ACUPUNCTURE
|
Conditions that can be helped by acupuncture and electroacupuncture
A. Good evidence base Adverse reactions to radiotherapy and/or chemotherapy Allergic rhinitis (including hay fever) Biliary colic Depression (including depressive neurosis and depression following stroke) Dysmenorrhoea, primary Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm) Facial pain (including craniomandibular disorders) Headache Hypertension (high blood pressure) Knee pain Low back pain Malposition of fetus, correction of Morning sickness Nausea and vomiting Neck pain Pain in dentistry (including dental pain and temporomandibular dysfunction) Periarthritis of shoulder Postoperative pain Renal colic Rheumatoid arthritis Sciatica Sprain Stroke Tennis elbow B. Evidence base less strong Abdominal pain (in acute gastroenteritis or due to gastrointestinal spasm) Acne vulgaris Bell’s palsy Bronchial asthma Cancer pain Cardiac neurosis Cholecystitis, chronic, with acute exacerbation Cholelithiasis Competition stress syndrome Diabetes mellitus, non-insulin-dependent Earache Female infertility Facial spasm Female urethral syndrome Fibromyalgia and fasciitis Gouty arthritis Hypo-ovarianism Insomnia Labour pain Lactation, deficiency Male sexual dysfunction, non-organic Ménière disease Neuralgia, post-herpetic Neurodermatitis Obesity Osteoarthritis Pain due to endoscopic examination Pain in thromboangiitis obliterans Polycystic ovary syndrome Premenstrual syndrome Prostatitis, chronic Pruritus Radicular and pseudoradicular pain syndrome Raynaud syndrome, primary Recurrent lower urinary-tract infection Reflex sympathetic dystrophy Sjögren syndrome Sore throat (including tonsillitis) Spine pain, acute Stiff neck Temporomandibular joint dysfunction Tietze syndrome Tobacco dependence Ulcerative colitis, chronic This list is taken from the report published by the World Health Organisation (2003) Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. The full list can be accessed here. |
What is Acupuncture?
Acupuncture involves placing very fine needles in specific points (acupuncture points) on the body. Developed by the Chinese over 4000 years ago, a considerable amount of reliable research in the last 30 years has established acupuncture as a modern and effective treatment for many medical problems, not just for pain relief. The list on the left prepared by the World Health Organisation (WHO) gives an idea of acupuncture's scope. What type of acupuncture does Dr Monk use? There are two broad divisions in acupuncture, Western Medical Acupuncture (WMA) and Traditional Chinese Acupuncture (TCA), which includes Five Element Acupuncture. Dr Monk practises Western Medical Acupuncture. This is an adaptation of traditional acupuncture based on a modern scientific understanding of the working of the body. It follows the principles of evidence based medicine. From a large amount of scientific research carried out we can now explain and understand many of the effects of acupuncture in terms of western medicine. This has helped to make it acceptable to western doctors, and many patients are reassured by this scientific basis. It leads to a rational and logical basis for using needles or electroacupuncture to produce largely predictable responses in the body. How does Acupuncture produce an effect? Stimulating acupuncture points produces a series of effects in the body, which fall into two main groups; A. Local effects - these occur at or near the site of needle placement. These responses include increased blood flow, relaxation of tense muscle and release of pain relieving and healing chemicals. B. Central effects - stimulating an acupuncture point also sends signals through the spinal cord to the brain. These 'central responses' release chemicals involved in pain relief, mood stimulating, immune responses, and so on. What this means is that as well as local responses, acupuncture can also produce widespread effects throughout the body which are largely predictable, and this suggests why patients can report improvement in a wide range of conditions when they have treatment. Knowledge of these neurophysiological principles (tin other words, the mechanism of action in the body) allows us to prescribe an effective and evidence based way of treating your problem. Does Acupuncture hurt? Most people find needle acupuncture comfortable, feeling only a slight prick as the needle is placed at the acupuncture point. Once the needle has been inserted most people don't feel anything at the point, although often a sense of relaxation and well being is produced. Is it possible to have Acupuncture without needles? Yes. For those patients who are afraid of needles or for certain conditions, acupuncture techniques which don't involve needles are used. These include; 1. noNeedleElectroAcupuncture (nNEAP) This is a modern substitute for needle acupuncture. Tiny electrical impulses are applied to acupuncture points on the surface of the body through small pads which are taped to the skin; you feel only a slight tingling or buzzing sensation at these points during this treatment. 2. Auriculotherapy Acupuncture points on the ear appear to correspond with different parts of the body. Treating these ear points can be particularly helpful in a large number of problems, including certain types of pain. The points are stimulated using a small hand held probe and you will feel a mild tingling sensation at the point. Again no needles are used. This approach is often used in conjunction with nNEAP to body points. 3. Pulsed red light Acupuncture points respond to red light pulsing at certain frequencies. We use a small handheld instrument, about the size of a pencil, for this. The completely painless technique is very helpful for certain conditions. In practice I have found it useful for painful scars and small areas of eczema, and is also very successful in the treatment of treat hay fever and sinusitis. For an in-depth review of how acupuncture works, and the scientific evidence for it, you might find the following references useful; Bowsher D. Mechanisms of acupuncture. In: Filshie J, White A, editors. Medical Acupuncture - A Western Scientific Approach. 1st ed. Edinburgh: Churchill Livingstone; 1998. p. 69-82. Filshie J, Thompson JW. Acupuncture. In: Doyle D, Hanks G, Cherny N, Calman K, editors. Oxford Textbook of Palliative Medicine. Oxford: Oxford University Press; 2004. p. 410-24. Cummings M. Acupuncture and trigger point needling. In: Hazelman B, Riley G, Speed C, editors. Soft Tissue Rheumatology. Cambridge: Oxford University Press; 2004. p. 275-82. Barlas P, Lundeberg T. Transcutaneous electrical nerve stimulation and acupuncture. In: McMahon S, Koltzenburg M editors. Wall and Melzack's Textbook of Pain. 5th ed. Philadelphia: Churchill Livingstone; 2005. p. 583-90. Lundeberg T. Effect of sensory stimulation (acupuncture) on circulatory and immune systems. In: Ernst E, White A, editors. Acupuncture - A Scientific Appraisal. 1 ed. Oxford: Butterworth Heinemann; 1999. p. 93-106. White A, Cummings M, Filshie J. An Introduction to Western Medical Acupuncture. London: Churchill Livingstone; 2008. |
In the last few years we have seen many robust clinical studies published with large numbers of patients e.g. more than 5000 patients in an allergic rhinitis study (Annals Allergy, Asthma & Immunology 2008;5;535-543); 659 women with dysmenorrhoea (Am J Obstet Gynecol 2008;198;166,e1-166e8); 3600 patients in a study on hip and knee arthritis (Arthritis & Rheumatism 2006;54(11);3485-3493).
These are large scale trials which strongly support the evidence base for acupuncture. 
fMRI brain scan showing different parts of the brain responding to acupuncture
http://deskarati.com/2010/11/30/acupuncture-changes-brains-perception-and-processing-of-pain/ |