TMJ and Acupuncture

6 Feb 2017 Medical

TMJ and Acupuncture

What is TMJ/TMD?
TMJ stands for Temporomandibular Joint.  The actual disorders associated with this joint are more appropriately termed TMD and refer to issues in the muscles and bones around the jaw.  Often patients report pain, clicking, lock jaw, headaches, and neck pain associated with TMJ dysfunction.

What causes TMJ/TMD?
The patient might have a history of clenching or grinding their teeth or inflammation in the joint itself.  This could be from an injury in the area or chronic muscle tightness in the neck that affects the jaw. Dental work can also contribute to TMJ pain.  The patient may feel jaw pain following a root canal, implant work, wisdom teeth extraction, amalgam removal etc.  Other possible issues that can contribute to or exacerbate pain in the jaw are fibromyalgia, stress, systemic imbalances, and sinus problems.

What can I do to relieve TMJ/TMD pain?
Acupuncture can work wonders!
We look at patterns in the body and use needles and/or massage to open the channels and bring balance to the affected area.  Acupuncture helps to move qi and blood thereby reducing inflammation, increasing circulation and relieving pain.  Other specialists can help in conjunction with acupuncture such as chiropractors and physical therapists. We recommend seeking practitioners who look at the body as a whole to identify stress/injury patterns. Please ask for referrals if needed!

Case Study
A 48 year old male presents with TMJ pain after having several amalgams replaced by his dentist.  He was experiencing acute pain in his jaw accompanied by neck and shoulder pain, headaches, and sinus congestion. The range of motion in his jaw was limited. He had a chiropractic treatment to address the alignment and spacing in the jaw area and felt that after being adjusted, the pain remained and the range of motion had not improved. He had also tried physical therapy and diligently did the recommended stretches and strengthening exercises.  With this treatment, he felt some improvement but the issue was still unresolved.  The patient had been dealing with high levels of work-related stress for the past 6 months.

Outcome: After 6 acupuncture treatments, the TMJ pain had completely resolved and the range of motion returned to normal. The patient reported improved sleep as well!

The practitioner focused on opening circulation in the face and jaw area.  Reducing stress and rebalancing the channels was also a major component of the treatment plan.  His high levels of stress were causing an underlying holding and tightening in the body and face that was preventing the release of pain. The chiropractic treatment addressed the misalignment of the jaw. Physical therapy worked to strengthen and balance the muscles in the face area. Acupuncture addressed the stress patterns so the body was able to relax and release the tension.

written by Iris Martin


6 Feb 2017 Medical

Many people have heard of Craniosacral therapy but in the chiropractic forum there is another technique that delves deeper into this notion and realm that craniosacral therapy rests upon. Sacro-occipital therapy (SOT) is a chiropractic technique that analyzes the body through the membranous connection of the sacrum to the occiput or skull. This membrane is called the dura. The dura has connections inside the skull, at certain points in the spine, and in the sacrum. The dura surrounds the brain and the spinal cord and holds them in the cerebral spinal fluid. This system works very closely with the respiratory system. With each breath the sacrum tilts forward just enough to create a pumping mechanism for the cerebral spinal fluid (CSF). Circulation of the CSF serves an important role in flushing the brain of waste products and toxins.

Craniopathy is used to determine and adjust misalignments of the separate cranial bones. The cranial bones each have their own movement pattern with each breath as the CSF surges in the skull with each breath. The movement should be equal and free on both sides. One side or both sides of a particular cranial bone can be restricted due to muscle tension on the outside of the skull or due to an increase in pressure on the inside of the skull if the CSF flow is inhibited and therefore building up.

Craniopathy includes craniosacral therapy but is more specific in correcting distortions in the cranial bones and in the micro movements of the cranial bones. The technique will include palpation of the cranial bones and of the palate to determine which corrections may be needed. The palate is an important part of the analysis as it relays information of the position of all the cranial bones. For this reason, it is important for all infants to have their palate felt by a certified practitioner as the infant may have a distorted pattern present due to the passage through the birth canal. The infant’s latch and suck reflex is directly affected by their palate as well.

