Articles in Category: Acupuncture

Acupuncture

Written by Richard McMahon, BSc (Acupunture), Dip Remedial Massage on Monday, 03 July 2017. Posted in Newsletters, General Health, Acupuncture, Chinese Medicine

Acupuncture

Acupuncture

By Richard McMahon

BHSc (Acupuncture), Dip Remedial Massage

 

What is Acupuncture?

Acupuncture is a therapy that has been an integral part of the Chinese Medical Tradition for over 2500 years making its way to the west in the early 70's. Acupuncture involves the insertion of fine, single use needles into specific points in the body with the aim of increasing the natural healing capacity of the body and reducing pain.

 

Do the Needles Hurt?

Patients’ sensitivity is extremely varied but most people do not find Acupuncture to be especially painful. Once the needles are in place most patients find they feel deeply relaxed and calm. However, these treatments are not weak, and in order for a sense of pain relief to occur post treatment, some sensation will be felt. Sometimes treatments are uncomfortable but the idea is to get a good outcome, rather than being specifically gentle and potentially not get a specific result.

 

Are there any Side Effects to Acupuncture?

The most common side effects of Acupuncture are deep relaxation and drowsiness. However small amounts of bruising can occur occasionally, aching around a tight muscle that has been treated is common in sensitive patients, similar to a deep remedial massage which can last for up to 24 hours, and extremely rarely a patient may feel faint and light headed if they are sensitive and haven't eaten anything that day.

 

Can I Benefit from Acupuncture Even If I Don't Have Reason to Get Medical Treatment?

Acupuncture has a strong regulating effect on the body and nervous system and can be useful in reducing stress and encouraging better rest and recuperation. Overall, Acupuncture has the potential to create a positive outcome for different conditions.

 

How Long Will It Take to Recover?

Most patients are very relaxed and sleepy after treatment so intense activity shouldn't be scheduled immediately following treatment. If treatment was for specific injuries or strong muscle tension, it is best to rest after treatment and the area can be achy for up to 24 hours in sensitive people. The patient should expect to be sore the day after treatment however relief should be felt the following day. The acupuncturist is interested in the response the patient is feeling a couple of days after treatment rather than the immediate 24 hour response, often if the acupuncturist is interacting with the problem then a reaction is most likely going to occur, if a patient has a more reactive system they may be sore for a couple of days, but if that means that in a week the patient is on the road to recovery then that's a good outcome from treatment. All of these effects are temporary and usually not perceived as an issue for patients.

 

How Many Visits Will I Need?

It totally depends on the patient and is adjusted case by case. This relies heavily on how much a patient is willing to do as homework e.g. stretching, diet and sleep and how much stress they have in their lives.  

 

Do You Use Herbs?

It is preferable to combine Chinese herbal therapy with Acupuncture when treating internal conditions such as digestive issues, sleep disturbance, menstrual irregularities etc. Herbal treatment aids in healing of injuries but usually external herbal formulas such as liniments or soaks are used in the West.

 

Do You Use the Heat Moxibustion?

Moxibustion is a fantastic therapy but due to smell/smoke I only use it when really necessary such as conditions of strong fatigue or when the patient has strong sensitivity to cold or strong pain that is worse in cold or damp weather.

 

Is It Similar to Getting an Injection?

Acupuncture needles are extremely thin so are usually much more comfortable than the larger needles used for injections.

 

Do You Use the Electrical Devices?

Electrical stimulation can be used to enhance treatment especially if the condition involves swelling e.g. chronic knee injuries or bursitis of the hip.

 

What Are the Known Conditions Treated by Acupuncture?

Musculoskeletal conditions treated include; lower back ache, knee pain, bursitis, tendonitis, tennis elbow, frozen shoulder, muscle tension, arthritis, sciatic, joint pain, sporting injuries.

Digestive conditions treated include; heartburn, diarrhoea, constipation, abdominal bloating or pain and ulcers.

The respiratory system can have beneficial effects from Acupuncture; these include the common cold, asthma, sinusitis, bronchitis, chronic cough, low immune system.

Acupuncture can also help with women suffering from menstrual cramps/pain, irregularity, abnormal bleeding and menopausal symptoms.

Cardiovascular problems can also be treated by the use of Acupuncture; these include patients with high or low blood pressure, fluid retention, chest pain poor circulation, muscle cramps, stress, insomnia, withdrawal from medication or drugs, headaches, migraines, facial and inter-costal neuralgia, some paralysis conditions, post stroke recovery, fatigue, chronic pain, post-op recovery.

What Should I Expect on My First Acupuncture Visit?

When you first attend our clinic for treatment you will be asked to fill out a detailed form about your general health and the history of the complaint that you would like treated. It is important that you fill out the whole form even if you feel the questions don't relate specifically to the condition you would like worked on. This questionnaire assists in understanding the unique state of your body so that we can address any underlying imbalances that may be contributing to your condition.

