Thoughts on Acupuncture

[CXCommuter]

Just had my first acupuncture treatment- the experience itself was a non event- mild discomfort when the needles go in and a mild ongoing ache. Not sure about any impacts to my muscles (it was coupled with massage). Will see later today/tomorrow. I am booked in for another session in a fortnight

Wondering if others have any experiences of acupuncture, i.e possibly ranging from the OMGosh it was the best, to MEH/why bother to OMGosh it was painful and I ended up in Emergency.

[yugyug]

My sister in law is an acupuncturist. It's very safe - practitioners spend years learning insertion points. But by evidence-based medicine standards any benefit you may feel is entirely from the placebo effect. Other than avoiding no-no areas for insertion the ancient 'system' on which it is based is ridiculous.

I have had loads done and it does tend to make me feel good, but I can't say how. It kind of feels like the deep tissue insertion and then manipulation does do something at the muscular level, but what I don't know. The problem acupuncture presents evidence-based medicine is that it is extremely difficult to assess with properly controlled studies, though there are some interesting studies I could tell u about. I could also tell u some pretty amazing stories about treatments my sister in law has seen or performed herself.

In China there is an academic movement asserting it's credibility and efficacy, but it's not taken seriously elsewhere. There is an interesting researcher at Sydney university who is trying to study it as a placebo though, trying to figure out why it may work better than other placebo treatments - which conceivably could discover a mechanism for action beyond placebo effect, but it's not there yet.

[cyclotaur]

My physio(s) use it to release spasm and tightness in the the lower back, glutes and hammys before proceeding with further treatment. Works well.

[foo on patrol]

My physio(s) use it to release spasm and tightness in the the lower back, glutes and hammys before proceeding with further treatment. Works well.

This was my experience also. I had been swallowing painkillers for years trying to get relief from lower back pain.(think 1.5 sheets some days) Then I got a referral to a Physio that used it and I had relief within a day.

Foo

[petie]

My physio(s) use it to release spasm and tightness in the the lower back, glutes and hammys before proceeding with further treatment. Works well.

I think technically that's dry needling which I too have had great relief with. Never tried acupuncture and I think it targets different areas to dry needling. Keen to give it a try when necessary though, most people rate it highly.

[cyclotaur]

^^ Yep, technically you're right. As I see it dry needling is what conventional medicine calls it lest it legitimise some whacky, unscientific, pseudo-medical tradition that's probably been around longer than old Hippocrates himself. [emoji1]

[CXCommuter]

My physio(s) use it to release spasm and tightness in the the lower back, glutes and hammys before proceeding with further treatment. Works well.

This was my experience also. I had been swallowing painkillers for years trying to get relief from lower back pain.(think 1.5 sheets some days) Then I got a referral to a Physio that used it and I had relief within a day.

Foo

That sounds familar also- not so sure it worked though- I think I prefer the "no pain, no gain" style of massage but trying to find someone strong enough to manipulate 350km/week cycling legs is rather hard

[NeillS]

Dry needling and acupuncture are totally different. Trigger point dry needling has an excellent evidence base behind it now, since they did ultrasound and fine wire electrode studies on its efficacy in the last 5 years. It does what massage does - releases tight myofascial bands which, according to our knowledge, create around 70% of the musculoskeletal pain that people experience. I would tend to concur with that estimate from my experience in both dry needling and myofascial pain. Your nervous system uses trigger points to warn you of an issue - it's like a precursor to serious injury (from overuse) in most cases. Dry needling relieves the trigger points better than anything I've ever seen. Chinese acupuncture is a different kettle of fish altogether.

[yugyug]

Dry needling and acupuncture are totally different. Trigger point dry needling has an excellent evidence base behind it now, since they did ultrasound and fine wire electrode studies on its efficacy in the last 5 years. It does what massage does - releases tight myofascial bands which, according to our knowledge, create around 70% of the musculoskeletal pain that people experience. I would tend to concur with that estimate from my experience in both dry needling and myofascial pain. Your nervous system uses trigger points to warn you of an issue - it's like a precursor to serious injury (from overuse) in most cases. Dry needling relieves the trigger points better than anything I've ever seen. Chinese acupuncture is a different kettle of fish altogether.