The corrections are often performed with breaths and there are extra-oral (outside the mouth)and intra-oral (inside the mouth) techniques to make the adjustments. This technique is extremely gentle and is performed with light holds with the finger tips. Craniopathy is a branch under the Sacro-Occipital Technique (SOT) which is considered a low-force technique. Practitioners certified in Craniopathy and SOT often will work in conjunction with dentists because the Temporomandibular Joint (TMJ) can be directly addressed with Craniopathy.

You may have cranial misalignments or asymmetries if you continue to have migraines or headaches, jaw pain, recurring sinus congestion, or low back pain or tightness that is not resolving with traditional care. Other issues that have plateaued may also be helped with cranial work.

Gut Brain Axis

5 Dec 2016 Medical

We have long since discovered the brain to be the master control center of of the body and its organ systems. More recently we have begun to understand that the body has a “second brain” via the vast network of neurons in the gut known as the enteric nervous system. The number of neurons in our gut equals that in our spinal cord which we suspect is so vast for the purpose of regulating the trillions of microbes that reside there.

Though it seems some people still want to believe that what we eat doesn’t have a big impact on health, there is plenty of research to suggest otherwise. For example, our diet and gut health directly impacts our mood because ninety percent of the serotonin in our system is made in the gut. Serotonin keeps our mood balanced and a deficiency leads to depression. In turn, neurotransmitters including serotonin are key regulators in gut function.

The brain is still the master controller of the body and it communicates with the gut via neurons, neurotransmitters and hormones. We would have to further discuss each one of these pathways to see all the ways our digestion can be affected. Digestion is so much more than eating and having a bowel movement. It determines the health and integrity of our tissues and if structure is negatively impacted then so will function.

Let’s see what poor function means for the two systems in question. Some indications of poor brain function are poor memory, inability to find words, and difficulty learning new things. Indications of poor digestive function are difficulty digesting food, constant episodes of bloating and gas, alternating constipation, etc.

The first thing we can do to directly impact and help our gut’s micro biome is to take probiotics. If there has been no significant change after a course of probiotics, it would be wise to do an anti-inflammatory diet or a blood test to rule out any food intolerances that would be causing inflammation and an adverse environment in the gut. We can also rule out vagal nerve involvement by doing a few tests in the office. Let’s discuss the vagus nerve more and give it its due reverence.

The vagus nerve is the direct nerve pathway by which the brain communicates with the gut but it also innervates the heart, lungs, throat and facial muscles. The vagus nerve is responsible for calming down the organs after stress or a period of the fight or flight response. The better your vagus nerve is working, the more quickly your body can be calm again and resume its healthy and regular activities. If the vagus nerve is functioning sub optimally and one of its organs, such as the gut, is compromised we can prescribe exercises that would bring it back into full gear. The vagus nerve can also be kick started with coffee enemas.

Here is the take-home message: If your brain or gut function is not working at the level you want it to, you can take steps now to begin to address that. We can help.
Dr Eugenie Giasson-Gomez

Ear Issues, Tinnitus and dizziness

26 Sep 2016 Medical

What is the Ear?

The external ear is called the auricle. It is the pretty part of the ear that we see on the outside of the body and where we hook glasses or wear earrings. The mechanics of the ear exist inside the hole in the head into the auditory canal that proceed to the middle and inner ear. This is where most ear issues occur. The labyrinth is the organ of hearing inside the internal ear.
What are the most common ear problems?

* Ear pain
* Dizziness
* Tinnitus (ringing in the ears)
* Fluid in the Ears
* Allergies

What is the Cause of Ear Pain?

Ear pain is most commonly caused by infection in the external ear (otitis externa) or the middle ear (otitis media). The infection itself can appear due to the following reasons; cold virus, secondary infection and/or swimming. Other causes of pain can be due to allergies that will cause fluid build up and pressure behind the ears themselves.

What is the Cause of Dizziness?

This is commonly a cause due to a spinal mis-alignment, allergies/ fluid in the ears and allergies. Some infections of the ear will also cause dizziness and nausea.

What is the cause of Tinnitus (ringing in the ears)?

It can occur due to age related hearing loss, fluid in the ears, a circulation problem or injury to the ear itself (physical trauma). Some head trauma has also been known to cause what is perceived as ringing in the ear.

How are ear conditions diagnosed?

