Does Acupuncture Work?

By Simon Strauss MBBS Dip Acup Nanjing 1978

The International Association for the Study of Pain's Clinical Update (November 1996) position paper "Does Acupuncture Work?" edited by an august body of Anaethetists, Neuroscientists, Pharmacologists and Psychiatrists explores the issue; Does Acupuncture Work for the control or management of acute and chronic pain syndromes?

As the IASP is the world's penultimate pain management organization their four-page position paper deserves to be taken seriously by Australian medical practitioners as well as their funding and regulatory bodies.

Their conclusions are reproduced below.

"Peripheral sensory stimulation techniques are recognized as useful for the treatment of pain. Acupuncture has a traditional basis but also is a technique of peripheral sensory stimulation because it targets the neural network for endogenous pain modulation. It is effective against some forms of chronic pain, where it can allow significant long-term benefit, but it is not a blunderbuss for treating all pain. Pain pathophysiology and selection of optimal parameters of acupuncture determine its effectiveness. Episodic nociceptive pain, as in dysmenorrhea, can be preempted with acupuncture, but acupuncture exacerbates rather than preempts the acute pain that follows dental extractions. Long-term pain reduction can be obtained in chronic nociceptive musculoskeletal pain, while chronic idiopathic pain is comparatively unresponsive to acupuncture."

The position paper also included a summary of effective parameters.

Site Of Needle Insertion
A combination of local needles in segmental receptive fields and distal needles in myotomes or sclerotomes both segmental and extrasegmental to the origin of pain is optimal.
(See: Traditional Chinese Medicine's NEAR and FAR technique -Simon Strauss)

Intensity Of Stimulation
Pain decreased with either superficial needle insertion or deep mode acupuncture with deqi*, but more patients responding to deep mode.
(*Deqi Acupuncture sensation of numbness, swelling, distension or dull pain. -Simon Strauss)
Duration Of Treatment
30 minute treatment was effective. Longer treatment relieved similar numbers of patients, but greater numbers had increased pain.
Timing Of Intervention
Preemptive acupuncture for dental extraction pain increased postoperative pain and analgesic consumption. By contrast, treatment of chronic episodic dysmenorrhea with acupuncture one week prior to menses reduced pain and analgesic consumption.
Mode Of Stimulation
Chronic nociceptive musculoskeletal pain is reduced by low frequency electrical stimulation. Periosteal stimulation has the greatest effect upon nociceptive visceral pain of dysmenorrhea, although other modes of acupuncture and low frequency tens also reduced pain.

Permission for use of the Clinical Update granted by L Jones IASP July 7 1997.

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