Acupuncture

A rough outline
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.
 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
 Yellow emperor
Theories of chinese medicine, including acupuncture, and the
importance of the balance of life forces
 Meridian/channel

 Qi ( der chi)

 Cun; chinese inch; still used as unit of

measurement
 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
 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
 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.
 Mentions acupuncture as a cost effective
treatment option
 ( but guidance heavily criticised by pain
specialists; injection treatments not
recommended)
 Tension headache/migraine
 Pain of osteoarthritis
 Chronic low back pain.
 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
 Traditional acupuncture points
 Selection segmental points
 Use of trigger points
 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
 QUICK
 SAFE
 CHEAP?
 EFFECTIVE?
 10 minute treatment, 5-6 needles, no
stimulation usually. Up to 6 sessions
 Use of Visual Analogue Score
 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
 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.
 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
 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.
 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.
Practical demonstration
Any volunteers?