The ear exam goes with a physical exam of the external ear. The doctor uses an otoscope and looks into the medial can and the ear drum to see if fluid is present. The doctor will look at the ear canal to determine if it is red and swollen or any damage like a scratch or foreign body is in the canal. If a patient has too much ear wax for the doctor to see, they will use an ear curette to remove the wax. The next part of the diagnoses comes from symptoms. Here is a short list of symptoms that accompany ear problems:

* Headaches
* Ear Pain
* Tooth pain
* Vertigo
* Fullness in the ear
* Ear itching
* Tinnitus or ringing in the ear
* Loss of hearing
* Loss of balance
The doctor will then evaluate whether any of these symptoms are due to virus or infection by checking past history of illness or trauma and taking the patients temperature.

What are the common Diseases of the Ear and how are they treated?

* Ear infection: Topical medication and/or oral antibiotic ( herbal alternatives available) and Chiropractic adjustments of the neck to drain fluids.
* Vertigo: Chiropractic adjustments, acupuncture and Epley’s Maneuver
* Tinitus: Chiropractic adjustments or acupuncture (if these fail to relieve the ringing a neurologic exam is often warranted)
* Meinere’s Disease: medication, acupuncture, or rehabilitaation and in extreme cases surgery
* Allergy related ear fullness: medication, acupuncture and massage

Chiropractic Adjustment for the Respiratory System

8 Aug 2016 Medical

During the Spring and winter months we used to have people suffering with terrible allergy symptoms. But I am writing this article for the summer because in California more and more people are having allergies in the summer due to growing climate changes and our fire season. One surprising solution to provide relief for breathing issues is chiropractic adjustments. So we are looking at how chiropractic helps on both a mechanical level and on the level of the nervous system specifically the autonomic nervous system.

First of all if a rib is not articulating with the mid back vertebrae’s correctly we will have a mechanical impingement of the rib cage which directly effects our ability to take a full breath. Sometimes if we have a rib mis-aligned we may never realize there is a problem unless we try and do some deep breathing and realize we are limited. Other times we may have pain that prevents the full breath in and so be restricted that way this may even feel like a sharp pain while taking a full breath in that stops us short.

Secondly we know that any adjustment that stimulates the nervous system will also stimulate the autonomic nervous system which is split into parasympathetic ( relaxation side) and sympathetic ( stress response side). In the case of asthma or allergies we get constriction of the bronchi and mucous formation in the trachea. Stimulation of the sympathetic nervous system will help by bronchodilating and reducing mucous and this stimulation comes from stimulating a sympathetic chain located in the thoracic vertebra from T1 to L3. Sympathetic stimulation for the trachea is T1-T4.

Current research states that a chiropractic adjustment will affect the autonomic nervous system when done in the thoracic spine causing a reduction in mucus and bronchodilation. (McCorry, Laurie K., PhD. “A Physiology of the Autonomic Nervous System.” American Journal of Pharmaceutical Education 71.4 (2007): n. pag Web 12 Feb 2013)

So here is how to do a quick check on yourself:

  • Sit up very straight and put your hands on the lower part of your rib cage and take a deep breath in and out. Does your rib cage move evenly if no or unsure you would benefit from and adjustment.
  • Can you take a full breath in?
  • Do you have pain with taking a full breath or pain in your rib cage when laying on your side.

If you did answer no to any of he above questions and you also have allergies and asthma then semi-regular adjustment especially during your allergy season can help manage your symptoms.

Headaches & Acupuncture

14 Jun 2016 Medical

Many people suffer from frequent headaches. There are many types of headaches. For treatment to be beneficial it is necessary to differentiate the causative factors. Acupuncture is a safe, drug-free alternative headache treatment without side effects.

Stress induced/tension headaches

Busy lifestyles and work schedules can create high levels of stress. When the body is in a constant or frequent state of stress, blood and qi stagnates in the body. Often, this manifests as a headache. It is important to incorporate stress-reducing activities in your daily life to keep the blood and qi moving smoothly throughout the body. Acupuncture has been shown to greatly reduce stress and promote relaxation. For more on the science behind acupuncture and stress relief, check out this article:

Also, poor ergonomically designed work spaces can create tension in the upper back and neck which can lead to headache. Acupuncture can help headaches caused by postural issues by needling, cupping, or using gua sha to release the affected muscles. However, it is important to note that it will often come back if the posture isn’t corrected.


