Emergency doctors are using Acupuncture to treat pain, now here’s the evidence

Emergency medicine is not all about life and death situations and high-tech solutions. Our study, the largest of its kind in the world, shows using acupuncture in the emergency department can relieve acute pain.

The study, published today in the Medical Journal of Australia, finds acupuncture is as effective as medication in treating pain for lower back pain and ankle sprain. But it took more than an hour for either to provide adequate pain relief.

Our study builds on previous research to show the effectiveness of acupuncture to treat chronic (long-term) pain.

Yet, there are several barriers to using acupuncture routinely in emergency departments.

What is acupuncture and who practices it?

Using acupuncture to relieve pain involves placing needles in various parts of the body to stimulate the release of endorphins and other neurochemicals, which can act as the body’s naturally occurring pain relievers.

For generations various cultures around the world have used acupuncture to treat multiple conditions, including providing pain relief. And in Australia, it is reimbursed through the Medicare Benefits Schedule when administered by a medical doctor.

Further reading: Modern acupuncture: panacea or placebo?

Acupuncture is one of the most accepted forms of complementary medicine among Australian general practitioners. It also appears in treatment guidelines for doctors in how to manage pain.

Why we ran the study and what we did

Anecdotally, we were aware that several emergency department doctors, in both public and private hospitals in Australia, were treating patients’ pain with acupuncture. But until this large federally-funded study, no-one had set up a trial like it to show how effective it was.

Our trial was an “equivalence” study, which means we aimed to see if the different treatments were equivalent rather than seeing if they were better than placebo. We did this as it would not be ethical to give a placebo to people coming to an emergency department for pain relief.

So, we randomly assigned more than 500 patients to receive standard painkillers, standard painkillers plus acupuncture, or acupuncture alone when they presented with back pain, migraine or ankle sprain at four Melbourne hospitals (some private, some public). While the patients knew which treatment they had, the researchers involved in assessing their pain didn’t (known as a single-blind study).

The type of acupuncture we used included applying needles at specific points on the body for each condition, as well as along points chosen by the treating acupuncturist. This was to reflect what would happen during regular clinical practice.

Doctors who were also qualified medical acupuncturists and practitioners of traditional Chinese medicine (registered in Victoria with the Chinese Medicine Registration Board of Australia) performed the acupuncture.

After treatment, we assessed patients’ pain after an hour, and every hour until discharge. We also rang them for an update 24-48 hours after being discharged.

What we found

We found acupuncture, either alone or with painkillers, was equivalent to drugs-alone in providing pain relief for lower back pain, ankle sprain, but not for migraine.

When patients looked back on their treatment, the vast majority (around 80%) were satisfied with their treatment regardless of which treatment they had.

However, no treatment provided good pain relief until after the first hour.

What are the implications?

Our findings suggest acupuncture may be a viable option for patients who come to the emergency department for pain relief. This is especially important for those who cannot or choose not to have analgesic drugs.

This is also an important finding in light of the potential for side effects and abuse with opioid analgesics, which might otherwise be used to relieve pain in the emergency department.

Previous research shows using acupuncture to treat chronic pain is comparable to morphine, is safer and doesn’t lead to dependence. Our findings suggest acupuncture also has a role in treating acute pain.

However, our research raises several issues, not only about conducting such research but also in implementing our findings in practice.

We had to overcome many ethical, policy and regulatory issues before we started. These included issues around the qualifications of medical and non-medical acupuncturists and employing traditional Chinese medicine practitioners to deliver acupuncture in a western medical hospital.

And to more widely implement our findings, we need to discuss the type of practitioners best placed to deliver acupuncture in hospital, what type of training they need to work in the emergency department and what type of conditions they should treat.

Hopefully, our study will spark further research to address these issues and lead to the development of safe and effective protocols for acute pain relief that may involve combining both modern and ancient forms of medicine to achieve rapid and effective analgesia for all emergency department patients.

 

This article originally appeared on theconversation.com

Yoga Therapy and Healing

As yoga therapy becomes even more mainstream, and the benefits more widely accepted, more people are jumping on the bandwagon and the growth accelerates.

As practicing yoga therapists for many years, we have known how yoga therapy can help anything from sciatica to a failed marriage.   So it’s great to finally be recognized and become part of the mainstream. But one of the problems associated with the popularization of yoga, is the tendency to apply it as a panacea and imply that all you need to do is “know” how yoga will fix this or that and prescribe it.   This has lead to a predominantly allopathic and left brained paradigm in the delivery method.  

A few years ago at a Yoga Therapy conference I was on a panel to answer questions from attendees curios to know more about what yoga therapy could offer.  Many questions related to applications of yoga therapy in the form of  What posture do you recommend for such and such a condition?”

Someone even asked for postures to cure altitude sickness.  My response was a little smug.   “Take a car ride down the mountain or try a headstand. At least a head stand will get you a few feet closer to sea level.

Fundamentally there is nothing wrong with such questions and I apologize for my smug response. The problem is the mind-set from which such questions arise.  A mindset that as professionals we feed and that is based on a paradigm of healing that says “do this procedure or apply this technique to get this result”. To me this approach sells yoga therapy short.  Yoga therapy is an holistic science. One that honors the complexity of being human and the unique makeup of each one of us in every aspect – body, mind, and spirit. To clarify this take a look at the following comparison between two different paradigms of healing that I have attempted to identify.

Two Models of Healing

PRESCRIPTIVE MODEL

  1. Based on diagnosis and treatment
  2. Based on cause and affect
  3. Outcome is known from study of previous cases and application of scientific method
  4. Alleviation of pain or disappearance of symptoms = successful intervention
  5. Power is primarily with the therapist
  6. Client follows directions to affect cure
  7. Dependence on therapist is possible and even likely
  8. What is important is decided by therapist
  9. Therapist is invested in successful outcome
  10. Answers are more valued than questions
  11. Ambiguity and chaos are limited in the healing process

HOLISTIC TRANSFORMATIONAL MODEL

  1. Based on co-created exploration
  2. Based on unique manifestation of energy of the individual
  3. Outcome is unknown
  4. Awareness of underlying dissonance in body, mind, and spirit can lead to life transforming change on same dimensions
  5. Power is primarily with the client
  6. Client makes choices from options presenting from new self generated awareness
  7. Empowerment of client is likely
  8. What is important is decided by client
  9. Therapist leaves client to determine relative success without attachment.
  10. Questions can be more valuable than answers
  11. Ambiguity and chaos are valued and inherent in the healing process.


Article originally appeared on http://pryt.com/2015/10/yoga-therapy-blog/yogatherapy-and-healing/ and was written by Michael Lee.