Acupuncture Therapy

1. Acupuncture Therapy Dallas Dooley Susan Swords

2. 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….

3. 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

4. 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 cool • Yang means sunny or hot • The balance of Yin/Yang represents a healthy state of physical health and mental health

6. Tradition Chinese Medicine • Concept 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

7. Concept of 5 elements • Each 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

9. five elements of life

10. 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.

11. 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

12. Acupuncture points

13. 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

14. 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

15. 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

16. 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.

17. 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

18. 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

19. 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

20. 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

21. 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