New draft guidelines issued for consultation by the National Institute for Health and Care Excellence (NICE) advise against the use of many routine drugs for chronic primary pain. This includes paracetamol, non-steroidal anti-inflammatory drugs (i.e aspirin and ibuprofen) benzodiazepines or opioids. The guidelines state these should not be offered because there is little or no evidence that they make any difference to people’s quality of life, pain or psychological distress.
If you’ve ever been asked to rate your pain on a 0-10 scale, you’ll know how hard that can be. It might change. It might be a 3/10 in the morning, but a 9/10 when you start moving. So when someone asks you to rate it out of 10, what do you do? Do you put it as a 3 or a 9? Or do you go somewhere in the middle and say a 6/10? Taking the middle road might seem like a good idea, and is often what happens. The problem is- that doesn’t explain to your chiropractor that sometimes it’s not so bad, and sometimes it’s a heck of a lot worse and completely stops you from doing anything with your day.
Acupuncture is often seen as a form of complementary medicine, although it is used nationally in many NHS general practices, as well as the majority of pain clinics and hospices in the UK. It is recommended by the National Institute for Clinical Excellence as a treatment for lower back pain, and a range of other conditions. If we decide together that acupuncture is a good choice for you, then we can start the treatment there and then! Our chiropractor Philippa is fully trained and registered to use acupuncture as part of her treatments in clinic.
Acupuncture involves the insertion of needles (which are about the thickness of a human hair, and about 1 inch long) into specific points in your body. Mention “acupuncture” to someone, and you may think of something like the image below, using dozens of needles.
It may surprise you to know that we tend to use a maximum of 6 needles in our treatments! This is because we use a Western medical approach to acupuncture in clinic, which is different to traditional Chinese treatments.
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A medical approach to acupuncture involves a few essential features:
Medical history, examination and clinical investigations (if necessary) are all used to form a diagnosis.
An appropriate plan of management, and appropriate needling points are identified.
As with all our treatments at Acorn Health, the appropriate treatment is given, in a way that is carefully tailored to the individual. This can mean using more needles (usually up to a maximum of 6), using percutaneous electric nerve stimulation, or increasing the length of time the needles are inserted.
Your response to treatment is monitored, and subsequent treatment is determined based on your response to this treatment.
Acupuncture is, in itself, a phenomenon- it produces an unique sensation, can alleviate pain in areas quite far away from where the needle is inserted, and patients have been known to spontaneously report feelings of improved wellbeing and deep sleep after treatment! This treatment is also a powerful tool for pain relief, and this sometimes occurs immediately after removing the needles; several hours after treatment; or gradually accumulating over a course of several treatments.
So if acupuncture is a phenomenon, with varied responses for each individual, how do we know that it is an appropriate, evidence-based, effective treatment for you?
Here are five mechanisms to help explain how acupuncture works:
1) Acupuncture promotes healing. It stimulates nerve fibres in the skin and muscle, and this leads to the release of a substance called CGRP- calcitonin gene-related peptide (no, we won’t quiz you on this later!) This substance causes blood vessels around the needle to dilate, and increases blood flow, which encourages tissue healing.
2) When a needle stimulates nerve fibres, these travel to a specific part of the spinal cord, called the dorsal horn (which helps regulate pain signals). This stimulation helps to reduce the response of the dorsal horn to pain, and this is probably the main mechanism by which acupuncture relieves pain, and what it is most commonly used for.
3) These nerve signals then transmit up to the brain, and stimulate the body’s pain-suppressing mechanisms. (Yes, our body can suppress pain- think about the times when you haven’t noticed a scratch or a graze because you’ve been concentrating on something else). This is why acupuncture is so helpful, as it can suppress pain throughout the entire body.
4) Parts of our brain that control emotion, behaviour and sleep are also stimulated by acupuncture, and so acupuncture has a calming effect and can improve our feeling of wellbeing.
5) When our muscles are strained or injured, it develops a small area of damage (called a trigger point) which can be slow to heal and can cause persistent pain. Acupuncture helps to deactivate and reduce these trigger points.
If you would like to find out more about this type of treatment, what it can be used for and whether it could be a good option for you, book an appointment with us today!