Acupuncture is a therapy based on inserting needles into the body, and then manipulating them. It aims to restore patient health and wellbeing. It has been practised for more than 3,000 years in the east, and it was responsible for introducing traditional chinese medicine into europe. Today, research teams all over the world are striving to devise new ways of combining acupuncture with conventional medicine.
Acupuncture can play an important role when combined with conventional treatments, not just because of its benefits, but also because it has no side effects and does not increase the use of medicines. It is therefore an excellent support for patients, not forgetting that the spine specialist’s instructions must be followed at all times with regard to any symptoms or condition.
Origins and basic concepts in acupuncture
Acupuncture arose in China more than 3,000 years ago and is part of chinese traditional medicine. It originates from a form of holistic medicine that sees the human mind and body as a unified whole. In this context, every disease is the result of an imbalance that needs to be, and can be, corrected. Ever since the 1970s, there has been a growing desire to understand and categorise the phenomena related to acupuncture from the point of view of western science. In this regard, most research tends to suggest that acupuncture works through a neuroendocrine mechanism.
The acupuncturist is a professional who knows precisely where to find the ‘acupuncture points’, which western medicine associates with reactive zones in the nervous, muscular and connective tissue systems. The therapist stimulates these areas by inserting and manipulating very fine, disposable needles.
As well as being very useful for relieving pain and reducing anxiety, an acupuncturist can treat a wide variety of conditions and improve the patient’s general state of health. They can also recommend preventive and complementary treatments, and treatments to maintain health. Publications such as the Guidelines for Primary Care Management of Low Back Pain, produced by Canada’s Institute of Health Economics: Toward Optimized Practice (TOP) demonstrate that acupuncture is a very safe technique in the hands of qualified doctors and it can be used as a single therapy or as part of an integrated programme of active treatment.
Acupuncture and back pain
Today, conditions that may benefit from acupuncture include:
- Radiating or non-radiating upper, middle, or lower back pain with a duration of more than 6 weeks.
- Acupuncture is a cost-effective treatment for pain, its effects on the way the body functions and psychological alterations in patients with mechanical lower back pain lasting longer than 6 weeks. (National Institute for Health and Care Excellence (NICE, 2009)).
- The American Academy of Family Physicians and the American Pain Society recommend acupuncture to treat subacute, chronic and non-specific lower back pain. A recent article by Taylor et al. (Pain Practice, 2014) makes the same recommendation for the treatment of chronic lower back pain, according to the World Health Organization.
- Acupuncture is recommended as a single therapy or as part of an integrated programme of active treatment for chronic lower back pain (TOP). The British NICE guidelines recommend 10 sessions of acupuncture over a period of 12 weeks as a treatment for lower back pain that has lasted for more than 6 weeks.
- The Cochrane review, “Acupuncture for neck pain” provides evidence of improvements in chronic neck pain, with or without radiation to the upper limbs, with the use of acupuncture.
- Spine pain with a significant component of anxiety and depression.
- Discs affected in several areas with or without disc protrusions.
- Lower, middle or upper back myofascial pain syndrome.
- Spondyloarthrosis in the elderly.
- Residual pain after spinal surgery.
- Neck pain with a significant tension component.
An acupuncture session
During the first session, the acupuncturist reviews the patient’s complete medical history, and their diet, sleep patterns, family history and symptoms. They also tend to check the pulse, the tongue and facial colouration. Once the reason for the visit has been determined, the acupuncturist will decide what treatment to employ.
The patient must remain lying down and relaxed during treatment. Sterile needles are inserted into the skin at precise points, manipulated, then left in place for 20 or 30 minutes. Every case is different, so the time will depend on the therapist’s judgement and the symptom being treated. Insertion of the needles, which are very fine, is not painful, but it is normal to feel a tingling sensation. In any case, the intensity depends on the person, the point being treated, the stimulation technique and the acupuncturist’s experience.
The number of acupuncture sessions needed will also depend on the severity of the symptom, its duration and the nature of the treatment being given, but improvements are usually seen from the first sessions.