The cause of migraines can be varied and complex. Therefore, the diagnosis and protocol decided upon by your practitioner can be quite varied as well. It is important for the patient to notice patterns and signs associated with their migraines as acupuncture can be a very effective preemptive tool to prevent the full onset from occurring. At the first sign, call and get an acupuncture appointment as soon as possible.

In treating other types of headaches, it is quite common for needles to be placed on the head and neck. For migraines, the protocol can be quite different. As acupuncture needles promote qi and blood circulation into whatever area of the body they are placed, with migraines we want to draw the energy out of the head and down into the body and lower limbs. If the migraine is especially severe, the patient may not be able to tolerate needles on the head as well.

Headache related to sickness (Head cold/flu)

Varying symptoms guide us to the pattern with which the patient is presenting. Chinese Medicine is very centered around the idea of opposites (i.e. yin/yang, hot/cold etc.) so symptoms such as fever vs. chills (or both alternating) or dry vs. productive cough help to point the practitioner in the right direction. Once the correct diagnosis is made, herbs and points can help address the symptoms and many others including headache.

The location of the pain on the head indicates which channels are affected. Needling specific points along these channels can greatly and in many times instantly alter, decrease, or eliminate the headache.

Cycle-related headache

Some women experience headaches before, during, and/or after menstruation. The timing of a headache in relationship to a woman’s cycle can indicate different pathology patterns. The location of the headache also gives us as practitioners a lot of insight about the channels that are affected. For more in depth information on the varying types of menstrual headaches and useful herbal combinations, go here:
Red flag headaches

If you have any of the following types of headaches you should seek urgent medical care.

Sudden onset with severe pain
Headache accompanied by fever or neck pain
Onset after the age of 50
Neurological signs (confusion, change in personality, unconsciousness)
Following a neck injury or adjustment
Tips for avoiding headaches

Drink plenty of water
Exercise regularly
Avoid alcohol, coffee, and chocolate
Introduce meditation or other stress-reducing activities into your life
Get regular acupuncture!!
As always, with our medicine, prevention is a key component. The more in-balance your body is, the less likely you are to suffer from pain of any kind.

What is a Detox?

14 Jun 2016 Medical

Our body has a built in detoxification system that allows us to get rid of unwanted particles that build up from our own natural processes – examples include using our muscles, hormones and other naturally occurring duties that our body performs. The goal of a detox is to reduce the amount of toxins we put into our body and thus optimize our bodies own detoxification system.

Why should I Detox?

Doing a detox periodically or setting habits that help you eliminate waste on a daily basis has been found to be essential and only becomes more critical as we have more and more toxins that bombard our bodies in our modern lifestyles. There are also periods of time in our lives where a detox is needed to clear out hormonal changes (menopause, postpartum, puberty) Here is a small list of common items that can cause an increase in toxins within our body that are part of our everyday lives:

Meats – even organic animals will still contain hormones which may be greater than our bodies needs)
Cosmetics and lotions
Household products
Construction materials
Fungus and Mold
Dry cleaning
Burning Fuels
BBQ food

And the list goes on.

What are the different types of detox?

The different types of detox’s depend on which organ you are targeting. Here is a list by organ:
Liver – this is the main blood cleaner in your body so any hormone or metabolite that is in the blood stream will pass through the liver. This is the main reason a liver cleanse is the most common. Detox’s rich in antioxidants are the best choice.
Kidney – Cleanse both blood and urine of toxins allowing things to be processed out through our urine. Detox’s that include drinking lots of water are always a good choice.
Gallbladder – This is where bile is stored which breaks down fat and allows it to empty. A detox for this has to contain a good oil most commonly used is olive oil.
Intestines – They process food as well as hormones and other metabolites, which clear through the feces. Detox’s that focus on herbs that have a mild laxative effect as well as high fiber are a good choice.
Lungs – Lungs are important as they filter anything that we breathe and some of these things can go into the blood stream. Doing a lung detox is about learning how to do quality breathing using oregano or eucalyptus steams and perhaps a change of location to a place such as by the ocean that has very clean air.
These detoxs can be made more efficient by adding herbs and other vitamin’s and minerals. Please contact our office so that one of our doctor’s can help you choose a cleanse that is right for you.

How often should I do a detox?

