1 / 20

Acupuncture

Acupuncture. A rough outline. My background. GP; since 1990 BMAS; British Medical Acupuncture Society ( founded 1980); foundation course 1999 Intermediate study days. Used acupuncture since; few basic conditions, predominantly pain control. Origins of acupuncture. Chinese medicine>2000yrs

nasia
Download Presentation

Acupuncture

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Acupuncture A rough outline

  2. My background GP; since 1990 BMAS; British Medical Acupuncture Society ( founded 1980); foundation course 1999 Intermediate study days. Used acupuncture since; few basic conditions, predominantly pain control.

  3. Origins of acupuncture • Chinese medicine>2000yrs • Yellow Emperor’s Classic Internal Medicine; 260BC • Confusianist beliefs; “pulse”diagnosis • Earliest instruments; sharp stones, flints; later wood, bamboo, silver, gold, copper

  4. Yellow emperor Theories of chinese medicine, including acupuncture, and the importance of the balance of life forces

  5. TCM terms • Meridian/channel • Qi ( der chi) • Cun; chinese inch; still used as unit of measurement

  6. Use in modern medicine • Some evidence base developing • BMAS; quarterly journal • Difficulties in performing trials; effects of “sham” acupunctre. • Effects of acupuncture better compared to “usual” treatment or no treatment? • Still a subject of great debate

  7. Western medical approach • Much research into physiology of how acupuncture works • Gate theory of pain;mediated via dorsal columns, ascending influences on CNS • Release endorphins • Changes in connective tissues

  8. Mode of action? • Peripheral nerve stimulation is integral part of mechanism • Increased concentrations neurotransmitters and endorphins measured experimentally • Stimulation A delta fibres; inhibition non myelinated C fibres; ascending connections spinothalamic tract, limbic system. • Connective tissue effects; fibroblast stimulation.

  9. Nice guidance “non specific” low back pain, 2009 • Mentions acupuncture as a cost effective treatment option • ( but guidance heavily criticised by pain specialists; injection treatments not recommended)

  10. Robust clinical evidence • Tension headache/migraine • Pain of osteoarthritis • Chronic low back pain. • Nausea and vomiting

  11. Treatment of nausea and vomiting • Cochrane review 2009; use of acupuncture at PC6 confirmed to be of benefit. • May also be used in palliative care, post operative sickness

  12. Points selection • Traditional acupuncture points • Selection segmental points • Use of trigger points

  13. Modes of treatment • Brief “in and out” needling; often quite superficial • Use of single needle into trigger point • Use of stimulation; manual/electrical • Auricular acupuncture ( Nogier); used in addiction setting • Indwelling “press” needles • Moxa ; Artemis vulgaris. Adds heat

  14. GP acupuncture;pragmatic approach • QUICK • SAFE • CHEAP? • EFFECTIVE? • 10 minute treatment, 5-6 needles, no stimulation usually. Up to 6 sessions • Use of Visual Analogue Score

  15. Audit; 12 months • I have treated 16 patients, total of 57 treatments 9(range 2-7); all in 12.5 minute appointments • Headaches; 1 • Hyperemesis; 5 • Neck and shoulder pain; 8 • Back pain, sciatica; 2

  16. Are there any risks? • Infection; very low; no need for disinfection skin( review; one case in 66,000) • Certain points; pneumothorax • Care in immunosuppressed/anticoagulants • Minor bleeding/bruising common • Care with underlying structures; eg median nerve at PC6.

  17. The acupuncture response • First treatment can make it worse or have no effect • It is estimated that 80% will have a response • Some are “strong reactors”; start gently • Effect tends to be cumulative and after eg 5-6 sessions benefit can be maintained for months • Beware endorphin effects; warn patients

  18. BMAS • The British Medical Acupuncture Society is a registered charity established to encourage the use and scientific understanding of acupuncture within medicine for the public benefit. • Members are regulated healthcare professionals who practice acupuncture within the scope of their professional practice.

  19. Foundation course • Over 2 weekends, cost £580. 24 hours. • Teaching approx 33 points which enable treatment of wide variety of conditions. • COBC; certificate of basic competence; or Diploma.

  20. Practical demonstration Any volunteers?

More Related