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Acupuncture Therapy for Joint Injuries

Brittany Ruck

date: 10/14/2006

           

WHAT IS ACUPUNCTURE TREATMENT?

Classical acupuncture was developed in China as much of 2 or 3 thousand years ago as a component of traditional Chinese medicine used to diagnose and treat pain and disease.

The term 'acupuncture' has been defined as stimulation, primarily by the use of solid needles, of traditionally and clinically defined points on and beneath the skin, in an organized fashion for therapeutic and/or preventive purposes. The original acupuncture points are specific superficial anatomic locations defined in traditional Asian texts. The skin on or over these points is generally lower in transdermal electrical resistance than the skin surrounding them. These acupoints and points are also defined by other terms in modern physical medicine including "trigger points," "motor points," or "osteopathic lesions.”

In traditional Asian medicine these points are stimulated either by puncture and manual manipulation of solid needles or by local heating. Heating is generally accomplished by the burning of dried, powdered Artemisia vulgaris (moxa), referred to as "moxibustion." This moxa is either placed or held just above the acupoint by the acupuncturist (indirect moxibustion), attached to a needle penetrating the point, or applied directly to the skin.

 

In modern times, additional methods of stimulating the acupoints include applications of electric current to needles in the points or skin electrodes over the points, injections into the points, laser-light directed onto the points, or finger-pressure massage of selected points, called "acupressure." In addition, many new points and whole new systems of points have been described on specific body-parts.

 (Current Biographies in Medicine, http://healthpsych.psy.vanderbilt.edu/Acupuncture_Drug_Addiction.htm).

 

WHAT CAN ACUPUNCTURE THERAPY DO FOR JOINT INJURIES?

Acupuncture has been successfully used for hundreds of years. In recent years, research has been able to identify that acupuncture stimulates the production of endorphins and cortisol in the brain. These chemicals are considered vital in pain relief and inflammation control, included that associated with severe cases of arthritis.  

As physiotherapists are often treating conditions involving pain and inflammation, it has become a valuable tool in rehabilitation management. Acupuncture also has the effect of relaxation, improving sleep function and promoting energy and well being.  Such physiotherapists recommend acupuncture for therapy for joint replacement patients.

 

(Maximum Potential Physiotherapy, http://maxphysio.ca/progser/joi_rep_rec.html).

 

Common joint ailments such as tennis elbow can also benefit from acupuncture therapy.  In fact, research from a pilot study presented at the annual meeting of the American Academy of Physical Medicine and Rehabilitation in San Francisco suggests that acupuncture not only relieves the symptoms of tennis elbow, it appears to resolve the condition completely.

 

(Acupuncture for Tennis Elbow, http://www.acupuncturetoday.com/archives2001/feb/02elbow.html).

 

 

 

 

 

 

WHAT IS THE RATIONALE BEHIND ACUPUNCTURE THERAPY?

 

Oriental medicine is based on an energetic model rather than the biochemical model of Western medicine. The ancient Chinese recognized a vital energy behind all life form and life processes. They called this energy Qi. In developing an understanding of the prevention and cure of disease, these healing practitioners discovered that this energy flows along specific pathways called Meridians. Each pathway is associated with a particular physiological system and internal organ. Disease is considered to arise due to a deficiency or imbalance of energy in the meridians and their associated physiological systems. Acupuncture points are specific locations along the meridians. Each point has a predictable effect upon the vital energy passing through it. Modern science has been able to measure the electrical charge at these points.

 

(Medical Care of Western New York, http://www.medicalcareofwny.com/for-patients.htm#Acupuncture).

 

 

WHO DOCUMENTS THE EFFECTIVENESS AND SAFETY OF ACUPUNCTURE THERAPY?

 

In the hands of a comprehensively trained acupuncturist, safety is assured. Acupuncture needles are sterile and disposable. Depth of needle insertion depends upon the nature of the problem; usually needles are inserted from ¼ to 2 inches in depth

 

(Medical Care of Western New York, http://www.medicalcareofwny.com/for-patients.htm#Acupuncture).