Without knowing each and every one of my patients’ cases, the answer is generally 1-2 times per year, but this number can go up drastically if you have hormone imbalances, illness and disease currently attacking your body. This is something to talk to your doctor about. There are daily detox practices that we do recommend and they are listed below:

Exercise – it pumps out waste in your blood stream and allows you to sweat releasing more toxins
Eating Veggies – eat as many as you possibly can forever and always
Drinking Lemon Water – start the morning with hot water and fresh squeezed lemon
Drink more water
Reduce smoke exposure
Reduce alcohol consumption
Reduce meat consumption

What are the common Detox myths?

Liquid diets can push out toxins faster – they can but they are a quick fix so make sure you are doing a long term daily detox.
Drinking tons of water will detoxify your body – while it is good for the kidney and liver you can actually over do water leading to fatigue and vomiting.
Replacing meals with powdered drinks is a good detox – while smoothies and juices can help. Increase the green veggies which helps detox many of the pre-made detox powders don’t actually help you achieve body balance.
Detoxing means not exercising – while this can be true for a day or two, detoxes that are so harsh that you aren’t able to allow your body to naturally sweat eliminate one of the best ways to release toxins. This method is not generally recommended.

When should I Not detox?

There are some conditions that are not a good time to detox and here is a small list:

Chemo Patients
Major illness
Around your period
Under weight
IBS, Diverticulitis, Chron’s, Ulcerative Colitis (many cleanses may cause pain and irritation but not all)

Whatever detox method you use, always use common sense and if you need help our office can help you select a detox, that is right for you.

Post Partum Depression

14 Jun 2016 Medical

Before I was pregnant, I had volunteered at an event called Jenny’s Light and it is NOT named after me. It is a foundation created to bring awareness to postpartum depression something that effects 1 in 7 women and can range from very mild to very severe. In the case of Jenny, she took her own life and her family created a foundation to help prevent that from ever happening in anyone else’s family.

It’s important to recognize the signs in our friends and loved ones. It effects so many women. When a couple is in my office, I always make sure the significant other is aware of the signs. Often the new mom will not see the signs and know that it’s happening. See below for a basic list of the most common signs:

Mood swings
Feeling overwhelmed
Reduced concentration
Appetite problems
Trouble sleeping
Depressed mood or severe mood swings
Excessive crying
Difficulty bonding with the baby
Withdrawing from family and friends
Loss of appetite or eating much more than usual
Inability to sleep (insomnia) or sleeping too much
Overwhelming fatigue or loss of energy
Reduced interest and pleasure in activities usually enjoyed
Intense irritability and anger
Fear that you’re not a good mother
Feelings of worthlessness, shame, guilt or inadequacy
Diminished ability to think clearly, concentrate or make decisions
Severe anxiety and panic attacks
Thoughts of harming yourself or your baby
Recurrent thoughts of death or suicide

There are many resources to help with identifying postpartum depression:
One of my favorite quizzes that is one that the new mom can take or a partner can take for her is here:

Help Resource guide:

Treatment options:

Acupuncture and herbs
Support groups

Supporting the cause:

This is a great cause that you can join and either donate, race or volunteer. Our office has a booth every year trying to help create awareness about this issue that can effect many women. Come and join us each May for the 5K race at Vasona Park in Los Gatos to help prevent future postpartum tragedies.

Shoulder pain and decreased range of motion

5 Apr 2016 Medical

What are the causes of some shoulder pain?

Rotator cuff injury – tears or strains to the rotator cuff muscles
Rotator cuff tendinitis – this is inflammation of one of the rotator cuff muscles usually by overuse.
Frozen shoulder syndrome (adhesive capsulitis)
Thoracic outlet syndrome
Rotator Cuff impingement syndrome
Tenosynovitis (inflammation of the tendon sheath)
Ankylosing Spondylitis
Slipped Disc
Lung Cancer
Heart attack
Ectopic Pregnancy

Sometimes the causes of pain are due to an injury whether from a repetitive motion or trauma, even more rare is when it is due to a referred pain like ectopic pregnancy or heart attack that refers into the arm and shoulder (these are less common and are a medical emergency).

What is the rotator cuff?

The rotator cuff is made up of 4 muscles, the ball and socket joint and capsule and 2 bones.

Bones: Scapula, humerus
Muscles: Supraspinatus, infraspinatus, teres minor and subscapularis muscle.
Joint: The ball and socket joint is where the scapula and the humerus meet and they have a capsule encasing them with capsular ligaments (ligaments attach bone to bone) and then again encased by the tendons of the 4 muscles listed above.

