
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.