Acupuncture

What are the origins of acupuncture?

In its original form 2000 years ago acupuncture was based on the principles of traditional Chinese medicine. According to these, the workings of the human body are controlled by a vital force or energy called "Qi" (pronounced "chee"), which circulates between the organs along channels called meridians. 

There are 12 main meridians, and these correspond to 12 major functions or "organs" of the body. Although they have the same names (such as liver, kidney, heart, etc), Chinese and Western concepts of the organs correlate only very loosely. Qi energy must flow in the correct strength and quality through each of these meridians and organs for health to be maintained. The acupuncture points are located along the meridians and provide one means of altering the flow of Qi. 

Although the details of practice may differ between individual schools, all traditional acupuncture theory is based in the Daoist concept of yin and yang. Illness is seen in terms of excesses or deficiencies in various exogenous and endogenous pathogenic factors, and treatment is aimed at restoring balance. Traditional diagnoses are esoteric, such as "kidney-yang deficiency, water overflowing" or "damp heat in the bladder." 

How does it fit into ‘western’ healthcare ideas?

Many of the conventional health professionals who practice acupuncture have dispensed with the concepts of meridians and Qi energy. Acupuncture points are seen to correspond to physiological and anatomical features such as peripheral nerve junctions, and diagnosis is made in purely conventional terms. An important concept used by such acupuncturists is that of the "trigger point." This is an area of increased sensitivity within a muscle which is said to cause a characteristic pattern of referred pain in a related segment of the body.

Acupuncture when done to relieve trigger points in this way is often called ‘Dry Needling’.

What are Trigger Points?

Trigger points are highly irritated spots located in muscle tissue and the fibrous layers (fascia) in and around muscles. Trigger points can be laid down whenever a muscle is damaged or stressed and often exist alongside other mechanical problems such as joint strains. Pain may or may not be present when a trigger point develops. In the event of physical or emotional stress, these irritated spots may trigger spasm and pain. Trigger points when active produce pain both locally as well as referred elsewhere. The pattern of referred pain from trigger points is similar from individual to individual. By injecting irritant chemicals into muscles of volunteers, researchers have mapped the referral patterns for trigger points in most of the muscles of the body. These referral pattern maps may be seen at all the Back2Health Clinics where they are used to guide practitioners to the underlying cause of patients pain.

Western acupuncture ( also called Dry Needling) uses the stimulation of fine acupuncture needles to release stubborn or recurrent trigger points. This treatment has proved superior to other techniques in removing the pain and muscle dysfunction that trigger points cause.

How does acupuncture work

The effects of acupuncture, particularly on pain, are at least partially explicable within a conventional physiological model. In lay terms it may be explained that the signals caused by nerves stimulated by acupuncture needles block signals from pain nerves both in the spine as well as in the brain. In addition chemicals released during acupuncture have a calming effect on the whole nervous system. Because muscle spasm is part of a ‘pain cycle’ acupuncture relaxes tight muscles. This explanation describes how pain and muscle dysfunction are helped by acupuncture however, certain aspects of traditional acupuncture, which have some empirical support, resist conventional explanation.

Dry Needling at Back2Health

The practitioners at Back2Health using dry needling all have a medical degree or similar as their primary qualification. The training in needling is secondary to this.

Dry needling and PENS are used as part of a course of care and are only used to reduce pain and restore muscle function.

No other complaints are treated by needling at Back2Health.

If anyone wishes to investigate the possible benefits from acupuncture for other problems we would encourage them to consult an acupuncturist trained in traditional Chinese medicine.

The evidence base for the effectiveness of acupuncture grows

Of all the complimentary therapies acupuncture has one of the largest bodies of research evidence demonstrating its effectiveness. Unfortunately much of the research has been poorly carried out and the results may be misleading. Recently however there have been an increasing number of research projects published by experienced teams of scientists in reputable peer reviewed journals.

Following a two year study published in August 2000 in The British Medical Journal the British Medical Association’s Board of Science and Education has found that acupuncture has proved effective in treating back and dental pain, nausea and vomiting, and migraine. They conclude that acupuncture should become more widely available on the NHS and family doctors should be trained in some of its techniques

The University of Texas Southwestern Medical Centre in Dallas has been looking into the effectiveness of treatments for lower back and neck pain. They found that percutaneous electrical nerve stimulation (PENS) [gentle electrical stimulation of acupuncture needles] was more effective than a range of traditional techniques such as transcutaneous electrical nerve stimulation (TENS) and exercise therapy in providing pain relief and improved physical functioning.  In the paper published in The Journal of the American Medical Association on March 2nd 1999, Dr. Ghoname and colleagues wrote "Compared with the other three modalities, 91 percent of the patients reported that PENS was the most effective in decreasing their low back pain (LBP). The PENS therapy was also significantly more effective in improving physical activity, quality of sleep and sense of well being."  They continued "Due to the apparent cumulative effects of PENS over the course of the treatment period, this data suggests that this treatment modality over a longer period of time has the potential to produce prolonged beneficial effects in patients with long-term LBP,".  The authors advise that to achieve the maximum benefit from non-drug therapies such as PENS, it is best to use a mix of rehabilitative therapies. Guidelines in the UK indicate the most effective rehabilitative therapies are manipulation and exercise.

GP, the weekly magazine for family doctors in the UK , has published an article by Dr Richard Halvorsen. In this he details the results of a trial of a variety of treatments for LBP. In the conclusion he writes “ The analysis demonstrated that the treatment of back pain with acupuncture was significantly more likely to benefit patients than control conventional treatments”.

Acupuncture and Osteoarthritis

Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial
BMJ, doi:10.1136/bmj.38029.421863.EB (published 15 March 2004) Andrew J Vickers et al.

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© September, 2009 - Back2Health Group