East meets West

Robert Bennett, MD

Professor of Medicine and Nursing OHSU

Integrative Medicine:

Examples:Traditional Chinese medicine (herbs, acupuncture, gigong)Hands–on therapy (osteopathy, massage), Lifestyle(education, nutrition, exercise)Mind-body therapies (yoga, Tai Chi).

East meets West

A marriage of conventional Western medicine with other healing modalities, including complementary and alternative medicine (CAM), for which there is evidence of safety and effectiveness.

1)The Myofascial

Web

2)Mindful

Movement

3)Eastern

Treatments

4)Optimal

Nutrition

The Topics

1)The Myofascial

Web

2)Mindful

Movement

3)Eastern

Treatments

4)Optimal

Nutrition

The Topics

Myofascial Trigger Points

Why is it important to

eliminate myofascial

trigger points ?

Pain generatorsSpinal cord

BrainAnatomyof Pain Central

sensitization

Trigger Point Therapy

1)The Myofascial

Web

2)Mindful

Movement

3)Eastern

Treatments

4)Optimal

Nutrition

The Topics

The raisins sitting in my sweaty palm are getting stickier by the minute. They don't look particularly appealing, but when instructed by my teacher, I take one in my fingers and examine it

Time Magazine, February 2, 2014

The ability to focus for a few minutes on a single raisin isn't silly if the skills it requires are the keys to surviving and succeeding in the 21st century

Conclusion: Eight weeks of daily yogic meditation reversed the pattern of increased expression of genes associated with inflammation

Science meets Meditation

Epigenetics:Changes in gene

expression related to

environmental factors

1)The Myofascial

Web

2)Mindful

Movement

3)Eastern

Treatments

4)Optimal

Nutrition

The Topics

Traditional Chinese Medicine

Yin and yang symbol for balance. In Traditional Chinese Medicine, good health is believed to be achieved by a balance between yin and yang

Main components: Herbal medications Acupuncture Massage (Tui na) Exercise (qigong)

AcupunctureA 5000-year old medical

system based on the theory

that“Qi” (the life force which flows throughout our body) is out of balance

Deare, JC, et al. Acupuncture for treating fibromyalgia. Cochrane database review. 2013, May 31

1.There is low to moderate-level evidence that acupuncture improves pain and stiffness

2.The effect lasts up to one month

Reviewed 9 randomized controlled studies (i.e. sham acupuncture) involving 321 subjects:

Cochrane database review 2013

3. Electro acupuncture is probably more effective than manual acupuncture

4. The effect of acupuncture does not differ from sham acupuncture in reducing pain or fatigue

1)The Myofascial

Web

2)Mindful

Movement

3)Eastern

Treatments

4)Optimal

Nutrition

The Topics

Probiotics

Elie Metchnikoff first suggested the possibility of colonizing the gut with beneficial flora in the early 20th century.

WHO definition: micro-organisms which, when administered in adequate amounts, confer a health benefit on the host

 1845 - 1916

Kefir

A new era in medical science has dawned with the realization of the critical role of the "forgotten organ", in generating a variety of functions which sustain health and, when disrupted, leads to disease.

Quigley, EM. Prebiotics and probiotics; modifying and mining the microbiota. Pharmacology Research. March 2010

Recent Review

Your gut harbors 100

trillion organisms

Prevotella copri  – rheumatoid arthritisBacteroides prevotella – obesityClostridium perfringens – multiple sclerosisLactobacilli & Bifidobacteria– irritable bowel

Patients with recurrent Clostridium difficile infection underwent therapy with donor feces that were infused, through a naso-duodenal tube.This treatment was compared to a a group of patients treated with a conventional 14 day vancomycin regime.

Coprophagy ?

Results of fecal transplantation study

After 2 fecal transplantations there was a 94% cure

rate

The good microbes, such as Bifidobacterium and lactic acid bacteria, feast on chocolate

When you eat dark chocolate, they grow and ferment it, producing compounds that are anti-inflammatory

A prebiotic?

Are you a chocolate lover?

What about the descending

inhibitory pain system ?

Descending Inhibition

RememberActivate your descending

inhibitory system every day