MOD007 – Acupuncture – Traditional Chinese

Definition:

Acupuncture is a complementary therapy derived from ancient Chinese medicine, involving the insertion of fine needles into specific points on the body to stimulate healing and alleviate various symptoms. In the UK, it is practised both within the NHS and in private settings.

Explanation:

Acupuncture is based on the concept of balancing the body’s vital energy, known as Qi, along meridians or energy pathways. By inserting needles at precise acupuncture points, practitioners aim to restore harmony and alleviate symptoms. However, in the UK, Western medical acupuncture is more commonly practised, focusing on the neurophysiological effects of needle insertion.

Western medical acupuncture, also known as dry needling, is based on current understanding of anatomy, physiology, and pathology. It stimulates sensory nerves under the skin and in muscles, prompting the body to produce natural pain-relieving substances such as endorphins. Many UK practitioners integrate both traditional and modern approaches, tailoring treatments to individual patients based on medical diagnosis and evidence-based practice.

Evidence to Efficacy:

There is substantial evidence demonstrating the efficacy of acupuncture for various conditions:

Evidence from Systematic Reviews and Meta-Analyses

A comprehensive overview of systematic reviews found that acupuncture showed promising effects for 33 outcomes across 22 conditions. Specifically, acupuncture demonstrated moderate to large effects with moderate to high certainty evidence for:

• Improving functional communication in post-stroke aphasia
• Relieving neck and shoulder pain
• Alleviating myofascial pain and fibromyalgia-related pain
• Reducing non-specific lower back pain
• Increasing lactation success rates within 24 hours of delivery
• Reducing severity of vascular dementia symptoms
• Improving nasal symptoms of allergic rhinitis

Evidence for Chronic Pain Conditions

A systematic review by Vickers et al. (2018), involving over 20,000 patients with osteoarthritis, chronic headache, or musculoskeletal pain, concluded that:

• Acupuncture was more effective than control for all pain conditions
• Acupuncture is not merely a placebo for chronic pain treatment
• The effects persisted over time, with a 15% reduction in pain still evident at one year

Evidence for Specific Conditions

• Low Back Pain: A meta-analysis by Manheimer et al. (2005) found that acupuncture effectively improved functional status and reduced low back pain.
• Knee Osteoarthritis: A randomised controlled trial by Scharf et al. (2006) demonstrated that acupuncture, in addition to routine care, provided greater improvement in knee osteoarthritis symptoms compared to routine care alone.
• Migraine: A randomised controlled trial by Linde et al. (2005) showed that acupuncture was more effective than no acupuncture in reducing migraine headaches.

These studies provide strong evidence supporting acupuncture’s efficacy for chronic pain conditions, headaches, and certain neurological and musculoskeletal disorders. There is also growing evidence supporting the use of acupuncture for mental health concerns and relaxation:

Anxiety and Depression: A systematic review published in the Annals of General Psychiatry in 2021 found that acupuncture therapy aimed at reducing anxiety in patients with Generalised Anxiety Disorder (GAD) had beneficial effects compared to controls. The review concluded that acupuncture was more effective than the control condition in reducing symptoms of anxiety, with a standard mean effect size of -0.41.

For depression, a comprehensive overview of systematic reviews found that acupuncture showed promising effects for 33 outcomes across 22 conditions, including depression. Specifically, acupuncture demonstrated moderate to large effects with moderate to high certainty evidence for alleviating depression-related symptoms.

Stress and Relaxation: Acupuncture has been shown to have a positive impact on stress reduction and relaxation. Dr David Mayer, from the National University of Health Sciences Whole Health Centre, notes that acupuncture can be an effective way to improve mental wellbeing. He states that most patients will feel better immediately after treatment, with acupuncture moving qi, blood and fluids which can reduce inflammation and thereby reduce stress-related symptoms.

Broader Mental Health Applications: A literature review noted that acupuncture increases several central nervous system hormones, including ACTH, beta-endorphins, serotonin, and noradrenaline, which contribute to its effects on mental health.

 Governing Body:

The British Acupuncture Council (BAcC) is the leading self-regulatory body for the practice of traditional acupuncture in the UK. It was formed in 1995 and maintains a register of qualified practitioners. The BAcC sets high standards for education, ethics, discipline and safe practice.

Other notable professional bodies include:

• The Association of Traditional Chinese Medicine and Acupuncture UK (ATCM)
• The Acupuncture Association of Chartered Physiotherapists (AACP)
• The British Medical Acupuncture Society (BMAS)

Training and Certification

Acupuncture training in the UK is primarily overseen by the British Acupuncture Accreditation Board (BAAB). The BAAB accredits courses that meet rigorous standards, typically at the honours degree level. Accredited courses include:

• College of Integrated Chinese Medicine (Reading)
• Northern College of Acupuncture (York)
• City College of Acupuncture (London)
• The Acupuncture Academy (Leamington Spa)

Graduates from BAAB-accredited courses are eligible for automatic membership with the BAcC.

Oversight and Standards

The National Institute for Health and Care Excellence (NICE) provides evidence-based guidance on the use of acupuncture within the NHS. NICE currently recommends acupuncture for chronic primary pain, tension-type headaches, and migraines.

