, S., Phillips, N., Pastuszek, A., & Timperley, D. (2016). Sinusitis. Australian Family Physician, 45(6), 374-377. Retrieved from https://www.racgp.org.au/download/Documents/AFP/2016/June/AFP-June-Focus-Morcom.pdf
Rosenfeld, R. M. (2016). Acute sinusitis in adults. The New England Journal of Medicine, 375(10), 962-970. doi:10.1056/NEJMcp1601749
Rössberg, E., Larsson, P. G., Birkeflet, O., Söholt, L. E., & Stavem, K. (2005). Comparison of traditional chinese acupuncture, minimal acupuncture at non-acupoints and conventional treatment for chronic sinusitis. Complementary Therapies in Medicine, 13, 4-10. doi:10.1016/j.ctim.2005.01.002
Shu, J. D., & Chiu, A. G. (2012). Acute & chronic sinusitis. In Current diagnosis & treatment in otolaryngology – head & neck injury (3rd ed.). Retrieved from http://accessmedicine.mhmedical.com.proxygw.wrlc.org/content.aspx?bookid=386§ionid=39944049
DISCLAIMER: this blog post is intended for informational purposes only. Do not perform any treatments included in the post yourself. This includes, but is not limited to, acupuncture, herbal medicine, and Chinese nutritional therapy. They should only be performed by educated and licensed acupuncture practitioners.
National Institutes of Health (NIH) studies have shown that acupuncture is an effective treatment alone or in combination with conventional therapies to treat the following:
Nausea caused by surgical anesthesia and cancer chemotherapy
Dental pain after surgery
Addiction
Headaches
Menstrual cramps
Tennis elbow
Fibromyalgia
Myofascial pain
Osteoarthritis
Low back pain
Carpal tunnel syndrome
Asthma
It may also help with stroke rehabilitation.
If you are curious about the benefits of acupuncture, scheudule an appointment for a personal consultation, and evaluation.
