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.