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Working From Home – How to Prevent Pain

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The most common complaint in my clinic now is neck and/or back pain due to working from home since the onset of the pandemic.

No matter how well a workstation is designed, we are not designed to sit or stand for prolonged periods of time.

In this Blog you will learn why your office space may be causing you pain and what to do about it.  With a few simple modifications to your work space and work habits you can help prevent the onset of pain from working from home.

If you are already experiencing pain from working from home acupuncture treatments can rapidly relieve your pain along with following the easy steps below.

Why is working from home causing you pain?

Research shows that repetitive motion, poor posture and staying in the same position can cause or worsen musculoskeletal disorders.

1. Repetitive Motion

Repetitive motion is carrying out repetitive tasks for long periods without suitable rest breaks.  Examples of repetitive motion at your desk is; typing, using your computer mouse and writing.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a common repetitive injury from working at a desk.  The carpal tunnel is a narrow passageway in your palm where a nerve (median nerve) runs through it.  When the passageway narrows due to swelling from injury the nerve is compressed.

Symptoms of Carpal Tunnel Syndrome are: 

  • Tingling and numbness in palm, thumb, or first two fingers, especially during the night or in the morning.
  • Aching pain in the wrist and hand, with occasional shooting pains up the forearm.
  • Weakness in the hands and fingers and trouble gripping or holding objects.

How to Prevent Carpal Tunnel Syndrome:

  1. Avoid bending wrists for long periods.
  2. Avoid leaning on the heel of your hand or your wrist.
  3. Reduce your force.  Strike the keys on the key board lightly.
  4. Relax your grip.  For prolonged handwriting, use a big pen with an oversized, soft grip adapter.
  5. Change your computer mouse and keyboard.  Many people benefit from using a split/V-shaped ergonomic keyboard. If possible, try one for at least a week.  Make sure that your computer mouse is comfortable and doesn’t strain your wrist.
  6. Improve your posture.  Incorrect posture rolls shoulders forward, shortening your neck and shoulder muscles and compressing nerves in your neck and shoulders.  This can affect your wrists, fingers and hands and can cause neck pain.  Start with arranging your work space using the ergonomic guidelines below.
  7. Take short, frequent breaks. Alternate tasks when possible.
  8. Do the below stretching exercises every 20-25 minutes.  Do not do any stretch or movement that is uncomfortable or painful.

Prayer Stretch

The prayer stretch
  1. Start with your palms together in front of your chest just below your chin.
  2. Slowly lower your hands toward your waistline, keeping your hands close to your stomach and your palms together, until you feel a mild to moderate stretch under your forearms.
  3. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.



Wrist Flexor Stretch

The wrist flexor stretch
  1. Extend your arm in front of you with your palm up.
  2. Bend your wrist, pointing your hand toward the floor.
  3. With your other hand, gently bend your wrist farther until you feel a mild to moderate stretch in your forearm.
  4. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.




Wrist Extensor Stretch

The wrist extensor stretch
  1. Extend your arm in front of you with your palm down.
  2. Bend your wrist, pointing your hand toward the floor.
  3. With your other hand, gently bend your wrist farther until you feel a mild to moderate stretch in your forearm.
  4. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.




How to Treat Carpal Tunnel Syndrome:

  • Acupuncture can provide immediate relief and treat CTS
  • Ice wrist and palm to reduce swelling
  • Wear a wrist splint at night to keep the wrist straight
  • Include the above wrist stretches in your breaks

2. Poor Posture

Poor posture leads to chronic strain and discomfort.  When working at your desk with an incorrect posture you develop excessive tightness in your shoulders and chest with weakness in your neck and mid-back. This combination of weakness and tightness forces your shoulders to roll inward and your head to project forward.

This postural problem, known as Upper Crossed Syndrome is exceptionally common in computer workstation users.

Believe it or not, the average human head weighs around 5kg or 11lbs!  That’s more than most new-born babies and all that is balanced on just 7 vertebrae in your neck and supported by about 20 muscles that are responsible for moving your head around and keeping that weight in place.

