Medical Acupuncture Treatment for Musculoskeletal Pain Relief
Acupuncture is viewed as a holistic, complementary and alternative medicine that stands outside of the Western scientific tradition. According to Vickers and Zollman (1999) acupuncture can be partly explained through a physiological model.
Acupuncture is known to stimulate A delta fibres (sensory nerve finer which carry cold pressure and pain signals) entering the spinal cord. These mediate segmental inhibition of pain impulses carried in the slower, unmyelinated C fibres (slower pain fibers) and, through connections in the midbrain, enhance descending inhibition of C fibre.
Acupuncture is also known to stimulate release of endogenous opioids and other neurotransmitters such as serotonin. This is likely to be another mechanism for acupuncture’s effects, such as in acute pain and in substance misuse (1999, 974).
ACUPUNCTURE FOR LOWER BACK PAINS:
With regard to lower back pain, acupuncture is generally found to be effective compared to routine care, and as such it has been approved by the National Institute of Health and Care Excellence (NICE) as a treatment option on the NHS.
Dry needling is used for the assessment and treatment of myofacial pain syndromes and dysfunction due to myofacial trigger points / tension areas / muscle spasm / increased tonicity’ (Waumsley 2015).
Dry needling it focuses on the trigger point as a point of tension or tenderness, or elsewhere described as ‘dry knots’ (JOSPT 2013) within the muscle that needs to be released. JOSPT (2013) and Kietrys et al. (2013) have suggested that it is an effective way of treating muscle pain; in particular, the insertion of a needle into the trigger point has been associated with a ‘twitch’, which may be a sign the treatment is helpful.
WHAT RESEARCH IS OUT THERE TO SHOW ITS EFFECTIVENESS?
A Cochrane review of 35 randomised controlled trials (RCTs) involving 2861 patients (Furlan et al. 2005) on the effectiveness of acupuncture and dry needling.
With respect to acute and chronic lower back pain, found that there was evidence to suggest that acupuncture was more effective for chronic lower back pain than no treatment
A Cochrane review of 26 RCTs involving 4093 women (Pennick and Liddle 2013) concluded that acupuncture was effective in reducing evening pelvic and lumbo-pelvic pain. Cheshire et al. (2013) conducted a study of 61 patients in the Beating Back Pain service, which combines acupuncture, self-management exercises.
A patient data meta-analysis of 17,922 patients by Vickers et al. (2012) found that acupuncture is effective for chronic pain (in this case neck and back pain, osteoarthritis, chronic headache and shoulder pain)
Some studies have found acupuncture very effective for treating knee osteoarthritis (reductions in pain, stiffness and function) .
Acupuncture has in most trials been viewed as effective for migraine and tension-type headaches (TTHs) compared to conventional treatments, with fewer side effects. NICE guidelines have approved acupuncture for both of these conditions.