The more we study dry needling, the more we understand its benefit and expand its use in the treatment of musculoskeletal injuries.  Addressing everything from low back pain, migraines, and sports injuries; dry needling proves beneficial in the most common muscle, tendon, ligament, and joint issues.

Since we  utilize this technique, it is important to for patients to know what to expect from treatment, and what conditions can benefit from this therapy. 

The most common issues we treat in the office 

• Pelvic floor dysfunction 
• Repetitive stress injuries
• Low back pain, neck and shoulder pain, hip pain, calf pain 
• Persisting pain that worsens over time
• Aching pain in the muscle
• Deep muscular pain that is not improved by massage or chiropractic 
• A tender knots or adhesive spots in the muscle
• Difficulty sleeping due to muscular pain.
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Below are five important items to understand when seeking treatment.  

Dry needling is a skilled technique performed by trained acupuncturist or MD aimed at managing neuro-musculoskeletal injuries, pain, and movement dysfunction.  Dry Needling utilizes the same thin filiform acupuncture needle to penetrate the skin, fascia, and muscles to address adhesions, trigger points, and connective tissue.  By doing dry needling, just like in acupuncture, we are able to speed up healing and relieve pain by decreasing muscle hypertonicity, increasing joint range of motion, and correcting movement dysfunction through releasing a trigger point adhesion.

Acupuncture is an ancient traditional Chinese technique that utilizes the knowledge of meridians, reflex points, and fascia networks.  This focus allows an acupuncturist to work on more than just muscle pain but also a person's internal health disorders, energy, and qi.  Work up and exam include a physical, tongue, and pulse examination.  Needles are retained for around 15-25 mins. 

Dry needling focuses on skeletal, muscular, and neuroanatomy.  This allows for the identification of damaged and sensitive tissues, taut bands, and trigger points as well as injured and overused tissues.  At SFIM we utilize an extensive examination that includes movement analysis and orthopedic evaluation.  Needles are not generally retained.  A muscle twitch is elicited and then the needle is removed.

​A trigger point is a spot of muscle/fascia that is hypersensitive and composed of a taut muscular/fascial bands.  These taut bands restrict oxygenated blood flow, and can refer pain and tenderness while causing dysfunction. Trigger points can and may develop during occupational, recreational or sports activities when muscle use exceeds the muscles capacity to handle stress, disturbing normal recovery.  Dry needling differs from other types of therapy because it focuses on stimulating these trigger points and releasing the tension in order to alleviate pain.

That muscle jump you feel is also called a fasciculation or twitch response.  It is a localized, reflexive response of a dysfunctional area of muscle to palpation, or in our case, a dry needle.  When needling these adhesive knots and trigger points, this is one of our goals as it leads to a rapid release of a taut muscle band, decreasing tightness and sensitivity of the surrounding area.  A tight muscle or one with a trigger point will feel an achy discomfort with an occasional twitching or cramping sensation. This fasciculation response returns the muscle to a normal state by releasing inflammatory chemicals and restoring blood flow to the area.  

The Dry Needling technique uses acupuncture needles. These are thin filiform needles used to penetrate skin, fascia and muscles to address adhesions, trigger points and connective tissue to speed healing and relieve pain.  Often, our patients will describe the sensation as "odd and weird" but not painful per se.  Patients will experience a mild, dull ache during treatment and up to 24 hours post treatment.  Some discomfort is experienced during the rapid fasciculation but this discomfort is minimal and last only a few seconds.   It is normal to have mild to moderate muscle soreness after dry needling treatment.  Drinking lots of water, stretching, moving your body and heating the sore muscles can reduce the duration of the soreness.  Side effects include mild muscle soreness and bruising in some patients.

While dry needling is a new spin on an old technique, it's unfortunately only covered by around 5-10% of insurance plans.  Luckily, it is covered by FSA and HSA plans. 

Click here to enter your insurance information to see if your plan covers Dry Needling. 