With the head projected forward significantly more effort is required from the muscles and joints of the neck trying to hold the head in that forward position.  Research has showed that by tilting the head forward, the forces acting on the head increase dramatically.  This effort results in strain of the muscles of your neck and upper back that becomes uncomfortable and may also lead to neck pain, upper back pain, headaches, TMJ pain, cervical nerve compression and ultimately arthritis.

text neck posture

This is what most of us look like when we are using our mobile phones!

How To Improve Your Posture or Prevent Upper Crossed Syndrome

Correction of Upper Crossed Syndrome is accomplished by stretching the tight muscles, strengthening weak muscles, and modifying your workstation.  Below are strengthening and stretching exercises for Upper Crossed Syndrome.

Cervical Retractions – Perform 1 set of 10 reps, 3 times per day.

Stand with your back against a wall.  Your buttocks and shoulder blades should be in contact with the wall, heels 1-2 inches from the wall.  Focus your vision on a spot on the wall to avoid neck flexion (head tilted down) or extension (head tilted up).

Tuck your chin to make a “double chin” until the base of your skull contacts the wall.  Hold this position for 3-5 seconds and then relax.

Return to the starting position.

To progress, place a finger on your chin, and apply backwards pressure at end range. Imagine that your head is on drawer slides. Keep your mouth closed.

Deep Neck Flexion – Perform 1 set of 10 reps, 3 times per day

Lie on your back with your head supported.

Perform a “chin tuck” by retracting your head to create a double chin.

Lift your head, bringing chin toward your chest without lifting shoulders, as though you are looking at your toes.

Hold this position for 3-4 seconds.

Lower your head and relax.

          Keep your teeth apart during exercise to decrease straining at the jaw.


Levator Stretch – Perform 3 sets of 10 reps, 2 times per day, each side

While sitting, grasp the seat of your chair with your left hand.

Rotate your head toward the right and look downward toward the floor.

Place your right hand over the top of your head and gently pull down and diagonally in the direction you are looking.

Against the resistance of your hand, contract your neck in an attempt to push your head backward/diagonally from the direction you are looking for seven seconds.

Relax and gently pull your head further toward the floor to increase the stretch.

Lock into this new position, and make sure that you continue to keep your head rotated in the direction that you are pulling.

Trapezius Stretch- Sitting – Perform 3 sets of 10 reps, 2 times per day, each side.

While sitting, reach down with your right arm, grasping the bottom of a chair for stability.

While looking straight ahead, place your left hand on top of your head, and gently pull your head sideways toward the left.

Against the resistance of your arms, attempt to bring your right ear and right shoulder together for seven seconds.

Relax and stretch further toward the left. “Lock-in” to each new position, and do not allow any slack.


Pectoral Stretch – Perform 3 sets of 10 reps, 2 times.

Stand in the middle of a door frame (door open)

Place palms, forearms and elbows on the door frame on either side.

Lean forward to stretch your chest muscles. Hold for 7 seconds.


YTWL Scapular Depression – Perform 3 sets of 10 reps, 2 times.

Stand with your straight arms raised above your head in a “Y” position. Squeeze your shoulder blades together and downward throughout the following sequence of movements.

Lower your straightened arms to shoulder level, into a “T” position.

Next bend your elbows so that your fingers are pointing straight up while slightly lowering your elbows to make a “W”.

Finally, while keeping your elbows bent 90 degrees, lower your arms to your sides so that your elbows are touching your ribs to form an “L” on each side and squeeze.

Hold each position for 1-2 seconds.


Low Row – Perform 3 sets of 10 reps, 2 times.

Attach the center of an elastic exercise band to a door knob or other sturdy object in front of you.

Grasp one end of the band in each hand and with straight arms at your side, stretch the band backwards.  Squeeze your shoulder blades together and downward throughout the following sequence of movements.  Keep your palms facing backward and arms pointed straight down throughout the exercise.

Return to neutral and repeat


Brugger with a band – Perform 3 sets of 10 reps, 2 times

Begin sitting or standing with an elastic exercise band wrapped and secured around your palms.

Begin with your arms at your side, elbows bent, forearm’s pointing forward.