Interesting post. I know nothing more about dry needling than what I just read on wikipedia (make of that what you will) but it seems to me that it has the same problems as acupuncture in regard to clinical testing/control groups/use of placebo controls etc. FYI the wikipedia page doesn't concur that the evidence behind it is excellent, noting that systematic reviews have found the evidence weak due to to methodological problems. I'll read up on that ultrasound/fine wire stuff when I have the time though.

I found the content on the wiki page about needle size interesting, in that smaller needles were found to have less effect on muscular pain relief. A few years ago my sister in law moved to using the thinner Japanese acupuncture needles, and since then I've found her treatment less enjoyable/effective. These needles, being flexible, don't allow the same amount of manipulation as Chinese needles. But according to acupuncture theory, as far as I know, this isn't really required, because the purpose is not intramuscular stimulation, even if thats what the result is in practice, but rather to balance the flow of 'chi' through the body's meridian points. Which begs the question as to why in China, the home of the system, they maintain the use of thicker needles. IMO my guess is the use of thinner needles in Japan comes down more to aesthetic sensitivities and differentiation for the sake of it.

Well, at the end of the day I'd rather have a super hard massage anyway.

[CXCommuter]

Well, at the end of the day I'd rather have a super hard massage anyway.

I will be giving the Acupuncture/dry needling another go just to see (I do know it was using Japanese needles now though ) but yesthere is almost nothing like a good hard.... massage

[Grev]

Short sharp and sweet article from the ABC.

http://www.abc.net.au/health/minutes/st ... 609705.htm" onclick="window.open(this.href);return false;

[cyclotaur]

Dry needling and acupuncture are totally different. Trigger point dry needling has an excellent evidence base behind it now, since they did ultrasound and fine wire electrode studies on its efficacy in the last 5 years.......Dry needling relieves the trigger points better than anything I've ever seen.....

Well I'm glad it's been proven in recent years, but my physio was doing it to relieve my lower back in the '90s and he called it acupuncture then, and calls it dry-needling now, and sticks the pins in all the same spots.

I think the main difference is there is only experience, tradition and belief behind acupuncture, whereas dry-needling has taken that system and examined it to find out why, in physiological/neurological terms, it actually works.

[scotto]

dry needling, accupuncture
kentucky fried chicken, KFC
witchcraft, wican

same same ....

[Wingnut]

I believe that both acupuncture and dry needing can both be of a benefit but they are both different...the only similarity is the use of needles.

Sceptics and the ignorant...same same...

[warthog1]

I had been swallowing painkillers for years trying to get relief from lower back pain.(think 1.5 sheets some days)

Foo

In case you weren't aware, as many people aren't, if it was paracetamol, it's not great for your liver.

[kb]

I had been swallowing painkillers for years trying to get relief from lower back pain.(think 1.5 sheets some days)

Foo

In case you weren't aware, as many people aren't, if it was paracetamol, it's not great for your liver.

And possibly not so great for the pain either
Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial.

[CKinnard]

Get the diagnosis right first. I've ceased being surprised at how reticent GPs are to order $250 mri's but are happy to prescribe $500pa meds.

After getting the diagnosis right, I then believe in exhausting therapeutic interventions that follow the more gross principles of physics, before delving into the subtle or esoteric.

Two anecdotes:

- I have had low back pain all my adult life. I saw a few GPs in the early days. They took the standard line that it would go away after 6-8 weeks, which it obviously didn't. So then they prescribed anti-inflammatories and analgesics. They didn't work either. Disillusioned, I went to a chiropractor who did his own xrays, manipulated a couple of times, then told me it was all in my head. I did see an orthopedic surgeon early on, but he just looked at the xray and said it all looked good and it was probably stress from work. I then tried several more chiropractors, osteopaths, natural therapists, and acupuncturists over the decades. None gave any enduring relief. And none suggested I get it imaged. I eventually had it imaged, and found my lowest lumbar disc has degenerated to the worst a disc can and the bones either side are fusing. An orthopod friend says no doubt the disc has been traumatized and compromised since the original pain. In my view, many people with chronic back pain have disc pathology that is not being taken seriously by GPs. Acupuncture is unlikely to help them, as is most other non lifestyle interventions.

