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

Do Acupuncture Needles Hurt?

Many patients ask if acupuncture needles hurt when inserted into the body. This inquiry is relevant and common to almost everybody interested in getting an acupuncture treatment. We felt it was important to take some time to provide information about acupuncture needles and how they feel when used by a licensed acupuncturist.

What are acupuncture needles made out of?

Modern acupuncture needles are made out of stainless steel and come in various lengths and gauges of width. Acupuncture needles have a stainless steel shaft, with a handle made out of copper, steel or plastic.

How thick are acupuncture needles?

Needle thickness is a something many patients are curious about; there is a belief that the thicker the needle the more potential for pain. The thickness of the needle used for treatment depends on a variety of conditions ranging from the acupuncturist’s preference to the specific ailment being treated.

Acupuncture needles are solid with a fine point, unlike hypodermic needles that are hollow and primarily used for intramuscular injections or for drawing blood. Hypodermic needles have a sharp cutting-edge point, something that acupuncture needles do not have. A helpful comparison is that most acupuncture needles are so thin that you can fit about 10 of them inside the shaft of a hypodermic needle.

Who is allowed to use acupuncture needles?

While it is true that acupuncture needles can be purchased by people other than acupuncturists, it is strongly advised that you only allow a licensed acupuncturist to needle you. Please note that chiropractors, naturopaths and physical therapists are not licensed acupuncturists. They may perform acupuncture (or “dry needling”) but in reality acupuncture is part of Traditional Chinese Medicine that is performed by licensed acupuncturists who have extensive and thorough training.

A licensed acupuncturist has attended acupuncture school, has a master’s degree, a professional license and is required to have thousands of hours of training. In a previous blog post titled “The Importance Of Receiving Acupuncture From A Licensed Acupuncturist” we provide information about why you should only get acupuncture from a licensed acupuncturist. If you are considering getting acupuncture we strongly urge you to read through this post.

Do acupuncture needles hurt?

When patients receive an acupuncture treatment for the first time they often report having a variety of sensations. Some people describe feeling a dull ache, a tingling or pulsating sensation or experience nothing at all. There are other people who state that they feel a small pinch when the needle is inserted but the sensation dissipates quickly.

Very rarely will a patient report feeling any pain after a needle is inserted; if so, it will quickly be removed. Pain isn’t something that should be felt or elicited, in fact a common reason acupuncture needles are used in the body is to alleviate pain. What is more common is that patients will state that they will feel some discomfort after being needled but after they settle in and relax the sensation soon passes.

If you’ve been thinking about getting acupuncture but have been worried about whether or not it hurts, we hope that this article helped to alleviate some of those fears.

This article originally appeared on Above & Beyond Acupuncture, and was written by Paul Kerzner.