Our dry needling appointments are focused, one on one sessions.  Fees are $250 for initial consultation, exam and treatment, $200 for follow up sessions 

More and more people are coming into the office seeking help with symptoms of Long-COVID.

What exactly is Long-COVID you ask?
That is a great question and one that doesn’t really have a great answer. The mechanisms that cause Long-COVID are not yet well understood, it is a diagnosis used to describe a collection of symptoms that develop after a person is acutely infected with COVID-19.

There is no way to predict who might develop Long-COVID, it can affect both those who become seriously ill, and those with initially mild infections. There is a wide range of symptoms associated with Long-COVID (the CDC lists some of them here) and those symptoms can vary in terms of severity and predictability as well. This variability and the lack of understanding around the causes of the disease mean that there are not very many cohesive treatment strategies for Long-COVID, which can be disheartening for people dealing with it. 

Fortunately for us, we don’t need to understand the mechanisms of Long-COVID to help its sufferers manage their symptoms and feel more resilient. One of acupuncture’s magical qualities is its ability to activate the parasympathetic nervous system, often referred to as our rest and digest state. It is the optimal state to be in if we are trying to reduce inflammation, promote healing and elevate mood. And while we might be biased on this one, we think community acupuncture is especially powerful for people who are dealing with chronic illness because feelings of isolation are known to have a big impact on how well we heal. 
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The symptoms of post-covid we are most treating in the office are:

• Fatigue that is persistent & often worse with activity
• Unrefreshing sleep  Waking up exhausted after a full night of sleep
• Cognitive/neurological problems  Difficulty remembering things, poor concentration, brain fog, inability to process new information
• Muscle or joint pain 
• Digestive symptoms  Nausea, diarrhea and/or constipation
• Increased sensitivity  to light, smell, or sound
• Racing heart beat
• Headaches

At the same time that we are helping our Long-haulers cope, they are helping us by sharing their experiences and the lessons they have learned so far on their journeys.

For anyone out there dealing with Long-COVID we encourage you to stay hopeful, and get empowered.

Connect with others, gather information and get acupuncture!

There is fascial line from the pelvis to the jaw and this is created during embryonic development in the womb. On day 15 of conception an embryo forms two depressions – one becomes the mouth and the 2nd the opening of the urinary, reproductive and digestive tracts.

These remain forever connected even as the spine develops and creates space between them.

For many people this knowledge about the pelvic floor and jaw connection shifts their body awareness forever. They discover if they immediately ease up any tightness they’re holding often subconsciously at these two major points in their body the jaw and pelvic floor their whole body function improves 

Holding too much tension in the pelvic floor due to stress or excessive movement such as Kegels – can be a significant cause of incontinence or pelvic floor dysfunction often called a hypertonic pelvic floor.

Pelvic Floor or the Root Chakra in Eastern tradition, is tied to fear, especially around our families, well-being, money, and safety. This is fascinating when consider that too often we hold tension in the jaw as a way to repress anger, frustration and fear–you can see how important this connection is.

Are you noticing a connection between one or both, if so pay attention to where you are holding tension and learn how to address these biomechanics of your body that are affected both physically and mentally.
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To target these areas of the body we use a combination of acupuncture, dry needling, gua sha and fascia release
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A recent study out of Yale examined how one particular infection can trigger autoimmunity.

“Bacteria found in the small intestines of mice and humans can travel to other organs and trigger an autoimmune response, read more here.”

Our standard testing protocol at San Francisco Integrative Medicine goes far beyond testing for just this bacteria identified in the study.  The medical scientific community has now identified multiple infections related to autoimmunity, as well as ratios of healthy bacteria that when disrupted to trigger our own immune systems to attack us.

In order to reverse and heal autoimmune disease the pathogenic infections need to be identified, cleared without disturbing normal flora, and a healthy biome supported.  

If you would like to take action on your autoimmune condition, schedule a phone consult to discuss your unique situation.

