Acupuncture in London-Acupuncture Research Resources Vol.III

Acupuncture for back pain - the evidence: from NICE to NEJM

 
You may have heard that NICE recommends acupuncture as the treatment choice for persistent low back pain.

So what is NICE and why are they being so nice?

NICE is The National Institute for Health and Clinical Excellence (NICE), an independent body which job it is to provide guidelines to the NHS (the National Health Service in the UK) on the use of treatments and care of patients. The reason they are backing acupuncture for the first time is firstly and most importantly because it works, and secondly because its cost effective. Simples...

In the same statement NICE also: "advises against injections into the back or taking an X-ray of the lumbar spine for non-specific low back pain." So please think twice before you opt for cortisone injections into your back and consult with your GP and your Specialist to make sure it is the appropriate treatment for your condition.  

Here's a link to the NICE summary page of the Low Back Pain clinical guidance statement and documents.

And if you're really interested and want to read the entire guidance document follow this one, you'll need some time for this one.

What this means for you is, if you live in the UK and suffer from low back pain, and you haven't given acupuncture a try for your back pain yet, now is the time! 

You could even try and ask your GP, on that basis, if they would consider referring you and/or paying (your GP holds the CAM budget for the surgery's patients) for your course of acupuncture treatment. They might not but it doesn't hurt to ask, and remember to mention NICE guidelines :)

This guideline will be up for review in 2012 so its up to us (patients and acupuncturists) to prove that NICE made the right decision last year and continues to back acupuncture as a treatment choice for back pain, and maybe that will open their eyes to back acupuncture treatment for other conditions as well.

Acupuncture in London-Acupuncture Research Resources Vol.II

Acupuncture for pain - the evidence. And yes, you can see it!

I recently read this article in NCCAM site on acupuncture for treatment of pain with some fascinating research into the effects of acupuncture on the brain which I'd like to share with you.

Remember the notion, pain occurs in the brain. Not where you think it hurts...

By using the most sophisticated brain imaging tech top neuroscientists and radiologists can get their hands on (fMRI, PET, MEG) they are able to see changes that occur in the hypothalamus and the amygdala, these are areas in the brain which maintain pain. 

Even if these devices are not quite sophisticated enough to 'see the qi' yet, they are able to detect its effects in the brain.

The scientists involved are top researchers at the finest american institutions. What they are doing is very cool because it is these baby steps of true integrative medicine east and west that are paving the way torwards the 21st century medicine of the future. 

Check out the following quote from the article:

" Qi, meridians, yin, yang. How can researchers study acupuncture, a 2,000-year-old form of traditional Chinese medicine (TCM) based on foreign concepts that seem impossible to measure, let alone define?

To Richard Nahin, Ph.D., M.P.H., NCCAM's Senior Advisor for Scientific Coordination and Outreach, the answer is obvious: "We don't necessarily have to understand the concepts of qi or meridians to study the safety or efficacy of acupuncture."

Harvard Medical School neuroscientist (and practicing acupuncturist) Vitaly Napadow, Ph.D., L.Ac., agrees. "I firmly believe that everything can be studied with the scientific method. Unfortunately, we don't currently have a 'qi meter.' So, in my research, we don't focus on meridians or qi. We take a neuroscientific approach to study how acupuncture functions through the nervous system."

" Powerful imaging techniques—fMRI (functional magnetic resonance imaging), PET (positron emission tomography), and MEG (magnetoencephalography)—are now available to reveal areas of the brain affected during pain and to map the impact of acupuncture in patients experiencing pain. "

Bruce Rosen, M.D., Ph.D., principal investigator of an NCCAM Center of Excellence on Acupuncture and Brain Activity at Harvard Medical School. "

 NATIONAL INSTITUTES OF HEALTH • NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE

Click here to read the full article in the NCCAM newsletter

Acupuncture in London-Acupuncture Research Resources Vol.I

So can you show me some proof? 
   Does acupuncture do what its says on tin? 

In a word, the answer to both questions is a resounding YES!

Acupuncture has been consistently and continually practiced in China and beyond for at least the last 2500 years for which we have very good evidence (and probably even much longer, but we'll leave that for a future post).