What are the most common injuries?

1. Rotator Cuff Tendinitis – is by far the most common of the injuries and it is when you repetitively do a motion like painting, keyboard work at a computer or throwing a ball like a pitcher. The tendon usually near its insertion onto the humerus will become hot, painful and swollen.

2. Rotator Cuff Tear – often occurs after tendonitis has been present for sometime or some other wear and tear that finally causes the tendon or muscle to snap leaving the arm weaker.
3. Frozen shoulder (adhesive capsulitis)–is by far more common in women and usually around the 40’s and 50 years of age. The humerus usually adheres to the scapula and the muscular capsule becomes adhesive like glue making reaching things over the head difficult or sometimes even impossible. There is no known direct cause for this condition.

4. Rotator Cuff Impingement syndrome–when one of the 4 muscles talked about earlier becomes pinched by usually a boney prominence of the scapula. The most common muscle of the 4 for this to occur to is the supraspinatus.

5. Osteoarthritis–when the bones start to develop signs of wear and tear showing an increase in bone on some parts of the humerus and scapula and a decrease of bone on other parts.

How is my shoulder pain diagnosed?

The most common type of diagnostic tools are orthopedic tests like the painful arch test (lifting the arm from your side to beyond 90 degrees). Physical or manual muscle tests are performed to see if there is a weakness present in the muscle or if pain occurs suggesting damage. Xray are done to see if there is arthritis followed by MRI’s to see if there are muscle tears or inflammation.

How is shoulder pain treated?

Chiropractic care does testing to determine if there is a mis-alignment of the humerus or scapula and also the thoracic and cervical vertebra as they are a common area that refers pain into the shoulder. They will re-align the area, do muscle work and give at home exercises. If home exercises are not enough or the patient is unwilling to do them, we will refer the patient to a physical therapist for treatment.
Physical therapy will work to reduce inflammation and pain and strengthen the rotator cuff muscles as well as the trunk muscles so that mis-alignment is corrected and future injury is prevented.
Injections done by a pain specialist or an orthopedic surgeon are done in connection with physical therapy or chiropractic care and it is used to stop inflammation that allows for healing.
Surgery is done when repair of a muscle tear is needed and it can be open surgery or arthroscopic.
Acupuncture is done to break the pain cycle and is helpful in cases with arthritis and tendonitis.

Pain & Acupuncture

5 Apr 2016 Medical

How does acupuncture effect pain?

Acupuncture works in a variety of ways to ease pain.  It releases endorphins which are our bodies’ natural painkilling chemicals.  Acupuncture also acts on serotonin levels and it has been shown that opioid peptides are released during acupuncture as well. Acupuncture also reduces inflammation and increases blood flow and circulation providing drug-free pain relief.

Does acupuncture help with chronic or acute pain?

Our medicine treats a wide variety of both acute and chronic issues. In acute cases, we can often help the pain subside completely, whereas in cases of chronic pain, acupuncture can be a very helpful tool to manage pain safely on a long-term basis with little to no side effects.

What are some examples of conditions treated with acupuncture?

Menstrual cramps
Chronic Pain Syndrome
Carpal Tunnel
Cancer related pain
Post-surgery recovery

What kinds of modalities are used by acupuncturists to treat pain?

Massage–We use a variety of massage techniques to relieve tension, promote blood flow, and to open the channels.
Cupping–Suction cups are placed over affected areas to draw out stagnation and promote blood flow.
Electric stimulation–Small electrical current is delivered to selected acupuncture needles to promote blood circulation, decrease inflammation and alleviate pain.

Pain facts

Pain affects more Americans than diabetes, heart disease and cancer combined.
1 in every 4 Americans have suffered from pain lasting longer than 24 hours and millions more suffer from acute pain.
Pain is the most common reason Americans access the health care system.
It is a leading cause of disability and is a major contributor to health care costs.
Pain is a significant public health problem that costs 560-635 billion dollars annually.
Adults with lower back pain are 4 times as likely to experience serious psychological distress when compared to those with no lower back pain.

Iris Martin LAc.
Light & Joy Acupuncture Inc.
15100 Los Gatos Boulevard, Suite 1
Los Gatos, CA 95032

1 2 3 4 6