Move your hands apart from each other to maximally stretch the band while simultaneously rotating your palms out, straightening your arms, and pinching your shoulder blades together as your hands move behind your hips.

Return to the start position and repeat.


Work Station Ergonomics for Good Posture

Work station ergonomics can help a person be more comfortable at work.  It can reduce stress on the body and reduce injuries caused by prolonged awkward positions and repetitive tasks at a workstation.

Laptop computers are not ergonomically designed for prolonged use with the monitor and keyboard so close together. For prolonged use it’s recommended to add a separate monitor and/or keyboard. The laptop can be placed on books so that the top of the screen is at eye level, then use an external keyboard so that your elbows can rest at 90 degrees by your side.

3. Prolonged Stationary Sitting or Standing

Working at a computer often involves very few changes in body position.  This lack of movement can lead to muscle pain and strain.  It doesn’t take long to develop muscle pain and strain, the process has already started at the first sign of discomfort.

Even if you’re comfortable, you should never sit in one position for a long time.  Every 20-25 minutes take a short break to stretch.

Also look away from your screen occasionally and focus your eyes on an object far away to reduce eye strain.

Stretches For Your Breaks – Every 20-25 minutes

Don’t forget to add the wrist stretches above into your routine.

Click on this link if you would like to download this poster (sourced from Barbre Ergonomics) and print it for your workstation.



In the meantime enjoy all the perks of working from home; hanging out with your furry friend, dressing comfortably, avoiding rush hour traffic and enjoying your morning coffee in your favourite cozy spot at home. 

Wishing you all safe and joyous days ahead.

Alfie and I working from home.


Exterior and Interior Disease – Understanding COVID-19 From A Traditional Chinese Medicine Perspective

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Writing a blog is wonderful way to stay connected to my patients, and anybody else who is reading this, whilst in self-isolation due to the Covid-19 virus mandates.

I would like to introduce to you in a very simple way, cold and flu from a Traditional Chinese Medicine (TCM) concept.  And provide simple daily tips to increase your immunity to prevent a cold or flu and how to treat MILD signs and symptoms of a cold and flu.

The Language of Traditional Chinese Medicine

Before I begin explaining TCM concepts of bacteria and viruses I am already going to go off topic here!

First, I want to acknowledge how much the early physicians of China knew about infectious diseases (and most other areas of health), which they characterized as a pestilence, 1000’s of years ago without any of the technology we have today.

Equally important is to not undermine the unique language and terminology TCM utilizes, which is very difficult for other cultures and physicians rooted in modern science.  The words Qi, Yin and Yang bring to mind ideas of an esoteric and almost spiritual connotation to most of the Western World.  Simplistic definitions for these words are frequently repeated, such as Qi meaning energy.   But there is no single simplistic meaning to these words, rather an array of potential meanings that must be applied in context.

Such words were created in the Chinese language to express complex, yet concrete, ideas and concepts, within the context of TCM that you will read below.

These words objectively express fundamental ideas of complex physiology in the body.  And I have found, integrate well with modern terminology and disease description.

To better understand these terms outside of Asian culture, one must understand the context of the language itself. The Chinese language is perhaps the oldest original language left on our planet, and is composed of pictorial characters rather than letters. This use of written characters allows the Chinese culture to express concrete ideas that are very complicated and dependent on the context of the surrounding characters.

While these concepts and terms may be hard to grasp, they are very important and unique to modern Western medicine, as they reflect a medical philosophy that is:

  • Holistic (body, mind and spirit)
  • Acknowledges and integrates the laws of nature and the universe
  • Is based on an individualized diagnostic system that contrasts to a one-size fits all allopathic model of medicine.

Interior and Exterior Diseases

Establishing the depth of a disease in the body is important to the diagnosis and treatment of the disease.  A cold or flu often starts in the exterior and if not eliminated will progress to the interior of the body where it can become a chronic disease.

The Covid-19 virus is known as a Pulmonary Pestilence in TCM.  It starts in the exterior and progresses to the interior of the lungs.

