Articles in Category: Chinese Medicine

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.

 

 

 

 

 

 

 

 

 

 

 

 

Sports Medicine Acupuncture

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

Sports Medicine Acupuncture

By Richard McMahon

BHSc (Acupuncutre), Dip Remedial Massage

 

This series of articles aims to explain the basic considerations of modern Sports Medicine acupuncture that is still a part of the broader field of Chinese Medicine and how it is separate from what is commonly referred to as “dry needling”.

When acupuncture is used for musculoskeletal conditions the focus is predominantly on the affected tissue and external channel theory and less on internal constitutional considerations ie. organ theory. In saying that there are many cases in which the internal state of the body; dominant emotional patterns, convalescence from colds and flues, the ability to tolerate cold, wind or dehydration or generalized fatigue will have a strong effect on the musculoskeletal complaint and as such a full assessment is always made with the onset of treatment and addressed if appropriate.

The standard method of treatment of traditional Chinese acupuncture involves the combination of local points (at the site of the problem), adjacent points (nearby the site of the problem) and distal points (at the other end of the affected channel on which an injury or dysfunction is found).

In contrast, “Dry needling” as it is now known, involves the insertion of a needle directly into a painful band in a muscle. This technique is commonly used by Chiropractors, Physiotherapists, GPs and others who specialise in musculoskeletal pain. Dry needling generally involves very strong manipulation of the needle to try to obtain a muscle twitch or fasciculation and is often quite uncomfortable. The needle is not retained as is the practice of traditional acupuncture.  Dry needling is not considered a part of the acupuncture tradition springing from the work of Travell and Simons who brought to the attention of the west the awareness of trigger points ( hypersensitive nodules found along taught bands in muscle that refer pain in specific patterns). Prior to this time many patients with chronic pain were tragically considered to be more in the realm of psychotherapy, rather than for hands on treatment.

In the early days treatment involved the use of hypodermic syringes with anaesthetic or saline solution but this was found to have a comparative effective without the liquid so the term “dry needle” is used today. Interesting though is the fact that a large number of the standard trigger points are traditional acupuncture points and the referral patterns often follow the traditional channel pathways. The Chinese channel framework was not familiar to Travell and Simons at this time.

Chinese acupuncture does utilize tender point needling known as “Ashi” needling, but it is generally not as vigorous and the needle is retained in place and combined in with the rest of the treatment considerations.

In traditional acupuncture there is a saying “where there is free flow, there is no pain and where there is pain there is no free flow”.  Pain is considered to be caused by an obstruction in the healthy flow of blood and energy through the site of discomfort. This needs to be assisted to move via treatment with acupuncture, massage, cupping, stretching and movement. Heat is often used as it dilates blood vessels and encourages increased circulation and muscular relaxation. Ice is used extremely cautiously and for a very limited period of time in Chinese medicine as it constricts blood vessels. The use of adjacent and distal points is considered to be very important as they encourage the body to re-establish the circulation through the entire channel as it is seen to be one functional component of our connective tissue.

In the next instalment of this article series we will look at some of the physiological changes that acupuncture has been shown to induce in the body in regards to modulating pain and the inflammatory cascade.