In Health,

Dr. Bezjak and Dr. Korian 

First off its a good reminder that the fact that we eat food and have abdominal organs could alone be the reason bloating occurs.  It's not normal to have a completely flat abdomen all day long while you're nourishing yourself properly with enough calories to sustain good health. 

A Few Daily Reasons Bloating Can Occur - If you notice that you get bloated after eating make sure you double down on these factors before jumping to any health conclusions.

• Eating too fast
• Eating too much
• Consuming a lot of sodium
• Sparkling and bubbly beverages
• Menstruation 
• Eating a high load of carbs

But if you've crossed all those off your list and are still bloated, here are some other health-related reasons for bloating you can dive deeper into:

• Lactose intolerance
• Constipation 
• Low stomach acid
• Gut bacteria imbalance
•  Food sensitivity

The only REAL way to know if any of those factors are true for you is to work with a practitioner for educated insight and testing. (Pssst - Dr. Bezjak specializes in this!)

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• Eliminate bloat triggers
• Dial in your good eating habits
• Determine what foods you're sensitive to
  
• Address underlying gut infections or microbiome imbalances
  

If you still need some help and guidance after implementing these tips, book a 15 min complimentary phone consult to see how functional medicine can address bloating and other digestive complaints 

There are two types of cholesterol: good cholesterol or HDL (high-density lipoprotein) and bad cholesterol or LDL (low-density lipoprotein).

HDL is usually termed the good kind of cholesterol because it moves from your arteries to your liver, which then expels it from your body. The counter of that is LDL, the bad kind of cholesterol, which goes to your arteries, where it may collect in the artery walls, creating a clog.

Hong qu (red yeast rice) is a rice that has been fermented with monascus purpureus yeast. The process changes the color of the rice from white to red, hence the name "red yeast rice." For centuries, hong qu has been used in China as both a food and herbal medicine. It has also been used as a coloring agent to prepare fish, fish sauce, fish paste, rice wine, and red soybean curd.

In the late 1970s, Professor Endo, from Japan, discovered monacolin-k from red yeast rice, and found it could reduce the blood cholesterol in humans. This discovery provided scientific support for the effectiveness of the traditional red yeast rice. Since the late 1990s, red yeast rice has been commonly used in the U.S. as a dietary supplement to promote healthy cholesterol levels.

​Red yeast rice extract may help to reduce total cholesterol levels, lower levels of LDL (“bad”) cholesterol, increase levels of HDL (“good”) cholesterol, and lower the levels of unhealthy fats called triglycerides. It appears to accomplish this by restricting the liver’s production of cholesterol itself. By lowering cholesterol concentrations, red yeast rice extract may help to prevent heart disease and other complications.

Individuals with moderately elevated cholesterol levels (200 to 239 mg/dL) may benefit from a dietary supplement such as red yeast rice extract. However, those with very high cholesterol levels (240 mg/dL or above) are at considerable risk for heart disease and should consult with their primary care provider before deciding to start any new supplements or medications 

The best way to achieve and maintain a healthy cholesterol level is to take red yeast rice extract as part of an overall regimen that includes exercise and a whole food diet (like DASH or Mediterranean) that is high in soluble fiber. 

There are different ways of wishing people “Happy New Year,” depending on what region of China you are in. We are from Southern China, where our traditional greeting is “Gong Xi Fa Cai!”, which means “congratulations and prosperity.” Other greetings are:

• Wan Shi Ru Yi: everything follows your will
• Ji Xiang Ru Yi: harmony and everything follows your will
• Sui Sui Ping An: harmony and safety year around

Cleaning
Part of celebrating the Chinese New Year involves cleaning. Traditionally, homes are cleaned before the New Year, but sweeping and dusting isn’t done until the third day after New Year out of fear that good fortune will be swept away. The floors can be swept, starting by brushing the dust and dirt towards the middle of the house or building. Once the debris is piled into the center, it’s moved to the corners where it remains until the fifth day, at which point it can be thrown out.