Exterior Diseases  Covid-19 virus and TCM

Exterior disease are like your common cold and flu, Bell’s Palsy and many skin conditions.  They are acute and do not last very long.  Pathogens (germs, virus, bacteria etc) that surround us enter the body via wind into the exterior, the surface of the body.  As the pathogen lodges itself in the exterior, the exterior parts of the body are affected, which are the skin, muscles, tendons, joints and orifices (including the mucous membranes).

Typical Signs and Symptoms of an exterior condition:

  • Acute and short duration
  • Simultaneous chills and fevers
  • Sneeze
  • Cough
  • Runny nose
  • Muscle and joint ache
  • Recent headache
  • Intolerance to wind or cold

Signs and symptoms are further influenced by the type of pathogen that invaded the exterior, such as wind, heat, cold, dryness and dampness.  For example, an invasion of dampness,  a type of pathogenic excess fluid, is characterized as sticky, dirty and heavy.  Dampness will give rise to a feeling of a heavy body, foggy/muzzy head, strong body and joint ache and copious phlegm – runny nose and congested sinuses.  An invasion of dryness will produce a dry cough, dry mouth, dry throat, dry nose and dry tongue.

Pathogens in the exterior tissues are best eliminated by sweating.  People with a strong immune system can fight this pathogen at the exterior level preventing it from penetrating deeper into the body where it can become chronic.  A fever accompanied by sweating is good sign that your immune system is fighting the pathogen.

Contagious diseases that affect the sinuses, bronchials and throat often have exterior signs in their initial stages.  Therefore, as soon as one recognizes and treats the onset of an exterior disease, the more likely you can reverse their progression to an interior disease.

Interior Diseases

If the pathogen is not purged by sweating it will move deeper into the body in stages.  If a person has extremely weak Wei Qi (weak immunity) the pathogen can penetrate directly into the interior.  The interior areas of the body include bones, internal organs, deeper  nerves and blood vessels.

Signs and Symptoms of an interior condition are vast depending on which areas are affected.  Using the above the example an exterior damp type of cold that penetrates the interior, such as the lungs, will manifest as a chronic cough with profuse sputum (pneumonia, bronchitis) or chronic sinusitis.

The treatment of an interior disease will often require an in person visit with your TCM practitioner and/or Western physician.

Covid-19 Virus

The Covid-19 virus is known as a Pulmonary Pestilence in TCM.  It starts in the exterior manifesting mostly as fever and dry cough.  If the patient has a compromised immune system and/or is not treated early it progresses to the interior, the lungs, where it can cause increased difficulty breathing, pneumonia.  In TCM the treatment is to cleanse and detoxify the lungs and all other symptoms are treated to avoid complications.

TCM Doctors specializing in Chinese herbs have developed Chinese formulas to treat early to middle stages of Covid-19.  This video demonstrates the power of TCM and how successfully it can easily adapt to modern diseases and integrate with modern Western medicine.

Food for Health

Food for health, just like Chinese herbs,  is a full branch of Traditional Chinese Medicine and so easy to incorporate into your day.  Food and Chinese herbs have unique TCM therapeutic functions.  For example for Dampness we would use drying herbs or foods.  There are even specific herbs and foods that will dry particular areas or organs.

Therapeutic functions:

  • Disperse (expand, spread)
  • Astringe (hold, bind)
  • Tonify (nourish, boost)
  • Sedate
  • Warm
  • Cool
  • Moisten
  • Dry
  • Eliminate toxins
  • Move (exterior, interior, ascend, descend)

Treating an Exterior Disease

At the first sign of a possible infection of a cold or flu we want to expel the pathogen to the exterior and purge it via sweating.  Profuse sweating is not recommended and promoting sweating is NOT recommended for the very weak, very old and very young.

Beneficial Herbs and Spices  Cinnamon in TCM

At home in our kitchen we may have a plethora of ingredients for home made remedies.  This is very convenient for those now on a tight budget or in self-isolation.   When you start to feel sick (cold or flu) we want to choose herbs and spices that have the action of dispersing to the exterior and opening (expanding) the sweat glands to sweat out the exterior  disease lodged  near the surface.