 

Your therapist will then ask a series of questions to further understand your unique constitutional make up. Your pulse will be taken and your therapist may need to perform some abdominal palpation to obtain further details about the state of the body.

 

Sports medicine assessment techniques will now be utilized if you are attending the clinic for a musculoskeletal complaint.

 

Management of Osteoarthritis with Traditional Acupuncture

Written by Richard McMahon, BSc (Acupunture), Dip Remedial Massage on Wednesday, 11 November 2015. Posted in General Health, Acupuncture, Chinese Medicine

Management of Osteoarthritis with Traditional Acupuncture

By Richard McMahon

BHSc (Acupuncutre), Dip Remedial Massage

Overview of Osteo-Arthritis

Osteoarthritis (OA) is a progressive degenerative joint disease that is characterised by the gradual loss of cartilage and subsequent loss of joint movement and pain. It is a leading cause of disability among adults and is associated with major impacts on physical function and mobility. Diagnosis is based on radiological changes and the clinical presentation of joint pain; including tenderness, limitation of movement, crepitus (crunching sounds), and variable degrees of localized inflammation. The prevalence, disability, and associated costs of treating osteoarthritis are expected to steadily increase due to our aging population. It is estimated that approximately 10% of men and 18% of women aged 60 years or older have symptomatic osteoarthritis worldwide. As there is currently no known cure for Osteo-arthritis treatment focuses on management of symptoms. It is common practice to prescribe non-steroidal anti-inflammatory medication, paracetamol or in severe cases opioid drugs for pain management. These strategies come with potential side effects so alternate strategies may be desired by patients suffering from the condition.

Research

Included is a summary of a meta-analysis of the studies that have been undertaken on the use of acupuncture in the treatment of osteoarthritis. Additionally an individual study performed in the UK notes the response and cost effectiveness of acupuncture. Also of interest is the inclusion of electro acupuncture for patients who are poor responders to traditional acupuncture and suggestions for treatment frequency and duration.

The systemic review and meta-analysis is titled “Pain management with acupuncture in Osteo- arthritis” by Manyanga et al. The stated objective of the review was to identify and synthesize date from previous randomized controlled trials comparing acupuncture to sham acupuncture, usual care, or no treatment, in adults diagnosed with osteoarthritis. Usual care refers to conservative therapy, pharmacological treatments, and rehabilitive exercises. In most trials, acupuncturists employed traditional hand stimulation of the acupuncture points. The most commonly used acupuncture points were ST34, ST36, Xiyan, GB34 and SP9. These are considered local points and belong to the traditional channel network of Chinese Medicine. Please see our previous articles on Sports Medicine Acupuncture to understand the importance of local, adjacent and distal acupuncture in traditional protocols.

The analysis includes 12 trials and a total of 1763 participants. Duration of interventions ranged from two to twelve weeks, with total follow-up durations ranging from four to 52 weeks. Through the review the researchers found acupuncture administered to adults with osteoarthritis to be associated with a statistically significant reduction in pain intensity, improved functional mobility and improved health-related quality of life. Reductions in pain were greater in trials with longer intervention periods. Major adverse events with acupuncture were not reported. The researchers suggest that acupuncture is most effective for reducing osteoarthritic pain when administered for more than four weeks. The researchers also postulate that due to the chronic inflammatory nature of OA it may be necessary for a “threshold dose” to obtain benefits and as such recommend 10 treatments on average with the aim of reversing the pathological changes that may have occurred in the central nervous system in regards to pain modulation.[i]

 

The second study noted above reports on a nurse led acupuncture study with the aim of postponing or avoiding knee surgery for patients with OA of the knee. 90 patients agreed to participate and after 1 month the trial achieved clinically significant improvements in pain, stiffness and function which continued for up to 2 years for over a third of patients. Acupuncture was given at weekly intervals for 1 month, and then reduced progressively to 6 weekly which mirrors common clinical practice. Patients who did not respond to manual acupuncture are given electro acupuncture and treatment was discontinued at 6 weeks if there is still no response. The researchers concluded that the use of acupuncture was associated with significant reductions in pain intensity and an improvement in functional mobility and quality of life. [ii]

Treatment recommendations

As noted in the above studies acupuncture treatment of OA is best performed weekly for 4-6 weeks and then gradually spread out to a maintenance dose as pain and stiffness decreases. Maintenance schedule depends on a patient’s response to treatment which will be determined by the underlying level of degeneration, their tendencies towards inflammation and the amount of activity required in their day to day lives.



 

[i] Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis

Manyanga et al. BMC Complement Altern Med. 2014; 14: 312.

[ii] Group acupuncture for knee pain: evaluation of a cost-saving initiative in the health service, White et al, Acupunct Med. 2012 Sep; 30(3): 170–175.