Decorating
Whether you intend on hosting an extravagant New Year’s Eve party with dozens of friends, or you plan on having a low-key evening with your family, you should decorate your home to reflect this ceremonial event. Some traditional decorative practices for the Chinese New Year include the use of red lanterns, couplets, door god designs, and images of the upcoming year’s Chinese astrology animal (hint: 2015 is Year of The Goat).

Fireworks
We can’t talk about ways to ring in the Chinese New Year without mentioning fireworks. This joyful practice is said to expunge the old year while welcoming the new one. Traditional belief is that all doors and windows should be left open on midnight New Year’s Eve so the old year can go out. Just remember to close them back once the celebration is over!

Wear Red
When you’re choosing an outfit to wear on New Year’s, look for something red. Red is symbolic of happiness and longevity, and wearing it is believed to bring a similar future to the individual. This is the reason why you see so many people dressed in red during the Chinese New Year celebrations.

Don’t Use Knives
Lastly, avoid using knives on New Year’s Day. You may find it difficult to prepare food, but traditional Chinese superstition states that using knives “cuts” off a person’s good fortune. 

Join us first Friday of the month for community acupuncture!
Feb 4th
March 4th 
April 1st
May 6th 
June 3rd 

​Chapped lips, dry, flaky skin, and an itchy scalp. Does it sound like something your skin is going through?

Even in San Francisco where winters tend to me milder, lower temperatures suck moisture from your skin leaving it extremely dry and flaky. Micro-needling can be a powerful skin treatment and just the moisture boost your skin needs. 

Below I'll review more about what this procedure is, why it is beneficial for the skin, and what precautions one needs to take before and after

Also known as Collagen Induction Therapy, it is a minimally invasive procedure which rejuvenates your skin from within. The microscopic pin-pricks initiate the repair process in the skin. This is the body’s natural response to any disturbance in the structure of the skin. There is increased blood flow to the areas treated. The activity of a protein called Collagen increases manifold. Collagen is responsible for the elasticity of the skin. It is the part that holds it firmly and prevents the loosening of skin.

​My sessions focus on nourishing and reviving skin:

• The skin is washed and cleansed
  
• 25 min Celluma Light therapy session to further treat the skin and prep collagen regrowth.
• An anesthetic gel may be applied on top of your skin to provide a numbing effect. Although this treatment is not painful, some people tend to have a low pain threshold. Even if you are one of those people, you don’t have to worry one bit. After the gel is applied,  the treatment is very comfortable. 
• While the numbing cream is taking effect, a full acupuncture treatment is done to encourage facial rejuvenation and get your body into a relaxed state. 
• The numbing is removed and the area is cleansed and disinfected.
• Micro-needling: A pen-like instrument to make microscopic pin-pricks on your facial skin. These pricks are so small that they are not visible to the naked eye. The pen is slowly moved over all the target areas.
  
• After the procedure is over, a stem cell serum and calming cream and mask is applied

The whole process takes nearly 90 minutes.

Tone and Texture - After 2 treatments 

There's definitely a winter theme here and that's prioritizing your body's needs. With that, lets Focusing on the power of the parasympathetic system and the importance of “rest and digest” especially when it comes to fertility.

It’s a cycle that is so easy to get caught up in. Being  constantly on the go, with entire days spent in a busy “fight or flight” mode (sympathetic) without any time for our bodies to really slow down and recharge.  When we spend our day rushing and stressing, our body’s natural instinct is to shut down on unnecessary organ functions (like the reproductive organs) and only focus on getting you away from that stressor. 

​There are plenty of things that can assist in switching from fight or flight (sympathetic) to feed and breed (parasympathetic). Meditation, yoga, and mindfulness to name a few. One of the most effective ways to mitigate stress, however, is acupuncture.  What makes those "Acu Naps" so powerful is it quickly and efficiently gets your body into a parasympathetic state. 

Whether you are trying to conceive, get a better night’s sleep, or just lower your stress levels, SF Integrative Medicine is here to help you take your health in hand and find some inner calm.