The Professional Standards Authority for Health and Social Care (PSA) oversees the BAcC’s register, providing an additional layer of quality assurance.

NHS Integration

Acupuncture is available on the NHS in some areas, primarily for the conditions recommended by NICE. However, availability varies across the country.

Statutory Regulation

It’s important to note that acupuncture is not currently subject to statutory regulation in the UK. This means that, while professional bodies maintain high standards for their members, there is no legal requirement for acupuncturists to be registered with a professional body.

What Good Looks Like:

Here are some crucial elements that can significantly impact the effectiveness and experience of acupuncture:

Proper Point Selection: You should ensure that your acupuncturist selects the most appropriate acupuncture points for your specific condition. This requires their thorough understanding of traditional Chinese medicine theory and an accurate diagnosis of your individual imbalances.

Needle Technique: Pay attention to your practitioner’s skill in needle insertion and manipulation. A skilled acupuncturist will help you achieve the “de qi” sensation, which is essential for optimal therapeutic effect.

Patient Relaxation: Your ability to relax during the treatment is vital. If you are tense, you may not respond as well to the treatment and could experience more discomfort.

Treatment Frequency and Timing: Be mindful of the timing and frequency of your treatments. For chronic conditions, a series of sessions may be necessary to achieve lasting results.

Integration with Lifestyle Advice: Ask your acupuncturist for appropriate lifestyle and dietary recommendations to enhance the effectiveness of your acupuncture treatment.

Patient-Practitioner Relationship: Cultivating a strong therapeutic alliance with your acupuncturist is important. Clear communication can improve your outcomes and overall satisfaction with the treatment.

Sterile Technique: Ensure that your practitioner adheres to strict hygiene and sterility protocols. This is essential for your safety and to prevent any adverse events.

By focusing on these key factors, you can ensure a more effective and satisfying acupuncture experience.

 What to Ask a Practitioner:

Here are the key questions to ask before you agree to work with a practitioner:

What safety protocols do you follow?

Desired answer: The practitioner should explain that they use single-use, sterile disposable needles, thoroughly wash their hands and sanitise between patients, clean and disinfect treatment surfaces, follow proper sharps disposal procedures, and adhere to any relevant COVID-19 safety measures.

What is your approach to diagnosis and treatment planning?

Desired answer: The practitioner should describe their process for taking a detailed medical history, performing tongue and pulse diagnosis, explaining their diagnosis and proposed treatment plan, discussing the expected number of treatments and outcomes, and expressing their willingness to work alongside other healthcare providers if needed.

How do you determine which acupuncture points to use?

Desired answer: The practitioner should explain that their selection of acupuncture points is based on the specific diagnosis according to Traditional Chinese Medicine principles, the individual patient’s symptoms and constitution, and their ability to adapt the treatment as the patient’s condition changes.

What can I expect during a typical treatment session?

Desired answer: The practitioner should outline that a typical session lasts between 45 to 60 minutes, usually involves the use of 5 to 20 needles, and that the needles are typically left in place for 20 to 30 minutes. They may also mention any additional techniques they use, such as moxibustion or cupping, and describe the possible sensations you might experience during treatment, such as tingling or warmth.

How do you handle adverse reactions or complications?

Desired answer: The practitioner should mention that they have proper first aid training and equipment on hand, know when to refer patients to other healthcare providers, are willing to discuss and address any concerns promptly, and follow proper incident reporting procedures.

Do you provide lifestyle and self-care advice alongside acupuncture?

Desired answer: The practitioner should confirm that they offer guidance on diet, exercise, stress management, and other lifestyle factors that can support your treatment and overall health.

Related Therapies:

Herbal Medicine (MOD067): The use of plant-based remedies to treat various health conditions. Herbal medicine can complement flower essence therapy by addressing physical symptoms alongside emotional imbalances.

Cupping Therapy (MOD005): While not strictly acupuncture, it is often used in conjunction with it. It involves placing cups on the skin to create suction, promoting blood flow and healing.

Tai Chi (MOD157): A Chinese martial art practiced for both defence training and health benefits, including stress reduction and improved balance.

Moxibustion (MOD006): Involves burning moxa (a type of dried herb) near or on the skin to warm and stimulate acupuncture points.

Reiki (MOD142): A Japanese energy healing technique that involves channelling universal life force energy through gentle or no touch. Reiki can be combined with sound healing to enhance relaxation and energy flow.

Chiropractic (MOD029): A healthcare profession focusing on the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, especially the spine, using manual adjustments and other techniques to improve function and alleviate pain.

Osteopathy (MOD121): A system of medicine that emphasizes the physical manipulation of muscle tissue and bones to diagnose, treat, and prevent illness or injury, based on the principle that the body’s systems are interconnected and capable of self-regulation and self-healing.

Yoga Therapy (MOD182): A physical and spiritual practice that combines postures, breath control, and meditation. Yoga can complement Reiki by promoting physical flexibility and mental clarity, enhancing overall well-being.

Mindfulness-Based Stress Reduction (MBSR)(MOD106): A structured program that combines mindfulness meditation and yoga to cultivate awareness and reduce stress.