Understanding Asthma and Its Treatment

Whether rising rates are related to air pollution, environmental changes, allergens, or other factors, asthma continues to affect a growing number of people each year.

One notable trend is the increasing number of adults being diagnosed with asthma. While many people associate asthma with childhood, adult-onset asthma is becoming increasingly common.

Modern asthma treatment typically follows a stepwise approach, meaning treatment intensity increases as symptoms become more severe or difficult to control.

Step 1: Quick Relief for Occasional Asthma Symptoms

The mildest form of asthma is usually treated with a short-acting beta-2 agonist (SABA) inhaler.

Common examples include medications such as albuterol.

These medications work by rapidly relaxing airway muscles and opening narrowed bronchial tubes during an asthma attack.

Because they work quickly, they are often called rescue inhalers.

Patients use these medications only when symptoms occur, rather than on a daily basis.

This treatment level is generally appropriate for individuals who experience only occasional asthma symptoms.

Step 2: Controlling Airway Inflammation

When asthma symptoms become more frequent, treatment typically progresses to the next level.

This often includes:

• Rescue inhalers as needed

• Inhaled corticosteroids (ICS)

Many patients feel concerned when they hear the word "steroid."

However, inhaled corticosteroids differ significantly from oral steroid medications because they deliver small amounts of medication directly to the lungs, minimizing systemic exposure.

Inhaled corticosteroids are among the most effective asthma treatments because they:

• Reduce airway inflammation

• Decrease airway hyperresponsiveness

• Lower the risk of asthma attacks

• Improve long-term symptom control

Additional medications may also be considered, including:

• Leukotriene receptor antagonists

• Theophylline

These medications can help improve symptom control when inhaled steroids alone are insufficient.

Step 3: Combination Therapy

For moderate persistent asthma, treatment often includes:

• Inhaled corticosteroids

• Long-acting beta-2 agonists (LABAs)

Unlike rescue inhalers, LABAs provide longer-lasting airway relaxation.

The combination of inhaled corticosteroids and long-acting bronchodilators is one of the most commonly prescribed asthma treatment strategies because the medications work synergistically.

Some patients may also require adjustments in steroid dosage or additional controller medications depending on symptom severity.

Step 4: Severe Asthma Management

When asthma remains poorly controlled despite Step 3 treatment, it is generally classified as severe asthma.

Treatment may involve:

• Higher-dose inhaled corticosteroids

• Multiple controller medications

• More intensive monitoring

Healthcare providers typically attempt to maximize inhaled therapies before considering long-term oral steroid treatment due to the greater risk of side effects.

Step 5: Advanced Asthma Care

The most severe forms of asthma often require care from asthma specialists or pulmonologists.

Treatment may include:

• Biologic therapies

• Anti-IgE treatment

• Targeted immune therapies

• Advanced pulmonary evaluation

Patients at this stage often receive care through specialty clinics or major medical centers.

Asthma Medications Control Symptoms—But They Do Not Cure Asthma

One important concept many patients misunderstand is that asthma medications generally manage symptoms rather than permanently eliminate the underlying condition.

That does not mean treatment is optional.

Uncontrolled asthma can lead to:

• Reduced lung function

• Frequent exacerbations

• Emergency room visits

• Hospitalization

• Long-term airway remodeling

For this reason, maintaining appropriate asthma control remains extremely important.

Patients are often stepped down to lower medication levels after several months of stable symptom control and stepped up again if symptoms worsen.

How Eastern Medicine Approaches Asthma

From an Eastern medicine perspective, asthma is generally viewed as a chronic condition requiring long-term management rather than a quick fix.

While some treatments may help improve symptoms relatively quickly, reducing recurrence and supporting long-term respiratory health often requires ongoing care.

Treatment plans frequently combine:

• Acupuncture

• Herb medicine

• Lifestyle modification

• Respiratory support strategies

The goal is often to support lung function, improve breathing regulation, and help the body maintain better respiratory balance over time.

Acupuncture for Asthma

Patients often search for:

• "Acupuncture for asthma"

• "Natural asthma treatment"

• "Acupuncture for shortness of breath"

• "Integrative asthma care"

because they are looking for additional ways to improve symptom control.

Research suggests acupuncture may provide meaningful benefits for some asthma patients.

A 2023 systematic review and meta-analysis found that acupuncture treatment was associated with improvements in:

• Asthma symptoms

• Quality of life

• Pulmonary function

In particular, patients receiving acupuncture demonstrated significant improvement in:

Forced Expiratory Volume in One Second (FEV₁%) is a commonly used measure of lung function and airway obstruction.

The review also reported:

• Improved Asthma Quality of Life Questionnaire (AQLQ) scores

• Better symptom control

• Reduced frequency of asthma exacerbations

compared with control groups in several studies.

These findings suggest acupuncture may serve as a useful complementary therapy alongside standard asthma care rather than a replacement for prescribed medications.

Herb Medicine and Asthma

Research on Herb medicine for asthma has also grown in recent years.

Studies suggest that Herb medicine may be particularly helpful when used alongside conventional asthma treatment rather than as a stand-alone therapy.

Researchers have reported potential benefits including:

• Improved asthma control

• Better symptom scores

• Reduced airway inflammation

• Enhanced quality of life

One commonly reported finding is a potential steroid-sparing effect, meaning some patients may require lower medication intensity over time while maintaining symptom control under appropriate medical supervision.

Importantly, patients should never discontinue prescribed asthma medications without consulting their healthcare provider.

Integrative Asthma Care in Washington (WA)

Asthma management is often most successful when it combines multiple approaches.

Depending on the individual, a comprehensive asthma support plan may include:

• Inhaler therapy

• Pulmonary specialist care

• Allergen management

• Exercise and breathing training

• Acupuncture

• Herb medicine

• Lifestyle modifications

The goal is not only to reduce symptoms but also to improve lung function, decrease asthma attacks, enhance quality of life, and support long-term respiratory health.

References

Acupuncture for Asthma

• Pang J, et al. (2023). Clinical evidence for acupuncture for adult asthma: Systematic review and meta-analysis of randomised sham/placebo-controlled trials. Complementary Therapies in Medicine, 75, 102956.

  Findings included improvements in asthma symptoms, quality of life measures, and pulmonary function outcomes, including FEV₁%.

Herb Medicine for Asthma

• Wang J, et al. (2018). The efficacy and safety of Chinese herbal medicine for adult asthma: A systematic review and meta-analysis. Frontiers in Pharmacology.

  The review found that combining Herb medicine with conventional asthma therapy may improve asthma control and support reductions in medication burden for some patients under appropriate supervision.