Acupuncture: East meets West

A HAIR-THIN needle pricks the skin. What happens next depends on who you ask. A traditional Chinese practitioner will tell you that acupuncture manipulates the body’s vital energy, Qi (pronounced chee), balancing the opposing forces of Yin and Yang. When Yin and Yang are in harmony, Qi flows freely along pathways called meridians and you stay healthy, but when the Qi gets blocked you become ill. Inserting needles into points along a meridian unblocks Qi and restores the body’s healthy balance.

Western scientists explain it differently. They say inserting needles at acupuncture points stimulates the nervous system to release morphine-like substances that block pain signals. It may also trigger neurotransmitters and neurohormones, which influence such dynamic systems as circulation and the immune response.

Ever since acupuncture caught on in the West, we’ve been seeking to replace the Eastern mysticism with hard facts. But clinical trials so far have produced a disappointingly mixed bag of results that don’t seem to back up the anecdotal claims for the wonders of acupuncture. There might be a steadily building case for clinical relief of some types of pain and nausea. But the inconclusive studies still outweigh the positive ones.

Medication overuse Headaches

Up to a million people in the UK have completely preventable  severe Headaches caused by taking too many painkillers, doctors have said.

They said some were trapped in a “vicious cycle” of taking pain relief, which then caused even more headaches.

The warning came as part of the National Institute for Health and Clinical Excellence’s (NICE) first guidelines for treating headaches.

NICE is also recommending Acupuncture in some circumstances.

This can end up getting into a vicious cycle where your headache gets worse, so you take more painkillers, so your headache gets worse and this just becomes worse and worse and worse”

“Medication overuse headaches” feel the same as other common headaches or migraines.

There is no definitive UK data on the incidence of the condition, but studies in other countries suggest 1-2% of people are affected, while the World Health Organisation says figures closer to 5% have been reported.

While painkillers would be many people’s instant response, they could be making sufferers feel even worse.

Whiplash Injuries & Trigger Points

Persistent muscle pain following whiplash is commonly considered the result of poor psychosocial status, illness behaviour, or failing coping skills. However, there is much evidence that this persistent  pain may be due to neurophysiologic mechanisms involving peripheral and central nerve sensitisation. Myofascial trigger points may play a crucial role in maintaing this sensitisation. Recent research suggests that the chemical environment of myofascial trigger points is an important factor. Several consequences are reviewed when central pain mechanisms and myofascial trigger points are included in the differential diagnosis and in the management of patients with persistent pain following whiplash.

Treating Chronic Muscle Pain by Robert Gerwin

Chronic muscle pain (myalgia) is a common problem throughout the world.

Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain.

The two common muscle pain conditions are Fibromyalgia and Myofascial Pain Syndrome.

Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis.

Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle.

The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying causes of persistent or chronic muscle pain in order to develop a specific treatment plan.

Chronic myalgia may not improve until the underlying precipitating or perpetuating factors are themselves managed.

Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypo-mobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency.

Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition.

Acupuncture studies by NCCAM

Introduction

Physical pain is a common occurrence for many People; in fact, a national survey found that more than one-quarter of U.S. adults had recently experienced some sort of pain lasting more than a day. In addition to conventional treatments, such as over-the-counter and prescription medications, people may try Acupuncture in an effort to relieve pain. This fact sheet provides basic information about pain and acupuncture, summarizes scientific research on acupuncture for specific kinds of pain, and suggests sources for additional information.

Key Points

• People use acupuncture for various types of pain. Back pain is the most commonly reported use, followed by joint pain, neck pain, and headache.
• Acupuncture is being studied for its efficacy in alleviating many kinds of pain. There are promising findings in some conditions, such as chronic low-back pain and osteoarthritis of the knee; but, for most other conditions, additional research is needed. The National Center for Complementary and Alternative Medicine (NCCAM) sponsors a wide range of acupuncture research.
• Acupuncture is generally considered safe when performed correctly.
• In traditional Chinese medicine theory, acupuncture regulates the flow of qi (vital energy) through the body. Research to test scientific theories about how acupuncture might work to relieve pain is under way.

Can Twisting cause the Agony of Back Pain?

THE first comprehensive model of the human spine is challenging our assumptions about the causes of back pain. Contrary to the idea that spinal injuries are caused by a combination of compression, bending, tension and shear forces, the 3D animated model suggests many injuries are the result of quick twists of the vertebrae, making the joints between them rotate.

Nick Beagley and Vladimir Ivancevic of the Defence Science and Technology Organisation in Edinburgh, South Australia, have spent the past 18 months developing their mathematical model, called the Full Spine Simulator (FSS). Existing models of the spine evaluate forces placed on a single joint, or a simple series of joints, and allow each just a few degrees of freedom. But the FSS represents all 25 movable joints of the spine, and gives each its full six degrees of freedom.

TMJ & Facial Pain

Tempo-Mandibular Joint Pain

Patient: Woman 58 years
Occupation: Unable to work
Pain: 10/10

Complaint: Long term Facial and Jaw Pain, which started about 10 years ago. This pain was made worse with any exposure to cold or when the patient was stressed. There was also a constant feeling of having something stuck in her throat.

This pain was always present to some degree, being worse at night. The patient had been examined by numerous Doctors and an ENT Consultant. There was no diagnosis, all tests for pathology were negative.

Diagnosis: This Lady was very tense and distressed, but examination showed distinct Trigger Points in the
Sternocleidomastoid Muscle, which is the muscle running from the Sternum to behind the Ear.

Treatment: I treated this Lady using Acupuncture to the Sternocleidomastoid Muscle, and after 2 treatments her pain was 95% improved.

Prognosis: This Lady should remain Pain Free, but it’s worth while asking her to return for a reassessment in a month, as She has suffered with this condition for a very long time. The underlying cause of this condition is not known.

Arthritis of the Hip.

Arthritis of the Hip.

Patient: Man 66 years
Occupation: Retired Accountant
Pain: 3/10

Complaint: This Gentleman is a keen Golfer, he has minor O.A. of the left Hip . Walking any distance causes pain in the groin and knee. The condition is not bad enough to need an Hip replacement operation. The pain is negligible at rest.

Treatment: Deep Massage and Mobilisation of the Hip & Low Back. Acupuncture of Trigger Points around the groin and inner thigh really eased the condition, and allows the Gentleman to play Golf.

Prognosis: The hip joint may deteriorate over time and need a hip replacement operation. I see this Gentleman at monthly intervals, and things have been stable for 2 years.