During most of that time the Chinese Doctors of the last 2 millennia collected many hundred of thousands of case studies as well as experiential and empirical knowledge of what worked and what didn't.

They had not though been as obsessed as we are in the West in RCTs (Randomised Controlled Trials) as the be all and end all of 'evidence' that the medicine is based on. So although there is indeed a huge mountain of evidence that acupuncture works its only in the last few decades that the Western methodology of testing what works in medicine has become prevalent.

That said there is a growing amount of good quality research done all over the world which I can point you towards. I'd like to start locally with our very own NHS, with whats become an annual update on acupuncture produced and collated by NHS Evidence which is a great little resource, follow the link below to check it out:

The 2010 Annual Evidence Update on Acupuncture aims to identify, organise and present all relevant systematic reviews and large-scale randomised controlled trials (RCTs) published between February 2009 and February 2010. 

Yin and Yang simplified - its all about balance.

What are Yin & Yang and how do they relate to the body?

Taijitu

As one of the fundamental theories of Chinese medicine Yin yang theory was developed circa 5th century B.C. It is based on the idea of the two opposite qualities in nature that complement each other. Like day and night, male and female, heaven (sky) and earth, hot and cold, they are interdependent in so far as they give each other meaning and one cannot exist without the other. 

In nature yin and yang can be seen as the shady and sunny side respectively of a slope. Beyond that we can look to the properties yin yang have in the body like coolness and warmth, movement and stillness, inside and out, up and down. They are like the opposite sides of the same coin.

The human body is made of substance and energy, form and function,  yin and yang, so every part of the body can be defined in relation to any other part. 

Yin and yang in balance and working together in harmony within the human body result in optimal health. Its all about balance.

 yin and yang balanced with acupuncture

What is this Qi you speak of? in under 150 words...

Qi

"What is this? cheese!"  

Its difficult to translate the concept of Qi or Chi into english mainly because like with most things in chinese medicine it was developed in china, thousands of years ago, from a chinese medical point of view which is full of associations and ideas that we in the west are not familiar with. 

Qi is pronounced ‘chee’ (just like in the word cheese) and you can interpret it as the vital life force (or breaths) that runs through every living body, which is responsible for that constant movement from yin to yang and from yang to yin. 

Qi is the basis of all phenomena in the universe, in the human body it manifests in physical and spiritual capacities as both function and energy. It is responsible for all the activities that occur in the human body, from digesting food and immune functions to blood circulation and mental activities.

What are the acupuncture channels? what are the acupuncture points?

acupuncture channels and acupuncture points simplified.

Meridian theory (or jingluo), describes in detail the channel pathways and connections. It maps out the flow of Qi energy throughout the human body (check out charts). Each organ system has its meridian, along which the acupuncture points are strategically located.

Every point has its functions and indications, so by placing acupuncture needles in certain points we can access the specific pathway to the Qi that will rectify the imbalance in the system and solve the problem. In the body there are twelve 12 primary meridians and 361 acupuncture points through which the Qi flows.

Try to picture acupuncture meridians like a system of motorways that enables perfect communication and facilitates free flow of Qi, blood and information thru the body. An illness then would be an interruption or blockage of this flow. The acupoints are like junctions or exits on these motorways which, when needled, enable us to influence the flow of Qi in the body.

For example, keeping the motorways in mind, we could see a traffic jam in the Foot Tai Yang Urinary Bladder meridian manifesting as back pain. In this case, performing acupuncture on points along the UB channel unblocks the congestion and restores the smooth flow of Qi throughout the body relieving the pain in your back!

What is Acupuncture?

So what is acupuncture in under 150 words...

Acupuncture is an ancient system of medicine which was developed in China over 3000 years ago. It is based on the concept of Qi (or chi) which is the vital life force that flows in our bodies through an energetic network of channels that are called meridians.

When the Qi or energy flows freely through the channels we experience health and well being. However, when the flow of energy gets blocked that is when discomfort, pain or ill health present themselves.

There is an old Chinese saying that illustrates this point well which translates: 'Pain, no free flow. Free flow, no pain'. So what we try to do with acupuncture is to restore the free flow of the Qi throughout the body. By doing that we can eliminate the symptomatic manifestations of the obstruction of energy flow, i.e. pain, discomfort etc , achieve balance and regain health.