The Way to Make a Point About Pain
You probably don’t want to be in pain. Yet it is common for many people to have persistent or undefined pain, the lingering results of sports injuries, overstressed muscles or illness. These are the pains that are difficult to treat. You may take analgesics, such as aspirin, but the pain persists. One answer: acupuncture.
We first explored acupuncture at UVa in an article on alternative medicine (HELIX, Early Winter 1995). Since then, acupuncture has continued to move steadily into medicine’s mainstream.
Originating in China, the procedure has been around for a long time - some 2,500 years, in fact. Practitioners of acupuncture insert needles into the body at predetermined points. Often used as a way of promoting health as well as fighting disease, acupuncture’s goal is to bring about a change in the medical condition or a change in the body itself.
In Western countries, acupuncture has long been considered a "nontraditional" or "Eastern" practice, but it has now come into its own - increasingly recognized as a useful and effective treatment for pain. UVa currently offers patients acupuncture at the UVa Musculoskeletal Center.
Here, Dr. Alan P. Alfano - the UVa Department of Physical Medicine and Rehabilitation’s licensed medical acupuncturist and also a board-certified physiatrist - regularly uses acupuncture to treat patients for a variety of moderate to severe painful conditions, including low back pain, neck pain, sports injuries, headaches, nerve pain, arthritis pain and other conditions.
Bring up the subject of acupuncture with most people, however, and they immediately think of needles. Actually, explains Alfano, the patient hardly feels the needles at all - no more than a slight pinch. The procedure, in fact, is almost without any sensation, although some patients report a "heaviness," "numbness," or a "tingling sensation." Many patients even fall asleep during the treatment.
The needles, about three to four inches long, are sterile and disposable - used only once to avoid any chance of infection. Occasionally, the acupuncturist may stimulate the needle with a small electronic device, depending on the condition being treated.
Treatments take approximately 20 minutes, but they can vary, again depending upon the patient’s condition. "We usually know if the treatment is being beneficial within the first three to five treatments," says Alfano. "Sometimes we see marked difference in only one treatment."
How acupuncture actually works has been hard to determine. In recent years however, it has been the subject of an increasing amount of research. Medical scientists already know that the body releases a number of chemicals, called opioids, into the bloodstream. These chemicals act much like morphine. The application of acupuncture appears to stimulate the release of these chemicals to help relieve pain.
Today, many medical institutions in the United States are using acupuncture in conjunction with individualized exercise and conditioning programs - which is the way it is usually being used at the UVa Medical Center. Acupuncture is particularly useful in decreasing pain levels to the point where the patient can participate in the activities of daily living, including sports.
"The use of acupuncture for difficult pain problems is often accompanied by an exercise program that complements acupuncture treatment," says Alfano. "This is our typical approach in the Physical Medicine Department at UVa."
Why would a patient choose to have acupuncture? Alfano says it’s often a matter of personal preference. "Some people don’t like to use medication," he explains, "and acupuncture is a reasonable alternative to medication as well as being an adjunctive treatment if the patient has difficult in taking medication."
Acupuncture, he explains, is a very versatile procedure and can be used with psychotherapy, biofeedback and more traditional medical practices.
What’s more, many individuals with persistent pain often find that their treatment options are limited, particularly if they cannot tolerate analgesics or other medications to relieve the pain. Those with arthritis, for example, often encounter the problems of using medications that can be relatively toxic and that can cause problems with the liver, kidney and stomach. In many of these situations, acupuncture may be a good choice. "look at it this way," says Alfano, "it’s a fact the most pain management medication is mind-altering in some respect. It can, for example, make you sleepy, irritable or euphoric. Acupuncture, on the other hand, uses no chemicals yet produces relaxation."
Again, Alfano stresses, the procedure is a sensible alternative to more Western approaches to managing pain, which generally emphasize the use of medication.
"Acupuncture," says Alfano, in describing the procedure’s advantages, "is a useful complementary technique along with something else that can be tried simultaneously, but is should not be a we’ve-tried-everything-else-so-let’s-try-acupuncture approach."
Today, the use of acupuncture for a variety of pain situations is gaining momentum across the country. The increased interest in acupuncture’s value and efficacy points - if you’ll excuse the pun - to the need for further research into determining outcomes measurements. The National Institutes of Health, for example, through its Office of Alternative Medicine, is funding acupuncture research across the country.
Sums up Alfano: "In my practice, it is an important weapon in the battle against pain."
In other works, pain is not something to be stuck with.
Reprinted from Helix, UVa Health System, Winter 1996/Spring 1997. Volume 14, Number 1.