Acupuncture is one of the many skills used within physiotherapy as an integrated approach to the management of pain and inflammation and as a means of stimulating the body’s own healing chemicals in order to aid recovery and enhance rehabilitation.
Acupuncture within physiotherapy is used against the background of clinical and research evidence. The concept of Traditional Chinese Medicine [TCM] is an ancient system of written scripts as far back as 1000BC, founded on the holistic concept of treatment and an acknowledgement of the body’s ability to return to its balanced state of health, given the correct stimulus to do so.
There are many forces within the body that require balance in order to achieve health and fitness; two forces that are commonly referred to are YIN [negative] and YANG [positive]. Treatment with Acupuncture is undertaken with the aim or restoring all the body systems to a state of balance (homeostasis). This is achieved by an in depth physiotherapy assessment to determine the source of the imbalance and the correct acupuncture points required to address this imbalance and facilitate the body’s return to a state of health both physically and mentally.
The body has the ability to “self repair; the use of Acupuncture, Acupressure or Electro-Acupuncture enhances the repair mechanism and enables an improved recovery time. This allows other physiotherapy treatments such as exercise, muscle strengthening and rehabilitation to achieve more effective results.
The acupuncture needle will stimulate the flow of QI [pronounced ‘chee’], which circulates in channels or meridians within the body. The QI circulates within the deeper organs of the body, but connects to the superficial skin. In the state of a normal healthy body, a balance exists between these systems. Both the superficial energy and the deeper energy can be influenced by the stimulation of specific acupuncture points. If injury, disease, emotional trauma or infection occurs, the natural flow of QI within the meridians and organs may well be affected and the result is an altered flow, either a slowing or stagnation of QI causing pain and inflammation, or a deficit of QI, which may cause weakness, exhaustion and longer debilitating disease. The stimulation of relevant acupuncture points may free stagnation, reduce excess or indeed, increase QI to the specific area or organ and thus help to restore normal QI flow and balance.
Acupuncture is used by Physiotherapists, against a background of sound research and evidence, as a means of enhancing pain modulation via the stimulation of the brain and spinal cord to produce NATURAL pain relieving chemicals, such as endorphins; melatonin to promote sleep, serotonin to promote well being, to name but a few. These assist the body’s healing process and offer pain relief as a precursor for other manual or exercise therapy.
Acupuncture is also used by Advanced AACP members as a means of addressing some systemic and longer term illness, but always with the aim of enhancing physiotherapy treatment and improving the quality of life.
There are several techniques in applying Acupuncture that are described below:
Conventional Acupuncture involves the use of single use, pre-sterilised, disposable needles of varying widths, lengths and materials that pierce the skin at the Acupuncture points. The Physiotherapist will determine the locations of the Acupuncture points, based upon the assessment of the cause of the imbalance. A number of needles may be used at each treatment and these are typically left in position for some 20-30 minutes before being removed.
Trigger point Acupuncture may also be used to facilitate relaxation in specific muscles following trauma such as whiplash injury; for longer term unresolving muscle pain such as repetitive strain injury (RSI) or as a means to obtain increased muscle length in order to aid stretch and rehabilitation such as sports injuries . Here the needle is placed into the affected muscle until it is felt to relax under the needle and then removed. Trigger point needling is often much quicker and therefore does not require the 20-30 minute treatment time.
Acupressure uses the Physiotherapist’s hands over Acupuncture or trigger points in order to relieve muscle tightness or to stimulate QI flow and balance the body. It is a healing art that uses the fingers of the Physiotherapist on the key Acupuncture points. The amount of pressure used varies according to the condition and requires trained, sensitive hands. It is often used with sensitive patients, patients with a needle phobia , children or frail patients.
Laser is the acronym for Light Amplification by Stimulated Emission of Radiation and the use of Lasers to effect treatment is known as low-level laser therapy [LLT] [Baxter 1994].
Laser stimulation may be used to effect any Acupuncture treatment for which needles are typically used. It is particularly suited for nervous patients, children, sports injuries, sensitive areas and ears.
Laser Acupuncture may be available from Physiotherapists who are fully trained in the correct application and contra-indications of laser therapy.
Moxabustion and Cupping are techniques used to introduce warmth into the Acupuncture points, either at the end of the Acupuncture needle in the case of Moxabustion, or to areas which require increased stimulation of QI flow in the case of cupping. These enhancements have the effect of increasing the circulation, removing waste products, reducing muscle spasm and pain.
They may also be used as precursor to the Physiotherapist stretching the damaged tissue or mobilising a joint. Conditions treated with the techniques include Osteo-Arthritis, areas of poor QI flow or cold conditions.
Following the detailed physiotherapy assessment, inserted needles can be coupled to the electrodes of an electro-acupuncture apparatus. These units are designed to deliver variable amplitudes and frequencies of electrical impulses. Low frequency electro-acupuncture is intended to contribute to the mechanism of pain reduction, especially stimulating chemicals from the brain which will aid analgesia, relaxation and sleep.
It is particularly useful in the more chronic pain problems and sits against a background of research to support its use. Your Physiotherapist may use TENS machines over specific acupuncture points in order to help this mechanism and enhance the pain modulation.