Sunday, July 14, 2013

Acupuncture and the use of Chinese medicine for the treatment of pain: Who is using it and how does it work? PainAustralia Article

In May 2012 I was asked to write an article for the PainAustralia group, Painaustralia is a national not-for-profit body established to improve the treatment and management of pain in Australia. Finally the article came out in their latest news letter. It was a delight to see it. I am very proud of the up to date referencing too!

Here's the link to the article on their site and the full article below!

Acupuncture and the use of Chinese medicine for the treatment of pain: Who is using it and how does it work?
By Damien Bodnarchuk  B.Hlth Sc Trad Chinese Med(UTS)/Cert Trad Chinese Med (Beijing)/Dip Nat Hlth Yoga (NCC)/ M.AACMA

In China, where Western and Eastern medicine are combined in all major hospitals under the term ‘integrated medicine’, it is used by millions of people. In the wards which I visited in Beijing, I witnessed it used with oncology, rheumatology, dermatology and range of other issues.

Chinese medicine is based on ancient information written 2000 years ago, from the second century BC. This information was condensed and systemised in the beginning of the 20th century, at the time of China’s cultural revolution. The four-year undergraduate course in acupuncture in the 21st century contains the same basic information from 2000 years ago, using the same main reference materials.

Acupuncture was first approved by the World Health Organisation (WHO) as a method for treating pain in 1979 and today it is endorsed by health services worldwide.

In the UK the National Health Service (NHS) offers acupuncture, and in the US it is recognised by the National Institute for Health (NIH), the primary agency of the United States government responsible for biomedical and health-related research.

In Australia, acupuncture has been reimbursed by the Australian National Health System under the Medicare Benefits Scheme (MBS) (Items 173, 193, 195, 197 and 199) since 1984, and it is one of the most accepted forms of complementary medicine among Australian GPs.1

It is also increasingly used by patients, with a 2008 study finding that 9.2 percent of Australians had used acupuncture in the 12-month study period, with back pain the most common condition treated. 2

Pain Conditions Responsive to Acupuncture
The WHO lists the following pain conditions as those that can be successfully treated with acupuncture:
·         neurological pain (such as headaches, migraines and facial neuralgia);
·         musculoskeletal issues (such as back pain, osteoarthritis, sciatica, shoulder and elbow pain); and
·         many types of sporting injuries.3

New research from Australia has shown acupuncture can also be effective in the management of acute pain.4

Understanding Acupuncture through Western Medicine
Western medicine addresses the complex multiple system effects of acupuncture on the body. There are studies ranging from effective noticeable brain changes under MRI scans, nerve pathway theories, hormone release changes (opioid systems activated in the brain), blood flow changes and even placebo effects, although there are many demonstrated physiological responses.5

The most recent study, a meta-analysis of 17,922 patients published in September 2012, showed significant differences between true and sham acupuncture trials. The study concluded that cupuncture is more than just a placebo, effective for the treatment of chronic pain and therefore a reasonable referral option for doctors.6

Another study conducted by the University of York, UK, investigated the economic value afforded by acupuncture for the treatment of lower back pain, neck pain, dysmenorrhea, migraines, arthritis, and headaches, concluding it to be a cost-effective intervention.7

There are many studies available and there are many in-progress that suggest a range of effects, with a 2007 German pain trial finding acupuncture reduces lower back pain twice as much as conventional therapy (compared to drugs, physical therapy and exercise).8

In 2005, an RMIT trial examined the effect of acupuncture for pain relief on more than 1,000 patients at the Emergency Department of the Northern Hospital in Melbourne, and it was shown to be a potentially effective therapy for acute pain management. This led to a three-year NHMRC-funded project to treat acute migraine, back pain and ankle injuries currently underway, led by Professor Marc Cohen and Professor Charlie Xue.9,10

Research into acupuncture is continuing in Australia, particularly through the University of Western Sydney and the University of Sydney, as well as the RMIT in Melbourne.

Understanding Acupuncture through Eastern Medicine
The eastern medicine understanding is based around the concept of energy. Good health is understood to be the smooth flow of energy through meridians or pathways in the body. Pain is stated as being energy that is stuck and the use of acupuncture needles inserted in the body moves this stuck energy and helps the body heal itself. The source of energy is still elusive, and there is no current scientific definition for it.

Diagnosis and Treatment Process
Diagnosis is conducted with the visible signs and symptoms of an issue and then interpreted according to Chinese medicine theory, and treatment is given accordingly. Most patients report some sensation in the body with acupuncture. This can be a dullness, heat, muscle spasm or feeling at the point of insertion, or at other areas in the body where there are no needles. Often straight after a treatment a patient will feel physically, emotionally or mentally noticeably different for a short period of time.

Damien Bodnarchuk is a professional Chinese medicine physician, previous president of the UTS Chinese medicine society and is on the Australian Acupuncture and Chinese Medicine Association NSW State board. He practices in rooms at Gp on Ebley medical centre in Bondi Junction and can be contacted through their website or on 9387 1171.

2 Xue et. al. 2008
3 WHO acupuncture web page WHO
5 Huang W, Pach D, Napadow V, Park K, Long X, et al. (2012) Characterizing Acupuncture Stimuli Using Brain Imaging with fMRI - A Systematic Review and Meta-Analysis of the Literature. PLoS ONE 7(4): e32960. doi:10.1371/journal.pone.0032960 April 9, 2012
6Vickers et. al.2012/
8 Michael Haake, PhD, MD et al. Arch Intern Med. 2007;167(17):1892-1898.

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