 

 

 

 

 

 

 

 

 

 

 

 

How Long will it take to Get Better?

Written by Don Williams BSc, MChiro, ICSSD. on Wednesday, 23 September 2015. Posted in Massage, General Health, Sporting Injuries, Acupuncture, Training and Performance, Chiropractic

How Long will it take to Get Better?

By Don Williams

B.Sc., M.Chiro., ICSSD., PG Dip. NMS Rehabilitation Cert DNS. Memb: FICS, CEA

 

One of the most common questions that we get asked every day in practice is, “How long will it take to get better?” Unfortunately there is no short answer to this question, however, in this article I will try to outline some of the contributing factors and delineate some guidelines and ideas which may help answer this question for you.

 

Everyone is an individual, and in that sense, how different people respond and heal from different injuries does vary somewhat, some injuries are particularly unpredictable, shoulders are particularly problematic in identifying how well or how quickly they will respond to treatment. However with most injuries, there are general time frames in which most healing will occur.

 

Most people who have ever had an injury and minor procedure which required stitches will remember that the stitches generally come out in around 7 days and this time frame is a good indication of how long a cut or trauma takes to “bond” back together, however, the general healing process generally takes around 21 days. This is the timeframe for the body to lay down a “callus” or matrix of fibres around the injury and develop new connections and bridges to stabilise the injury and repair. But this timeframe is dependent on good blood flow and environment for repair, additionally, just because the injury is stabilised, does not mean that it is fully healed and fully function. This healing process and time frame is specifically relevant for muscle and skin.

 

Areas of the body that receive poorer blood supply take longer to recover. Tendons and particularly joint cartilage and ligaments receive a lower direct blood supply and take longer to heal. We normally expect that tendon and ligament injuries will take 6 weeks to start to repair well and 3 months to be stable.

 

Bones fractures also take longer to heal. Interestingly, the ratio of cortical bone (the dense outer “shell”) to cancellous bone (the “spongey” inner core) also affects the healing rate. So when we look at bones like the tibia (the larger of the two lower leg bones) they take a particularly long time to heal (up to 4 months).

 

The other interesting thing to note is that an injury is not always something that is readily assessable via an x-ray or scan and often, the severity of the pathology on the scan can be very unrelated to the amount of pain. For example, someone with severe degenerative changes noted on an x-ray may not have any pain, and in contrast, someone with very severe pain may have really good looking x-rays.

 

It is also important to note that many people use pain as a guide to where they have a problem or not. This is a situation which has been reinforced with dodgy advertising commercials by big pharmaceutical companies suggesting that all of our aches and pains can be targeted and resolved with a little tablet.  At times pain killers can be helpful, but it is important to realise that, contrary to the advertising campaigns, and the statements of the celebrities fronting these commercials, these drugs do not “target” the source of pain. They work globally in the system to mask the pain. In fact anti-inflammatories drugs can actually slow the healing process and all of these drugs have potential for complications and side effects, some of these can be severe.

 

But pain is only the tip of the iceberg. Pain exists as an indicator that something is going wrong in our system. We have an area that is under duress or load which is unhappy or injured. Sometimes there are weaknesses or imbalances or inappropriate actions which have caused this problem to develop. Getting rid of the pain is a good start, but addressing the underlying dysfunction or causative factors is also important to reach a good long term outcome.

 

Part of our goal in assessment at Institute of Sports and Spines is to try to assess the contributing factors which caused your problem to develop in the first place and help you to eliminate or address these issues.

 

Another complicating factor as eluded to, early in the article is the individual nature of response.

Sometimes we will see muscle spasm problems which are very severe and painful, which is not related to severe pathology. At times these issues will respond very quickly to treatment and at other times they will be a little stubborn and take a little longer. Generally, the response to treatment gives a more accurate prediction of how quickly the issue will settle. Further to this, if you have had previous episodes of the same problem, the previous response rate is generally a reasonable indicator of the response rate for future episodes.

 

So as a general time line for healing rates:

  • Early tissue healing occurs in around 7 days

  • The majority of soft tissue healing takes around 21 days.

  • Early bone healing takes 6 weeks (up to 4 months so large, long bones)

  • Cartilage and Ligament issues take around 6 weeks to 3 months

  • Re-education and retraining takes a minimum of 3 months

  • Remodelling can take up to 1 year.

 

In a perfect world things can progress more quickly. The addition of complicating factors can drag these times frames out.  The better that problems are managed and treated increases the probability of a good resolution and good long term outcome.

 

Later in this newsletter and over the next few additions we will outline more specifically injuries of the neck, back, knee, hip, shoulder and tendonopathies.

 

If you have any further questions then talk to the team and we will help you out with more specific advice.

 

Fracture Healing -

 

Fracture Healing

 


Wound Healing -

 

Wound Healing