- When 28, I saw 2 doctors about acute excruciating pain in my elbow. They gave me the usual anti-inflams and anagesics, which hardly scratched the surface. I then went off to the usual alternative therapists, who didn't help either. Eventually I got a GP to refer me to an orthopod who did an xray and blood test - acute gout attack of a previously fractured elbow where a bone fragment had recently come loose.

So get the diagnosis right, first and foremost before seeking out esoteric feel good therapies. If one doctor doesn't do it for you, see another.
Imaging is highly underutilized in Australia in my view. Those who argue it is too expensive, as in a $250 mri, usually haven't considered the annual cost of pain meds, lost income from days off work, pain and suffering.

[NeillS]

^^^ good post. I see stuff like this all the time, nearly every day. My radiologist often tells me I'm the physio who sends him the most work out of anyone, and I still think I'm a bit reticent with imaging sometimes!

Bearing in mind of course, that imaging can be pretty unreliable itself at times..... Yours sounds pretty clear cut!

[march83]

I had been swallowing painkillers for years trying to get relief from lower back pain.(think 1.5 sheets some days)

Foo

In case you weren't aware, as many people aren't, if it was paracetamol, it's not great for your liver.

there's also this on links between paracetamol and alzheimers: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921468/" onclick="window.open(this.href);return false;

[Dave-in-LK]

I swear by it

I have two prolapsed discs in c3-c4 ...they are ok now

This happened two years ago where inputs woke up and couldn't move my head without pain shooting down my arm (referred pain)

Tried chiropractors, physios and swimming ...nothing worked

Went to acupuncture clinic that oddly offers traditional physio or acupuncture, you choose ..or you can mix the two together.

8 weeks later I'm good to go ....for the first 3 weeks I had two sessions per week then one session per week after that. Wasn't cheap at 70 bucks per session but when your in agony you dint care about coin.

I'm drug and alcohol counsellor and I know all about painkillers and the side effects and why they aren't a long term solution for many people.

The Chinese have being doing their thing for 10,000 years or more, I think they know what they are doing.

Every 6 months I go and have one prevention session, he does some manipulation with his hands and then acupuncture. Feels good as gold.

[bigfriendlyvegan]

dry needling, accupuncture
kentucky fried chicken, KFC
witchcraft, wican

same same ....

No, KFC is testable and verifiable. It is something that is well studied by food/ag scientists as well as economists and accountants. It's something that you can test and you can use the concepts derived from it to predict. The rest is bunk.

[Dave-in-LK]

Whatever works

I have seen acupuncture work for physical injuries post car accidents. I have seen it work for addictions also and mental health conditions.

For some it won't work.

If I had to do a count of the number of clients that it doesn't work for that we refer to it's probably 25%. Man the amount of people that I see heavily medicated that are unhappy with their pain management is much much higher than 50%.

One client said that he did t feel there was much long last effect from it after he left - maybe an hour but he said for 2 hours he was in no pain and that he said that was still a positive. He was a car accident client. He was on about 4 different drugs which were hammering his brain and his kidneys

He's now doing acupuncture once a week, restorative yoga and swimming instead. Yup he said pain is still there but all of those things make his brain better which outweigh the drugs option which while reducing pain have side effects. The amount of people that take excessive pain killing medication is huge. The other thing that happens is tolerance, the more you take the less effective it is. Sure pain killing medication can be useful but in my opinion (opinion only ok) that you need other aspects to pain management.

[redsonic]

I swear by it ....

The Chinese have being doing their thing for 10,000 years or more, I think they know what they are doing.

The historical/traditional argument does nothing to convince me. Western doctors were bleeding people for thousands of years, and no, they didn't know what they were doing. I'd prefer to be convinced by randomised, blinded trials.

[Mulger bill]

I'd prefer to be convinced by randomised, blinded trials.

I'm sure everybody would but I can't see the Western medical industry ever putting a cent towards unbiased trials.

[redsonic]

I'd prefer to be convinced by randomised, blinded trials.

I'm sure everybody would but I can't see the Western medical industry ever putting a cent towards unbiased trials.

This is true, and it's why we need government funded independent research (e.g. universities, CSIRO) and need to make sure that they are not forced into the profitability trap.