ALG Head of Education Michelle Weddell considers the role of acupuncture in today’s treatment of patients.
Derived from ancient Chinese medicine, acupuncture is a treatment in which fine needles are inserted at specific sites in the body.
Often seen as a form of complementary or alternative medicine, it is today used by the NHS, pain clinics and hospices to stimulate nerves under the skin and in muscle tissue to produce pain relieving substances such as endorphins.
Traditional acupuncture is based on the belief that an energy – known as Qi – flows through the body. Following Yin and Yang philosophies, this energy is always flowing and changing and is the divide between matter and energy.
Acupuncturists believe that when Qi dose not flow freely in the blood vessels of the body and its meridians, then it can cause blockages or illnesses.
Health problems often treated with acupuncture are diverse but include headaches, migraines, back pain and osteoarthritis as well as infertility, anxiety and asthma – although the National Institute for Health and Care Excellence (NICE) only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraines.
Yin and Yang relate to everything and not just the human body. Traditionally Yang is sunny and Yin is shady, however the meaning of Yang has developed into referring to heat, movement and upward and outward movements – while Yin is the opposite.
Meridians carry this energy and connect the organs together – but the organs in traditional Chinese medicine are different to the organs we know in Westernised medicine.
Where the meridians flow close to the surface there are points where the wind streams in and out. In the lower limbs some of the channels run from the foot to head, taking in the stomach, urinary bladder and gall bladder.
When seeing a new patient, a Chinese physician takes a medical history just like we do in Western medicine. But he wouldn’t stop there. Of equal importance would be an inspection of a patient’s pulse in their wrist, and their face and tongue.
Only then would he decide which organ is out of balance. Treatment would involve fine needles being inserted into key areas of the body to stimulate or sedate an organ to alter that person’s Qi. Needles are typically left in for a minimum of twenty minutes.
Today, physiotherapists and podiatrists are taught a modern version of Chinese acupuncture – although it is still viewed as an extended scope treatment.
So just how does modern acupuncture differ from traditional Chinese acupuncture?
Modern acupuncture does not reply on the examination of the pulse and the tongue. Instead we are taught to carry out a thorough medical, social and surgical history as well as look for other signs and symptoms a patient may have.
Frequently, modern acupuncture is offered to help relieve pain and most practitioners don’t believe that it can treat allergies, asthma and bronchitis or help a person to stop smoking.
Acupuncture needling is carried out with very fine needles of varying lengths depending on the body site that is being treated.
Short needles, 15mm in length and up to 0.20mm in diameter, are used for superficial needling, while longer 50mm needles up to 0.30mm in diameter are used in the back and soles of the feet.
The depth of insertion depends on the area being treated. Plantar fasciitis may need periosteal pecking of the calcaneus whereas treating diabetic painful neuropathy may only need superficial insertion into the back of the calf muscle.
In modern acupuncture needling points use a combination of segmental inserts at the site of pain and then follows dermatomes and the nervous system and trigger point inserting on tender points often in muscles.
When treating pain, some patients do experience warmth and sensations away from the point of insertion of the needle which does not respond to the nervous system, making us think there is a possibility of channels as in Chinese acupuncture.
The success of acupuncture varies between patients with 20 per cent of people not experiencing any response, while many are left feeling relaxed or mildly drowsy.
Courses of acupuncture vary with an average of six treatments for maximum impact. However, in diabetic pain neuropathy the repeat of treatment every four weeks has been found to reduce symptoms and the need to take medication.
Physiotherapists are able to treat the whole body with acupuncture whereas the podiatry profession concentrate on the lower limbs.
When choosing an acupuncture practitioner it is important to ensure they are a regulated healthcare professional or a member of a recognised national acupuncture organisation.
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