Common Diaphoretic (sweating) and Dispersing Herbs: 

  • Fresh ginger *(NOT dry)
  • Scallions and Chives (NOT onions)
  • Cinnamon
  • Mint or peppermint
  • Szechuan pepper corns
  • Cayenne red pepper*
  • Clove

Sweating Procedure

  1. Drink a cup or more of hot diaphoretic herbal tea (see below)
  2. Take a hot bath or shower
  3. Drink more hot tea
  4. Cover yourself in blanket and sweat

Do not sweat  to the point of exhaustion.  After sweating change your bedding and rest.  This procedure can be repeated twice daily until exterior signs lift.

If a hot bath or shower is inconvenient, drink 1/2 cup of tea every half hour in bed until perspiring freely.  When diaphoresis does not work this indicates a deeper/interior condition likely exists.

Sweating therapy can also be beneficial for infectious diseases marked by rashes.  It helps bring the toxins in the rash out of the body.






Diaphoretic Herbal Teas:

Ginger Tea

3 slices of fresh ginger,  1/4  lemon juice and peel with rind, whites of 3 scallions, stick of cinnamon (or ground), some raw honey for flavor

Mint Tea

Fresh mint leaves, 1/4 orange peel with rind, whites of 3 scallions, 3 cloves, some raw honey for flavor

For predominating chills add Cayenne red pepper to your tea.



Garlic can stop a cold or flu if taken at the onset of symptoms.   Hold half a peeled garlic clove against your cheek for 20-30 minutes every 3 hours during the day.  Move the garlic clove in your mouth occasionally to avoid a “burning” sensation.

 Beneficial Foods                  Garlic in TCM                                             

It is best to eat much less and eat a simple, liquid-based diet.  If chills predominate eat vegetable and/or grain soups and if fever is more predominate consume fresh fruit and vegetable or fruit juices.

  • Cabbage
  • Green peppers
  • Asparagus
  • Parsley and cilantro
  • Carrots
  • Broccoli
  • Turnips and parsnips
  • Horseradish*
  • Chives and scallions*
  • Garlic*
  • Kale
  • Bok choy
  • Collard greens
  • Asparagus

For predominating chills use more warming herbs and foods marked with “*”.

Convalescing From An Interior Or Exterior Disease

An important part of recovering from a flu like Covid-19 is hydration.   Consuming soup is more effective than simply drinking water.  Soups provide a slow release of fluids, allowing it to assimilate in the body, whereas water moves through the body quickly and has a more cleansing affect.

For people convalescing from the flu soups should be nourishing, easy to digest and aid in digestion to ensure the assimilation of nutrients.  These soups are also wonderful for anybody recovering from any chronic illness and for the elderly.

Porridge and congee can be eaten for breakfast.  It is recommended to use: oat meal, millet, rice, cream of wheat or polenta.

Soups For Recovering From The Flu:                             

  • Chicken and rice
  • Beef and barley
  • Miso
  • Corn chowder
  • Mushroom soup
  • Congee
  • Lentil soup
  • Butternut/Squash/Sweet potato soup





Rice Congee Recipe:

This recipe is from Andrew Sterman and has more congee recipes here.

To make good congee, use good quality medium-grain or long-grain white rice, preferably grown in the style suited to the Asian market in Canada.   Also avoid short-grain, arborio or risotto rices, they are too sticky.

1 cup dry rice makes enough congee for 4-6 people.  Eventually the amount of water for 1 cup white rice is 8-10 cups.

Begin by bringing 8-12 cups water to a boil.  Use a stock pot on the stove burner behind the congee pot.  Simple stocks can be used, but avoid complex chicken or bone stocks for congee.

