Category Archives: NeuroScience

Most doctors don’t get a Nutrition course?

Let me explain why:

But we get courses in the groundwork that explains nutrition: BIOCHEMISTRY

I was in medical school 20 years ago

I got my MD degree about 20 years ago, and we did have a fundamental course in nutrition but it wasn’t a heavy weight course as I remembered it, but important enough for me to feel that at least I could say that I’m one of the few doctors maybe?? that got a nutrition course.

Biochemistry is the mother of Nutrition

I know a lot of nutrition focused doctors around the world frequently quote that most doctors don’t get a nutrition course. That is probably true, however, it’s not the whole truth. Because, all doctors I know get several courses on BIOCHEMISTRY which is the MOTHER of Nutrition. Biochemistry is the groundwork for which helps us understand how our bodies work and how our bodies interact with nutrition. And there’s biochemistry of what happens when things go wrong like CANCER.  If nutrition were a course, it would be bundled into biochemistry. We all studied the biochemistry of humans, animals, bacteria, viruses, and plants. I think back when we were in medical school, I have a feeling that the very smart doctors who were in charge of our medical education probably felt that nutrition was somehow influenced too strongly by businesses and probably felt it wise to just teach us the basics of how to evaluate nutritional claims. Now that’s wiser than cramming down our throats some information that would change from time to time as we search for the truth. I believe that search swings like a pendulum around what is the truth or the “best practice.” So we’ll go from one wild extreme to the other and back and forth sometimes.

Smart doctor colleagues love biochemistry

Many smart doctors I know even have degrees in Biochemistry such as my wife, Dr. Tammy Wu – plastic surgeon, and Dr. Monica Wood – orthopedic hand surgeon.

As doctors and medical professionals, we should all embrace our biochemistry roots and apply it to nutrition

I have had a renewed interest in Nutrition and have had this interest for the past 7-8 years as I decided to transition myself to a vegan diet. But most of that interest comes from our skills in evaluating medical studies – which is a skill I was supposed to learn in medical school, and balancing that with the understanding and reviewing of the subject of biochemistry – which is the chemistry of life. I believe that my other physician colleagues in Modesto and in the world have similar interests especially as we come more and more to the conclusion that some of the best medicines come from nature. Even BOTOX comes from nature.

Back Pain Acupuncture Treatments in Modesto, CA


Acupuncture for Back Pain, Neck Pain, and Hip Pain

One of my favorite things to do in acupuncture is to treat back pain with acupuncture.  I am an acupuncturist and surgeon practicing in Modesto, CA with my wife, Dr. Tammy Wu who is a board certified plastic surgeon.  My office is inside her office – we practice at the same location.  Her name is on the top of the building.  Our address is 2336 Sylvan Ave. Suite C, Modesto, CA 95355.  For more info besides this blog, you can visit our more formal back pain acupuncture page.

I’m using the term back pain to include the whole posterior chain of the body which includes the neck, the back – upper and lower back pain, and hips  – for example pyriformis syndrome, or pain in the buttock area, and sciatica pain (irritation of the sciatic nerve).

I can’t fix everyone’s back pain, but muscular back pain works best with acupuncture

I’ve noticed that the back pain / neck pain / hip pain that responds best to my style of acupuncture is pain which is mostly related to muscles.  Pain in the back can originate from three main sources: muscular back pain, skeletal/joint related back pain, and nerve related back pain.

However, the results may be different for back pain acupuncture with other practitioners.  I’m just blogging about my own results.

Back pain relief is one of the most effective things I do with acupuncture

I do a lot of different things with acupuncture.  I work on stress, depression, fertility, asthma, allergies, carpal tunnel, fibromyalgia, smoking cessation – the list goes on, but back pain acupuncture is on top of the list for effective relief of symptoms.

Is the back pain relief temporary with acupuncture?

I get this question often.  Sometimes the back pain / neck pain / hip pain, etc comes back.  But often times, I think it’s because we didn’t get rid of the source of the problem.  Sometimes the back pain is postural or caused by work – some of these things are hard to change.

Does back pain acupuncture hurt?