 

According to a website titled “Acupuncture Today,” states that acupuncture is effective in even difficult cases of tennis elbow.  This website asserts that a Dr. Peter Dorsher, a medical doctor certified in acupuncture, conducted a study on numerous patients with tennis elbow who had been suffering pain up to several months before seeking acupuncture treatment.  The doctor reported that the needles appeared to immediately loosen the tight muscles around the elbow joint and found acupuncture to be such a powerful tool for relieving pain that he intended to use it as a primary treatment for tennis elbow.

 

(Acupuncture for Tennis Elbow, http://www.acupuncturetoday.com/archives2001/feb/02elbow.html).

 

 

 

PROFESSIONAL AND SCIENTIFIC REVIEWS OF ACUPUNCTURE THERAPY:

An acupuncture treatment is a procedure, like surgery or a psychotherapy session, rather than a drug. For this reason it has been very difficult to subject acupuncture to the gold-standard of randomized blinded trials, and almost impossible to conduct truly double-blind trials.

 Much of the clinical data available for acupuncture consists of case-series, such as those often reported for new surgical procedures. For areas in which fewer such definitive trials are available, a greater emphasis has been placed on including large case-series or other sources of less definitive, but still potentially useful clinical data. In addition, every attempt has been made to include the most complete possible list of "side effects" and other adverse events that have been reported in association with acupuncture. This may have resulted in the inclusion of multiple descriptions of single adverse events as well as the probable inclusion of events in which acupuncture was only one of many interventions being used and may not have been the cause of the side effects.

(Current Biographies in Medicine, http://healthpsych.psy.vanderbilt.edu/Acupuncture_Drug_Addiction.htm).

One journal paper that was published in association with Royal Berkshire Hospital NHS Trust, Reading, describes “a randomized placebo-controlled cross-over design to evaluate acupuncture as a useful treatment adjunct in the management of patients with rheumatoid arthritis (RA)” (5). Acupuncture or placebo was given with an intervening 6 week wash-out period while the acupuncturist, patient and statistician were blinded. The outcome measures included the inflammatory markers, visual analogue scale of pain, global patient assessment, 28 swollen and tender joint count, and a general health questionnaire. The results obtained demonstrated “no significant effect of treatment or period and no significant interaction between treatment and period for any outcome variable. No adverse effects were reported” (5). In conclusion this study determined that the type of acupuncture testes cannot be considered as a useful adjunct to therapy in patients with RA.

Another paper published (with affiliation to the Foundation for the Study of Traditional East Asian Medicine, Amsterdam, The Netherlands), discusses “those medical conditions in which clinical trials of acupuncture have been conducted, and where meta-analyses or systematic reviews have been published. It focuses on the general conclusions of these reviews by further examining official reviews conducted in the United States, United Kingdom, Europe, and Canada each of which examined available systematic reviews” (6).  This paper found that for a number of conditions such as fibromyalgia, osteoarthritis of the knee, and tennis elbow the evidence is considered promising, but more and better quality research is needed (6).

 

 

CONCLUSIONS:

 

Despite the widespread hype of acupuncture as a miracle treatment for joint ailments of countless types, the empirical evidence gathered by scientific research has not found overwhelming, significant evidence in support of acupuncture for the treatment a joint ailment such as rheumatoid arthritis, tennis elbow, or joint pain in association with joint replacement surgery.

 

 

REFERENCES:

1.)     Maximum Potential Physiotherapy, http://maxphysio.ca/progser/joi_rep_rec.html.

2.)     Acupuncture for Tennis Elbow, http://www.acupuncturetoday.com/archives2001/feb/02elbow.html.

3.)     Current Biographies in Medicine, http://healthpsych.psy.vanderbilt.edu/Acupuncture_Drug_Addiction.htm.

4.)     Medical Care of Western New York, http://www.medicalcareofwny.com/for-patients.htm#Acupuncture

5.)     David, J., Towensend, S., Sathanathan, R., Kriss, S., Dore,

C.J. (1999). The effect of acupuncture on patients

with rheumatoid arthritis: a randomized, placebo-controlled cross-over study. Rheumatology (Oxford) (Rheumatology (Oxford, England)). 1999 Sep; 38(9): 864-9.

6.)     Birch S, Hesselink JK, Jonkman FA, Hekker TA, Bos A.

(2004). Clinical research on acupuncture: part 1. What

have reviews of the efficacy and safety

of acupuncture told us so far? J Altern Complement Med. 2004 Jun;10(3):468-80.

 

 

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