  1. Put 1 cup uncooked long-grain white rice in large pot.  Turn heat to high, add a tablespoon of good oil (grapeseed, organic peanut, safflower, etc).  Stir so each grain is coated lightly with oil.  Add two generous pinches salt.
  2. Then, add just enough boiling water to float the grains, perhaps 1 cup (no need to measure carefully).  Stir constantly as the grains absorb the water.  When almost dry, add more boiling water, keep stirring.  After 3 or 4 gradual additions of water while you are nearly constantly stirring (about 10 minutes), the grains will have given up starch to the water.
  3. Once the grains have released starch into the cooking water, you can add a lot more water and turn the heat down to a gentle low simmer for about 30-45 minutes, now stirring occasionally.  Do not allow the grains to settle and stick to the bottom of the pot.  Add water (stock) as needed to get the special congee consistency, in other words, milky water between discernible rice grains, very soft cooked.
  4. Once done, congee is always served with other things—start with a few simple ingredients.
  5. Eat with simple condiments (with scallion, soy sauce, ginger and toasted sesame oil) or improvise more substantial additions: sliced fish, seafood, nuts, pumpkin/squash, corn niblets, soft-boiled eggs, gently cooked bean sprouts, dried scallops, sliced pork, duck, chicken, cilantro, etc., often utilizing leftovers from the refrigerator or contributions from the freezer.  Always consider your intention when selecting ingredients, based on your growing knowledge of food energetics and current health needs.

Avoid Dehydrating Foods and Drink:

  • Onions and garlic
  • Hot spices
  • Tea and coffee
  • Soda water
  • Alcohol

Treating An Interior Disease

When an Exterior disease moves deeper into the body creating an Interior disease the treatment protocol to eliminate the pathogen differs.  The pathogen’s only exit is via the the intestines and bladder therefore it is very important to main good bowel movements to eliminate the pathogen.  We also need to add bitter foods to our diet as they are descending in nature and will help eliminate the disease.

As previously mentioned the treatment of an interior disease will often require an in person visit with your TCM practitioner (for Chinese herbs and acupuncture) and/or Western physician.

Beneficial Foods for Good Bowel Movement:

  • Oats, rye, barley, oat meal, millet, brown rice, corn (polenta, grits), spelt, amaranth
  • Fruit with peel, especially apples and asian pears
  • Nuts and seeds, especially almonds, pine nuts, pumpkin seeds, flax, chia
  • Green vegetables
  • Carrots, beets, parsnips, daikon, mushrooms

Foods That Are Descending:

  • Endive, radicchio
  • Olives
  • Artichoke
  • Water cress
  • Broccoli, raw
  • Dandelion greens
  • Bean sprouts

Steps to Prevent Catching A Cold or Flu


  • Moderate regular exercise is recommended.
  • Lack of physical activity, excess sexual activity and overwork impair immunity. 
  • Maintain an orderly, pleasant living and working environment.
  • Stay hydrated.
  • Quality sleep is important for your body to restore itself.
  • It is essential for those with very weak immunity to associate with completely supportive people.
  • Sunlight, clean, fresh air and pure water strengthen the immunity.
  • Avoid overexposure to dampness and protect against other climatic extremes.


Healing your mindset is the foundation for immunity; gratitude and forgiveness are the preliminary steps. 


We want to avoid sugar, gluten and dairy (especially cheese) as they are damp forming foods.  Dampness can easily affect the lungs creating excess phlegm and mucous in the upper and lower air ways.

In winter when it is the cold and flu season, we want to avoid icy foods and fluids as they are hard on the lungs.  These can weaken the lungs making them more susceptible to disease such as pneumonia and bronchitis

Beneficial foods

  • Eat whole foods, choosing a variety from a grain and vegetable-based diet.
  • Moderate under eating and simpler food combinations can strengthen immunity.
  • Do not eat late at night.
  • Avoid intoxicants, refined or chemically contaminated foods, rancid nuts and seeds.
  • Limit oils and fats.
  • If candida overgrowth symptoms are present, further dietary discipline is necessary.  Candida exists in high levels in individuals with a weak immune system.  Candida inhibits proper assimilation of essential amino acids and other nutrients further weakening immunity.
  • Supplements include; zinc, selenium, Vitamins; A, B, C, E and B complex.
  • Whole food supplements are often immeasurably more effective than the synthetic variety.  Vitamins in whole foods include: whole or barley grass concentrates, sea vegetables, chlorella and spirulina are all beneficial for long term use.

Chinese Herbs

Chinese herbal formulas to strengthen the immunity are readily available.  They are best taken 1-2 months before the cold and flu season.