Acupuncture,
Spinal Manipulation Applied To Pain
Alternative
therapies such as acupuncture and spinal manipulation may be
worth a try to help relieve neck, back, and knee pain, according
to a study reported in the Annals of
Internal Medicine.
Studies
looking at the two therapies were reported recently by experts
in pain management. They agree that acupuncture and spinal manipulation
do not help everyone who tries these types of therapies, but
many people have benefited.
In
one study of patients with painful knee arthritis, University
of Maryland researchers compared acupuncture with sham acupuncture,
a process in which needles are inserted into points that are
not true acupuncture points.
A
third group received education sessions on arthritis management.
The 570 patients were randomly divided to receive either 23
sessions of acupuncture over 26 weeks; 23 sessions of sham acupuncture
over 26 weeks; or six two-hour education sessions.
After
26 weeks, the true acupuncture group experienced greater improvement
than the sham group or the education group in both pain and
function.
"This
echoes the results of studies we have been doing for 11 years
now," says study author Dr. Brian M. Berman, director of the
Center for Integrative Medicine at the University of Maryland
School of Medicine.
"The
effect is not huge," Dr. Berman adds, "but none of the things
we do with osteoarthritis patients have a huge effect."
In
the second study, Dr. George Lewith of the University of Southampton
in England and his colleagues compared acupuncture versus electrical
stimulation of acupuncture points in 135 patients with neck
pain.
The
patients were evenly divided between the two groups. Acupuncture
reduced the neck pain and produced slightly higher effects compared
to mock acupuncture.
"Acupuncture
is safe and effective for neck pain so it's worth trying," says
Dr. Lewith, senior research fellow at the University of Southampton.
"We need to do more big studies, but above all else we need
to understand why such a safe treatment is so effective in the
long term."
In
the third study, which was conducted at several US Army and
Air Force bases, researchers examined 131 patients with low
back pain who had been referred for physical therapy. They were
randomly assigned to receive either spinal manipulation with
a physical therapist plus exercise, or exercise alone with a
physical therapist for four weeks.
The
researchers found the results depended on patient status at
the start, as measured by common criteria such as the duration
of symptoms, the patients' lumbar mobility, and how well they
could rotate their hips. Those who met more of the criteria
fared better, the study found.
The
results are no surprise, says Dr. Donald W. Novey, medical director
of the Center for Complementary Medicine at the Advocate Medical
Group at Lutheran General Hospital, in Park Ridge, Ill.
"Some
people respond wonderfully, some not at all," Dr. Novey explains.
The
same is true for knee arthritis, he says, adding, "It does not
help every patient."
Dr.
Novey says he encourages patients to "always consider simpler
and more economical measures first" to reduce pain. In the case
of arthritis of the knee, for instance, that means losing excess
weight to reduce pressure on the knees, he notes.
Always
consult your physician for more information. |
According
to the National Institutes of Health
(NIH) National Center for Complementary and Alternative Medicine,
in the past two decades, acupuncture has grown in popularity
in the US.
The
report from a Consensus Development Conference
on Acupuncture held at the NIH
in 1997 stated that acupuncture is being "widely" practiced
by thousands of physicians, dentists, acupuncturists, and other
practitioners for relief or prevention of pain and for various
other health conditions.
According
to the 2002 National Health Interview
Survey, the largest and most comprehensive survey of
complementary and alternative medicine (CAM) use by American
adults to date, an estimated 8 million adults had ever used
acupuncture, and an estimated 2 million adults had used acupuncture
in the previous year.
The
NIH Center describes acupuncture
needles as metallic, solid, and hair-thin. Persons experience
acupuncture differently, but most feel no or minimal pain as
the needles are inserted.
Some
people are energized by treatment, while others feel relaxed.
Improper needle placement, movement of the patient, or a defect
in the needle can cause soreness and pain during treatment.
The
NIH Center states that it is important
to seek treatment from a qualified acupuncture practitioner.
The
US Food and Drug Administration (FDA)
approved acupuncture needles for use by licensed practitioners
in 1996. The FDA requires that
sterile, nontoxic needles be used and that they be labeled for
single use by qualified practitioners only.
Relatively
few complications from the use of acupuncture have been reported
to the FDA in light of the millions
of people treated each year and the number of acupuncture needles
used.
Still,
complications have resulted from inadequate sterilization of
needles and from improper delivery of treatments, states the
NIH Center.
Practitioners
should use a new set of disposable needles taken from a sealed
package for each patient and should swab treatment sites with
alcohol or another disinfectant before inserting needles.
When
not delivered properly, acupuncture can cause serious adverse
effects, including infections and punctured organs, according
to the NIH Center.
Always
consult your physician for more information.
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