A few patients say that it doesn’t hurt at all.  But most patients will feel something, but it’s not that uncomfortable that they wouldn’t come back.  There are four forms of acupuncture which I use and if the patient is somewhat uncomfortable, I can eliminate some of the forms of acupuncture and still have a reasonably effective acupuncture treatment for the back pain.  The four forms of acupuncture used to treat back pain in my Modesto practice are:

  • Energetics acupuncture
  • Microsystem acupuncture – using the ear.
  • Local acupuncture
  • Electro acupuncture

Note the electricity doesn’t hurt as much as it sounds.  In fact many patients report that it feels soothing.

hammer for back pain?

Don’t worry, I won’t use a hammer as part of back pain acupuncture.

What to expect after acupuncture for back pain

  • Some feel a better range of motion right after the treatment – as they are walking out the door
  • Some feel nothing at all
  • Some feel soreness the next morning.
  • Many start to feel better 48 hours after the treatment

How many treatments are needed?

For most patients with back pain, I’ve found that patients will usually need 5-10 treatments.  I think most patients do about 8 sessions.  But I usually tell the patients that we have to determine a “cut off” for acupuncture.  Because I have found that I can’t fix everyone’s back pain, I’d like to come up with a way to make sure that we’re not wasting time and resources.  I’ve found that if a patient has tried acupuncture for four times and has not received some partial relief, I’m about 90% sure that additional acupuncture wouldn’t help.

Is there Botox for Back Pain?

YES! there is!  This is available as well at my practice.  Injecting Botox and precise location of shots are very similar to parts of acupuncture.

Do we take insurance for back pain acupuncture?

Unfortunately we do not accept insurances.  Some patients have found methods to bill insurances on their own if they know that they have acupuncture coverage.  We are not involved in that process.  Many have reported receiving about $25 back for their visits for back pain acupuncture.  We know for sure that most insurances do not cover for certain acupuncture treatments such as fertility.

Other back pain and acupuncture resources


I hope you will consider Surgical Artistry in Modesto, CA for your back pain treatment.  We’ll use acupuncture techniques and possibly Botox if requested.



1 hour Lecture by Grace Nadolny, MD on 4/20/13 in Modesto, CA, CME provided by Sutter Gould Medical Foundation as part of it’s Subspecialty Lecture Series.  4 hours total of CME was provided.  Part of the 4 hours of CME included discussion about back pain and ovarian cancer.

Why this is interesting to me

  • I have learned some of this before in my NeuroScience years at Brown University.  It was good to review.
  • I have an acupuncture practice which has a good number of patients with depression.

Learning points (not all points were made in the lecture, but they were learning points for me):

Evidence Based medicine supported treatment of depression

  • includes the use of methylphenidate, exercise, and sertraline


  • Ritalin
  • NE and DA reuptake inhibitor.  (Norepinephrine adn Dopamine)
  • Psychostimulant
  • Used for ADHD, Narcolepsy, and Depression


  • Also known as Zoloft, Lustral
  • SSRI – selective serotonin reuptake inhibitor


  • Population affected: 20%
  • Depression is a state of chronic stress
  • CV risk
  • Diabetes risk
  • Anatomically there is decreased amount of gray matter in the brain.  Decreased size of  Cortex and Hippocampus has been found.


The hippocampus is involved in several functions of the body including:

  • Consolidation of New Memories
  • Emotional Responses
  • Navigation
  • Spatial Orientation

Current concepts of depression

  • glutamatergic theory of depression: exposition to stressful stimuli increases hippocampal glutamatergic neurotransmission and triggers excitotoxic changes.
  • Another theory: depression is closly correlated with neuronal atrophy due to a decrease in BDNF (Brain Derived Neurotrophic Factor)
  • Monoamine hypothesis is considered old school:  deficiency in monoaminergic neurotransmission.  Monoamines being Catecholamines (NE, DA) and Indolamines (5-HT).

Results of Star*D Trials

Sequenced Treatment Alternatives to Relieve Depression

  • Officed based – what is done after a patient fails first line treatment for depression?
  • Level 1 through Level 3 choices in medication to switch to.

After the lecture:  What about Acupuncture for Depression?

I asked Dr. Nadolny about what she thought of acupuncture for depression.  And she seemed very excited.  She said that she didn’t know that acupuncture was readily available in Modesto, CA.  I do hope to recommend some of my patients to Dr. Grace Nadolny in the future and other psychiatrists too, because I feel that at times combination treatment with acupuncture and excellent psychiatric care would be of greatest benefit.

Disclaimer:  I am not an expert on the topic of Depression.  These are notes from a lecture that I took and feel free to use this as a springboard for your own studies.