Pins and needles

THIS week is world acupuncture awareness week. Practitioners throughout New Zealand will be marking this week by offering discounted assessments and treatments, open clinics, lectures and other public events.

Although acupuncture has been around for several thousand years in Eastern countries such as China, Japan and Korea, it is a relative newcomer to the world of Western medicine.

In fact, some credit President Richard Nixon’s visit to China in 1972 with the burgeoning interest in the practice of acupuncture in the US in the 70s and 80s.

Nowadays, acupuncture is considered a far more mainstream option when it comes to health and wellbeing. World awareness week will focus primarily on its role in the treatment of lower back pain, depression, migraine and period pain. However, the range of conditions that acupuncturists will treat is far more extensive than this.

Over the past decade or so, acupuncture has been increasingly studied by researchers looking to back up the anecdotal proof of its efficacy. So far, there is good scientific evidence for its use in the management of: Nausea and vomiting after chemotherapy Headaches Migraine prevention Post-operative nausea Neck pain Dental pain Other conditions where acupuncture is likely to be effective, either on its own or as an adjunct to other treatments, despite a lack of good evidence at present, include: Addictions Pain relief after injury Stroke rehabilitation Tennis elbow Frozen shoulder Fibromyalgia Osteoarthritis Carpal tunnel syndrome Asthma. Acupuncture involves inserting small needles into various points in the body to stimulate nerve impulses.

Traditional Eastern acupuncture is based on the idea of ‘‘qi’’ (vital energy) travelling around the body via pathways known as meridians. The placement of the needles is thought to affect these meridians.

The Western version of acupuncture is called ‘‘dry needling’’ and focuses more on the releasing of trigger points. The insertion of needles is known to cause multiple biological responses, both local to the insertion site and more distally in the central nervous system.

These responses include the release of endogenous opioids (powerful natural pain-killers), alterations in blood flow and immune functions, and changes in the secretion of various neurotransmitters and neurohormones. It is not yet clear which of these biological responses is responsible for the clinical benefits that patients experience.

Although I have been recommending acupuncture to my patients for years, I had my first ever treatment last week. I visited Belinda Falconar in Wellington, who practises mainly Japanesestyle acupuncture.

I was most impressed by the thorough approach to my visit – the first 15 minutes of my consultation involved a very detailed interview about my medical history and any current symptoms I was experiencing.

She then inserted 13 very fine needles into various parts of my body, including my ears, much to my children’s amusement when they quizzed me later on. It was painless, and I was surprised how relaxed and sleepy I felt during the treatment. This sensation lasted well into the night, and I slept like the proverbial baby. A surprisingly pleasant experience, and one that I will repeat.

Belinda told me most people require six to 10 sessions depending on what they present with, often coming for monthly maintenance sessions once their original issue has been resolved.

ACC does fund registered acupuncturists to treat conditions relating to an injury, which makes it an affordable option at $35 a session (it is $85 per session without the ACC subsidy).

Belinda is on the New Zealand Register of Acupuncturists and is keen to see the industry get some tighter regulations around who can practise ‘‘needling’’. Her bachelor degree in acupuncture was obtained at the Wellington School of Acupuncture, and took four years to achieve.

She is concerned that there are many practitioners calling themselves acupuncturists, when, in fact, they are practising ‘‘dry needling’’. Many of these practitioners have taken only short courses and may be putting patients at unnecessary risk.

She suggests if you are looking for an acupuncturist, visit the NZRA website (acupuncture. org.nz) and only use a registered provider.

Cathy Stephenson is a general practitioner and medical forensic examiner.