Transcript Acupuncture
GETTING TO THE POINT: A DISCUSSION ON ACUPUNCTURE JENNY MILLER, DC DISCLAIMER • The views and opinions expressed in my presentation today, including any examples or assumptions, are mine personally, and do not necessarily reflect the official policy or position of the Department of Veterans Affairs or any agency of the U.S. Government.” INTRODUCTION • Education/Background/Experience • How did you get into acupuncture? HOW DOES IT WORK? • Eastern vs. Western Perspective • Eastern • Meridians • Balance • Western • Muscular Tension • Blood Flow • Endorphins TYPICAL VISIT • Initial Visit • 60 minutes • Exam and History • Initial treatment • Follow-up Visit • 30 minutes • Continued treatment • Self-care instructions TYPICAL VISIT • The “tools” • Needles • Vary in length and thickness • Vary in material • Electro-stimulation TYPICAL VISIT • Common Complaints • • • • • • Low back pain Neck pain Headaches Stress/Anxiety Sleep concerns Sinus pain/congestion TYPICAL VISIT • Cautions/Contraindications • Often relative rather than absolute • • • • • • • Unexplained or undiagnosed medical conditions Sepsis or overwhelming infection Unexplained/unstable syncope or seizure Pacemaker patient should avoid electro-stimulation Pregnancy Needle phobia Epilepsy or uncontrolled movements TYPICAL VISIT • Cautions/Contraindications (continued) • • • • • Diabetes Allergy to stainless steel Non-cooperative/Confused patients Steroids Local contraindications • Active infection • Skin lesion • Malignancy at the insertion site TYPICAL VISIT • Bleeding disorders & use of anti-coagulants • These are not absolute contraindications as acupuncture needles are nearly always thinner or finer than phlebotomy needles and intravenous catheters which are routinely administered in hospitals; however, the acupuncture provider should always be notified of bleeding risks. TYPICAL VISIT • Considerations • ADHD or inability to sit calmly • Significantly low pain tolerance • Needles should not be placed in the orbit or umbilicus EFFECTIVENESS & LITERATURE • Cherkin, D.C., Sherman, K.J., et al. (2009). A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Low Back Pain. Archives of Internal Medicine, 169(9), 858-866. • Hollifield, M., Sinclair-Lian, N., Warner, T.D., & Hammerschlag, R. (2007). Acupuncture for Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial. Journal of Nervous & Mental Disease, 195 (6), 504-513. EFFECTIVENESS & LITERATURE • King, H., et al. (2015). Auricular Acupuncture for Sleep Disturbance in Veterans with Post-Traumatic Stress Disorder: A Feasibility Study. Military Medicine, 180 (5), 582-590. • Li, J., et al. (2014). Acupuncture Treatment of Chronic Low Back Pain Reverses an Abnormal Default Mode Network in Correlation with Clinical Pain Relief. Acupuncture In Medicine: Journal of the British Medical Acupuncture Society, 32 (2), 102108. INTEGRATIVE HEALTH • Acupuncture is one piece of the puzzle • Integrative Health Program offers • Group Orientation • Health Coach • Massage Therapy • “Bridge to Self-Care” INTEGRATIVE HEALTH • IH also works closely with these programs & groups: • • • • Nutrition and MOVE programs Yoga/Tai Chi Mind Body Medicine Group Smoking Cessation Group ACUPRESSURE • • • • Digit Pressure Bracelets Ear Seeds Press Tacks ACUPRESSURE ACUPRESSURE SELF-CARE • Acupressure • Breath work & breathing exercises • Mantram/Affirmations/Visualization/Meditation • Stretches/Exercises/Tennis ball/Foam roller • Posture/Work station recommendations • Essential Oils CASE STUDIES • 44 year old female • CC: Bilateral knee pain 8-9/10 at worst; also cervical, thoracic, and headache pain • Goal: increase walking which is limited to six blocks due to pain • Participating in MOVE program & lost 20 pounds in 2-3 months CASE STUDIES • Treatment • Twice per week for three weeks with follow up visit three weeks after • Outcome • Knee, headache, neck, upper back pain symptoms mild at most. No pain at time of visit • Walking 3-5 miles 3-5 times per week • Lost nearly 30 pounds total • Self care: acupressure points, tennis ball massage • Rated benefit of acupuncture 9 on scale of 10 CASE STUDIES • 78 year old male • CC: Headache, also knee pain, & right wrist pain • Average HA pain 3-4/10 with severe HA once/week. • Knee pain present 20 years. Intermittent, 8/10 with stairs • Right wrist pain limits bowling activities • Tai Chi and Yoga classes several times per week aid in sleep CASE STUDIES • Treatment • Twice per week for three weeks • Outcome • Headaches “manageable” • Knee pain improved, noted mainly with kneeling. • Improved flexibility right wrist and decreased pain • Planning to begin bowling that week • Benefit rated 10 on scale of 10 • Self-care: acupressure • Continue tai chi and yoga classes CASE STUDIES • 46 year old male • Mid and lower back pain 20 years • Increased with prolonged activity • Avoids going fishing due to low back pain • Nightmares • Consistently making sleep difficult • Currently taking medications for nightmares CASE STUDIES • Treatment • Twice per week for three weeks with follow up three to four weeks later • Outcome • • • • Fishing on a weekly basis Started a new job spending more time on his feet No nightmares Benefit rated 9-10 on scale of 10