MEDICAL ACUPUNCTURE

1. Introduction to Acupuncture

Once regarded as a mystical form of Eastern medicine, acupuncture has grown from its debut in North America more than 30 years ago into one of the most popular modalities utilized in the contemporary health-care marketplace. Originally developed in China, acupuncture has evolved over thousands of years and has formed the cornerstone of Traditional Chinese Medicine (TCM).

Many types of healthcare providers now utilize acupuncture in clinical practice, including chiropractors, physiotherapists, Registered Nurses and medical doctors. A natural corollary of this trend has been a continuing integration of acupuncture into a Western medicine model. Utilizing a blend of ancient methods and modern biomedical concepts, practitioners of many disciplines are regularly incorporating acupuncture treatment not only as a stand-alone therapy, but as an integrated modality in a variety of health-care environments.

Patients all over the world now seek acupuncture treatment in its various forms for a multitude of ailments including pain relief, headaches, arthritis, addiction management, sports injuries and general well-being, to name a few.

Acupuncture’s popularity has been further bolstered by the increasing attention it is being paid in scientific circles. Numerous trials demonstrating its effectiveness have recently been published in major medical journals, with more to come. Other interesting lines of research currently in progress include investigations into the biomechanical effects of acupuncture on connective tissue structure, function, and healing, and its impact on the peripheral and central nervous systems.

2. What is Medical Acupuncture?

Medical Acupuncture is the biomedical adaptation of Chinese acupuncture methods, and is an effective and simple treatment approach based on current concepts of neurophysiology, neuroanatomy, and pathophysiology. As in traditional acupuncture, Medical Acupuncture involves insertion of solid needles at relevant points on the body in combination with manual needle stimulation or electrical stimulation, diagnosis is attained through thorough history taking and physical examination. Based on this process, anatomical points that are relevant to the condition are selected for needling.

3. What are the benefits of acupuncture?

Acupuncture is generally considered to have non-specific effects. This means that in addition to addressing acute injuries and symptoms, it can have generalized benefits for the body as a whole. The benefits of acupuncture can include, but are not limited to:

• pain relief
• decreased swelling
• muscle relaxation
• breaking down scar tissue
• pain modulation and endorphin release
• changes in autonomic nervous system activity (vasomotor tone, cardiac rhythm, peristalsis etc.)
• diverse neuroendocrine and immune responses
• general relaxation
• a feeling of psychophysical well being
• improved sleep
• nausea relief during chemotherapy

Acupuncture can be very effective for treating both acute injuries and chronic conditions. When utilized by a trained health-care professional, it is very safe. A medical acupuncture provider will be able to discuss your medical problems, understand the results of medical tests, and understand what medication you are taking and why – so be sure to inform them of this information.

5. How are Medical Acupuncture providers trained in Canada?

The Medical Acupuncture Program at McMaster University in Hamilton, Ontario is an Evidence Based Approach to Traditional Chinese Medicine (TCM) has been approved by;The Royal College of Physicians and Surgeons of Canada & The College of Family Physicians of Canada.
For further details on this program, please visit http://www.acupuncture-program.com/

6. How is Medical Acupuncture regulated in Canada?

Acupuncture is not regulated by all provinces in Canada. It is therefore important that you choose a practitioner who is trained according to World Health Organization standards, and who is fully certified through a recognized, reputable program based in a university or college.

7. Is Medical Acupuncture safe?

In the hands of properly trained and certified practitioners, acupuncture is a very safe form of treatment. However, any procedure involving insertion of needles into the body has some potential problems. In addition, there are a few "side effects" potentially produced by acupuncture treatment which can occur in some people. A well-trained practitioner will ask a patient to remain in a relaxed position for 15-30 minutes after the first treatment with acupuncture, to ensure that no adverse reaction will develop.

Here is a list of some of the side effects you may, or may not, experience:

• momentary discomfort where the needles are inserted
• drowsiness and sleepiness
• localized Bruising
• temporary worsening of your symptoms
• fainting
• feeling faint, during or after treatment

• damage to an internal organ from insertion of a needle
• Infection in the area where the needle was inserted
• Infection spreading throughout the blood system to infect previously damaged heart valves
• premature onset of labour, in a late-stage pregnant.

PAIN RELIEF FROM MEDICAL ACUPUNCTURE TREATMENT
Acupuncture is very effective for relieving pain. There are a number of mechanisms, both direct, and indirect, that are responsible for this. Inserting needles into anatomical locations creates a very small injury, which your body must quickly heal. This stimulates healing of the surrounding tissues including muscle, fascia, nerves, skin, and connective tissue. Indirectly, acupuncture has widespread effects on numerous tissues and systems in the body.

One of the main mechanisms of acupuncture analgesia is the release of myofascial trigger points. There is a close correlation between traditional Chinese acupuncture points for pain and common muscular trigger points. As noted by R. Melzack, co-author of “The Gate Theory of Pain”, this represents a major convergence of Western and Eastern knowledge. The traditional Chinese "Ah Shi" (translates to 'Oh yes') points are frequently equivalent to trigger points, which are hyperactive bands of muscle that reproduce pain syndromes with direct palpation.

Relaxation of "stuck" myofibrils, increased local blood supply, the release of spinal dynorphin and encephalin (endogenous opioid, or pain-relieving compounds) have all been put forward to explain the rehabilitative effects of trigger point needling. In addition to local needling, distal points below the elbow or knee are used to modulate the sympathetic nervous system and modulate pain signals at the source. Trigger points or “Ah Shi” points can be analyzed clinically by using direct palpation. The contribution of trigger points to the pathogenesis and maintenance of pain remains unknown, and is an important area of research that may well resolve many of the questions involving common pain states.

Melzack, in a recent article on the role of compensation in chronic pain states, appears to support the importance of these concepts. "Patients who failed to respond to conventional forms of therapy were sometimes cured if the physician recognized that abnormal autonomic nervous system activity may persist indefinitely after a brief injury or that trigger spots may develop at the site of even relatively minor injury. Major procedures such as cordotomies may fail, but simple ones such as trigger point injections, may produce sudden remarkable recovery and subsequent return to work."

Many family doctors have responded to their patients' needs by adding pain management tools to their practices. These tools frequently include pain assessment techniques, Acupuncture, Manipulation, Relaxation Training and Re-education of job task and posture. Medical acupuncture in particular is one of general practice's growth areas.

From the early 1970s when only a few medical practitioners used acupuncture, there is now widespread use and integration of alternate stimulation techniques developed from Traditional Chinese Acupuncture. (Stimulation techniques developed from Traditional Chinese Acupuncture include Dry needling, Electro-acupuncture and TENS, Trigger point injection and dorsal column stimulation.)

The results of controlled studies which have been extensively reviewed show good evidence for the short term effectiveness of acupuncture in many pain states. The long term studies, particularly where the well trained acupuncturist has been given the freedom of (traditional) normal practice profiles, have been encouraging, with success rates far higher than those associated with the placebo response.