ACUPUNCTURE THERAPY

Dallas DooleySusan Swords

WHAT IS ACUPUNCTURE? Traditional Chinese Medicine

Insertion of needles into the skin at numerous different sites of the body

Established over 5,000 years ago

Used to treat a number of different illness including pain, nausea, stress, depression, anxiety….

TRADITIONAL CHINESE MEDICINE A form of medicine that originated several

thousands of years ago Focused around herbal treatments,

acupuncture, moxibustion, dietary therapy, and qi exercise

Based on a concept of Qi A force field of energy within the body The energy and center piece of all elements of

the universe Qi is expressed through channels or

gateways throughout the body called meridians

TRADITIONAL CHINESE MEDICINE Concept of Yin and Yang

The basis for all things in nature and the universe

All living things are in search for the balance of Yin/Yang

Yin means shady or coolYang means sunny or hotThe balance of Yin/Yang represents a

healthy state of physical health and mental health

TRADITION CHINESE MEDICINEConcept of 5 Elements Fire (Heart, Small Intestine) Earth (Stomach, Spleen) Metal (Lung) Water (Bladder, Kidneys) Wood (Liver)

The elements not only represent these organs they also represent direction, seasons, emotions, colors, taste and climatic sensations

CONCEPT OF 5 ELEMENTSEach of these element feeds off of each other and contributes a vital part to the TCM

It takes cohesion of all these elements to have a healthy and balanced body

FIVE ELEMENTS OF LIFE

CONCEPT BEHIND ACUPUNCTURE

Chinese healers thousands of years ago felt that the human body contained gateways or channels throughout the body called meridians.

It was believed that the obstruction or injury of these channels is what caused pain and illness.

Chinese healers determined that inserting very small and fine needles into different points on the body would opens these channels up and release the obstruction of qi or energy that was being contained.

HOW ACUPUNCTURE WORKS

Insertion of needles into the skin at predetermined areas of the body

Depending on the illness that is being treated, the needles may be placed millimeters under the skin or several centimeters under the skin

There are 14 main channels or meridians throughout the body with over 365 acupuncture points feeding those channels

ACUPUNCTURE POINTS

REVIEW OF LITERATURE A total of six studies were reviewed Each study was unique to the study of

acupuncture Focused on use of acupuncture for chronic

pain. But also studied the effectiveness for pregnancy induced pain

Obtain information on the safety and effectiveness of acupuncture

Also studied if the needle insertion depth made a difference to the effectiveness and safety of acupuncture

TRIGGER POINTS AND ACUPUNCTURE POINTS FOR PAIN: CORRELATION AND IMPLICATIONS Identified trigger points as hyperirritable

spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers

AKA “knots in your muscle” Study set out to determine if trigger point

pain was located in the same regions of the body as acupuncture points.

75% of trigger point pain was also located in an acupuncture needles site

Therefore nearly 75% of trigger point pain (muscles knots) could be relieved by acupuncture

ADVERSE EVENTS FOLLOWING ACUPUNCTURE: PROSPECTIVE SURVEY OF 32000 CONSULTATIONS WITH DOCTORS AND PHYSIOTHERAPISTS

Study set out to determine the safety of acupuncture

Authors recruited several acupuncture therapist to collect data and report the number of adverse effects that occurred with acupuncture therapy

Study was conducted using 32,000 consultation with several acupuncture therapist

Study reveled that adverse effects occurred with 671 in 10,000 studies

The most common adverse effects were bleeding at the needles site or aggravation of associated symptoms

A REVIEW OF THE EVIDENCE FOR THE EFFECTIVENESS, SAFETY, AND COST OF ACUPUNCTURE, MASSAGE THERAPY, AND SPINAL MANIPULATION FOR BACK PAIN This study set out to determine which form of

“alternative” medicine was the most effective

The determined that massage therapy, spinal manipulation and acupuncture were all considered alternative forms of medicine

Study reveled that massage therapy was more effected in the treatment of chronic lower back pain, and that of acupuncture.

Although showed that acupuncture produced quicker relief of symptoms than that of placebo

Showed that besides massage therapy, acupuncture was the safest practice.

INTRAMUSCULAR AND PERIOSTEAL ACUPUNCTURE IN PATIENTS SUFFERING FROM CHRONIC MUSCULOSKELETAL PAIN

Study that focused on the effectiveness of treating chronic musculoskeletal pain using intramuscular (IMA) versus periosteal acupuncture (PA)

Authors hypothesized that PA would have better pain relief than IMA

After 6 months of treatment, 46% of the IMA group and 45% in the PA group obtained clinically relevant pain relief & there was a significant decline in analgesic use

Found no difference in pain relief between the IMA and PA groups

Study showed that both forms of acupuncture treatments had more of a significant pain relief 6 months after treatment than the control group

ACUPUNCTURE TREATMENT OF PREGNANT WOMEN WITH LOW BACK AND PELVIC PAIN-AN INTERVENTION STUDY

Study aimed to evaluate effectiveness of acupuncture in pregnant women versus the most common treatment being the sacro-ileac belt

Two groups were evaluated, one receiving treatment at 20 weeks gestation and the other at 26 weeks gestation

The 26 wk gestation group had greater pain relief than the 20 wk gestation group Both groups had significant pain relief throughout

their treatments A weakness to this study was that there were

only 32 women who completed the study & no control group

SAFE NEEDLING DEPTH OF ACUPUNCTURE POINTS

The study focused on the proper needling depths and consequences of needling too deep

Most practitioners insert the needle 75-80% of the needle length based on their experience while textbooks suggest needling at a few millimeters to several centimeters

Needling depth also varied according to the patient’s age, BMI, body weight & length, and gender

Limitations to this study included that most of the research was performed on dissected cadavers

Researchers found there were no universal guidelines exist in how deep needles should be inserted Consequences include: pneumothorax and

organ injury

ACUPUNCTURE AND ADVANCED PRACTICE NURSES Acupuncture can be used to treat a variety of

ailments APNs should give their patients options in

their treatment when patients have chronic pain or chronic nausea and vomiting

Covered by some insurances and less expensive that modern medicine

Acupuncture has been used for thousands of years and has been successful

Alternative to narcotic pain medications, frequent radiological studies and surgeries

REVIEW OF LITERATURE REFERENCES Cherkin, D.C., Sherman, K.J., Deyo, R.A., Shekelle, P.G. (2003). A review of the

evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain. American College of Physicians, 138(11), 898-907.

Chou, P.C., Chu, H.Y., & Lin, J.G. (2011). Safe needling depth of acupuncture points. The Journal of Alternative and Complementary Medicine, 17(3), 199-206.

Ekdahl, L., & Petersson, K. (2010). Acupuncture treatment of pregnant women with low back and pelvic pain-an intervention study. Scandinavian Journal of Caring Sciences, 24, 175-182.

Hansson, Y., Carlsson, C., & Olsson, E. (2008). Intramuscular and periosteal acupuncture in patients suffering from chronic musculoskeletal pain. Acupuncture in Medicine, 26(4), 214-223.

Melzack, R, Stillwell, D.M., & Fox, E.J. (1977). Trigger points and acupuncture points for pain: correlation and implications. Pain, 2(23), 3-23.

White, A, Hayhoe, S, Hart, A, & Ernst, E. (2001). Adverse events following acupuncture: prospective survey of 32,000 consultations with doctors and physiotherapist. British Medical Journal, 323, 485-86