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Dr. Shawn Thistle

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Pain Relief From Medical Acupuncture

Acupuncture is very effective for relieving pain. There are a number of mechanisms, both direct, and indirect, that are responsible for this. Inserting needles into anatomical locations creates a very small injury, which your body must quickly heal. This stimulates healing of the surrounding tissues including muscle, fascia, nerves, skin, and connective tissue. Indirectly, acupuncture has widespread effects on numerous tissues and systems in the body.

One of the main mechanisms of acupuncture analgesia is the release of myofascial trigger points. There is a close correlation between traditional Chinese acupuncture points for pain and common muscular trigger points. As noted by R. Melzack, co-author of “The Gate Theory of Pain”, this represents a major convergence of Western and Eastern knowledge. The traditional Chinese "Ah Shi" (translates to 'Oh yes') points are frequently equivalent to trigger points, which are hyperactive bands of muscle that reproduce pain syndromes with direct palpation.

Relaxation of "stuck" myofibrils, increased local blood supply, the release of spinal dynorphin and encephalin (endogenous opioid, or pain-relieving compounds) have all been put forward to explain the rehabilitative effects of trigger point needling. In addition to local needling, distal points below the elbow or knee are used to modulate the sympathetic nervous system and modulate pain signals at the source. Trigger points or “Ah Shi” points can be analyzed clinically by using direct palpation. The contribution of trigger points to the pathogenesis and maintenance of pain remains unknown, and is an important area of research that may well resolve many of the questions involving common pain states.

Melzack, in a recent article on the role of compensation in chronic pain states, appears to support the importance of these concepts. "Patients who failed to respond to conventional forms of therapy were sometimes cured if the physician recognized that abnormal autonomic nervous system activity may persist indefinitely after a brief injury or that trigger spots may develop at the site of even relatively minor injury. Major procedures such as cordotomies may fail, but simple ones such as trigger point injections, may produce sudden remarkable recovery and subsequent return to work."

Many family doctors have responded to their patients' needs by adding pain management tools to their practices. These tools frequently include pain assessment techniques, Acupuncture, Manipulation, Relaxation Training and Re-education of job task and posture. Medical acupuncture in particular is one of general practice's growth areas.

From the early 1970s when only a few medical practitioners used acupuncture, there is now widespread use and integration of alternate stimulation techniques developed from Traditional Chinese Acupuncture. (Stimulation techniques developed from Traditional Chinese Acupuncture include Dry needling, Electro-acupuncture and TENS, Trigger point injection and dorsal column stimulation.)

The results of controlled studies which have been extensively reviewed show good evidence for the short term effectiveness of acupuncture in many pain states. The long term studies, particularly where the well trained acupuncturist has been given the freedom of (traditional) normal practice profiles, have been encouraging, with success rates far higher than those associated with the placebo response.
 
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